医疗责任保险调处医疗纠纷的现状和对策建议

医疗责任保险体系的建立和保险机制的推行,无疑对医疗纠纷的化解带来积极的作用,但还存在法律依据的未及详尽、承保方的利益驱动与事故赔偿核定标准的权威缺失、以及因此导致投保方与患方在处理理赔时选择保险制度的愿望不高等问题.对此,笔者建议:变自主投保的商业保险方式为建立强制医疗责任保险制度,建立第三方调解鉴定机构,统一医疗损害赔偿标准,完善医疗责任保险相应的配套制度.     

从案例看医患纠纷的成因及对策

医患纠纷在医疗机构中普遍存在,影响医疗机构的有效运作,也影响和谐社会的构建,有效预防和妥善解决医患纠纷是医院管理中的当务之急。虽然每宗医患纠纷都有其特定性,但也有其普遍性和规律性。通过研究多宗医患纠纷案例,分析认为导致医患纠纷的原因中,医患之间、医院内部沟通不足以及医务人员服务态度不端正所占比例最大;同时,医务人员责任心不够导致医疗过失在导致医患纠纷原因构成中所占比例虽然不大,但其造成的后果却最为严重。鉴于此,为有效预防和妥善解决医患纠纷,必须要加强以细节为核心的医院管理制度建设,加强“以病人为中心”的医院文化建没,加强对医务人员良好细节习惯的培养,加强对医务人员贯彻执行医院管理制度和履行医务人员行为规范情况的检查和考核。     

“风险医疗”的概念、特点及在实践中的应用

防范医疗风险是卫生管理领域的重要任务之一,但鉴于医疗技术的不断进步和诊疗领域的拓展,有必要引入风险医疗的概念,使医患双方在克服疾病、战胜自然的努力中共担风险,共享成果,并可以避免因诊疗效果不佳导致的医疗纠纷。     

再议法医在医疗纠纷技术鉴定中的定位、问题及建议

目前医疗纠纷鉴定机构主要为医学会和司法鉴定机构,其鉴定的主体分别为医疗专家和法医,当前学术界对两类鉴定主体参与医疗纠纷司法鉴定有两种不同主张,有些主张由医学会进行医疗纠纷鉴定,有些主张由法医进行医疗纠纷鉴定,文章认为法医进行医疗纠纷鉴定有他的合理性,他在医疗纠纷的定位应为“‘专职的司法鉴定人、独立的诉讼参与人”。但是,法医作为鉴定人也存在一些问题和不足,文章针对现存的问题进行了分析,提出了相关的建议。     

护士长的工作方式对护患关系的影响

目的探讨护士长的工作方式对护患关系的影响。方法护士长改变传统的工作方式,每天与病人家属进行有效沟通,主要针对新病人、危重症病人、临出院病人。结果实验组病人家属对护理工作的满意度较对照组有明显改善。结论与病人家属建立良好的护患关系,为患者及家属提供优质的服务,是改善护患关系的重要举措。     

After “Hello” with a wounded warrior: A student journey

The article describes the journey of a terror-stricken student growing into an adept healthcare provider; representing courageous personal and professional growth after a “Hello” in a nursing school immersion experience. The journey includes the student’s emotional maturity and courage, recognizing the uniqueness of military culture, realizing the magnitude of the patient’s losses, ascertaining patient concerns, personal recovery goals and long-term support network. Together recovery milestones are recognized and achieved. The article underscores the importance of nurse education in facilitating student’s effective nurse-patient communication techniques considering diverse cultural elements, and consistently applying these theoretical concepts into practice. Assignments geared toward a holistic patient perspective can serve to develop student leadership progress toward becoming informed and engaged citizens, enlarging worldviews and a heightened awareness of relevant global issues, and spark passion related to national policy reform. Commitment to professional ownership of personal and professional growth throughout nursing school leads to positive transitions as a seasoned healthcare provider.     

In search of a caring relationship - Nursing students’ notions of interactions in the nurse-patient relationship

The aim of the study is to explore how nursing students talks about their notions on interactions in the relationship between nurse and patient. Empirical data has been obtained from 22 students in their first semester of the Swedish undergraduate nursing programme, applying thematic, individual interviews and using qualitative content analyses. The most significant finding is that although the students had none or limited pre-understanding of caring and the interaction between nurse and patient they were aware of the pre-supposes for establishing such an interplay, articulated in a desire to find out how to build an authentic and trustful caring relationship. Empirical data also show that the students, in the stage of beginners, were trying to identify and relate to basic concepts within caring science. The restricted understanding could then be understood as a matter of the students not being able to express more than they had words for. The results provide new insights into the interactions in the nurse-patient relationship, seen from the perspective of beginner students. These insights could be useful, for lecturers and clinical supervisors, who play a paramount role in the development of each student's acquisition of theoretical and practical knowledge.     

安全管理在儿科护理管理中的应用价值

目的探讨安全管理在儿科护理管理中的应用价值。方法该组研究纳入在该院儿科收治的100例患儿,病例资料选取时间从2018年3月—2019年3月,将所有患儿按照随机数字表法分成两组。对照组50例患儿实施常规护理,而研究组50例患儿实施安全管理,对比两组的护理纠纷发生率和患儿家长的护理满意度。结果研究组患儿的护理纠纷发生率为2.00%,明显低于对照组的发生率14.00%(χ^2=4.891,P=0.026<0.05)。研究组患儿家长的护理满意度为98.00%,明显高于对照组(84.00%),组间对比差异有统计学意义(χ^2=5.982,P=0.014<0.05)。结论安全管理应用于儿科护理管理中有助于降低护理纠纷发生率,提高患儿家长的护理满意度,值得在临床上进行深入研究和推广。     

整体护理对外科护患关系信任度的影响

通过调查术后患者对护士的信任程度,进行模式病房与普通病房护患信任度的对比分析,探讨整体护理实践对护患间信任度的影响。结果提示建立护患信任的根本在于实施“以病人为中心”的整体护理,护士要充分发挥主观能动性,在构成护患信任的五要素上努力。作者认为模式病房的实践,对护患间信任度有促进作用,并提出全面开展整体护理的必要性。