Work experience in orthopedics (1) Over the years, under the leadership of the nursing department and with the joint efforts of all nurses, we have been busy for 20XX years and successfully completed the work plan at the beginning of the year. Our work in the past year is summarized as follows:
First, carry out quality care.
With the strong support of leaders at all levels in the hospital and the guidance of the nursing department, patients' satisfaction, society's satisfaction, government's satisfaction and nurses' satisfaction were achieved by standardizing clinical nursing work, optimizing nursing work mode, implementing nursing classification management, implementing the responsibility from beds to people, effectively implementing various diagnosis and treatment measures for patients, solidly promoting the development of quality nursing services, and continuously improving patients' satisfaction.
1, optimize the nursing mode and implement the nursing responsibility. By strengthening the training of all staff, fully understand the importance of nursing reform, create a good working atmosphere for the implementation of the demonstration project of general quality nursing service, optimize the workflow, reform the working mode, implement flat management, and the nursing team leader is fully responsible for implementing the nursing work of this group; The responsible nurse grasps the patient's condition, implements basic nursing measures and fully understands the patient's needs. According to patients' condition, nursing difficulty and technical requirements, the head nurse assigns patients with different severity to nurses with different energy levels for nursing, and each nurse in charge is responsible for about 10 patients on average, which fully embodies the value of nurses while ensuring the quality of nursing and makes nurses see the prospect of career development.
2. The head nurse's on-site management has achieved remarkable results in five rounds. Early rounds: pay attention to the quality of night care after work; Ward rounds after medical orders are issued: focus on the implementation of medical orders and the implementation of nursing measures; Ward round at noon: check whether the patient's meals and therapeutic diet meet the treatment requirements before going to work in the morning; Ward rounds after work in the afternoon: check continuous work; Night rounds: check the handover records of critically ill patients, surgery, blood transfusion and other patients before going to work in the afternoon. Through five rounds of patient-centered and problem-solving on-site management mode, supervise the implementation of basic nursing work, timely fill in the gaps, and pay attention to patients, environment, equipment, doctor's advice and other issues; An important handover book has been established to achieve full, comprehensive and professional seamless service. 3. Implement high-quality service, enhance nursing connotation, collect feedback from patients regularly, and publicize grading nursing standards at nurse stations; Strengthen the visiting time and system of missionaries, ensure professional nursing and optimize the order of wards. Implement personalized nursing to give full play to patients' autonomy and participation. Nurses in bed management always guard patients, stay close to patients, highlight the characteristics of specialized nursing, and do a good job in perioperative health guidance. Implement the core system, establish and improve the ward safety warning signs. Attach importance to the first communication, strengthen the communication in key links, and establish a harmonious doctor-patient relationship and nurse-doctor relationship. 4. Implementing flexible scheduling and improving performance appraisal In order to tap the potential of human resources and meet the needs of practical work and patients, a flexible scheduling system for nursing staff was implemented. The head nurse set up a shift appointment book to solicit nurses' wishes. When the peak period of treatment and nursing or the nursing workload increases sharply, the head nurse starts the nurse deployment plan and adjusts the nurse shifts in emergency to ensure the safety and quality of nursing in emergency. The implementation of linking work quality with performance appraisal has aroused nurses' work enthusiasm, discovered nursing safety hazards in time and eliminated them in the bud.
Second, nursing safety management
Orthopedic patients who stay in bed for a long time are prone to dysfunction and various complications, some of which are patients with advanced bone metastasis. Therefore, orthopedics has become a high-incidence department of medical disputes. Nursing safety management is the focus of work, and detail management permeates every quality standard.
1, to ensure the continuous improvement of nursing quality, set up four quality management teams in health education, nursing medical record writing, disinfection and isolation, and basic nursing, and record and summarize the problems found in time. Accept the irregular inspection by the quality inspection team of the nursing department and the sensory control department every month, and the head nurse inspection team of the whole hospital will check it in the middle, evening and night every month, and pay attention to the inspection results. The head nurse went deep into the ward to check with the staff on duty, and held a nursing quality and safety analysis meeting in time for a series of problems found in the inspection.
Manage defects and errors, analyze the causes, formulate corrective measures and supervise their implementation to ensure the continuous improvement of nursing quality.
2. Management of key periods, key links, key personnel and special patients
Key time periods refer to shift change time, afternoon shift, night shift, rest days and holidays. There are very few employees these days. Nurses are prone to mistakes. Patients are prone to dissatisfaction. The key links are busy and intensive links such as preoperative, postoperative, severe illness and rescue. Key personnel refer to critically ill patients, surgical patients, patients with special changes in their condition, as well as new nurses, senior nurses and nurses who often make mistakes; Special patients refer to patients who have changed their major and transferred to other hospitals, patients who have medical disputes or opinions, patients who are taken care of by leaders, and patients who are known by our hospital staff. Practice has proved that these people often have unsafe factors. Head nurses should strengthen follow-up inspection, rationally allocate nursing human resources and ensure the quality of work in all links.
Three, disinfection and isolation, hospital infection control work
Regularly conduct disinfection and isolation training for doctors and nurses in departments, standardize the management of medical waste classification, collection, storage, packaging, transportation and handover registration, and prevent infection outbreaks caused by poor management of medical waste. Check the quality of work irregularly.
Fourthly, standardize the writing of nursing documents and strengthen the consciousness of nursing legal system.
Organize general nurses to repeatedly study the requirements of Gansu province's nursing medical record writing standards, and implement the recording methods of three-test sheet, long-term temporary doctor's order, nursing record sheet, operation and change of major sheet, and ward nursing handover report according to the actual situation of the hospital. Make nurses more clear about the significance of writing nursing documents, standardize nurses' behavior, simplify nursing writing, return time to nurses, turn nurses into patients and improve nursing quality.
Five, open source and reduce expenditure, improve economic efficiency.
Increase income: follow the business philosophy of maximizing social benefits and rationalizing economic benefits, master various charging standards skillfully, and carry out nursing services, such as arteriovenous foot pumps. In addition, minimize the waste of water and electricity, all kinds of disposable consumables and medicines, and pay special attention to the repair and maintenance of medical equipment in the department to ensure normal operation and create the greatest economic benefits for the department.
Six, ward management
Nurses' participation in ward management is the content and requirement of the handover system. This work will be put forward as the focus of next year's work in the plan, and specific work requirements will be put forward for nurses.
Experience of orthopedic work (II) Based on the principle of patient-centered and patient-centered, under the leadership of the nursing department and with the joint efforts of all nurses and sisters, the work plan was successfully completed.
First, quality care.
With the strong support of leaders at all levels in the hospital and the guidance of the nursing department, patients' satisfaction, society's satisfaction, government's satisfaction and nurses' satisfaction were achieved by standardizing clinical nursing work, optimizing nursing work mode, implementing nursing classification management, implementing the responsibility from beds to people, effectively implementing various diagnosis and treatment measures for patients, solidly promoting the development of quality nursing services, and continuously improving patients' satisfaction.
1. Optimize nursing mode and implement nursing responsibility.
By strengthening the training of all staff, fully understanding the importance of nursing reform, creating a good working atmosphere for carrying out the demonstration project of general quality nursing service, optimizing the workflow, reforming the working mode, implementing flat management, and the nursing team leader is fully responsible for implementing the nursing work of this group; The responsible nurse grasps the patient's condition, implements basic nursing measures and fully understands the patient's needs. According to patients' condition, nursing difficulty and technical requirements, the head nurse assigns patients with different severity to nurses with different energy levels for nursing, and each responsible nurse is responsible for about 8 patients on average, which fully embodies the value of nurses while ensuring the quality of nursing and makes nurses see the prospect of career development.
2, the head nurse on-site management, five rounds achieved remarkable results.
Early rounds: pay attention to the quality of night care after work; Ward rounds after medical orders are issued: focus on the implementation of medical orders and the implementation of nursing measures; Ward round at noon: check whether the patient's meals and therapeutic diet meet the treatment requirements before going to work in the morning; Ward rounds after work in the afternoon: check continuous work; Night rounds: check the handover records of critically ill patients, surgery, blood transfusion and other patients before going to work in the afternoon. Through five rounds of patient-centered and problem-solving on-site management mode, supervise the implementation of basic nursing work, timely fill in the gaps, and pay attention to patients, environment, equipment, doctor's advice and other issues; An important handover book has been established to achieve full, comprehensive and professional seamless service.
3. Implement high-quality service to enhance nursing connotation.
Collect patients' voices regularly, and publicize grading nursing standards at the nurse station; Strengthen the visiting time and system of missionaries, ensure professional nursing and optimize the order of wards. Implement personalized nursing to give full play to patients' autonomy and participation. Nurses in bed management always guard patients, stay close to patients, highlight the characteristics of specialized nursing, and do a good job in perioperative health guidance. Implement the core system, establish and improve the ward safety warning signs. Attach importance to the first communication, strengthen the communication in key links, and establish a harmonious doctor-patient relationship and nurse-doctor relationship.
4. Implement flexible scheduling and improve performance appraisal.
In order to tap the potential of human resources and meet the needs of practical work and patients, the flexible scheduling system for nursing staff was implemented. The head nurse set up a shift appointment book to solicit nurses' wishes. When the peak period of treatment and nursing or the nursing workload increases sharply, the head nurse starts the nurse deployment plan and adjusts the nurse shifts in emergency to ensure the safety and quality of nursing in emergency. The implementation of linking work quality with performance appraisal has aroused nurses' work enthusiasm, discovered nursing safety hazards in time and eliminated them in the bud.
Since the development of high-quality nursing service, general nurses have improved their understanding and changed their service concept. Flat bed management makes the relationship between doctors and patients closer and more harmonious. The responsibility of nurses is in place, which increases the patient's sense of security; The number of calls is reduced, and the optical response time is shortened; Continuous, full and comprehensive nursing service organically combines basic nursing with specialized nursing, promotes patients' recovery as soon as possible, and wins the trust of patients. The satisfaction rate of patients in nursing department is over 99%.
Second, nursing safety management
Orthopedic treatment has high transparency, and patients are prone to dysfunction and various complications, as well as car accidents and work-related injuries. It is prone to legal problems, so orthopedics has become a high-risk department for medical disputes. Nursing safety management is the focus of work, and detail management permeates every quality standard.
1, in order to ensure the continuous improvement of nursing quality, four quality management teams were established, including health education, nursing medical record writing, disinfection and isolation, and basic nursing, with ten head nurses as team leaders. Record and summarize the problems found in time. The head nurse and the attendant went deep into the ward for examination, and held a nursing quality and safety analysis meeting in time for a series of problems found in the examination. In view of nursing defects and errors, analyze the reasons, formulate rectification measures and supervise their implementation to ensure the continuous improvement of nursing quality.
2. Management of key periods, key links, key personnel and special patients
Key time periods refer to shift change time, afternoon shift, night shift, rest days and holidays. There are very few employees these days. Nurses are prone to mistakes. Patients are prone to dissatisfaction. The key links are busy and intensive links such as preoperative, postoperative, severe illness and rescue. Key personnel refer to critically ill patients, surgical patients, patients with special changes in their condition, as well as new nurses, senior nurses and nurses who often make mistakes; Special patients refer to patients who have changed their major and transferred to other hospitals, patients who have medical disputes or opinions, patients who are taken care of by leaders, and patients who are known by our hospital staff. Practice has proved that these people often have unsafe factors. Head nurses should strengthen follow-up inspection, rationally allocate nursing human resources and ensure the quality of work in all links.
3, pay attention to first aid and emergency training.
In view of the fact that there are many orthopedic patients in car accidents and many emergency patients during doctors' operations, an emergency reporting system and various emergency plans are formulated to improve the emergency capacity of soil conservation. Improve the training of nurses' first aid skills, and take various forms to carry out first aid procedures, cardiopulmonary resuscitation, first aid knowledge, first aid equipment use training, etc. Rescue instruments, medicines and emergency equipment should be checked daily by special personnel and maintained in time to ensure that they are in standby state at any time.
In recent years, we have made some achievements, which are inseparable from the leadership and guidance of the nursing department. We still have many shortcomings, but we are not proud or discouraged. Let patients' needs become the driving force of nursing professional innovation. Only by doing things carefully can we do a good job in nursing. In the new year, taking the high-quality nursing service activities as an opportunity, we should build a brand of nursing service and a nursing culture of caring for happy work, strive to build a high-quality and efficient clinical nursing team, and make nursing work to a new level.
Experience of Orthopedic Work (III) In the new year, with the improvement of department conditions, higher requirements are put forward for nursing work. We should take this opportunity to pay close attention to the quality of nursing service, strictly implement rules and regulations, strengthen professional and technical training and build a high-quality nursing team. Around the overall goal of the nursing department, orthopedics has formulated the following work plan:
First, highlight professional characteristics and build a nursing brand.
As a professional and technical industry, it is the top priority of orthopedic nursing to find a correct position in opportunities and challenges and take the road of professional construction. Focus on training 3 responsible nurses in the department to guide patients to carry out functional exercise. Further improve the means and methods of functional exercise guidance and adopt various forms of education to achieve results. It is planned to formulate functional exercises for common orthopedic diseases in 2000, and make a book with color pictures to let patients better understand the significance and methods of functional exercises.
Second, do a good job in quality management.
1, aiming at the difficulties and key issues in nursing work, set the work focus, and insist on integrating the patient-centered humanistic nursing concept into more practical and specific work details.
2. Carry out, permeate, run through and implement standardized nursing quality standards in the whole work of each nurse, so as to make nursing quality management rule-based and form a virtuous circle. Evaluate the quality of nursing from the patient's point of view, and take the patient's satisfaction as an important index to evaluate the quality of nursing, so that patients can really benefit from quality management.
Third, conduct standardized training.
1, cooperate with the nursing department to establish standardized training for nurses. Nurses with different seniority and ability have different training, so that everyone can develop the habit of active learning.
2. Continue to pay special attention to specialized knowledge training, improve nurses' professional quality, adopt effective learning methods such as nursing business rounds and bedside demonstrations, and improve the form of business rounds. Let experienced old nurses give lectures to new nurses and impart nursing experience. When the concept is vague, let's discuss and solve the problem together.
3. Conduct bedside nursing rounds every day, conduct secondary business study every month, conduct nursing operation demonstration and assessment once a month, and conduct teaching rounds once a month.
4. Encourage all nurses to participate in training inside and outside the hospital, exchange experiences and learn new technologies and knowledge.
Fourth, sort out the nursing process and inform.
1, a reasonable nursing workflow is the basis for the smooth development of daily work. There should be a reasonable workflow to guide the daily work of nurses in basic nursing, specialist nursing and health education. It is planned to refine each link on the basis of the existing workflow of undergraduate course, which is truly in line with the actual clinical work and feasible.
2. Effective nursing notification is necessary for patients to cooperate. We will improve admission notice, posture, treatment, special precautions and specialist rehabilitation.
Five, earnestly implement the patient-centered service.
Complete the change of nurses' concept and change the past service into service. Improve nurses' etiquette and build their own nursing brand. Patient-centered service is specific to every detail of nursing behavior. Establish standards for every work link from admission to discharge.
Sixth, cultivate excellent teams.
Discover the advantages of nursing staff in departments, use their advantages to guide their work and give full play to their personal specialties. To establish team spirit, we should let them make achievements in collaborative work and give full play to their personal strength.
Let everyone participate in management to enhance their sense of responsibility and ownership.
Seventh, do a good job in information transmission and document arrangement.
Every time I attend the morning meeting on the second day of the hospital meeting, I will convey the original content, and the department staff will convey and sign in. Store the distributed documents in categories for reference. It is planned to designate a special person to manage these documents. Strive to keep pace with hospital thought and actively integrate into hospital culture construction.
Eight, to carry out the cost-benefit study of nursing.
Avoid the idleness and waste of resources, improve the utilization rate of resources and rationally allocate nursing resources. Quantitative analysis can provide more health services suitable for social needs with as little manpower and material resources as possible, and achieve better economic and social benefits.
I recommend it carefully.