The medicinal properties must be whole to understand what the patient's disease
What are the hidden dangers of fire in the hospital
The fire escapes, fire staircases, fire elevators, emergency lighting, fire hydrant systems, evacuation lights, safety lights, automatic alarm systems and other facilities are complete, complete and bluffing often work. All will become a hospital fire safety hazards.
Combined with the clinical nursing safety hazards include what
The continuous development of medical and health science and technology and the improvement of the standard of living of the public, so that patients and their families have a deeper understanding of the legitimate rights and interests of medical treatment and familiarity with the quality of medical care, quality of nursing care, medical and nursing care and safety has put forward a higher demand. The author nearly 30 years of clinical nursing and education practice, know that the current nursing safety is an important indicator of nursing services, but also the patient's choice of medical treatment is one of the most direct and important indicators. As a gynecological care workers, should be standardized at any time feasible safety precautions, strengthen governance, to provide patients with high-quality services, reduce the occurrence of unsafe nursing phenomenon, the author on the nursing of common safety hazards of the reasons for the analysis and the corresponding prevention countermeasures to make a discussion.
1 clinical care in the analysis of the causes of hidden safety problems
1 business quality and responsibility to be improved
The quality of nursing staff is the primary factor related to nursing safety. Lack of business knowledge and lack of work experience are common safety hazards in nursing in some primary hospitals. Some nursing staff have low or unskilled technical level, poor cooperation with others, do not pay attention to learning and business and technical training, violation of technical operating procedures, often leading to operational errors or operational errors and nursing defects and accidents, which led to nursing complaints. Such as patients falling out of bed, falls, burns, suicide, etc. Many cases are nursing staff work off duty, sleep on duty or delayed, omitted treatment, not on time ward rounds, the implementation of the medical advice error, the patient's condition changes can not be found in time and other reasons, which are the lack of responsibility of the nurses.
2 poor service attitude, lack of legal awareness
Poor service attitude is also the main safety hazards, such as the work of the use of service taboos, do not pay attention to the way the conversation and tone of voice, answering questions simply lead to patient misunderstanding. If the nurse lacks understanding of patients and their families, does not take into account the service attitude, ignoring the psychological needs of patients, will not meet the expectations and requirements of patients. The patient is not a general consumer, the patient to the hospital to pay for medical treatment signifies that the hospital and the patient to establish a contractual relationship, the formation of a medical service contract. The hospital is through the health care personnel to perform medical care services for patients, the nurse's behavior is not only individual behavior, but on behalf of the hospital to perform the contract, the obligation to provide quality services for patients, to maintain the rights of patients. When nurses fail to realize this, and there is a gap between the actual work and the patient's requirements, complaints will be triggered.
3 Nursing facilities are not standardized and insufficient investment
In the construction and renovation of hospital facilities, a this grassroots hospital governors did not give full consideration to the requirements of nursing care, the patient comfort needs and resulting in irrational facilities, poor conditions. For example: stairs, toilets without handrails, the floor is too slippery and too bright. Some hospitals in the equipment input decision-making only focus on large or can produce direct economic benefits of equipment and facilities input, while ignoring the basic input of nursing equipment, resulting in a shortage of nursing equipment, not in place, thus forming factors affecting the safety of nursing. Such as trolleys, stretchers are old, beds without bed rails, resuscitation instruments are poorly maintained and so on. Extraordinary some usually infrequent use of rescue instruments, the number is too small to cause the rescue can not be used.
4 quality governance system is not standardized
Governance is to determine the functions and activities necessary to meet the quality requirements of the governance of the quality governance system is the core of the governance of nursing safety, the governance system is not perfect, the quality of the monitoring is not in place, are important factors that cause nursing insecurity. Nursing governance is the core of nursing safety. Only with governance in place can we ensure that patient care safety is guaranteed. In general, the lack of scientific governance of nursing staff is mainly manifested in the system is not sound, no rules to follow, the organization of governance is not strict, the lack of level by level governance, supervision, inspection, guidance and so on. Such as the existence of rescue car drugs, items placed in chaos, location is not fixed, rescue drugs without counting, labeling is not clear, rescue instruments are not in a state of readiness and so on.
2 Ideas and countermeasures for safety prevention
1 Enhance the legal awareness of nursing staff
Strengthening the legal knowledge education of clinical nursing staff is an effective means of preventing nurse-patient disputes and reducing nursing insecurity. Should be through occasional legal lectures and combined with practical case studies, so that nursing staff to understand the legal knowledge related to medical work, and further analysis of the clinical nursing work, which is a violation of the law, clear nursing and law closely related to the rights and interests of patients and caregivers rely on the law to maintain. Such as "Infectious Disease Prevention and Control Law" and "General Principles of Civil Law" and other laws, the nursing behavior of clear norms and corresponding constraints. Nursing staff must be clear about the legal provisions and obligations related to nursing, improve self-protection awareness, engage in nursing services in accordance with the law, and properly fulfill their duties to prevent the occurrence of nurse-patient disputes. Let nurses familiarize themselves with the adverse legal consequences of their own violations, strengthen the sense of responsibility, so that nurses know what they should do, how to do, so as to maintain the patient and their own ...... >>
Nursing safety problems and corrective measures
I. Nursing hazards and causes
1, potential nursing disputes
Clinical nurses are younger, experience and technology is not skilled, can not do a needle to see the blood, the volume of liquids, the number of personnel, the replacement of liquids in a timely manner, easy to return to the blood clogging of the pipeline, after the withdrawal of the needles can not be tied in a timely manner, a series of factors leading to the patient's family to the nurse's blood. A series of factors cause the patient's family members' opinions about the nurses to surge. Once the patient's condition worsens, it will directly lead to disputes.
2, basic care is not in place
Because the nurses are busy with medication, liquid change, have no time to pay attention to the patient's basic care content, such as turning, patting the back, nasal feeding and hyperthermia, diarrhea, constipation, etc., handed over to the family to operate, and then tell the nurse to report to the doctor to deal with the anomalies, can not guarantee that the condition of the observation on time, it is easy to complications or miss the best time for treatment. It's not that we don't do it, but we don't have the time. We feel that the nursing work has quantity but not quality, and we are busy all the time, and we really do very little for the patients, especially when we are on duty at weekends, we can't execute many medical instructions on time, and we can only wait for the end of the shift to execute them again. In short, under the limited human resources, there is no scientific and integrated management and distribution methods, so that the nursing work to the point of perfection.
3, safety hazards
When changing liquids, take several bottles at a time, a little inattention to change the wrong bed number; infusion card is not clear,
checking is not convenient, one is to affect the speed of checking, the second is easy to wrong drugs; surgery to move the bed is frequent, easy to make a mistake; night shifts, continuous shifts, mostly young nurses, lack of experience and communication skills, can not detect changes in patients' conditions in a timely manner, affecting the resuscitation treatment; critical and emergency surgery, the patient's condition, the patient's condition, the patient's condition, the patient's condition, the patient's condition and the patient's condition. Rescue treatment; critical, surgical patients in the general ward, long distance, fewer people, observation and treatment is not convenient, increasing the workload and work difficulties, the shifts exist in varying degrees, different nature of the safety hazards, health care safety is facing a major challenge.
4, nurses serious physical overdraft, high mental tension
Because of the heavy workload, fear of error and a high degree of responsibility for the work, nurses are in a state of high mental tension, psychological pressure is very high, serious physical overdraft, in the long run, is not conducive to physical and mental health. Loss of enthusiasm and enthusiasm for work, lack of love and compassion for patients, lack of attractiveness of the department, the team has no cohesion, is not conducive to the stability of the nursing team and the development of the profession.
5, companion management problems, difficulties
Critical, surgical, coma patients are many, the number of nurses is small, every day tired of completing the basic treatment, do not have the energy, manpower to provide basic life care, need to companion vigorously assist, therefore, can not limit the number of companions. With the chaperones staying in the department, water, electricity, heating and ward facilities are depleted, chaperones smoking cigarettes at night, sleeping on the floor, chatting, and hitching up and drying clothes all over the aisles are prohibited, and there are more chances of friction with healthcare professionals, which increases the possibility of cross-infection and many safety hazards. The effect of limiting the number of companions from the ward alone is not ideal.
Second, preventive measures
1, strengthen the safety and quality education, improve nursing safety awareness, eliminating unsafe hazards in nursing work is to avoid the risk of guarantee
(1) new nurses in the pre-service "medical incident regulations" study and pass the examination before entering the clinical work. Rotating nurses must enter our custody room specialized training for more than 3 months before they can follow the teacher shift. During this period, we provide operation training and theory reinforcement. And teach the basic skills of communication with patients and their families, with the basic ability to deal with disputes.
(2) Regularly organize legal education for nursing staff, the application of safety examples of reasoning, analysis of cases of violation of the alarm, firmly establish the "safety first, quality first" concept, enhance the awareness of laws and regulations, enhance the understanding of the consequences of nursing insecurity.
(3) Nursing quarterly in the hospital nurses conference on the quality of care and safety education, and in the monthly meeting of the head of the nurses to comment on the work situation, including the work of the existence of
of unsafe hazards, nursing errors and defects, the major errors and accidents should be analyzed and notified of the criticism.
(4) The nurse manager every day to use the morning shift time to give timely reminders of the problems that are likely to occur in the nursing work of the department to prevent.
2, adjust the shift, refine the workflow and work system is to reduce the nursing risk of the real guarantee.
In the nursing weak time to strengthen the personnel, such as noon, the weekend to increase the personnel and the old and young with, improve the efficiency of work, timely observation of the condition and deal with emergencies, the dispute will be nipped in the bud. The original overnight shift will be adjusted to the size of the night double work, retaining the help shift, the staff to increase the pressure to reduce, go to work to become happy. Strengthen the staffing of the guardianship room, refine the duties of each shift, clarify the duty responsibility, do a good job in the care of critically ill patients, the implementation of basic nursing care responsibility, to protect the safety of nursing.
3, strengthen communication with patients Master communication skills, improve service attitude, standardize service behavior, and protect patients' privacy. This is an effective measure to reduce nursing disputes ...... >>
What are the aspects of nursing safety education
Nursing safety education
I. Effectively strengthen the nursing safety education, establish a patient-centered service concept, and vigorously advocate the idea of changing passive service into active service. Specific measures:
1. Nursing staff must adhere to the weekly meeting system, to participate in the weekly medical safety education and learning, and found that a failure to implement the hospital's rules and regulations penalties.
2. Combined with our hospital to carry out the "quality nursing service demonstration project" to establish the concept of patient-centered service, provide proactive services to strengthen the nursing staff's sense of responsibility, advocate nursing staff with "love, care, patience and responsibility".
3. Through the strengthening of clinical nursing work, solid basic nursing services, in the whole society to establish a good image of the medical and health care industry wholeheartedly for the people to serve, and carry forward the humanitarian spirit of saving lives and promoting the harmony of doctor-patient relations.
II. Establish and improve the relevant rules and regulations, clear job responsibilities. Summarize the experience, and gradually explore and improve the hospital nursing management system suitable for our hospital, establish a long-term mechanism for continuous improvement of nursing quality, and constantly improve the level of nursing.
Specific measures:
1. To further implement the "Nurses Regulations", "Ministry of Health on strengthening the clinical nursing work in hospitals notice", "general hospitals hierarchical nursing guidelines (for trial implementation)", "inpatient basic nursing service projects (for trial implementation)", "basic nursing service work norms", "commonly used clinical nursing technical service norms," the requirements, and effectively strengthen the nursing The company's management, standardization of nursing services, and the consolidation of basic nursing care.
2. Establish and improve the relevant rules and regulations, and clarify the duties of the post.
1) Hospitals and wards have a complete plan to create, target tasks and implementation measures, nursing staff are registered, standardized practice.
2) The establishment of sound clinical nursing rules and regulations, disease care routines and clinical nursing service norms and standards.
3) the establishment of the post responsibility system for nurses, the development and implementation of all levels and types of nurses' post responsibilities and work standards, standardize clinical nursing practice.
4) To establish a performance appraisal system for nurses, combining the results of the appraisal with the promotion and evaluation of nurses according to the quantity and quality of clinical nursing work done by nurses and the satisfaction of hospitalized patients.
3. Define the basic nursing projects and work norms that clinical nurses should be responsible for, and must perform basic nursing duties, standardize nursing behavior, and improve nursing services.
4. Define the connotation of clinical nursing services, service programs and work standards. The service connotation of hierarchical care, service projects to include the implementation of the patient's condition observation, treatment and care measures, life care, rehabilitation and health guidance, and into the hospital affairs, as the content of the public to the patients, the introduction of patients and social participation in the evaluation mechanism.
III. Strengthen the study of laws and regulations and various rules and work norms.
Specific measures:
1. Carry out the "Nurses Regulations", "Ministry of Health on strengthening clinical nursing work in hospitals notice", "general hospital hierarchical nursing guidelines (for trial implementation)", "inpatient basic nursing service projects (for trial implementation)", "basic nursing service work norms", "commonly used clinical nursing technical service norms" and other laws and regulations, at least once a month, so that nursing staff master the rules and regulations of the work norms. At least once a month, so that nursing staff to master the rules and regulations and laws and regulations.
2. Establish and improve the rules and regulations, strict implementation of operating procedures, and constantly standardize the nursing workflow, the development of patient safety management plan. 3. Strengthen the management of quality control measures, increase the key quality control efforts, the Department of the establishment of the quality control team, regularly check the implementation of the system and the quality of each link in the quality management, the quality of the problem nipped in the bud, eliminating and reducing the occurrence of hidden problems.
4. Repeatedly strengthen the legal awareness of nurses, the use of the morning meeting and the usual business learning for legal knowledge and prevention of medical disputes case lectures, with specific cases to inform nurses, any negligence in a small link, may cause irreparable damage. Regularly convene safety analysis meeting, let nursing staff combined with the work of the post, looking for error-prone links, especially for the emergence of the problem, analyze the reasons and develop improvement measures. Update the management concept, encourage nursing staff to report safety hazards, and set up a hidden danger self-reporting incentive system, such as concealment and non-reporting, will be punished according to the appropriate system.
IV. Strengthen nursing "three basic" "three strict" learning assessment,
Specific measures:
1. Each have a theoretical examination, a technical operation assessment.
2. Encourage nursing staff to participate in various forms of internal and external business learning, training.
3. Develop preferential policies to encourage nursing staff to participate in adult higher education in order to improve the nursing staff's business skills and theoretical knowledge.
4. Adopt the method of inviting in and going out to strengthen the nursing new business and new technology learning, every two ...... >>
There are several methods of bedding commonly used in the ward
(1) spare beds: to keep the ward clean and ready to accept new patients
(2) temporary beds: to keep the ward clean and ready for the new patients or temporary beds for patients
(3) anesthesia beds: to facilitate the acceptance of nursing care for post-surgical patients, so that the patient's safety, comfort, prevention of complications, to avoid the contamination of bedding, easy to change, and to avoid the use of the bed. Contaminated materials, easy to replace.
(4) bedridden patients change bed linen method: to maintain the cleanliness of the patient, so that the patient feels comfortable, to prevent complications such as pressure sores.
What are the hazards of production safety accidents in densely populated places
First, the hazards of production safety accidents in densely populated places:
① Fire accidents;
② Explosion accidents;
③ Poisoning accidents;
④ Drowning accidents;
⑤ Accidents in equipment and facilities: accidents caused by equipment and facilities failure;
⑤ Accidents in equipment and facilities: accidents caused by equipment and facilities failure. Accidents caused by equipment and facilities;
⑥ Security accidents: accidents caused by security incidents;
⑦ Scalding accidents: accidents caused by high temperature due to man-made or accidental reasons, resulting in localized or large-scale injuries;
⑧ Collapse and subsidence accidents: accidents due to geological, weather, or man-made reasons that lead to ground subsidence, housing collapse;
⑨ leakage accident: refers to the loading of oil, gas, toxic substances due to the tanker or oil, gas pipeline for some reason led to gas diffusion into the air, or liquid flow into the open air and caused by the accident;
⑩ scrape and collision accidents: refers to the public **** transportation vehicles due to some reason led to the occurrence of scraping, collision accidents;
Accident: refers to the human causes of burns, strains and other accidents;
Other accidents: including falls, car accidents, electrocution, smashes, torts and other accidents or incidents that are not categorized.
Second, according to the Ministry of Public Security Decree No. 73, "Fire Supervision and Inspection Regulations" (since September 1, 2004 shall come into force) in Article 35 has been stipulated:
The provisions of the so-called densely populated places, refers to the following places:
1, hotels, restaurants, shopping malls, markets, stadiums, halls, public **** entertainment and other places where people gather;
2, hospitals, hospitals, hospitals, hospitals, hospitals and other places where people gather. p>
2, hospital outpatient buildings, ward buildings, school buildings, libraries and dormitories, nursing homes, child care centers, kindergartens;
3, passenger stations, terminals, civil airports waiting for trains, waiting for the ship, waiting for the aircraft hall (building);
4, public **** reading room of the library, the public **** exhibition hall exhibition hall;
5, labor-intensive enterprises Production and processing workshops, staff dormitories.
Third, the characteristics of crowded places
1, the number of people, high density. Dense places are often highly concentrated, in a certain space at the same time to accommodate a large number of people. On-site safety management is difficult, and most people lack of common sense to escape, once the fire accident, evacuation and escape difficult, very easy to cause mass casualties.
2, strong mobility of personnel, the composition of personnel is complex. Due to individual differences, in the face of sudden *** situation, it is very easy to cause confusion, thus triggering the occurrence of accidents.
3, the place where the nature of the building use change. Bars, Internet cafes, restaurants and other crowded places rarely use independent buildings, the operators are generally rented part of the building for renovation and remodeling, some of which are in the shopping malls or office buildings on a certain floor, some in the out-of-service warehouses or factories, and some in the first floor of the residential building, and some even in the residential building inside the remodeling.
What are the aspects of the duties of the head nurse of the ward
The duties of the head nurse of the ward First, the organization and leadership of the nursing staff's business learning and technical training. Second, responsible for the management of the ward, including nursing staff scheduling, rotation, temporary deployment, ward environment clean, safe, quiet, patients and accompanying, visiting staff management, all kinds of instruments, equipment, medicine management. Third, responsible for managing and instructing internship and probationary staff, and designating outstanding nursing staff with one star or above to lead the teaching. Fourth, supervise the staff of this group, hygienist and food dispenser to do all the disinfection and isolation system and cleanliness and hygiene work. Fifth, hold regular seminars for workers to listen to opinions on medical, nursing, diet and hygiene, and study and improve ward management. Sixth, under the leadership of the chief nurse and the operational guidance of the section chief, according to the nursing department and the work plan of the section, make specific plans for the ward and organize the implementation. Seventh, responsible for checking and understanding the nursing work in the ward, participating and guiding the nursing care of critical, major surgery and rescue patients, supervising nursing staff to strictly implement the rules and regulations and technical operation procedures, systematically checking the implementation of medical advice, strengthening the cooperation between doctors and nurses, and preventing errors and accidents. Eighth, to participate in the morning meeting and bedside shift handover, accompany the director of the department to check the room, in order to understand the problems in the nursing work, and to strengthen the contact between doctors and nurses. Participate in the consultation of the department and the discussion of major surgery, new surgery, difficult cases and death cases. Ninth, responsible for the nursing staff in the ward of political ideological work, education of nursing staff to strengthen the sense of responsibility, improve service attitude, abide by labor discipline. Tenth, the organization of the ward nursing room and nursing consultation, and actively carry out new technologies and new business and nursing research, complex nursing technology and new nursing business, to personally participate in the practice.