护理领域常见的医疗事故及防范对策

2002年2月20日国务院第55次常务会议通过了《医疗事故处理条例》，自2002年9月1日起施行。《医疗事故处理条例》扩大了原《医疗事故处理办法》中关于医疗事故的内涵，同时加大了医疗机构及其医务人员的责任。根据新的《医疗事故处理条例》法律规定，分析归纳护理领域常见的医疗事故和提出防范对策具有重要的现实意义。     

浅谈护理纠纷的防范

《医疗事故处理条例》于2002年9月1日正式实行。《医疗事故处理条例》集中体现了保护医患双方合法的权益、维护医疗秩序、保障医疗安全、适应经济和社会发展需要及促进医学科学发展的宗旨。同《医疗事故处理方法》相比，《医疗事故处理条例》有如下特点：①强调医疗事故重在预防。规定医疗机构应当制定防范、处理医疗事故的预案，预防医疗事故的发生。②明确     

《医疗事故处理条例》的学习与思考

国务院第351号会令发布的《医疗事故处理条例》(下称《条例》),9月1日就要实施了. 《条例》旨在规范医疗行为,调整医患关系,处理医疗事故.这个备受关注的行政法规,加上最高人民法院[2001]33号司法解释中关于医疗事故民事诉讼中举证责任倒置的规定,使得这些年饱受冲击的医疗卫生界感到压力很大.一次会上,一位著名的外科教授说"看来我只有两条路,要么改行,要么退休".而个别人士则称"新的医疗事故处理条例实施之日,就是中国的患者扬眉吐气之时",那么究竟应当怎样看待《条例》对医疗实践的影响,医院和医务工作者应有何种心态和对策来贯彻落实好《条例》呢?作者从以下三方面谈谈自己的学习心得和设想.     

护理领域常见的医疗事故及防范对策

20 0 2年2月2 0日国务院第5 5次常务会议通过了《医疗事故处理条例》,自2 0 0 2年9月1日起施行。《医疗事故处理条例》扩大了原《医疗事故处理办法》中关于医疗事故的内涵,同时加大了医疗机构及其医务人员的责任。根据新的《医疗事故处理条例》法律规定,分析归纳护理领域常见的     

浅谈护理纠纷的防范

《医疗事故处理条例》于2 0 0 2年9月1日正式实行。《医疗事故处理条例》集中体现了保护医患双方合法的权益、维护医疗秩序、保障医疗安全、适应经济和社会发展需要及促进医学科学发展的宗旨。同《医疗事故处理方法》相比,《医疗事故处理条例》有如下特点:①强调医疗事故重在预防。规定医疗机构应当制定防范、处理医疗事故的预案,预防医疗事故的发生。②明确规定发生医疗事故等民事责任争议的三条解决途径。医患双方当事人可通过自愿协商、申请行政调解、依法诉讼等途径。③扩大了医疗事故的内涵。将医疗机构和医务人员共同作为医疗事故发生…     

医疗事故民事赔偿责任问题新论

2002年4月14日，国务院发布《医疗事故处理条例》，对医疗事故的概念，医疗事故鉴定，医疗事故的处理程序和赔偿标准做了新的规定。依据新《条例》的规定，结全最高人民法院关于民事诉讼证据的司法解释的规定，就这一行政法规对医疗事故民事赔偿责任有何影响，怎样执行新规定的简陋部偿标准，在实践中应当怎样处理医疗事故侵权纠纷，进行了全面论述，并对医疗事故民事赔偿责任的认定和处理以及在司法实践中应当采取何种对策，提出了具体的意见。     

《医疗事故处理条例(草案)》国务院原则通过

据讯朱钅容基总理 2月 2 0日主持召开国务院第 5 5次常务会议 ,审议并原则通过了《医疗事故处理条例 (草案 )》。会议认为 ,医疗事故的处理涉及保护患者和医疗机构及其医务人员双方的合法权益 ,社会各界都很关注。为了完善处理医疗事故的法律制度 ,在总结 1987年国务院发布的《医疗事故处理办法》实施经验的基础上 ,制定《医疗事故处理条例 (草案 )》是非常必要的。会议确定 ,这一草案经进一步修改后 ,由国务院公布实施。《医疗事故处理条例(草案)》国务院原则通过$新华社     

医疗鉴定与司法鉴定的几点思考

国务院于2002年9月1日颁布实施《医疗事故处理条例》(以下简称《条例》)以来,国民对于医疗事故的认识有了日益成熟的表现,同时关于医疗事故的认定成了热点话题。其中医疗鉴定和司法鉴定的适合性和合理性成为争论的焦点。医学专家和法律界人士分别代表了不同的观点,本文从专业人士的角度,谈谈对他们的认识以及对我国医疗事业的影响。1定义和内涵1.1医疗鉴定我们通常所说的医疗鉴定是指医疗事故技术鉴定,根据《医疗事故处理条例》和卫生部颁布的《医疗事故技术鉴定暂行办法》的规定,医疗鉴定是指医学会组织专家鉴定组,依照医疗卫生管理法律、…     

护理人员对《医疗事故处理条例》掌握程度的调查分析

为调查全院护理人员对《医疗事故处理条例》知识的掌握程度，对200名护理人员按随机抽样的方式进行了问卷调查。表明：护士对《医疗事故处理条例》知识掌握的平均正确率为6274％。提示必须加强对护理人员的法律知识教育，增强对护理行为法律关系和法律后果的预见能力。     

配合《医疗事故处理条例》实施的若干做法

《医疗事故处理条例》已于2002年9月1日起实行,卫生部和国家中医药管理局为配合其实施,下发了一系列配套文件,《病历书写基本规范(试行)》就是其中之一。 由于《医疗事故处理条例》明确规定相关护理文件作为病人可以复印和复制的资料,是进行医疗事故技术鉴定的重要依据,所以在实施过程中,临床上普遍反响较大,争议较多。     

《侵权责任法》系列讲座之六:医事侵权赔偿散论

《医疗事故处理办法》时代,医疗事故除补偿之外,还建立了配套的保障制度,从补偿标准规定来看,当时医疗机构直接的补偿数额确实不大,但是,当时患方最终得到的补偿却并不少。《医疗事故处理条例》关于医疗事故民事赔偿的7条规定,具有可操作性,在《侵权责任法》生效后继续合法有效。死亡赔偿金现行规定存在的问题是体系混乱、内部互相矛盾、赔偿项目名称和计算标准不一致、赔偿范围不一致等。被侵权人由于其人身权益受到侵害造成死亡的能否请求精神损害赔偿,国内外立法及司法在实践和理论上都存在争议。     

Estimating the Value of Medical Education: A Net Present Value Approach

Background : Medical malpractice is prominently positioned in the consciousness of American physicians, and the perceived threat of malpractice litigation may push physicians to practice defensively and alter their teaching behaviors. Purpose : The purposes of this study were to characterize the attitudes of academic medical faculty toward malpractice litigation and to identify teaching behaviors associated with fear of malpractice litigation. Methods : We surveyed 270 full-time clinically active physicians in the Department of Medicine at a large academic medical center. The survey assessed physicians' attitudes toward malpractice issues, fear of malpractice litigation, and self-reported teaching behaviors associated with concerns about litigation. Results: Two hundred and fifteen physicians responded (80%). Faculty scored an average of 25.5 ± 6.9 (range = 6–42, higher scores indicate greater fear) on a reliable malpractice fear scale. Younger age (Spearman's ρ = 0.19, p = .02) and greater time spent in clinical activities (ρ = 0.26, p < .001) were correlated with higher scores on the Malpractice Fear Scale. Faculty reported that because of the perceived prevalence of lawsuits and claims made against physicians, they spend more time writing clinical notes for patients seen by learners (74%), give learners less autonomy in patient care (44%), and limit opportunities for learners to perform clinical procedures (32%) and deliver bad news to patients (33%). Faculty with higher levels of fear on the Malpractice Fear Scale were more likely to report changing their teaching behaviors because of this perceived threat (ρ = 0.38, p < .001). Conclusions: Physicians report changes in teaching behaviors because of concerns about malpractice litigation. Although concerns about malpractice may promote increased supervision and positive role modeling, they may also limit important educational opportunities for learners. These results may serve to heighten awareness to the fact that teaching behaviors and decisions may be influenced by the malpractice climate.     

新生儿死亡医疗纠纷案例的法医病理学分析

目的 探讨新生儿死亡医疗纠纷中临床及法医病理学特点,启示儿科医护人员在防范此类医疗纠纷时应注意的相关问题。方法 对四川大学华西基础医学与法医学院法医病理教研室1998年1月—2007年12月的60例新生儿死亡尸检案例进行回顾性统计分析。结果 60例中除3例非正常死亡外,57例为自然性疾病死亡。其中出生后24 h死亡32例（56.1%）,死亡男婴40例（70.2%）。死亡原因主要为胎粪吸入综合征、肺透明膜病、肺出血等窒息性疾病（49.1%）。其中医疗过失性纠纷21例（36.8%）,医疗过失的原因主要为观察不仔细、处理不及时、误诊漏诊、产前检查或助产处理不当、告知不足等。涉及纠纷的医院以市级医院居多（58.7%）。结论 医护人员应严格遵守诊疗常规和操作规范,对新生儿加强监护,及时抢救,同时应积极与家属沟通,以减少医疗纠纷的发生。     

Actions, behaviors, and characteristics of RNs involved in compensable injury

Malpractice claims analysis offers valuable insight into nursing practice. A review of 16 malpractice claims involving 19 RNs identified their characteristics, actions, and behaviors that contributed to monetary compensation. Most events involved failure to perform a timely assessment and intervention. Relationships were found among nurses' characteristics and the severity of patient injury. Malpractice claims analysis affords nursing leaders the opportunity to involve RNs in correcting deficiencies that contribute to practice errors.     

规范中医护理文书书写的对策

目的：探讨如何规范中医护理书，以适应《医疗事故处理条例》的要求。方法：采用护理部不定期抽查、护士长夜查及质控员交叉检查相结合的方法。对住院病历进行环节质控和终末质控。结果：通过加强对中医护理书的质控，找出存在的问题并提出相应对策，有效地提高了中医护理书的书写质量。结论：规范书写，规范记录，科学地记录诊治患的每一个环节，确保病历中各项护理书的质量，可发挥中医护理书在“举证责任倒置”中的重要作用。     

Analysis of medical malpractice claims to improve quality of care: Cautionary remarks

Medical malpractice claims can be analysed to gain insights aimed at improving quality of care. However, using medical malpractice claims in medical research raises epistemological and methodological concerns related to certain features of the litigation process. Medical research should therefore approach medical malpractice claims with caution. Taking one recent study as a an example, this article insists on three areas of concern: (a) the quantity of legal materials available for analysis; (b) the content of the legal materials available for analysis; and (c) the ways in which the content of the legal materials should be analysed and the types of inferences that it can support. The article concludes with general recommendations for future medical research that would incorporate medical malpractice claims. These recommendations centre around recognizing the qualitative dimension of legal reasoning.     

Behandlungsfehlervorwürfe bei der Chirotherapie

A total of 91 claims of malpractice in chirotherapy and their expert appraisal were evaluated by the German North Rhine expert commission between 2004 and 2017. It was possible to carry out a comparison with the period between 1976 and 2003. The frequency of claims and the rate of treatment errors were not subject to an upward trend, but there is a growing criticism that patients were provided with no or insufficient information. Malpractice claims related in particular to chirotherapy as the cause of disc herniation and vessel damage in the cervical spine (involving central side effects), as well as fractures and a worsening of the symptoms that had prompted treatment in the first place. This article presents five examples of typical malpractice claims and their appraisal. The conclusions derive from the evaluation of all 91 investigated cases in the above-mentioned period through the prism of the literature and jurisprudence, as well as taking into consideration the German Patient’s Rights Act (Patientenrechtegesetz), which obliges physicians to provide their patients with adequate documentation. It can be concluded as a result that essentially all confirmed treatment errors could have been avoided by following the Bingen recommendations of 1995.     

死亡病历护理抢救记录中的缺陷分析及管理对策

目的针对死亡病历护理抢救记录中的缺陷问题进行分析,制定相应的护理抢救记录书写规范,使其更加符合《医疗事故处理条例》,为医疗举证责任倒置提供客观、真实的资料,从而提高护理抢救记录书写质量。方法设计护理病历终末检查单,分为三大内容12小项,对随机抽取的300例危重护理抢救记录进行逐项检查,将其主要缺陷进行统计分析。结果查出缺陷287处,包括病情观察客观描述、准确记录抢救时间、护理记录书写及时性等多个方面缺陷问题。结论应强化护士法律意识;完善护理病历质控体系,加强对病历书写环节和终末质量检查关;建立院级护理文书书写指导小组;开展护理病历展评活动等措施。     

Tort reform: an issue for nurse practitioners

PURPOSE: To inform nurse practitioners (NPs) about the issues related to tort reform and its relationship to malpractice insurance costs. DATA SOURCES: Current journals, newspapers, professional newsletters, and Internet sites. CONCLUSIONS: NPs are paying more for their malpractice premiums, and many are losing their places of employment as clinics close due to the increased cost of premiums. One method proposed for curbing the flow of monies spent on premiums and litigation is tort law reform. California serves as an example; its Medical Injury Compensation Reform Act (MICRA) tort reform law was passed 25 years ago, and it has maintained stable malpractice premiums. Other states have proposed similar laws, but some have not had similar success. To curb litigation costs, not only should tort laws be reformed, but NPs and physicians should keep abreast of current practice standards in order to provide quality medical care. IMPLICATIONS FOR PRACTICE: Like physicians, NPs are affected directly by tort laws. These laws hold NPs accountable at the same level as physicians. In addition, many states limit NPs' practice to delegation of authority by a physician. Liability is therefore transferred from the NP to the physician and vice versa in cases of injury or wrongful act. In addition, many NPs are finding it increasingly difficult to locate insurers who will write policies for medical liability.