低年资护士护理缺陷自报分析会在护理安全管理中的作用

目的探讨低年资护士安全管理的有效途径,提高其护理安全防范意识．保障护理安全。方法成立低年资护士安全质量管理体系,开展低年资护士护理缺陷自报分析会,根据分析会情况加以调研,优化相关护理流程,进行质量跟踪改进。结果低年资护士上报护理相关安全事件661件,措施流程改进28项。与实施前同期相比,一般护理差错、严重护理差错、意外事件分别减少39．58％、50．00％、66．67％。结论开展低年资护士护理缺陷自报分析会可提高低年资护士对护理安全事件的认识及风险评估和管理能力,进而提高护理安全质量。     

低年资护士护理缺陷自报分析会在护理安全管理中的作用

目的探讨低年资护士安全管理的有效途径,提高其护理安全防范意识,保障护理安全。方法成立低年资护士安全质量管理体系,开展低年资护士护理缺陷自报分析会,根据分析会情况加以调研,优化相关护理流程,进行质量跟踪改进。结果低年资护士上报护理相关安全事件661件,措施流程改进28项。与实施前同期相比,一般护理差错、严重护理差错、意外事件分别减少39.58%、50.00%、66.67%。结论开展低年资护士护理缺陷自报分析会可提高低年资护士对护理安全事件的认识及风险评估和管理能力,进而提高护理安全质量。     

低年资护士的护理安全信息警示管理

目的 探讨对低年资护士实施护理安全信息警示管理的效果.方法 对35名低年资护士在常规护理安全管理的同时给予安全信息警示管理,包括建立护理安全信息警示管理体系,制定并应用护理安全信息周报表,执行安全信息警示管理并反馈等.结果 实施护理安全信息警示管理前后不良事件发生率比较,差异有统计学意义(P<0.05);实施护理安全信...     

外科病区高危药品的规范管理

目的规范病区高危药品管理方法,提高临床护理用药安全性。方法在病区成立专项小组,在专业药师的指导下制定病区高危药品目录,完善管理制度和使用流程,对护士实行高危药品知识培训。结果护士高危药品知识知晓率、医生满意率显著提高(P0.05,P0.01);临床使用高危药品的不良事件由管理前的11例次/年降至4例次/年。结论规范病区高危药品管理可有效降低高危药品风险,保障临床用药安全。     

孝感市新生儿病区护理安全管理现状调查研究

目的了解孝感市新生儿病区护理安全管理现状,为各级卫生行政主管部门及医院管理者制定相关管理策略提供依据。方法自行设计调查表,采取实地查看、查阅资料、询问与抽考护士等方式,对孝感市15所二级及以上医疗保健机构的新生儿病区护理安全管理现状进行全面综合调研。结果所查15所医院新生儿病区中,合格率最高的为输液管理(53.33%),最低的是护士专科技术操作考核(13.33%);不同级别医院在仪器设备管理、急救车管理等9个方面合格率比较,差异有统计学意义(P<0.05,P<0.01)。结论孝感市大部分医院的新生儿病区基本具备与医疗机构规模、级别相适应的硬件设施和技术力量,但存在不平衡现象,三级医院整体水平高于二级医院。总体上存在区域划分不合理,业务用房面积不足,部分仪器设备数量不足、性能不良,急救物品、药品管理不善,安全管理相关制度与机制不完善,护士专科技术水平与综合素质有待提高等突出问题,亟待改善与提高。     

风险管理在综合病区护理管理中的应用

目的 降低护理差错事故发生率,提高患者护理满意度.方法 对综合病区潜在和存在的护理风险进行评估归纳,制定、完善综合病区护理风险防范制度,落实风险防范措施.结果 实施风险管理后住院患者的满意度从87.94%上升到97.99%.护理缺陷、潜在护理隐患发生率由1.53%、3.67%下降至0.35%、0.43%(均P＜0.01).结论 对多专科综合病区加强护理风险管理,可保障患者治疗的安全性和提高其满意度.     

低年资护士护理不安全因素分析与管理对策

<正>临床低年资护士是护理队伍的新生力量,其素质的高低不仅影响护理队伍的整体素质[1],而且也影响医院的整体护理质量和护理安全,为了增强护理人员的风险管理意识,减少护理安全投诉事件的发生,持续改进护理质量,我科将自     

病区层级管理联合护士质控反馈会议在护理质量管理中的应用

目的探讨病区层级管理联合护士质控反馈会议对提高护理质量的效果。方法从2003年7月开始，在病区层级管理模式的基础上实施每周1次的病区护士质控反馈会议，对质控中发现的问题进行反馈、制订整改措施。结果与实施前比较，实施层级管理联合护士质控反馈会议后，病区各项护理质量显著提高（P〈0．05，P〈0．01）。结论实施层级管理及每周1次的病区护士质控反馈会议，能使护理各环节处于有效的动态监控中，使护理质量得以持续改进。     

病区层级管理联合护士质控反馈会议在护理质量管理中的应用

目的 探讨病区层级管理联合护士质控反馈会议对提高护理质量的效果.方法 从2003年7月开始,在病区层级管理模式的基础上实施每周1次的病区护士质控反馈会议,对质控中发现的问题进行反馈、制订整改措施.结果 与实施前比较,实施层级管理联合护士质控反馈会议后,病区各项护理质量显著提高(P＜0.05,P＜0.01).结论 实施层级管理及每周1次的病区护士质控反馈会议,能使护理各环节处于有效的动态监控中,使护理质量得以持续改进.     

新形势下低年资护士护理安全管理重在防范

安全是患者的基本需要。护理安全是保证护理质量的前提,是为患者提供安心、放心、满意的优质服务的基本保证。护理安全与患者的生命安全息息相关。随着各级医院的扩编,大量新护士进入临床,当前临床工作中低年资护士居多,其专业知识不够丰富、对病情     

Infection control measures in surgical wards and operating theaters

A variety of infection control measures are practiced to decrease the risk of transmission of pathogens. Standard precautions are thought to be the most effective against healthcare-associated infections. However, compliance with standard precautions is not sufficiently high in Japanese hospitals. Frequent handwashing is an important measure to reduce the risks of transmitting infectious organisms from one person to another, although it is not easy to maintain high compliance in healthcare settings. This problem has not been fundamentally resolved, although infection control practitioners have addressed this problem for more than 100 years. It is recommended that healthcare workers wear personal protective equipment, such as masks, gowns, gloves, goggles, and face shields, to provide barrier protection. Environmental consideration of operation rooms must be performed in order to decrease surgical site infections. Operating theaters should be cleaned routinely, if possible using a wet vacuum. Clean air should be supplied through high-efficiency particulate air filters and positive pressure maintained. Surgeons should be aware that they are an important potential source of surgical site infection.     

Microbiology as applied to surgical practice

Microbiology is integrated throughout surgical practice, and a working knowledge of its basic principles is essential in caring for surgical patients. In particular, it is important to have an understanding of the basic science behind micro-organisms and infection, as well as a knowledge of surgically important micro-organisms and methods of preventing infection in surgical patients. In this article we cover these topics with reference to the MRCS syllabus and include information about relevant micro-organisms and antibiotics.     

Microbiology as applied to surgical practice

Microbiology is integrated throughout surgical practice, and a working knowledge of its basic principles is essential in caring for surgical patients. In particular, it is important to have an understanding of the basic science behind micro-organisms and infection, as well as a knowledge of surgically important micro-organisms and methods of preventing infection in surgical patients. In this article we cover these topics with reference to the MRCS syllabus and include information about relevant micro-organisms and antibiotics.     

手术室与病房联合质量督查在手术患者交接中的应用

目的探讨降低手术患者交接缺陷的有效方法,保障患者安全。方法对223例胃肠手术患者(观察组)实施手术室与病房科护士长联合督查,促进流程再造,细化制度,制订相关规范,手术室、病房共同参与,完成手术患者的交接;并与实施常规手术交接的223例患者(对照组)进行比较。结果观察组手术患者交接过程中缺陷发生率显著降低,接送患者时间缩短,患者满意度提高;与对照组比较,差异有统计学意义(均P<0.01)。结论手术室与病房联合质量督查手术患者交接工作,能使多部门密切配合,提高手术患者交接的安全性。     

Postoperative epidural morphine is safe on surgical wards

The use of epidural morphine for postoperative analgesia outside of intensive care units remains controversial. In this report our anesthesiology-based acute pain service documents experience with 1,106 consecutive postoperative patients treated with epidural morphine on regular surgical wards. This experience involved 4,343 total patient days of care and 11,089 individual epidural morphine injections. On a 0-10 verbal analog scale, patient-reported median pain scores at rest and with coughing or ambulation were 1 (inter-quartile range 3) and 4 (interquartile range 4), respectively. The incidence of side effects requiring medication were as follows: pruritus 24%, nausea 29%, and respiratory depression 0.2%. There were no deaths, neurologic injuries, or infections associated with the technique. Migration of epidural catheters into the subarachnoid space and into epidural veins each occurred twice. Overall, 1,051 of the 1,106 patients (95%) experienced none of the following problems: catheter obstruction, premature dislodgement, painful injections, catheter migration, infection, or respiratory depression. We conclude that postoperative pain can be safely and effectively treated with epidural morphine on surgical wards.     

Adherence to surgical care improvement project measures and post-operative surgical site infections

Abstract Background: Surgical site infection (SSI) is unequivocally morbid and costly. The estimated 300,000 SSIs annually in the United States represent the second most common infection among surgical patients, prolong hospitalization by 7-10 days, and have an estimated annual incremental cost of $1 billion. The mortality rate associated with SSI is 3%, with about three quarters of deaths being attributable directly to the infection. Prevention is possible for the most part, and concerted effort has been made to limit these infections, arguably to little effect. Methods: Review of pertinent English-language literature. Results: Numerous risk factors for SSI and tactics for prevention have been described, but efforts to bundle these tactics into an effective, comprehensive prevention program have been disappointing. Numerous studies now demonstrate that the Surgical Care Improvement Program (SCIP), which focused on process improvement rather than outcomes, has been ineffective despite governmental support, financial penalties for non-compliance, and consequent widespread implementation. Conclusion: Required reporting has increased awareness of the problem of SSI, but just as the complexity of SSI risk, pathogenesis, and preventions reflects the complexity of the disease, many other factors must be taken into account, including the skill and knowledge of the surgical team and promulgation of a culture of quality and safety in surgical patient care.