V. Emergency plan for various types of emergencies: (a) medical risk error, accident prevention and emergency disposal plan 1, purpose 1.1 to safeguard the legitimate rights and interests of patients and medical personnel, to protect medical safety, minimize medical errors and accidents, according to the State Council promulgated the "Regulations on the Treatment of Medical Accidents," "Regulations on the Management of Health Care Institutions," and other policies and regulations, specially formulated the "Medical Risk Errors, Accident Prevention and Emergency Plan. 1.2 This plan applies to all medical and medical technology and related departments in the hospital.2 Prevention and emergency treatment 2.1 Organization Establishment of medical risk error, accident prevention and emergency treatment leading group (see annex 1) and doctor-patient communication office (see annex 2). The leading group is responsible for the leadership of the hospital's medical risk error, accident prevention and emergency treatment; the doctor-patient communication office is responsible for the mediation of doctor-patient disputes.2.2 Preventive measures2.2.1 Improve the medical quality and medical safety education system. Carry out hospital-wide medical safety education once a quarter. Medical accidents and defects that have occurred around us are analyzed, and experiences and lessons are learned from them. The newly assigned and transferred personnel must undergo strict pre-service quality and safety training, which focuses on medical regulations, various medical work systems, job duties of various personnel, and medical document writing specifications, and can only be employed after passing the training assessment and examination. 2.2.2 The clinical, medical and technical, and related departments must focus on the purpose of "Patient First, Medical Quality First, Medical Safety First", and improve the quality and safety of medical care and medical treatment. 2.2.2 All clinical, medical technology and related departments must focus on the purpose of "patients first, medical quality first, medical safety first", improve the quality of medical care to ensure that the implementation of the rules and regulations. 2.2.3 All kinds of rescue equipment should be in good condition, to ensure that at any time to put into use. According to the principle of resources ***sharing and special emergency equipment ***use, the medical department has the right to deploy according to the needs of clinical emergency.2.2.4 From the perspective of maintaining the overall situation, the departments, doctors and nurses, clinical and medical technology, outpatient and emergency, outpatient, emergency and wards should cooperate with each other; it is strictly prohibited to slander others and other departments in front of the patients, and to elevate oneself and other behaviors that are not in line with the medical morality. 2.2.5 In any case, the trainee and intern physicians are not allowed to participate in all kinds of consultations independently.2.2.6 Strengthen the attention and communication to the following key patients: ① low-income class patients; ② widowed elderly or children, but the family is not in harmony; ③ in contact with the medical staff has been dissatisfied with; ④ is expected to surgery and other treatments are not good; ⑤ I have too high expectations of the treatment; ⑥ for the explanation of the condition of those who said it is difficult to understand; ⑦ there are signs of infection; ⑦ the patient is not a patient, and the patient has no idea of what is going on. Those who have high expectations for treatment; (6) those who have difficulties in understanding the explanation of their conditions; (7) those who have signs of infection or have already had nosocomial infections; (8) those whose conditions are complicated and whose information indicates that disputes may arise; (9) those whose hospitalization advance payment is insufficient; (10) those who have already incurred outstanding medical fees; (11) those who are in need of expensive out-of-pocket medicines or materials; (12) those who may be able to shift the blame for traffic accidents; (13) those who have chosen to see the physician by the patient; (14) those who have a special status. 2.2.7 For the emergence of doctor-patient disputes, the head of the department must personally inquire and decide the next step of diagnosis and treatment measures. Arrange special person to receive patients and their families, and other personnel shall not explain the condition at will. 2.2.8 The examination must be strictly targeted, and the procedure and sequence of the examination should be reasonably arranged. Attaching importance to the examinations and laboratory tests that have important guiding significance for the regression and prognosis of the disease, the results should be carefully analyzed and properly stored. Conscientiously implement the reporting system of life emergency value to ensure timely implementation of various rescue measures.2.2.9 Reasonable use of drugs, pay attention to contraindications of drug compounding and adverse drug reactions, pay special attention to the drug safety of the elderly and children, and prohibit the use of quinolones in the people under 18 years of age. Strictly grasp the indications of drugs, strictly prohibit the abuse of antibiotics, the third generation of cephalosporin antibiotics generally shall not be used prophylactically. 2.2.10 Pay attention to the prevention and control of nosocomial infections, give full play to the role of infection monitoring personnel in hospitals and departments, register and report the nosocomial infections that have occurred in a timely manner, do not hide them, and submit to the technical guidance of the professionals.2.2.11 Blood transfusion must be examined for HIV, HCV, HBsAg and syphilis serum antibodies, etc. After blood transfusion, the blood bag should be handed over to the hospital for examination. The blood bag after transfusion shall be handed over to the Blood Transfusion Department for unified storage and shall be destroyed only after 7 days. 2.2.12 When doing invasive tests, all medical departments must be equipped with rescue equipment and ensure that it is available at any time; emergency tests must be arranged as soon as possible after receiving the application. Emergency laboratory tests must be issued within 30 minutes after receiving the specimen (except for individual tests). Emergency X-ray and CT examination must be completed in time. The Pharmacy Department ensures the normal purchase channels and quality of medicines, and ensures the timely delivery of rescue medicines. 2.2.13 Medical record writing and management. Strictly in accordance with the Ministry of Health, "Basic Standard for Medical Record Writing", "Jiangsu Provincial Standard for Medical Record Writing", "Regulations on the Handling of Medical Accidents", "Law of the People's Republic of China on Licensed Medical Practitioners", the requirements for medical record writing and management of medical records. At the same time, according to the relevant requirements to do a good job in the management of electronic medical records.2.2.14 Admission of patients ① Admission of patients to implement the principle of emergency priority, specialized treatment. Prohibit the blind admission of patients between departments resulting in delayed diagnosis and treatment and medical disputes. ② for chronic diseases and critical patients, each department must take the condition and the interests of patients as the starting point, not to refuse to accept patients on various pretexts. ③ Where the specialty or ward with empty beds shall not refuse to accept patients with borrowed beds from other departments under any pretext. ④ Patients shall sign the "Ethical Contract between Doctor and Patient" and "Notice of Admission of Insured Patients" when they go through the hospitalization procedure. During hospitalization, patients must sign a power of attorney when they cannot sign the consent for special treatment, special examination, blood transfusion, anesthesia and surgery due to various reasons, and the attorney is responsible for acting on behalf of the patient to fulfill his/her right to be informed and his/her right to choose during his/her stay in the hospital. The content of the patient's informed consent is as follows: a Diagnosis of the disease, the proposed examination, treatment measures, prognosis, unavoidable treatment contradictions, the toxic side effects of drugs in outpatient treatment; inpatient physician in charge, the attending physician and the corresponding department head (chief physician or deputy chief physician). b The possible adverse consequences of the examination and treatment measures and the further measures that may be taken to correct the adverse consequences, and the toxic side effects of the drugs that must be used in the inpatient treatment. cInternal materials to be retained during surgery. d The situation of out-of-pocket expenses in medical costs. e The performance of surgery, anesthesia and other invasive operations. f Discovery of lesions inconsistent with preoperative diagnosis during surgery. gWhen it is necessary to remove organs and tissues that have not been explained to the patient before the operation. h When a critically ill patient needs to be moved due to special examinations that may cause danger. i Blood transfusion, imaging, intervention, radiofrequency, tracheotomy, chemotherapy, etc. j Other contents that need to be understood by the patient or family members. All of the above relevant provisions should be documented in writing and signed by the patient or trustee.2.2.15 Regularly and irregularly supervise the implementation of the core system of medical quality and medical safety, and implement the accountability system of medical quality.2.3 Emergency response 2.3.1 In case of a medical error or accident, the supervising physician and the department director should be notified immediately, and at the same time report to the hospital's medical management personnel, including the hospital's medical department during the daytime and the hospital chief duty officer at night, and not to the hospital's chief duty officer, and not to the hospital's chief duty officer. for the hospital general duty staff, and shall not be concealed. Remedial measures should be taken to avoid or minimize further damage to the patient's health and to save the patient's life as much as possible. Error accidents caused by nursing factors, in addition to reporting according to the above procedures, and at the same time in accordance with the nursing system level by level.2.3.2 by the medical and political functions of the organization of department heads to find out the reasons.2.3.3 by the medical and political functions of the organization of multidisciplinary consultation, the participants in the consultation is the highest level of the physicians on duty.2.3.4 department heads and the medical and political functions of the department **** with the decision to receive the patient's family members of the staff, designated Specialized personnel to explain the condition. Determine the attending physician and department head as the error, accident or dispute the first responsible person, any other medical personnel shall not be involved in the handling of unauthorized.2.3.5 Medical administration function department in conjunction with the situation, whether to seal the content of the medical record as stipulated in the Regulations on the Treatment of Medical Accidents.2.3.6 Suspected transfusion, transfusion of blood, injections, medication caused by the adverse consequences of the function department personnel, the patient or family members*** the same present In the case of the patient's death, the family should be mobilized to carry out autopsy and record it in the medical record. 2.3.8 If the patient needs to be transferred to a different department for treatment, all departments must make every effort to collaborate with each other. 2.3.9 The department concerned must write a written report on the facts within the required time, and at the same time put forward a preliminary opinion on the handling of the case, and report it to the Medical Department. 2.3.10 No department or individual shall privately waive or exempt a patient's medical fees. No department or individual shall privately reduce or waive the patient's hospitalization fees. 3. By-laws 3.1 This plan shall be interpreted by the Medical Section. Each department will formulate medical risk prevention measures suitable for the department according to this plan and implement them. 3.2 The plan will be implemented from the date of publication.
(2) emergency plan for the treatment of acute and critical patients 1, the purpose of the implementation of this plan, to provide patients with fast, safe and effective diagnosis and treatment services, and to improve the success rate of rescue of acute and critical patients. To this end, the emergency plan is formulated for the treatment of critically ill patients.2 Emergency Response System and Personnel Responsibilities2.1 Leadership Group for Integrated Treatment of Acute and Critical Illnesses in Hospitals: with the president as the leader and the business dean as the deputy leader, the comprehensive treatment in hospitals exercise decision-making and commanding power.2.2 Medical Department and Nursing Department: play the roles of organizing, coordinating, giving feedbacks and assisting in management in the process of integrated treatment, and monitor the whole process of medical quality and safety. 2.3 Emergency Plan for Emergency Patients: to provide fast, safe and effective diagnosis and treatment services to patients through the implementation of this plan. 2.3 Comprehensive treatment of acute and critical illnesses expert group: for the implementation of comprehensive treatment of high-level technical force. 2.4 Section chiefs and head nurses, medical and technical section chiefs: as section management, responsible for arranging the staff and equipment, organization and implementation of comprehensive treatment. 2.5 Emergency Department, clinical departments and medical departments and other front-line health care personnel: the implementation of acute and critical patients treatment. 3, emergency requirements 3.1 The leading group members, medical department, nursing department, emergency and critical illness comprehensive treatment expert group must keep the communication tools unobstructed; 3.2 All the medical and nursing staff of the emergency department must be proficient in first-aid technology, deal with the patient decisively and accurately; 3.3 First-aid instruments should be maintained in a good condition, resuscitation medicines are ready, and should not be lent out, and the equipment that needs to be borrowed should be clearly borrowed channels and processes; 3.4 Outpatient clinics, emergency department, intensive care medicine and general wards should be very good at the first line. Medicine and general wards should cooperate well, make full use of hospital resources, conduct all examinations or consultations in a timely manner, be fast and effective, coordinated and orderly, and report to the competent departments and hospital leaders when necessary.3.5 The results of all tests and examinations should be tracked in a timely manner, analyzed carefully, and stored properly.3.6 Invite the superior physician to check the room in a timely manner, and make a good record of it carefully in the medical record. The medical record is written in time, reflecting the change of condition and important diagnosis and treatment process; keep the medical record properly, including outpatient emergency medical record.3.7 Strictly grasp the indications for surgery, pay attention to the principles of medication, contraindications to drugs, adverse reactions, and inform the family before applying expensive or self-financed drugs.3.8 Pay attention to communicate with the patients and their families, so as to make doctors and patients to establish a coordinated and cooperative good relationship for the patients' salvage and treatment.3.9 Organize and study the Emergency program to improve the emergency response ability of personnel at all levels.4. Reporting Procedures by Level 4.1 After receiving a critical patient, the physician on duty in each department and each professional group should quickly arrive at the patient's side to ask about the history and body check, make a preliminary diagnosis, and quickly complete the measurement and recording of vital signs. Physicians quickly prescribe medical advice to the nurse to implement, the condition of the emergency can be first oral medical advice by the nurse to review the implementation of the end of the resuscitation within 6 hours according to the fact that the addendum. After the emergency treatment as soon as possible to complete the admission record, the first record of the course of the disease, resuscitation records and other information. And inform the patient's family in detail about the condition, preliminary diagnosis, treatment plan and the degree of risk, etc., listen to the patient's family's opinion on the resuscitation treatment, and obtain their cooperation. 4.2 Serious trauma, hemorrhage, shock or cardiopulmonary insufficiency, etc. If the physician on duty has difficulty in dealing with the situation, he/she should immediately carry out emergency resuscitation and at the same time, report to the superior physician of the department to arrive at the scene to participate in the resuscitation. If the supervising physician still has difficulty in dealing with the situation, he/she should report to the chief of the department, who should immediately mobilize the staff of the department and contact with the relevant departments to participate in the resuscitation. In case of emergency, consultation can be requested verbally or by phone, but the consultation record should be recorded accordingly.4.3 In case of serious trauma, poisoning and other emergencies involving more than 2 persons, the physician on duty in day shift should immediately report to the chief of the department, and the physician on duty in night shift should report to the general duty officer, who should be responsible for coordinating and organizing the personnel to participate in the resuscitation. The chief of the department or the general duty should ask for support from the medical department when there are difficulties in dealing with the incident, and the physician on duty for particularly serious incidents can directly report to the medical department or the president in charge for support. The medical department should report to the supervising dean in a timely manner when dealing with serious medical incidents and sudden critical incidents.4.4 In the event of medical disputes or possible precursors of medical disputes, the physician on duty should quickly report to the supervising physician and the department head to arrive at the scene to deal with the situation, make a good record of the medical record and other paperwork, listen to the opinions and requirements of the patient and his/her family members, and actively communicate with the patient to prevent the situation from expanding, and report to the medical department in a timely manner. Then organize the relevant personnel of the Section to discuss and take effective measures to prevent further aggravation of possible injuries. (C) Emergency response plan for emergency accidents in the hospital 1. Protect the scene and report in time 1.1 In case of accidents of non-institutionalized patients in the hospital, the on-duty staff of the Emergency Department should be notified immediately. The Emergency Department is responsible for organizing and implementing the rescue.1.2 In case of sudden death, suicide or homicide, the scene should be protected at the first time and reported to the Security Section and the hospital leader in charge. The hospital leadership in charge, according to the preliminary judgment to report the police station and the Public Security Bureau. 1.3 for the sudden onset of death due to a person, the first to confirm whether it can be saved, such as not dead, should be carried out on the spot resuscitation; such as to determine that the death has been, should assist public security personnel to check the cause of death. 1.4 for the death of a person who died by suicide, the first to protect the scene, to dissuade unrelated people to come close to, to wait for the arrival of public security, security personnel to look for the deceased's suicide note and other evidence of the material. 1.5 For other deaths, first of all, protect the scene, observe whether there are suspicious people around, do not allow unrelated people to get close to the public security personnel to arrive, report the situation and provide relevant clues. 2, do a good job of aftermath work 2.1 When the public security, security personnel to find out the cause of the death of the deceased, should be done in a timely manner to communicate with the community. 2.2 If the deceased is a hospital to seek medical treatment or visit the patient, should be as soon as possible to contact with the family of the patient and the unit to get in touch with detailed information about the cause of death. Unit to get in touch with the detailed explanation of the cause of death. 2.3 Do a good job of explaining the surrounding masses and hospitalized patients, to dispel the suspicion and fear of everyone.