1 quality control management methods
1.1 Reform of the management organization of the operating room The operating room work is different from the ward nursing work, it has 11 surgical specialties, surgical types, work is busy, the original chief of nurses both to participate in the operation and management of the work of the whole department, inevitably there is a place to manage, and is now divided into thoracic surgery group, General Surgery Group, Urology Group, Orthopedics Group, Neurosurgery Group, Obstetrics and Gynecology Group, Plastic and Reconstructive Surgery Group, Pentacameral Surgery Group, Ophthalmology Group, 9 specialty groups, each group set up a group leader, group members rotate every year, the leader does not change. The nine groups are divided into three management districts with three district chiefs, and these group chiefs are respectively served by the chief nurse or nurse practitioner in charge, and the district chiefs are served by the senior group leader and the nurse practitioner in charge, and are rotated once every six months, so that the group chiefs and the district chiefs are all involved in the management of the department. In other words, we will change the management from nurse manager to three-level management of nurse manager, district manager and team leader. Once a month, we organize the district chiefs and the core group of staff in the department to conduct a random inspection of the quality control work, and evaluate the work of the three management districts and the professional groups. On weekdays, the head nurse conducts random checks of work according to quality control standards. The district manager is responsible for gatekeeping when the nurse manager is not on duty.
1.2 Management methods of quality control In order to ensure the safety of the patient's operation, the operation is centered on the double three passes. The first three passes, that is, preoperative preparation pass, intraoperative cooperation pass and postoperative treatment pass: medical education network www.med66.com
(1) preoperative preparation pass, to do the "eight checks", check the patient's name, gender, department, surgical diagnosis, name of the operation, surgical site, blood type, items prepared;
(2) intraoperative cooperation, to achieve three strict, that is, strict aseptic technical procedures, serious work attitude, to prevent the occurrence of errors and accidents;(3) postoperative treatment, to achieve "three", that is, the fixed object, fixed quantity, positioning.
The second three passes are the three passes before surgery:
(1) After the mid-shift personnel receive all the patients into the operating room, the mid-shift nurse checks one by one the operating room according to the notification form and scheduling table;
(2) The roving nurse checks the preoperative medical instructions according to the operating notification form and the medical record and checks the preoperative medical instructions implementation;
(3) The medical education network www.med66.com
(3) before the operation, the head nurse again check. These three passes are mainly aimed at bringing the patient to the wrong operating room, opening the wrong knife measures taken.
1.3 Methods of assessing quality of work Quality spot-checks are mainly carried out by the head nurse or the general nurse (or individual district managers) on a daily basis in accordance with the duties of nurses and quality standards, which include: sterilizing and isolating, resuscitating items, positioning of items in the operating room, cleanliness and hygiene, and duties of each shift. Spot check results in the morning meeting the next day to evaluate, and good management of the district manager, team leader and good work done comrades at the meeting to give praise, encouragement; on the existence of problems, at the end of the month and individual nursing assessment and bonus linked to the month.
1.4 Awards and penalties Management of good work of the district manager, a monthly bonus of 3 points, the work of each class duties to complete a good nurse monthly bonuses of 100%, the quality of work to complete the lack of nurses monthly bonuses of less than 100%, the end of the year reward for the year's work completed by the head of the team and the team members (funding from the Director's Fund). Bonus distribution program 10% for the title award, 90% for the performance award, the work done well or poorly in the performance of the award reflects the deduction of 1 point that is 1% of the bonus.
The duties of each class inspection items and demerit points standard see Table 1 ~ 3.
Table 1 hand washing roving nurse work quality standards
Inspection items demerit points standard demerit points description
Instrumentation with complete preparation 1 ~ 3 points with incomplete. Damage and loss
Thorough cleaning of instruments 1 point Bloodstains found on instruments
Complete registration of retained specimens 1 point One point is not enough
Careful counting of instruments on the dressing boards 1 point One point is not enough
Items are placed according to their position: suction apparatus, electrocautery burner, stools, etc. 1 point One point is not enough
Table 2 Quality standard of work of nurses in preparation of instruments
Check items Marking scheme Marking scheme Description
Table 2 Quality Standards for Instrument Preparation Nurses
Standard of Deductions for Checking Items Description of Deductions
Accurate preparation of instruments with good performance 1 point 1 failure. Failure to prepare major instruments that affect the operation for 15 minutes is considered an error
100% pass rate of sterile items 1 point One expired item was found
Sterile items are placed in a neat and orderly manner, and are checked regularly 1 point Disorderly placement, not in order
Regularly replace items and record the time 1 point One item is not sufficient
Table 3 Quality standard of cleanliness and hygiene work
Inspection items Deduction standard Deduction description
Operating room hygiene daily three sweeping and three mopping 0.5 points a do not do enough
Cleaning and mopping of the operating room at the end of the operation 0.5 points hygiene is not thorough
Ensure that the shadowless lamp, operating beds, doors, windows and footstools 0.5 points a place to fail
No blood stains and dust
Organization and discipline
The quality standard for hygiene work. Deduction standard: 0.5 points for leaving early or arriving 5 minutes late. Duty hold their posts, those who leave their posts without any reason, according to the severity of the situation, delayed patient rescue, from the strictest to the heaviest treatment, deducted 1 to 3 months of bonuses. Absenteeism 1d, deductions for the month bonus.
2 results
Our department through the above methods of quality control management, operating room nursing quality assessment for three consecutive years won the first place in the hospital rooms, get the Department of the monthly 5% bonus floating award.
3 experience medical education network www.med66.com
To grasp the quality management of the department, it is necessary to carry out reform of the personnel system. In the past, regardless of the big, small, business, administrative matters, are handled by the head nurse, busy all day long in the big and small things, but also personally participate in the operation, a hospital inspection and evaluation, not health is not thorough, or the staff of all classes of responsibility to answer the unskilled, the ability to cope with the stress is not good. After repeated discussions by the core group of the department, from a single nurse management to the chief nurse, district chief, team leader three-level management, play the role of senior nursing backbone management, to achieve both division of labor and cooperation, layer by layer, technical operations, business to find the district chief, team leader. Nursing director usually from time to time to spot check the work duties of each class, more questions, so that the staff can be in a state of stress, do ask questions, busy but not chaotic, so that the system has been implemented, the management of the department to achieve standardization and standardization of the work of the hospital, the Ministry of Nursing at any time to spot check the work of the operating room environment are to maintain a clean and tidy, nursing care in a neat and orderly manner. Medical education network www.med66.com
The duties of each class are linked to the bonus, so as to reward hard work and punish laziness, reward and punishment are clearly distinguishable, and fully mobilize and give full play to the enthusiasm of nurses. Before the duties of each class are not linked to the bonus, the work is good or bad, more or less the same, the end of the month the average bonus, the enthusiasm of the staff is not high. Since the development of a system of rewards and penalties, and the monthly nursing assessment and bonus linked to the work of the class duty to complete a good or bad, can be reflected from the bonus and nursing assessment, a task, comrades are scrambling to do.
In order to ensure the safety of the patient's surgery, strictly put the surgery double three pass. We are in view of other medical units due to the check is not strict, resulting in the wrong patient with the wrong knife serious lessons. Therefore, we believe that as long as the strict implementation of this checking system, it is possible to prevent the occurrence of medical errors.