Second, the characteristics of nursing practice risk: most of the medical disputes are more or less with the nursing work has a certain relationship with the nursing accident occurs alone, nursing accidents, nursing accidents tend to cause serious consequences, nursing disputes are very troublesome to deal with.
Third, nursing behavior and the relationship between the risk of practice
Nurses are both the basic power of clinical treatment, but also health education, medical services, an important force; both the specific implementation of medical advice, but also the doctor's close cooperation, but also the observation of the condition of the "sentinel". Due to the nursing work with continuity, dynamics, directness and specificity, nurses and patients contact the earliest, the opportunity is also the most, so the nurse's many nursing behavior constitutes a lot of risk factors.
Four, the nurse practice risk factors (a) the nurse practice obligation risk 1, there is no nurse practice certificate or practice certificate has not changed. 2, the failure to implement the provisions of the regulations and diagnostic and treatment specifications.
3, patient emergencies did not implement the necessary emergency care. 4, there is a problem with the medical advice: do not report still implemented. 5, the patient does not respect the patient's home address, telephone and other privacy.
6, disobedience to the health authorities or the arrangements of the medical and health institutions, to participate in medical rescue and other emergencies. (B) nursing operation risk 1, injection, infusion, blood transfusion, etc.:
(1) fluid leakage, surrounding skin, tissue necrosis, limb necrosis amputation 。。。。。 (2) Transfusion of the wrong fluid, transfusion of the wrong blood. The occurrence of blood transfusion reaction, fluid transfusion reaction or drug reaction can not be handled in time. (3) Taking the wrong medicine.
2, the nurse unauthorized to acquaintance injection, infusion. Patient procedures are incomplete, no medical records, can not prove that once the patient anaphylactic shock adverse consequences, the medical side is difficult to prove and face legal liability.
3, patients bring their own medicine problem risk: not only to adhere to the principle, the implementation of operational standards, but also focus on humanization. Patients bring their own medicine, the need for nursing staff to perform, should be informed of the risk of patients bring their own medicine, and sign the "patients bring their own medicine risk notification letter", while carefully checking the drug packaging, batch number, date, the appearance of the drug quality, and to strengthen the observation of the medication after use.
4. Pressure ulcers occurred during the hospital period when nursing measures were not in place, leading to complaints. 5、Disinfection and isolation measures are not implemented leading to the occurrence of nosocomial infections.
6, blind implementation of verbal medical advice, make-up notes are not timely, inaccurate, there is generally a dispute, the nurse can not provide effective evidence to defend themselves. (C) Nursing safety management risk 1, the risk of the patient's daily life: falls, falling out of bed, pressure sores.
2, the patient out of the risk: the patient shall not go out without authorization, do the examination, consultation allowed to go out, pay attention to the arrangement of accompanying personnel.
The risks of patients going out without authorization include: (1) potential disease outbreaks leading to sudden death of the patient; (2) traffic accidents resulting in disability or death of the patient; (3) the risk of patients committing other acts of misconduct. 3, the risk of theft of patients' belongings
(1) whether the nurse told the patient shall not bring valuables, a large amount of cash to the ward; (2) the hospital range of necessary security measures. 4. Potential risks of patient discharge
(1) The lack of written health education for discharge leads to binge drinking and relapse of the patient. (2) For the dead patient's body care: wound exposure and other family dissatisfaction. (5) Lost specimens, specimens not examined fee has been collected.
6, poorly kept medical records, incomplete page numbers, lost. 7, nursing record alteration, handwriting is not clear, record is not timely. Risks associated with poor management of medical equipment and environment
8, poor management of medical equipment. Such as in the use of medical equipment, medical materials, did not find quality problems or take a chance on the use of bad equipment, materials or environmental management defects arising from the quality risk.
Nursing risk prevention countermeasures (a) strict implementation of the provisions of the nurse practice 1, nurse practice qualification 2, fulfillment of the relevant duties of nurses (b) to reduce the occurrence of nursing operation risk
1, learning and mastering of the relevant departments issued by the operating procedures, such as the shift handover system, the checking system, the three-tier nursing system and the ward management system, etc.. 2、Centralized training for nursing staff to enhance the rescue and special event reporting and handling system.
3, the careful implementation of systems, routines, plans, etc., patients with transfusion reactions or drug reactions, timely reporting and treatment. Emergency treatment of blood transfusion reaction of hospitalized patients, drug reaction (allergy) emergency treatment, and so on.
4, improve communication with patients' families, strengthen the notification, sign the "pressure ulcer prevention risk notification letter", the establishment of the "bedsore patient turning card".
5, strengthen the management of medical records, medical institutions and their medical staff should be confidentiality of patient privacy. Disclosure of patient privacy or without the consent of the patient to disclose their medical records, causing damage to the patient, shall bear tort liability. Modification of the existing case cabinets, nurse station medical records should be strengthened anti-theft measures.
6, outgoing workers should strengthen the standardization of training, delivery of specimens should be timely, correct, and fulfill the signature system.
7, discharge instructions in place. Verbally informed of the do's and don'ts, defects: difficult to obtain evidence, passive in litigation, if necessary, verbal information can be converted into written information. 8, strengthen the concept of asepsis and the implementation of sterilization and isolation measures.
(C) to strengthen nursing safety management 1, strengthen the study of nursing technology, mastery of nursing theory and skills, to minimize the technical risks. Therefore, medical equipment needs to be managed by a person in charge, and the equipment needs to be checked regularly to see if it is in good condition.
2, nursing care needs to be in accordance with the requirements of the nursing level of regular ward rounds, more communication with patients, and timely treatment of potential problems, but also need to hold a rigorous work style, in the post requirements to ensure that energetic, fully committed. 3, the implementation of medical advice seriously
"Three checks and seven right" to maintain a clear and flexible mind, the use of mastery of knowledge and experience, to critical thinking work. 4, carefully study the "nursing document writing norms", strengthen specialized theoretical learning, objective, timely and accurate records of nursing documents.
5. Build a non-punitive nursing safety culture and take the initiative to report adverse events. Actively advocate, encourage health care workers to take the initiative to report adverse events, through learning "mistakes", improve the ability to identify "mistakes" and "immune" ability, through the hospital in the process of quality management and continuous improvement activities. Through the process of hospital quality management and continuous improvement activities to enhance the ability to protect patient safety.