In the actual nursing work, adverse events caused by failure to seriously implement various inspection systems still account for a high proportion. The specific performance is that the medication check is not strict, and sometimes it depends on subjective impression, such as calling the bed number instead of the name when giving treatment to patients, and not comparing the name, drug name and infusion card when changing fluids, which leads to the wrong infusion or oral medication error.
2. Incorrect execution of doctor's advice
It is manifested in blindly executing the wrong doctor's advice, violating the provisions of oral doctor's advice, misreading the doctor's advice, and sometimes relying on subjective impression, failing to find the change of patient's dose in time and affecting patients.
The execution time of the doctor's advice is not strict, including not sending the medicine to the mouth or delaying or advancing the administration time by 2 hours, taking it by mistake, missing it, taking it more, or even taking it without authorization. Some missed the drug allergy test or did not observe the results in time after the allergy test, and did not execute the doctor's advice in time when rescuing.
3. The nursing rules and regulations are not strictly implemented, which violates the operating rules of nursing technology. Because there are more junior nurses and lack of work experience, they are not familiar with some professional knowledge, basic common sense and operation process, and are not familiar with work process.
The patient's condition was not carefully observed, and the nursing measures were not in place: the bedridden patient did not turn over in time, resulting in pressure sores, violating the surgical safety inspection system, causing instruments and gauze to be forgotten in the surgical incision, violating the nursing operation rules, and causing the family members to feed the asphyxiated patient by nose.
The extravasation of intravenous drug solution causes local tissue necrosis, and various inspection operations affect the operation and inspection because of omission of skin preparation or multiple scratches on skin preparation: improper gastric lavage operation causes gastric perforation; Hot compress burn patients or cold compress frostbite patients.
4. The nursing grading system was not strictly implemented.
Patients were not observed and patrolled in strict accordance with the grading nursing system, and the patient handover system was not seriously implemented. Health education and education are not in place, and there is no foresight for possible adverse consequences, such as not repeatedly emphasizing safety hazards (falling down and falling out of bed) to patients.
5. Nurses' ability to evaluate patients is insufficient.
The patients with high risk factors of pressure sore were not evaluated, resulting in pressure sore. Failure to evaluate the high risk factors of patients' falls and take preventive measures led to patients' falls and bed falls.
6. Nurses' negative burnout can easily lead to nursing adverse events. Because of trivial nursing work, high technical and service requirements, high mental tension and great ideological pressure, it is easy to cause nurses' negative burnout, which is manifested in lack of concentration, lack of enthusiasm in work and indifference to patients (patient complaints).
7, drug management confusion
It is manifested in the following aspects: drugs are mixed, highly toxic drugs are mixed with generic drugs, drugs for injection are mixed with oral drugs, drugs for internal use are mixed with drugs for external use, the labels of medicine bottles are inconsistent with the drugs contained, drugs are expired, drugs that need to be refrigerated are not placed in the refrigerator, especially high-concentration drugs are placed separately without labels, which leads to nursing adverse events.
8. Nurses have poor safety awareness.
Lack of nursing safety knowledge, inadequate training for new employees and routine nursing training for diseases in this specialty, nurses' inexperience, ignorance of the treatment purpose and effect of some drugs in different ways, inability to judge and respond to changes in illness in time, poor emergency response ability, and some mistakes that should not occur.
9. The logistics system is not perfect.
Hospital logistics is the foundation of the whole hospital management and an important support and guarantee system for the normal operation of the hospital. With the continuous development of hospital discipline construction, the progress of modern technology and the expansion of equipment scale, the scope and knowledge of logistics work are getting wider and wider, the difficulty of logistics management is getting bigger and bigger, and the degree of logistics management specialization is getting higher and higher.
Drugs can't be delivered to the ward in time. Can't provide one-stop service. Submit an article for repair.
Extended data:
Measures to prevent nursing errors and accidents;
1, strictly implement the system of three checks and ten pairs of nursing.
2, strictly implement the nursing grading system, closely observe the changes of the condition, according to the need for young and old, coma patients to add protective fences, restless patients to prevent falling out of bed, mental disorders and suicidal patients should closely observe the dynamics to prevent accidents due to negligence of nursing staff.
3, strengthen the management of all kinds of drugs, injection drugs and oral drugs, oral drugs and external drugs are placed separately, medicine bottles are consistent with the drugs contained, drugs are checked regularly, marked when used, used first in the near future, adjusted in time to ensure that there is no expiration, drug counters are locked, managed by special personnel, and strictly handed over.
4, regularly check all kinds of first-aid drugs, articles, first-aid equipment, strict handover, to ensure that the function is complete, make the rescue smoothly.
5. All nursing measures are put in place, health education achieves the expected effect, prevents burns, frostbite and bedsores, and reduces nursing risks.
6. Strictly implement disinfection and isolation system to prevent iatrogenic infection caused by nursing operation.
7. Regularly check the electricity consumption of departments, publicize the use of oxygen for fire prevention and theft prevention, and the oxygen should be marked "away from fireworks" to ensure the safety of patients.
8, strictly implement the nursing adverse event reporting system, nurses in the work of adverse events, should immediately notify the doctor and head nurse, and report step by step, after discussion, formulate corrective measures to prevent such incidents from happening again.
9, improve the comprehensive quality of nurses, including medical ethics, professional, technical, physical and psychological quality, is the guarantee to do a good job in nursing.
10, learn relevant nursing laws and regulations, and understand the potential legal problems in nursing work and nursing documents such as self-care guidance errors, negligence, infringement and dereliction of duty.
1 1. Nurses actively adjust their mentality, reasonably arrange their schedules to reduce tension and anxiety, improve their ability to withstand various pressures, and do a good job in nursing with a positive and optimistic attitude.