In view of the hidden dangers in nursing work in neonatal intensive care unit, safety management is introduced into neonatal ward management, the content of nursing safety management is determined, and various systems are perfected and formulated. By strengthening management, improving nurses' awareness of nursing safety, implementing quality supervision, grasping every nursing safety link and using modern scientific management methods, the nursing management system is standardized and standardized to provide safe and satisfactory quality services for children.
Keywords nursing safety in neonatal intensive care unit
Nursing safety means that patients will not suffer psychological, structural or functional damage, obstacles, defects or death beyond the scope permitted by laws and statutory rules and regulations in the whole process of implementing nursing services [1]. It is the basis of ensuring nursing quality, an important measure to improve team spirit, and the guarantee of social and economic benefits of the hospital. The neonatal intensive care unit of our hospital was established in February 20 10. It's a closed management ward with no escort. It needs 24-hour nurses to take care of the whole process, mainly treating children within 28 days after birth. These children have no self-care ability and language function at all, and their condition is critical and changes rapidly. Nurses work without patient supervision every day, and the rescue instruments are complicated and there are many nursing operations, which have many hidden dangers and affect the medical quality. Under this condition, how to implement nursing safety management scientifically and avoid nursing defects and nursing accidents has become a problem that cannot be ignored in nursing management. The discussion is as follows.
1 Common nursing safety hazards in nursing work
1. 1 nursing staff
1。 1。 1 Lack of safety awareness and responsibility.
Nurses in neonatal department basically work in a relatively closed environment, lacking the supervision of children's families. Some nurses lack the spirit of prudence and independence, do not ask for instructions or report when encountering difficult problems, do not pretend to understand, and have insufficient understanding of some possible safety hazards. Because the observation was not timely, the skin necrosis was caused by the leakage of intravenous infusion of irritating liquid medicine; Improper feeding causes choking, aspiration and even suffocation inhalation diseases; Excessive milk temperature leads to oral mucosal damage; Improper covering or lying position causes obstruction of mouth and nose breathing and suffocation; Reduce the number of visits to children whose condition is relatively stable, which leads to the failure to find the changes of children's condition in time and lose the opportunity to rescue them.
1。 1。 Nursing records in neonatal intensive care unit are the most accurate and valuable records of patients' condition changes, and must be realistic. They are important evidence for patients and medical staff to deal with disputes, and must be highly valued. The specific nursing measures taken in the rescue process should be recorded in time, accurately and in detail. If the records are not timely, standardized, altered or inconsistent with the medical records, it will become a hidden danger affecting the nursing safety of neonatal department.
1。 1。 Poor professional knowledge and technical ability are mainly due to the threat to patient safety caused by factors such as low technical level, lack of experience and poor coordination ability of nursing staff. For example, due to the lack of nursing knowledge and experience, some children's early critical changes can not be identified in time, leading to the loss of rescue opportunities and even death; However, with the introduction and development of new technologies and new projects, the technical complexity of nursing work is constantly improving, and the technical requirements for nursing staff are constantly improving, which greatly affects nursing safety.
1。 1。 4. Violating the nursing system and technical operating rules, not strictly implementing the nursing system in nursing work (such as not seriously handing over the shift, not at the bedside, forgetting the special treatment of special critically ill patients); Violation of bath care operation routine, resulting in scalding of children; Improper execution of doctor's advice (such as forgetting doctor's advice, wrong execution of doctor's advice, unknown medication record during rescue), wrong drug placement, careless observation of illness, and lax implementation of checking system may all lead to errors and accidents.
1。 2 management aspects
1。 2。 1 The number of neonatal nurses is not enough, and the bed-to-nurse ratio can't meet the requirements, which can't meet the needs of grading nursing and safe life nursing for children. In addition to a lot of routine treatment and nursing work, all life care for children (such as bathing 1 time every day, feeding 8 times to 12 times every day, changing diapers, contaminated sheets, scarves and baby clothes at any time, etc. ) It was made by a nurse. The heavy work tasks of nurses, coupled with frequent shifts, often lead to physical and mental fatigue, mood swings, inattention and inattention.
1。 2。 2 Hospital infection management There are many patients in neonatology department, with complicated conditions, immature immune system and low resistance, which are easy to be infected with various diseases and cause cross-infection; If the disinfection and isolation system is not strictly implemented, the disinfection methods of equipment and articles are not strictly mastered, and the hand hygiene system is not strictly implemented, hospital infection will occur.
1。 2。 3. The management system is imperfect and the quality control is lax. Nursing managers lack foresight and proactive prevention of potential unsafe factors, fail to remind nurses to pay enough attention in time, lack of professional training, lack of professional ethics education, lax management supervision and other factors have affected the management of nursing safety organizations, which is not only the main cause of medical disputes and accidents, but also the greatest threat to patient safety.
1。 2。 4 Ward management is not rigorous: Ward management is not rigorous or out of control, which is an important factor affecting nursing safety.
For example, all kinds of instruments and equipment are not well kept and materials are not fully prepared.
2 nursing safety measures
2。 1 Strengthen study and training to improve the comprehensive quality of nursing staff.
2。 1。 1 strengthen the training of nursing business, starting with basic nursing, and require each nurse to master basic nursing operations such as baby bathing, milk preparation, feeding, diaper changing, umbilical nursing and temperature measurement. , and professional technical operation training and assessment. Facts have proved that only by mastering basic nursing theory knowledge, neonatal specialized nursing skills, rescue procedures, coordination methods, the use of various commonly used instruments and equipment, and observation of illness can we be calm and orderly in the busy neonatal nursing work and ensure the safety of children.
2。 1。 Pay attention to continuing education and improve nurses' professional knowledge in an all-round way.
Encourage nurses to put forward higher requirements for their own business development and strive to be technical backbones; Encourage nurses to actively participate in junior college and undergraduate nursing classes, actively adjust their knowledge structure, improve their knowledge level, and send nursing backbones out to participate in various learning classes. The study report system is implemented, which stipulates that all nursing staff who go out to visit, study and inspect should concentrate on their studies after returning, impart good experience and new technology, so that more nurses can understand the new development and trend of their profession and specialty, gain new knowledge and new ideas, continuously enrich their professional theoretical knowledge and improve the professional level of all nurses. 2。 1。 3. Improve professional ethics and ensure the quality of nursing.