Summary of Nursing Work in Hemodialysis Room In the past 20xx years, with the close cooperation of hospital leaders and the correct leadership of the nursing department and all the staff, all the nursing staff in the hemodialysis room have overcome the difficulties of short staff and heavy workload, paid close attention to the implementation of the target plan formulated at the beginning of the year, conscientiously implemented it, strictly implemented the Basic Operating Rules for Hemodialysis in Jilin Province, adhered to high standards and strict requirements, made great efforts in management and service, strengthened nursing safety management and improved nursing risk prevention measures. Take patients as the center, advocate humanized service, strengthen nurse-patient communication, improve patient satisfaction and avoid nursing disputes. Regular and irregular nursing quality inspection, to maintain the continuous improvement of nursing quality. Successfully completed all the tasks set at the beginning of the year, which was affirmed and praised by leaders and patients. Now the nursing work throughout the year will be summarized and reported.
First, improve the system, conscientiously implement the work system to ensure medical safety.
Seriously organize and study the responsibilities of nursing staff at all levels, various post responsibility systems and nursing work systems re-formulated by the nursing department at the beginning of the year, and implement them in practical work.
2. The hemodialysis room of Longjing People's Hospital has formulated quality management standards and strict work plans according to the requirements of class II compound review rules and the requirements of the establishment and qualification identification of blood purification room, improved various rules and regulations, technical operation specifications, emergency plans for various emergencies, emergency plans for dialysis patients' care and diet care, and other related documents, and standardized various operations according to the Standardized Operation Rules for Hemodialysis issued by the Provincial Blood Purification Center, and implemented the whole medical quality management of hemodialysis.
3. Adhere to the check system, strictly carry out three checks and seven checks on all nursing operations, strengthen the accuracy of implementing the doctor's orders, review the doctor's orders and set various parameters and indicators on the computer to ensure the quality of dialysis and the safety of patients, and ensure that there are no nursing errors and accidents throughout the year.
Second, strengthen learning, attach importance to improving the overall quality of nurses, and optimize the nursing team.
Strengthen business theory study and technical operation training: according to the business theory study and operation training plan at the beginning of the year, organize nursing staff to conduct business study twice a week and make study notes, and participate in operation training and assessment organized by the nursing department to ensure that all achievements meet the standards.
2. Strengthen the study of relevant knowledge, and constantly improve the professional and technical level of blood purification. Guided by the national 20 10 version of Operating Procedures for Blood Purification, the Standardized Operating Procedures for Hemodialysis issued by Jilin Blood Purification Center standardizes all operations, strictly implements the Management Measures for Hospital Infection and the Management Measures for Disinfection, strengthens disinfection and isolation management, and ensures the dialysis quality and treatment safety of patients.
3. Renew professional theoretical knowledge, improve the technical level of specialized nursing, carefully study and understand the detailed rules of dimethyl grade review and inspection, and learn the diet, treatment and nursing of uremia dialysis patients, which greatly improves the professional technical level of all nursing staff.
Third, change the concept of nursing, improve the quality of service, strengthen the communication between nurses and patients, advocate humanized service, improve the concept of humanized service, strengthen the awareness of active service, and carry out nursing service from the characteristics and personality of the clients.
Our dialysis department is facing a special group. Because the disease can't be completely cured after a long illness, when family members have some shortcomings in the long nursing process, it is easy for patients to feel lost and lose confidence in life. At the same time, due to the long dialysis time, their ability to manage their lives declines, and they have to bear high treatment costs, which makes them more prone to suicide and despair. Therefore, first of all, we should care for every patient with our sincerity and love, listen carefully to the patient's talk, try to understand the patient's psychology, be good at mastering the psychological characteristics of every dialysis patient, and win the respect and trust of patients with good professional knowledge and skillful communication skills. Help them treat the disease correctly, and patients can change their understanding of the disease, so as to face the reality with a positive attitude and establish confidence in treating the disease. And get the cooperation of family members to reduce the psychological burden of patients. Make patients have a good attitude to receive treatment, thus improving the quality of life.
2. Actively respond to the activities of "Quality Nursing Service Demonstration Project", actively organize nurses in departments to learn, change passive service into active service, creatively carry out work in nursing work, and always take patients as the center to provide patients with safe, high-quality and satisfactory nursing services. Pay attention to cultivating nurses' emergency ability in daily work, make a retrospective evaluation of each emergency work, draw lessons from it, and improve nurses' ability to deal with emergencies. Improve the sense of responsibility and keen insight of nursing staff, and let them develop a rigorous, agile and decisive work style. Closely observe the changes of patients' vital signs, do not ignore any symptoms, do not relax any hemodialysis links, and do not miss any rescue opportunity. Over the past year, * * * has carried out dialysis treatment for 4,074 person-times, and there have been no accidents of poor nursing and nursing mistakes, and there have been no cross-infection accidents of dialysis infection and infectious diseases throughout the year, which laid the foundation for safe medical treatment in our hospital.
Fourth, check regularly to improve the quality of nursing.
Medical quality management is the core content and eternal theme of hospital management, and dialysis quality control is an important part of standardized dialysis management and hospital medical quality management. Comprehensively strengthen the management of medical safety and the quality of nursing staff, so that all nursing staff can fully realize the importance of medical safety, and enhance the awareness of medical quality service and the consciousness of implementing rules and regulations. Regular quality supervision, inspection, assessment and evaluation, strengthening the management of key links, weak links and important links of hemodialysis, judging the completion of nursing quality indicators and proposing improvement measures are the guarantee to improve nursing quality. In order to improve the quality of nursing this year, the head nurse and the nursing supervisor of the department are responsible for the weekly quality inspection arranged by the nursing department, and conduct self-inspection more than four times a month. Through the usual examination, many problems that are easily overlooked are solved, which provides a guarantee for clinical safe medical care. Hold a special meeting on nursing safety once a month, give timely feedback on the existing problems, put forward the next work and preventive measures in time, analyze the reasons for the deficiencies in the inspection in detail, and strengthen the service consciousness and quality consciousness of nursing staff through in-depth and meticulous ideological education. Formulate practical improvement measures to change the weak links in the work in time. Some achievements have been made in ensuring the safety of hemodialysis and medical treatment and improving the quality of dialysis.
Five, to carry out new technologies, new projects, and constantly improve the professional and technical level.
1 June and April, our department developed a new treatment method of hemodialysis and hemoperfusion. Three patients received 12 times of treatment, and the clinical effect was remarkable, which not only met the treatment needs of patients, but also increased the economic benefits for the hospital.
2. While constantly studying new technologies and new projects, nurses are required to be good at summing up work experience and communicating with each other. I wrote two papers this year.
3. Three nurses were sent to the superior hospital to learn the operation technology of blood purification. 1 nurse has returned to work in the department, and two nurses are the reserve force. 1 nurse was sent to participate in the short-term training course of "standardized operation process of blood purification" in the whole province, which not only learned new theories, but also further standardized the technical operation.
Looking back on the work in the past year, under the correct guidance of hospital leaders and nursing department, and with the joint efforts of all staff, the nursing work in our hemodialysis department has successfully completed various tasks and achieved certain results. However, achievements are like the fruits of autumn. Although they are happy, they have all quietly fallen. While tasting success, we should also clearly see the shortcomings: be bold and innovative in management consciousness and persevere; Health education is still a mere formality; There are still a few comrades who are indifferent to the implementation of rules and regulations; Thesis writing and nursing research are almost absent; The demand of patients is the scope of our service, the satisfaction of patients is the standard of our service, the touch of patients is the goal we pursue, and the quality service is endless. We will constantly sum up experience, study hard, make the service more emotional and humanized, and make unremitting efforts for the hospital's service level to a new level.
20xx work plan:
1, further strengthen and implement the basic operating procedures of hemodialysis, and carry out various technical operations in strict accordance with the procedures.
2, strict implementation of infection management regulations, isolation dialysis intermittent nursing staff is relatively fixed, to further prevent cross infection.
3, strive for more nurses to go out to participate in relevant blood purification technology classes, regularly organize nursing staff business learning and technical operation training in the department, and constantly improve the theoretical knowledge and technical assessment of all nursing staff.
4. In order to ensure the dialysis quality of patients and strengthen the allocation management of dialysis water, the nurses in the preparation room are relatively fixed, and the dialysis water is monitored regularly to ensure the accurate allocation of dialysis water, and all monitoring indicators are within the normal range.
5. Strengthen the quality education of nursing staff, implement humanized service, care for patients like relatives, and implement flexible working system to ensure the treatment needs of patients.
Summary of nursing work in hemodialysis room II. Hemodialysis is the main treatment for uremia patients. Dialysis patients actually lead a very abnormal life. They are "tied" to dialysis machines to a large extent, and they have to rely on medical equipment and medical staff to survive all their lives. The financial burden of patients and their families is heavy, and long-term pathological factors also make patients emotionally unstable and irritable. With the change of medical model, hemodialysis patients should be given not only psychological comfort, but also humanistic care, advocate the concept of people-oriented nursing service, and improve the quality of life of dialysis patients. The so-called "small hemodialysis room" actually carries all the hopes of dialysis patients and is also an indispensable treatment for acute renal failure and various poisoning patients. This paper summarizes the nursing experience of hemodialysis room in 2006:
1. Define the post responsibilities, workflow and operation specifications of the dialysis center, and formulate the dialysis risk plan and emergency response plan.
Study hard to make hemodialysis nurses master it skillfully. Problems encountered in the work are well documented and can be solved in time. Rules and regulations are constantly supplemented and improved in the work. Work in strict accordance with the rules and regulations and workflow, and strictly check the system, including the setting of pre-flushing pipeline, blood vessel puncture, dialysis treatment and patient's treatment parameters, to ensure that there must be more than two nurses on duty in each shift to check each other, including whether there is blood leakage at the puncture site, whether the treatment parameters set by the machine are accurate, the dosage of anticoagulant and other drugs, and the patient's vital signs. Actively participate in business study and training in hospitals, and learn hemodialysis once a month. Support and encourage nursing staff to participate in specialized study, improve the comprehensive quality of nurses, fully mobilize their enthusiasm, enrich their knowledge and broaden their horizons.
Improving the quality of nurses is not only the professional level, but also the humanistic cultivation based on professional theory, including language cultivation, interpersonal cultivation, ethics cultivation, rational thinking cultivation and so on. Care about nurses in life and try to solve practical difficulties for them. Let nurses feel the warmth and friendship of the group. Establishing the concept of people-oriented nursing service is not only the humanistic care between doctors and patients, but also the working relationship, colleague relationship and friend relationship between nurses. Mutual understanding, trust and communication can create a good medical and working atmosphere, promote the relationship between nurses and patients, lay a good environmental foundation for further improving the quality of medical services and work efficiency, and play a multiplier role in the management of hemodialysis rooms. In the process of daily dialysis, nurses cooperate tacitly, and there is no shift dispute; During emergency dialysis, everyone can arrive at the first time. No matter whether it is emergency dialysis at night or dialysis on Sunday, there is no shirking phenomenon, and overtime will not affect the normal work of the next day.
2. Establish a people-oriented nursing management model and strengthen service awareness.
After patients start dialysis, they often have a lot of stress, such as the risk, pain and freedom of dialysis, the influence of the disease itself on the body, the cost of dialysis, the change of family relationship and so on. And their psychological problems are depression, anxiety, despair, and some even hate society and medical staff. Friendly and patient language communication can make patients feel safe, explain dialysis knowledge carefully, eliminate patients' fear, explain the dialysis effect of other patients and enhance patients' confidence in treatment. Try to reduce the burden of patients, make dialysis plans for them, and try to make them not dwell on the pain and life span of the disease, but pay attention to the quality of life and laugh at life.
Dialysis patients have long-term contact with medical staff and have strong dependence on medical staff. At the same time, I am familiar with the staff, treatment environment, dialysis procedures and methods, and even regard the hemodialysis room as my second home, and have obvious awareness of participating in management. In this regard, we communicate with patients at any time, explain and explain the new progress of hemodialysis treatment, and take the initiative to solicit opinions. When other diseases occur, contact patients actively for treatment and establish a smooth medical channel. Provide contact information, contact in time when encountering problems, and strive to solve them in the first time. For patients with serious illness, let a family member accompany them, so that patients can feel family affection, increase their sense of security, reduce psychological pressure and better cooperate with treatment. In the absence of family members, we also assume the responsibility of family members. In the long-term treatment process, we deliver water, feed, help and influence patients. Patients with bad mood and bad attitude should report to hospital leaders in time, and work out practical and relevant measures with various departments to gradually dispel their extreme thoughts of revenge on society.
3. Work hard and be careful.
Hemodialysis is risky. As a nursing operator, we should establish a correct and positive awareness of nursing risks, strengthen the concept of legal system, give full play to subjective initiative, control and avoid risks to the maximum extent, improve nursing quality and better serve patients. During dialysis, blood pressure is measured and recorded every hour, and vital signs are measured and monitored at any time when the condition changes. Some patients, especially those prone to hypotension during dialysis, need to be closely observed and their blood pressure should be measured every 5 minutes. Dialyzer parameters should be adjusted in time, such as temperature, conductivity, ultrafiltration rate and blood flow. Concentrate on your spirit and energy at work, and a little negligence may cause patients' losses and accidents.
Diabetic patients are prone to hypoglycemia because of sugar-free dialysis, so we should pay attention to the changes of consciousness, especially when sleeping. Because the edema is reduced after dialysis and drainage, and the skin at the puncture site is slack, it is easy to cause needle eye bleeding or needle removal, especially in winter, when the patient's arm is in the quilt, it often bleeds instantly and in a large amount. In addition to diligent observation, we should also explain the patient well and call in time if there is any abnormality. Dialysis was performed more than 600 times in 2006, and there was no medical error accident. And how to observe blood sugar and prevent hypoglycemia shock in hemodialysis of diabetic patients, and gained some experience; Analyze the hypotension in dialysis and take preventive measures to ensure adequate dialysis.
4. In line with the values of "patients first" in our hospital, we will continue to advocate the concept of people-oriented nursing service and give patients humanized care.
We have paid several poor dialysis patients 1000 yuan at our own expense (because most of the aid is personal behavior, so it is impossible to make detailed statistics), and we have given care and help in food and clothing. These are undoubtedly a drop in the bucket for dialysis patients, and they can't improve their life and dialysis situation at all, but they express our concern and encouragement to patients to some extent.
In addition to our efforts and achievements, there were also some slack in this year, which were manifested in poor professional and technical level, poor medical equipment and environmental management, poor service attitude and communication, and imperfect system. In this reflection, we also put forward opinions and suggestions, please pay attention to the hospital leaders and nursing department:
1, professional and technical level: firstly, the problem of arterial puncture, especially for patients undergoing first dialysis and emergency dialysis, is generally poor, with high toxin, and arterial puncture is difficult, so it is difficult to ensure dialysis blood flow. First, the experience of arterial puncture is still lacking, and when the blood flow is insufficient, they blindly choose to re-puncture; Second, the overall level of the hospital is not enough to do deep vein catheterization, which increases the pain of patients and easily causes patients' dissatisfaction. Secondly, this year, the medical staff in the hemodialysis room did not have the opportunity to go out for further study, the dialysis work remained basically unchanged, no new business and technology were developed, and no papers were published. Because the work of hemodialysis room is closely related to doctors, such as deep vein catheterization, ascites reinfusion, hemoperfusion and so on. , all need the guidance of doctors and the cooperation of doctors and nurses, but also need practical experience to learn, it is impossible to build a car behind closed doors. I hope hospital leaders can give us some opportunities to visit and study, and take a step further in improving professional level, strengthening disinfection and isolation measures, and developing new dialysis projects.
2. Medical equipment: The survival of dialysis patients depends on dialysis equipment, including dialysis equipment, water treatment equipment, perfect water and electricity supply, high-quality dialysis supplies and so on. This year, the route reuse and disinfection of dialyzers and dialysis tubes will be completed, and the conversion to disposable use will be completed. This transformation is the case.