Problems:
1. Differences in the placement of items on the resuscitation cart. The placement of medicines, items and instruments on the rescue carts of each department is highly variable; the placement of defibrillators is unreasonable; and the management of nurses is time-consuming and labor-intensive (the number of medicines, items and instruments need to be counted and the quality viewed on each shift).
2. There are many kinds of emergency medicines. There are various kinds of emergency medicines in the ambulance: anti-shock drugs, vasoactive drugs, respiratory stimulants, cardiac stimulants, hemostatic drugs, antipyretic and analgesic drugs, hormones, diuretic and dehydrating agents, solvent diffusers, antidotes, etc. The maximum number of types of drugs is 29. The maximum number of drug types is 29.
3, first aid items are more types. Rescue car with all kinds of first aid items: ventilation (such as ventilators, simple artificial respiratory capsule, pull the tongue clamp, mouthpiece, tongue depressor, oropharyngeal ventilator, oxygen pillows, etc.); all kinds of sterile packages (such as gas cutting package, static cutting package, catheterization package, etc.); a variety of injections (such as syringes, resuscitation needles, transfusion / transfusion of pressurized devices, etc.); other specialty items (such as three-lumen two-capsule tubes, emergency lights, gloves, ice caps, wiring boards) etc.). Moreover, the types of first aid items varied greatly from department to department, with the highest number of items reaching 40.
In addition, some departments are more casual about the storage of resuscitation items, and even use the resuscitation truck as a storage truck.
Improvement measures:
Standardize the configuration of resuscitation trolleys throughout the hospital.
Unify the model of resuscitation vehicles. By the clinical medical engineering department, medical department, nursing department research resuscitation car model, fully discussed, the introduction of high-quality resuscitation car and biphasic defibrillator, replacement of the hospital's various wards of the resuscitation car, unified hospital-wide resuscitation car configuration.
Harmonizing the configuration of medicines and articles in the resuscitation vehicle.
①The relevant functional departments are responsible for soliciting the clinical departments to admit and treat diseases and the most frequently used rescue drugs and items, and the preparatory group for the standardization of rescue vehicles discusses and determines 10 kinds of new rescue drugs.
② Drawing diagrams: the nursing department according to the rescue car structure to draw emergency drugs, items placed on the schematic diagram, hanging in the rescue car, easy to count the drugs, items. Each nursing unit in strict accordance with the nursing department unified design, printing and issuing the schematic placement of emergency drugs, items.
③Uniform establishment of marking system: according to the hospital regulations strictly regulate the number of drug base, marked with the name of the drug, the dose. High-risk drugs according to the hospital drug management system in the ampoule paste the corresponding high-risk bottle label, in order to use the first time to remind the nurses, and at the same time increase the "rescue drugs for children dosage and conversion reference information" table, to facilitate the rescue of health care workers with the conversion of medication.
4 Uniform order of medication: the hospital uniformly requires that the ampoule of each drug be sorted from right to left in accordance with the expiration time, to cultivate the nurses' mindset in order to prevent unfamiliarity with medication and delayed resuscitation.
⑤The introduction of a new type of disposable plastic locks with numbers to replace the original paper seals in the wards improves the aesthetics and facilitates the management of resuscitation trolleys.
The resuscitation trolleys are placed at fixed locations in the center of the ward, such as the nursing station in the ward.
The appearance of the ambulance is uniform and clear: the design of the uniform appearance of the logo, so that everyone can see at a glance.
Standardized disposal of items.
Rescue car management system:
1. The whole hospital is uniformly equipped with a rescue car, the items and drugs in the rescue car to implement the "five" management, fixed management, fixed point placed, fixed number of varieties, regular inspection and maintenance, and regular disinfection and sterilization. A full-time member is responsible for the management of the rescue car, real-time seal management system.
2. Every shift when the nurse handover check the seal of the gun rescue car, checking no error by the handover of both signatures, such as rescue car seal was opened or error, need to rescue all drugs, goods, equipment in the car to implement check, detailed check, handover of both confirm that there is no error, re-stick the seal and the handover of both signatures.
3, routine monthly check the performance of the first aid equipment. (blood pressure meter, stethoscope, pin board, flashlight, open mouth device, simple respirator, negative pressure suction device) to maintain good performance to keep it in a standby state: after the use of thorough cleaning, disinfection, and check its performance, and according to the requirements of the name of the person responsible for and the date.
4, rescue teaching car to keep clean and tidy, drugs at a glance. Placed reasonably easy to use.
5, drugs and equipment shortages or substandard should be timely maintenance and replacement, timely replenishment.
6, rescue goods register and the physical must be corresponding to correspond, there should be no missing items, more than one.
7, routine daily with water to wipe the shell once a month thoroughly cleaned once: each use thoroughly cleaned.
8, the process of rescue teaching if there is a questionable situation should be retained after the use of drugs after the empty bottle in order to provide an objective basis for rescue.
9, the head nurse regularly spot-checks the readiness of the items in the ambulance, and solves the problems in time.
10, rescue medicines and supplies, because of the rescue of patients after consumption, should be promptly counted to replenish, has been in a state of reserve.
11, in principle, may not be diverted from the rescue car medicines and equipment.