2. Doctors and nurses in 0/20 of Kloc are responsible for observing patients during the day and the first half of the night, and doctors and nurses on duty after midnight are responsible for observing and treating patients. And make timely medical record writing, hand-over and hand-over records.
3, medical staff must patrol the ward from time to time, timely find the condition changes, timely modify the diagnosis, adjust the treatment plan.
4. In case of illness change and unknown diagnosis. 120 The doctors and nurses in the observation room should consult with the doctors in charge or the department director in time.
Emergency room working system
1. All clinical departments should send doctors and nurses with certain clinical experience and technical level to work in the emergency room, and the rotation should not be too frequent. Interns and nurse interns are not allowed to work alone in the emergency class. A refresher doctor can only take up his post with the approval of the department director. 2. Emergency patients should be treated in a timely, serious and agile manner with a high sense of responsibility and compassion, closely observe the changes of their condition, and make records. Difficult and critical patients should immediately ask their superiors for consultation or emergency consultation. For critically ill patients who are not suitable for moving, organize rescue in the emergency room on the spot and escort them out of the ward after their condition is stable. Patients who need immediate surgery should be sent to the operating room for surgery in time. The emergency doctor should hand over the shift directly to the ward or surgeon. 3. The emergency room all kinds of rescue drugs and equipment ready, ensure ready to use. It is managed by a special person, placed in a fixed position, easy to use, frequently checked, supplemented, updated, maintained and disinfected in time. 4. Emergency room staff must stick to their posts, do a good job of succession, and strictly implement emergency rules and regulations and technical operation procedures. Establish operating procedures for various rescue techniques for critically ill patients. 5. The emergency room should be equipped with a number of observation beds, and patients should be treated and cared for by emergency doctors and emergency room nurses in relevant departments. To write a good medical record, open a good doctor's advice, closely observe the changes in the condition, and take effective measures for diagnosis and treatment in time. The observation time is generally not more than three days. 6. In case of major rescue, you must immediately report to the department director and hospital leaders to take part in the command. All patients involved in law and litigation should report to the relevant departments in time while actively treating them. 7. Emergency patients are not restricted by classification. Emergency patients who need to be transferred must contact in advance and get consent before they can be transferred. Emergency duty system, shift system 1, emergency medical staff must be on duty in strict accordance with the shift schedule, in case of special circumstances need to shift, must be approved by the department director.
2, the personnel on duty should be 5~ 10 minutes in advance, accept the succession, and make a good record of the succession, so that the responsibilities of each shift are clear and well documented.
3, the doctor on duty after the succession must be a comprehensive inspection ward, understand the patient's condition, especially for critically ill patients should know fairly well, and check whether all kinds of rescue equipment are in good condition, in use.
4, carefully observe the patient's condition changes in class, correctly handle and make records.
5, according to the needs of illness, can directly apply for consultation, but also through the department director, section chief on duty or medical organization consultation rescue.
6, timely report to the department director, the section chief on duty important things that will happen or have happened in this class. When personal safety is threatened, be prepared and report to the Security Section or 1 10.
7, the doctor on duty shall not leave without authorization, are not allowed to do private affairs that have nothing to do with undergraduate business. If you really need to leave, someone should fill the position and explain where to go. Ensure smooth communication and arrive at the post within 5 minutes after receiving the call.
Green channel management system
1, in order to carry forward the humanitarian spirit of saving lives, rescue critically ill patients quickly, timely and effectively, and give unconditional life support to all patients entering the emergency department.
2, green channel patients, give priority to rescue, examination and treatment, all formalities shall be handled by the nurse. If you need to consult, you should inform the consulting department in time, and the consultants should be present within 5 minutes.
3. After emergency treatment, the patients in Green Channel are in relatively stable condition and need hospitalization. Nurses assist in the hospitalization procedures, and medical staff accompany them in the check-in procedures, and at the same time handle the handover procedures.
4. Where 1 10 or 120 is sent to our hospital, if there are no family members present or the expenses are difficult, the handling personnel of 1 10 or 120 will fill in the green card first and report it to the medical department or the chief duty to handle the relevant formalities in time. Medical personnel should pay the fees in time.
Emergency observation room system 1. Patients who do not meet the hospitalization conditions but still need emergency observation according to their illness can stay in the observation room for observation. 2. The doctors and nurses on duty in the emergency department should pay close attention to observation and treatment according to the condition. All patients admitted to the observation room must open the doctor's advice, fill in the medical records in time according to the format, and record the condition and treatment at any time.
3. The emergency doctor on duty should check the bed once every morning and evening, and handle it at any time if the condition is serious. The attending physician checks the bed once a day, modifies the diagnosis and treatment plan in time, and points out the key work.
4. The nurse on duty in the emergency room should take the initiative to patrol patients at any time, make diagnosis and treatment on time and record and reflect the situation in time.
5. The medical staff on duty should observe the patient's temporary changes, and go to the bedside to see if there is any discovery, so as not to delay the illness.
6. The emergency medical staff on duty should observe the patients in the hospital bed, and carefully hand over the shift on time, and make written records when necessary. Outpatient system 1. The hospital should have a vice president who is responsible for leading the outpatient service. The directors and deputy directors of all subjects should strengthen the professional and technical leadership of undergraduate outpatient service. All departments (especially internal medicine, surgery, obstetrics and gynecology, pediatrics, etc. ) should determine an attending physician or senior resident to assist the director to lead undergraduate course room outpatient work.
2. All departments to participate in outpatient work of medical staff, work under the unified leadership of the medical department or outpatient department. When changing personnel, it should be discussed with the medical department or outpatient department.
3. Outpatient medical staff should send doctors and nurses with certain experience, and hospitals and departments with doctors in charge of outpatient and ward must arrange manpower.
4. Difficult and severe patients can't be diagnosed, and patients still can't be diagnosed after two follow-up visits. Please consult your superior doctor in time.
The director and chief physician should make regular house calls to solve difficult cases. For some patients with chronic diseases and specialist patients, specialist clinics should be set up according to the specific conditions of the hospital.
5. For patients with high fever, seriously ill patients, elderly people over 60 years old and patients in different places, outpatient service should be arranged in advance.
6. Carefully examine patients and record medical records concisely and accurately. The attending physician should regularly check the quality of outpatient medical care. 7 outpatient examination, radiation and other inspection results, must be accurate and timely. Outpatient surgery should be defined according to the condition. Doctors should strengthen the inspection and guidance of dressing rooms and treatment rooms, and operate them personally when necessary.
8. All outpatient departments should strengthen contact with inpatient departments and wards, and arrange inpatients in a planned way according to the use of hospital beds and patients' conditions.
9. Strengthen inspection and triage, strictly implement disinfection and isolation system to prevent cross infection. Pediatrics and internal medicine should set up infectious disease clinics. Make a good report on the epidemic situation.
10. Outpatient staff should be considerate, friendly, polite and answer questions patiently. Simplify the procedures as much as possible and arrange patients to see a doctor in a planned way.
1 1. Outpatients should always keep clean and tidy, improve the waiting environment, strengthen the waiting education, and publicize the knowledge of health and disease prevention, family planning and prenatal and postnatal care.
12. Outpatient doctors should adopt effective and economical treatment methods, use drugs scientifically and rationally, and reduce the burden on patients as much as possible.
13. Patients referred to the grassroots or other places should be carefully diagnosed and treated. When returning to the grassroots or in situ, suggestions for diagnosis and treatment should be put forward.