1. 1 The control system is not strict. Due to the careless implementation of various inspection systems, adverse events still account for a high proportion in actual nursing work. The specific performance is that the drug inspection is not strict, and only the bed number is called, not the name, which leads to the wrong fluid infusion or the wrong oral medication. Only looking at the drug packaging, not the drug name, only looking at the prefix of the drug name, not looking at the suffix, the check of the dose, usage and concentration of the drug is relatively loose, which is likely to lead to adverse consequences in clinic.
1.2 Failure to strictly follow the doctor's advice is manifested as blindly following the wrong doctor's advice, violating the oral doctor's advice, misreading and omitting the doctor's advice, and sometimes relying on subjective impression, failing to detect the patient's dose change in time, affecting the patient. 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.
1.3 The confusion of drug management is manifested in the mixing of several drugs, poisonous anesthetics with general drugs, drugs for injection with oral drugs, drugs for internal use with external use, inconsistent labels of medicine bottles with drugs for internal use, expired drugs and drugs that need to be refrigerated, which leads to nursing adverse events.
1.4 failed to strictly implement the nursing rules and regulations and the operating rules of nursing technology, and failed to strictly implement the nursing grading system, which was manifested as not patrolling the ward on time, not carefully observing the illness, not taking appropriate nursing measures, and not turning over in time for bedridden patients, resulting in bedsores; Violating the operation safety inspection system, leaving instruments and gauze in the operation incision; Violation of nursing operation procedures, such as nurses asking their families to give nasal feeding to patients, causing suffocation; Forgetting to loosen the tourniquet during infusion leads to crush syndrome; Local tissue necrosis caused by extravasation of intravenous drug solution; Various examinations and operations affect the operation and examination because of missing skin preparation or scratching many places during skin preparation; Improper gastric lavage operation causes gastric perforation; Hot compress burn patients or cold compress frostbite patients.
1.5 nurses are slack in their work and have a weak sense of responsibility. Young nurses lack nursing experience, which is manifested in sleeping at night, leaving their posts without permission, not patrolling the ward in time, being irresponsible to patients, and not concentrating their thoughts at work, resulting in serious consequences; In addition, because the nurses are young and inexperienced, they don't understand the therapeutic purpose and effect of some drugs, and they can't judge and deal with the changes of the condition in time, which leads to some mistakes that should not happen.
1.6 nurses' negative burnout easily leads to nursing adverse events. Because of trivial nursing work, high technical and service requirements, high mental stress and great ideological pressure, it is easy to cause nurses' negative burnout, which is manifested in lack of concentration, lack of enthusiasm in work, indifference to patients and lack of communication with doctors and patients, leading to adverse events.
2. Measures to prevent nursing errors and accidents
2. 1 Strictly implement the system of three checks and seven pairs of nursing.
2.2 Strictly implement the nursing grading system, closely observe the changes of illness, add protective fences for old, young and comatose patients as needed, and apply safety restraint belts to prevent patients from falling off the bed. Patients with mental disorders and suicidal tendencies should closely observe the dynamics to prevent accidents caused by negligence of nursing staff.
2.3 Strengthen the management of all kinds of drugs. Drugs for injection and oral drugs, oral drugs and external drugs should be placed separately. The label of the medicine bottle should be consistent with the medicine it contains. Drugs should be checked regularly. When used, they should be time stamped, used in the future, and adjusted in time to ensure that they will not expire. The counters for toxic drugs and narcotic drugs should be locked, and there should be special account books, and the shift should be strictly changed to ensure that the accounts are consistent with the goods.
2.4 Regularly check all kinds of first-aid medicines, articles and first-aid equipment, and strictly hand over them to ensure that the functions are intact and complete, so that the rescue can proceed smoothly.
2.5 All nursing measures are put in place, health education achieves the expected effect, prevents burns, frostbite and bedsores, and reduces nursing risks.
2.6 Strictly implement disinfection and isolation system to prevent iatrogenic infection caused by nursing operation.
2.7 regularly check the oxygen consumption of the department, and do a good job in fire prevention and anti-theft propaganda. Oxygen should have the words "away from fireworks" to ensure the safety of patients.