Clinical practice is the last stage of nursing teaching, and the quality of clinical teaching determines whether nursing students can successfully embark on nursing posts and adapt to nursing needs after clinical practice. The emergency department is the department with the heaviest patients, the most diseases and the heaviest rescue management task in the hospital, and it is the only way for all emergency patients to be admitted to the hospital. Changping Hospital is a general hospital, and the emergency department has specialist clinics for internal medicine, surgery, gynecology and pediatrics. Therefore, the work of the emergency department can be said to be the epitome of the overall work of the hospital, which directly reflects the emergency medical situation of the hospital. The quality of nursing work in emergency department and the quality level of personnel are different from those of nursing patients in other disciplines, which requires nursing students to have all kinds of first aid knowledge and operation, and has the characteristics of wide knowledge and strong comprehensiveness. According to the above characteristics, the clinical teaching methods in emergency department are explored, and the teaching experience is summarized as follows:
First, the teaching objectives:
Arrange special lectures according to the objectives, familiarize yourself with the department environment, and practice theory and nursing techniques before the end of the internship.
1, professional knowledge objectives are:
(1) Master the working system of intensive care.
(2) master all items, medicines and equipment in the emergency room, and achieve "five decisions"
(3) Master the use methods and precautions of various first-aid instruments.
(4) to master the use, dosage, administration method and toxic and side effects of various first-aid drugs.
⑤ Master the confidential medical system and communicate effectively with patients or their families.
⑥ Be familiar with the writing of rescue records, the cooperation in the rescue of critically ill patients and the observation of their condition.
2, the goal of skill operation is:
① Master CPR.
② Grasp the cooperation of tracheal intubation.
③ Master gastric lavage (manual and electric)
(4) Master the operation techniques such as oxygen inhalation and sputum aspiration.
⑤ Be familiar with the on-site rescue and treatment of "120".
Second, teaching methods:
1, warm reception:
Most students, from students to nurses, can't adapt to their new roles. Teachers should help them overcome psychological barriers, communicate with students in time, establish a good teacher-student relationship and study happily. Therefore, on the 1 day when nursing students enter the department, the teacher will warmly receive them, introduce the undergraduate situation, get familiar with the department environment, layout, goods placement, rules and regulations, class responsibilities, and eliminate strangeness.
2, the class division of responsibilities:
Familiar with the various responsibilities of the department, on the basis of completing the duties of the class every day, all kinds of nursing and learning for other patients will be carefully checked and guided by the teaching teacher.
3, theoretical training:
Generally, the head nurse or nurse in charge is responsible for giving lectures once a week, mainly to rescue patients' cases, so that nursing students can understand the causes, clinical manifestations, rescue methods and nursing points of acute and critical diseases, and they are required to master the operation techniques of various surgical first aid, the use of instruments and the use, dosage, administration methods and side effects of first aid drugs. Guide nursing students to combine theoretical knowledge of various disciplines with clinical practice and quickly improve their comprehensive theoretical level.
4, specialist technical training:
Let nursing students know that emergency patients should focus on the word "urgency", master the principle of giving priority to emergency patients, master cardiopulmonary resuscitation with models, independently cooperate with teachers to complete oxygen inhalation, sputum aspiration and ECG monitoring under the guidance of teachers, and strictly implement the system of three checks and seven pairs and various operating procedures in their work.
5, master communication skills:
Grasping the role of confidential medical system, emergency patients are generally urgent or critical, and disputes between doctors and patients are more likely to occur in this case. How to communicate effectively with patients or their families plays a decisive role. We can strengthen the language expression ability and communication ability of nursing students through special lectures, empathy and other forms to gain the trust and cooperation of patients (family members).
6, strict examination:
In the last week, the nursing students were given basic technical operation and theoretical examination. The examination content includes the theoretical knowledge of emergency department and common nursing operation techniques. The results are recorded in the appraisal form of nursing students, and the teaching teacher carefully fills in the internship appraisal, seeking truth from facts and making a comprehensive evaluation of nursing students.
7, evaluation of teaching quality, summing up experience and shortcomings:
After the internship, the nursing students were called to hold a summary meeting, pointing out the shortcomings and suggestions of the teaching teachers, and at the same time, the teaching teachers commented on the performance of the nursing students during the internship. Learn from each other so that teachers and nursing students can be further improved at the same time.
8. Stage summary:
After each round of teaching for nursing students in all subjects, the teaching teacher should conscientiously sum up the experience and shortcomings of this round of teaching, and at the same time adopt the reasonable opinions and suggestions of the students, sum up the achievements and improve them in time.
Third, experience:
The emergency department is the department with the heaviest patients, the most diseases and the heaviest rescue and management tasks in the hospital. It is seriously ill (all kinds of trauma and compound injuries), and there are many scenes that are difficult for ordinary people to accept. It is inevitable that nursing students will have fear when they first arrive. In view of this situation, we require teachers not only to have solid theoretical knowledge and clinical experience, but also to care about the psychological endurance of nursing students, and to guide them correctly through seminars, so that their psychological impact can be alleviated, and at the same time, let them realize that everything medical treatment does is to give patients hope again. Let nursing students learn to decompress and treat every patient with love while learning various first aid techniques. Using the above scientific teaching methods, our clinical teaching quality has been significantly improved.
Summary of Nursing Work in Emergency Department (Ⅱ)
Time flies, time flies, 20XX is coming to an end. Looking back on this year, under the leadership of the new xx Hospital and the correct leadership of hospital departments, nursing departments and department directors, the majority of nursing staff have made great efforts in service process, service attitude and service concept. Under the influence of the company's cost storm, Qi Xin made concerted efforts to actively save energy and reduce consumption, reduce costs, and improve the economic and social benefits of hospitals and departments. The work in the whole year was basically completed as planned, but there are still many shortcomings. The nursing work throughout the year is summarized as follows:
1. Workload statistics (the following units are all person-times) Remarks: As of 20xx165438+1October 25th.
Total infusion times intramuscular skin test Intravenous oxygen inhalation intubation enema gastric lavage and sputum aspiration.
30359 14584 8898 834 486 30 1 1 1 1 5
Blood drawing 120 Interview to rescue the deceased's medical records, aerosol inhalation, triage, vital signs and finger blood sugar measurement.
183 86 185 1 1 83 4230 3284 14532 2 16
2. Under the influence of the company's cost storm, the department has made great efforts to attach importance to cost management and minimize the use of low-value consumables. Everyone starts with saving a drop of water, electricity and a piece of paper, turning off the fan air conditioner, closing the doors and windows, and preventing fire and theft.
3. All the nursing staff carefully studied the contents of the "5.7 Revitalization Action Plan" speech. With the reform of municipal medical insurance system and the continuous acceleration of the company's divestiture and diversion of hospitals, everyone's sense of crisis has been greatly enhanced, with positive thoughts, energy saving and consumption reduction, and improved service attitude. They have learned the relevant knowledge of municipal medical insurance, established a new image, and improved economic and social benefits for departments and hospitals.
4. In welcoming the inspection work of Wulidian Community Health Service Center, we should unite as one and make good preparations for various materials, such as completing the basic health survey of community residents. Practice operation skills hard. Complete the relocation and transformation of the treatment room around the inspection work. Further standardize the operation procedures of infusion, write the observation record sheet of patients detained in infusion, the use and registration of various disinfectants, and the disposal of medical waste. Actively learn the relevant knowledge of Wulidian Community Health Service Center and do a good job in publicity. Assist in the establishment and work of Fuqiang Village Community Health Service Center. Actively prepare for the arrival of the inspection team and the work to be inspected.
5. All departments should pay great attention to service quality and service attitude. The service consciousness and service concept of most comrades have changed, and the consciousness of active service desk is also forming. We should try our best to think of patients, reduce their financial burden and reduce their back and forth. Open a green channel, first rescue critically ill patients, help them pay fees, take medicine, escort inspection, hospitalization, and then go through relevant procedures. Pay more attention to patients without family members or families. However, some comrades in our department are blunt in language, don't pay attention to time, place and scene, can't explain clearly, lack professional knowledge and health education, and the investigation and research on nursing satisfaction is not satisfactory. Service management is the focus of current and future work, which will further standardize and urge some language habits, enhance the study of business knowledge, and strive to make the interpretation of health education more scientific.
6. The department has a strong atmosphere. Some comrades take part in various forms of study and continuing education in their spare time. Departments often organize business study, which mainly includes: basic consciousness, observation and nursing of pupils and vital signs, observation and nursing of various common critical symptoms and diseases, use of common instruments and equipment, technical routines of various nursing operations, various rules and regulations, responsibilities of each class, triage knowledge, hospital infection management knowledge, evaluation criteria of nurses' stations, implementation rules of Chongqing Hospital Quality Management Year, knowledge of community health services, writing of nursing documents, etc. Through learning, the basic theoretical level of nursing staff has been improved to a certain extent, so as to better observe and patrol patients, nurse patients and make nursing records. Through the intensive training and teaching of employed nurses, the rescue technology and the quality of medical record writing have been improved.
7. Everyone actively used their brains to find ways to prepare various materials and strengthen business training and operation practice in view of the year of hospital medical quality management. Standardize the management and handover system of all kinds of first-aid instruments, equipment and medicines. So that the materials of the department can respond to all kinds of critical patients and emergencies at any time.
In the long river of years, the nursing work in our department is basically completed as planned, full of opportunities and challenges. While affirming the achievements, we should also clearly see the shortcomings, boldly innovate and persevere in management consciousness; In terms of service, it is necessary to further strengthen supervision and management, strengthen the observation and inspection of infusion patients, and not become a mere formality; In the implementation of rules and regulations, there are still a few comrades who are indifferent, the implementation of disinfection and isolation system is not strict, and the implementation is not strong. The above shortcomings will be corrected and implemented in our future work. Through our joint efforts, we will strive for a new level of outpatient and emergency care in the coming year.
Summary mode of nursing work in emergency department (Part III)
In 20XX, according to the work priorities of hospitals and nursing departments, the emergency department made a monthly nursing plan, put forward specific detailed measures, found problems in work, solved them in time, and made continuous improvement. Throughout the year, the emergency department carried out the "Three Good and One Satisfied" activities in conjunction with the national health system, enthusiastically served the masses, and ensured that 120 trains were dispatched in time, rescued in time and served in time, and all nursing tasks were successfully completed, with no complaints or mistakes throughout the year. The work summary report for the past year is as follows:
The first is the workload completed throughout the year.
1. Workload: emergency personnel, 120 person-times, various injections, gastric lavage, indwelling catheter, enema, severe emergency rescue, death, rescue success rate, cases/number of group injuries, and emergency drills.
2. Work compliance: the intact rate of first-aid articles reaches 100%. The qualified rate of disinfection and sterilization is 100%. The qualified rate of medical record writing is 100%. The nursing management score, service attitude satisfaction%, and the qualified rate of nursing technical operation examination are 100%. The qualified rate of nursing document writing was 100%.
Two, practice according to law, to ensure the quality and safety of nursing.
1. Strictly implement the laws, regulations and rules related to medical and health management. Strictly implement the "Measures for the Administration of Nurses in People's Republic of China (PRC)", clarify the rights, obligations and practice rules of nurses, and practice according to law. As always, there is no illegal practice. Conscientiously implement laws, regulations and rules.
2. Strengthen the training and study of laws, regulations and rules. Organize monthly training on laws and regulations, rules and regulations, safety knowledge and hospital awareness, and organize general nurses to conduct written examinations, with a pass rate of 100%.
Third, quality service to improve the quality of nursing staff.
1. Because the nurses in the emergency department are relatively young, according to the working characteristics of the emergency department, a targeted training plan is formulated, which requires everyone to master the first aid process, pre-hospital first aid, how to answer emergency calls, master the use of all emergency equipment in the emergency department, and strengthen theoretical study and assessment. Good results have been achieved through training. Scientific scheduling, taking the old with the new, three people in each class alternate between the old and the new, with strong technical ability and strong communication ability, so that the shifts are not fixed, flexible and reasonable, and the overall ability of the nursing team is guaranteed.
2. According to the nursing service rules formulated by the nursing department, organize all nursing staff to study hard and strictly implement them, with the head nurse taking the lead and strengthening inspection. Nurses are required to meet the requirements in dress, appearance, language and behavior, abide by rules and regulations and discipline, earnestly perform their duties, and make use of the morning shift to make rounds, return rounds and spot checks on holidays. Violators are strictly assessed.
Fourth, strengthen the three basics training and improve the first aid ability.
1. The emergency department made learning system and plan, insisted on organizing nursing business study and training and assessment of nursing operation skills every month, organized nursing business study *** 12 times throughout the year, and completed training and assessment of 23 nursing operation skills, with the qualified rate of 100%. Nursing rounds were conducted 4 times, and nursing cases were discussed 4 times.
2. Adhere to the morning questioning system, strengthen the professional knowledge learning of nursing staff, lay a solid theoretical foundation, effectively implement it, and do a good job in assessment.
3. Send 1 nurses to Sichuan Provincial Hospital to complete the study of emergency nurses, send head nurses to Shanghai Ruijin Hospital to study, and attend the management training of head nurses in Sichuan Provincial Hospital.
4. Three academic papers were published throughout the year.
5. Complete the teaching of clinical practice nursing students.
Five, strengthen the quality management of emergency nursing.
1. When there is a dispute between doctors and patients, medical documents are the most effective legal basis. In combination with the Regulations on Handling Medical Accidents, our department has carefully organized and studied the writing norms of various medical documents, assigned special personnel to be responsible for the quality control and custody of nursing documents, and required nursing staff to strictly implement the requirements of medical records, write relevant nursing records, and enhance their awareness of self-protection and legal concept.
2. Standardize all kinds of special operation precautions, and formulate TAT injection precautions, gastric lavage precautions, enema precautions and catheterization precautions according to the characteristics of the emergency room. The above operations must be agreed and signed by the doctor and the patient's family before the nurse can implement them.
3. 120 vehicle management. Ensure the departure time, obey the central instruction of "120", and make house calls within 3 minutes after receiving the dispatching instruction. Put the articles, instruments and medicines on the ambulance in a unified way, and fix the points, points, points and points. Strengthen the standardized management of in-vehicle hygiene, and the visiting nurses are responsible for the custody, reception, inspection and handover of instruments and equipment, oxygen and first-aid drugs. Ensure that the performance of instruments and equipment is in good condition, with sufficient power and oxygen, keep the car and the surfaces of various equipment clean and disinfect regularly. The head nurse gets on the bus for inspection every day and on holidays. Nurses are strictly handed over in each shift, and at the same time, they are trained in the operation of instruments in the car, so that everyone can operate skillfully and must master the use and measurement of first-aid drugs in the car.
4. Work in strict accordance with the rules and regulations, operating procedures and norms, master the on-site first-aid nursing technology, master the use of instruments and equipment, and prevent first-aid accidents and errors.
5. Ensure that the green channel is unblocked, and the general nurses master the emergency plan, which is reasonable and orderly.
Successfully organize rescue work.
6. Do a good job in the management of first-aid drugs and first-aid instruments. The preparation of first aid drugs and the debugging of various first aid equipment are the basis of first aid work. Now there is a special person in charge of every job, and the responsibility is carried out to people, so that the class can check regularly. During this year, the rescue work was not affected by the first-aid drugs and first-aid instruments, thus ensuring timely, accurate and rapid rescue of patients.
Six, the successful completion of the mandatory tasks and emergency rescue tasks of public health emergencies.
Seven, there are shortcomings
1. The implementation of various nursing systems is insufficient.
2. Nurses lack their own quality and self-management ability.
3. The problems found can't be reviewed for a long time, and it is easy to be one-sided and phased.