Safety is the basic need of human beings, but also the basic need of nursing, the following is a sample of my essay about the hidden dangers of safety nursing, welcome to read reference!
Thesis on the hidden dangers of safety nursing 1A brief exploration of the hidden dangers of dental outpatient nursing safety and prevention
Nursing safety refers to the implementation of the whole process of nursing, the patient does not occur outside the scope of the laws and regulations allow psychological, physical function of the damage, obstacles, deficiencies or death [1]. Due to the specificity of oral diagnosis and treatment and the enhancement of people's awareness of oral health, the safety hazards in the work of the dental clinic are increasingly exposed.
1 Oral outpatient safety hazards and cause analysis
1.1 Nurse-patient disputes
1.1.1 The nurse's own quality: the knowledge structure, technical level and ability, relative to the development of medical technology and the people's diversified service needs there is a gap [2]. In recent years, due to the increase in the number of employed nurses, mobility increased, the nurse oral cavity professional knowledge is lacking, lack of experience, lack of active service consciousness, can not timely understand the psychological needs of patients, or the patient's questioning, explaining and informing is not in place, so that the patient to produce dissatisfaction, resulting in disputes. If the nurse guide lack of specialized knowledge, can not meet the patient's consultation or guide misleading, leading to repeated registration of patients queuing.
1.1.2 Patient factors: With the patients' awareness of oral health care and legal concepts and self-protection awareness of the increasing patient expectations of the hospital's medical technology and quality of service is too high, and at the same time, due to the increase in medical costs and medical disputes continue to come to light and the guiding role of social public opinion, so that the patients in the clinic when the medical staff have distrust, the slightest mishandling, it will lead to Disputes.
1.1.3 Poor consultation environment, cumbersome consultation process: Our dental clinic due to the impact of the building structure, the layout is unreasonable, can not provide one-stop service, the patient needs to repeat the queuing price, payment, medication and so on. Appointment system is not sound, during the peak period leading to patients waiting time is too long or even the phenomenon of withdrawal, etc. leading to patient complaints, causing disputes.
1.2 The risk of hospital-acquired infections The important risk factors for hospital-acquired infections in oral clinics come from the secretions in the patient's mouth, blood, and a large number of ****-borne microorganisms.
1.2.1 The specificity of oral diagnosis and treatment: oral clinic patient mobility, the number of visits. Bacteria in the patient's oral cavity and respiratory tract can cause air pollution due to droplets and aerosols, which can lead to the spread of tuberculosis, pneumonia, influenza and other diseases.
1.2.2 The complexity of oral instruments: oral treatment in the use of a wide variety of instruments, and instruments with complex structures, expensive, which brings difficulties to the sterilization of instruments. Such as dental comprehensive treatment table water and gas system structure is complex, high-speed equipment can produce a strong instantaneous suction effect when stopped, so that the water and gas pipeline contamination. If the disinfection and sterilization disposal is not appropriate, it is very easy to lead to the occurrence of hospital infections. In the oral diagnosis and treatment work medical personnel to use a variety of sharp objects such as probes, expanding file needles, pulp extraction needle, etc., a little carelessness may cause the occurrence of occupational exposure of medical personnel.
1.2.3 medical personnel sterile concept is not strong, do not pay attention to the standard prevention: for a long time the stomatology medical personnel think that the oral cavity itself is a contaminated environment, it is impossible to do aseptic operation. Work often only focus on their own protection, ignoring the protection of patients.
1.3 Adverse drug reactions As patients are leaving the hospital after the end of outpatient treatment, if you neglect to inform the medication and precautions, after the emergence of adverse drug reactions can not be timely observation and treatment, resulting in medical disputes. Such as anesthetics, clove oil, plasticizing solution, cresol aldehyde and other dentistry drugs and nickel-chromium, silver-mercury restorative materials such as allergic reactions caused by the inappropriate use of seal arsenite inactivation agent caused by drug-induced apical periapical inflammation and mucosal alveolar bone necrosis. The use of tetracycline-type drugs resulting in children's dental developmental defects.
1.4 Accidents Oral care in the unsafe factors are mainly broken needle, extraction of the wrong tooth, temporomandibular joint injuries, the elderly suffering from cardiovascular and cerebrovascular disease proportion is high, can be due to nervousness leading to accidents. Mainly due to the lack of basic professional knowledge of nursing staff, lack of clinical experience, chair-side care with improper or violation of operating procedures.
2 Preventive measures
2.1 Sound and implement the rules and regulations The system is a strong guarantee of nursing safety [3], seriously implement the post responsibility system for nursing staff at all levels and types of nursing, the "Code of Practice for Sterilization of Oral Diagnostic and Therapeutic Instruments for Healthcare Institutions", the system of aseptic operation, to strengthen the management of nursing safety, and to encourage the system of reporting of nursing adverse events. Regular safety training for nursing staff, regular analysis and summarization of nursing adverse events, and rectification. Typical cases are discussed, prevention is better than cure, and nursing safety awareness is improved.
2.2 Strengthen nurse-patient communication, improve the consultation process Enhance the nurse's awareness of active service, establish ? The first step is to improve the quality of the service and to improve the quality of the service. The concept of nursing, improve service attitude standardize service behavior, respect for patients, understanding, humanistic care embodied in the whole process of the patient's visit. Strengthen nurse-patient communication, fully understand patients' physiological, psychological, social and other needs, and patiently answer patients' questions and satisfy their needs with sincere, warm, considerate and meticulous services and rich professional knowledge. Improve the consultation environment, provide patients with newspapers, magazines and health education columns to eliminate the anxiety caused by waiting; improve the consultation process, provide one-stop service, for those who are inconvenient to move, nurses can do it on their behalf or provide door-to-door service; rational allocation of nurses, arranging for nurses with a certain degree of experience and professional knowledge to serve as a triage, medical guidance, counseling work. Improve the registration and appointment system to avoid long waiting time.
2.3 Strengthen the dental specialty technology and first aid technology training Due to the popularization of four-handed operation and the continuous application of new technology and new materials in stomatology, the nurses are required to continuously learn and master the nursing operation process in order to meet the needs of clinical work. Dental clinic nurses are generally not skilled enough in first aid techniques and lack emergency response ability. Therefore, we should strengthen the training of nurses in first aid knowledge, first aid technology and the use of first aid equipment, as well as preventive training for emergency events such as patient falls, sudden fainting, cardiac and respiratory arrest, drug anaphylactic shock and other emergency plans, to strengthen the nurses' ability to cope with first aid events.
2.4 Strengthen the training of knowledge of nosocomial infection, strengthen the concept of asepsis Strictly implement the principles of standard precautionary and aseptic operation and oral instrument disinfection and isolation system. The instruments should be disinfected or sterilized for one person and one use, and the environment and object surfaces should be disinfected and monitored on a regular basis. Medical waste is strictly classified and correctly disposed of.
2.5 Preventing accidents in advance Nurses should assist the doctor in the initial assessment of the patient, to understand their basic health status and psychological state. Such as elderly patients to understand the blood pressure, recent history of heart attack, diabetes and blood sugar control, female patients should understand whether it is menstruation, to understand the history of allergies, and so on. For timid and nervous patients, psychological counseling, avoiding treatment in the fasting state. The ground is slippery, easy to fall down the place should be warned.
2.6 Strengthen the obligation to inform the patient as a special consumer, in the process of receiving treatment and care, the patient has the right and want to know the purpose of the treatment they are receiving, methods, precautions, adverse reactions, and the risks that should be borne, the special examination and treatment should be agreed to by the patient to fulfill the signing procedures. Patients should be informed of the precautions and possible adverse effects of the drugs used and the patients after root canal treatment, new denture patients, post-extraction surgery, orthodontic treatment patients.
3 Summary
Nursing safety is a prerequisite for the improvement of nursing quality, and is an important part of preventing medical errors and reducing medical disputes [4]. In daily work, we should learn to assess and identify possible unsafe factors and signals, regularly analyze and discuss unsafe factors in nursing, and develop corresponding preventive measures to ensure the medical safety of patients.
References
1] Hua Zhuojun, Yang Shujie. Strengthening nursing safety detail management[J]. China Nursing Management, 2008, 8(4):51?52.
[2] Sun Xiaolan. Introduction to nursing and nursing disputes [J]. Chinese Journal of Modern Clinical Nursing, 2008, 3(3):243?244.
[3] Duan Wenyu, Zhao Yuying, Zhang Lixia. Reasons for Nursing Correction and Preventive Measures in Hemodialysis Room[J]. Chinese Journal of Practical Neurological Diseases, 2009, 12(4):81.
[4] Wu Jiping. Introduction to outpatient nursing safety and quality management [J]. Modern Preventive Medicine, 2008, 35( 24):35?36.
Thesis on the hidden dangers of safety care article 2Experimental emergency nursing safety hidden danger prevention countermeasures
With the development of society, people's demand for medical services is growing, the requirements of health is getting higher and higher, the awareness of the law and self-protection is getting stronger and stronger, and the medical behavior is a complexity, The medical behavior is a complex, high-risk behavior, each link may exist unsafe factors. The emergency department is responsible for dealing with public health emergencies and the diagnosis and treatment of patients with acute and serious illnesses, and the work of the emergency department has a certain degree of specificity and complexity. The quality of emergency medical care directly reflects the quality of hospital medical care. Therefore, emergency care safety management has been the focus of hospital nursing managers. However, in recent years, with the soundness of the legal society, the reform of the medical system and personnel system, the patients and their families have gradually improved their awareness of self-protection, while the clinical emergency nurses are getting younger and younger, and their awareness of the law and self-protection is very weak, which has brought certain hidden dangers to the safety of emergency nursing. For the emergency department nursing insecurity hidden danger to develop appropriate preventive measures, so that emergency nursing work safer, faster, more effective, and minimize the occurrence of medical accidents.
1 emergency department nursing safety hazards
1.1 doctor-patient communication is not sufficient, service attitude is hard: to the emergency department of the emergency department for more than emergency patients, they often show moody, and pain and discomfort, and their family members also showed emotional tension and agitation, they need at this time is care, consideration and comfort. A few of the medical staff lack of compassion and patience, talk hard, reprimand the patient, do not pay attention to the patient's psychological state, it is very easy to cause dissatisfaction of the patient and his family, once the diagnosis and treatment effect is not good, it is very easy to dispute.
1.2 responsibility is not strong, careless: individual health care workers do not seriously comply with the operating procedures, questioning the patient is not comprehensive, the condition of the observation is not careful, should check the project does not do, do not talk about the principle of treatment, the operation of asepsis is not a strong concept, the three check the seven right is not strict, the handover system is not implemented, and even shirking responsibilities, do not dispose of the delay in the patient's diagnosis and treatment and rescue, and the emergence of medical errors, the formation of disputes. The dispute.
1.3 business technology is not good: nurses in the resuscitation can not be a needle in the blood, repeated puncture, and can not be immediately administered intravenously, affecting the speed of the resuscitation, cardiac arrest of the patient's artificial airway can not be immediately established and delayed resuscitation time.
1.4 Emergency awareness is not strong: Emergency patients are mostly sudden or acute cases, family members and patients are often anxious, hoping that the patient after the hospital to get timely rescue, such as nurses do not receive timely diagnosis, slow action, do not draw blood for laboratory tests in a timely manner, not timely escort for examination, the use of drugs are not used immediately, once the condition deteriorates, there will be disputes.
1.5 Rescue medication is not in place: the emergency department is an emergency department, first aid items, equipment, medicines should always be in good standby. If the items are not fully prepared before the rescue, not complete or not timely after the rescue supplement, making the rescue work busy and affect the rescue work, directly affecting the efficiency and quality of the rescue.
1.6 Resuscitation records are not timely and perfect: medical records are legal documents that record the process of medical activities, and nursing records are an indispensable part of the medical records. In emergency care, due to the diversity and complexity of the resuscitation nursing measures and some nurses are not serious, so that the resuscitation records are not standardized, the content of the incoherent, the focus is not prominent, and the buried disputes hidden trouble.
1. 7 poor communication between doctors and nurses Due to the busy emergency emergency work, doctors have no time to write written medical advice, so more oral medical advice. At this time, if the communication between doctors and nurses can not be readily communicated, the nurse implementation, easy to use the wrong drugs, or repeat medication because they did not hear clearly. Coupled with the nurse's nursing records are not timely enough, it causes problems [1].
2 Preventive measures
2.1 Sound emergency risk management mechanism
2.1.1 Implementation of the organization, clear responsibilities: under the leadership of the nursing department, the establishment of emergency nursing risk management team, the head nurse is responsible for the implementation of nursing quality monitoring, regular analysis of the current state of nursing, timely mastery of the relevant information, to find the nursing safety hazards, and put forward targeted precautions [ 2].
For the risks that have occurred, the organization of timely declaration, control and avoidance, to make appropriate treatment, minimize the cost of risk.
2.1.2 Develop a scientific risk management plan: based on past experience, combined with the current situation of emergency care, develop a practical risk management plan, clear objectives and measures, and organize the implementation.
2.2 Improve the emergency risk management rules and regulations: On the basis of adhering to and implementing the daily nursing work system, we should focus on improving the following systems in a targeted manner.
2.2.1 Risk identification and monitoring system: through investigation and research, to keep abreast of the emergency nursing staff's ideology and morality, business skills and other conditions, and timely grasp of the psychological state of patients and their relatives. 2.2.2 Risk analysis and declaration system: once the nursing risk occurs, the person concerned must declare in accordance with the requirements of the regulations, and the head nurse should organize the risk management team members to identify, evaluate and assess.
2.2.3 Risk prevention system: in order to prevent the occurrence of nursing risks, in the clinical care of emergency, we must urge nurses to make sure that they strictly implement the nursing operation norms, and resolutely implement all safety and quality management measures.
2.3 Improve the overall quality of nursing personnel: the success or failure of risk management is closely related to the quality of people [3]. Emergency nursing risk management should also implement the principle of people-oriented.
2.3.1 Strengthen the risk awareness of nursing staff: to strengthen the risk awareness education for nurses, combine nursing risk with the sacred duty of saving lives and respecting the legitimate rights and interests of patients, so that each nurse has a correct understanding of nursing risk.
2.3.2 Strengthen the nursing staff's business training: timely mastery of new nursing technology, constantly charging, updating understanding. Especially to enhance the training of emergency response ability.
2.3.3 Strengthen nurses' awareness of self-protection and risk awareness: in emergency management to strengthen nursing risk education, targeted learning related laws and regulations and hospital rules and regulations, firmly establish the quality and safety first, service first, patient first and the concept of nursing according to the law, the error will be eliminated in the bud, to provide safe care for patients.
2.4 Nursing staff with good verbal communication skills: good verbal communication is the basic requirement for the quality of emergency department nurses, requiring nurses to give understanding to different patients, tolerance, empathy for the patient's pain, avoiding hard language and cold expression, with a high degree of responsibility, responsive, calm and collected.
2.5 Emergency rescue room of all kinds of drugs, items, equipment in place: intact and spare, require every shift to check all the rescue instruments, to ensure that the instrument integrity rate of 100%, the required items are well-prepared, the patient arrives at the department to actively organize the rescue of the nursing staff to formulate a comprehensive nursing plan, the implementation of the article by article.
2.6 emergency department nurses should strengthen the prudent cultivation, enhance self-discipline: emergency department nurses regardless of when, where and what kind of situation should strictly implement the nursing system, operating procedures, seriously implement the three checks and seven pairs, and closely observe the changes in the condition of the patient infusion.
Nursing safety management is an art, the need for continuous summary in practice, continuous learning, safety is the basic needs of people, but also the basic needs of nursing, the establishment of sound rules and regulations, job responsibilities and work standards, mobilize nurses to work actively, creativity, to ensure the quality of clinical care, to strengthen the risk of education in the clinical work, everyone has to carry out the various work systems and operating procedures, to prevent problems before they occur. In the clinical work to strengthen risk education, everyone should implement the work system and operating procedures, to do to prevent problems before they occur, to provide security for safe nursing.
References
[1] Xie Xiaohong. Analysis and countermeasures of emergency nursing record defects. Chinese Journal of Malpractice, 2004, 1(1):143
[2]Xie Hongli, Zhang Xiuhua, Wang Aihua. On the Principle of Legal Holding in Dealing with Medical Disputes. China Hospital Management, 2003, 23(6):32
[3] Dong Aizhu. Survey and analysis of nursing staff's awareness of safety management. Chinese Nursing Journal, 2004, 39(3):194-196