1 quality control management method
1. 1 The organizational reform of operating room management is different from ward nursing. There are 1 1 surgical specialties, with many kinds of operations and busy work. It was inevitable that the head nurse would have to take part in the operation and manage the general work. Now it is divided into thoracic surgery group, general surgery group, urology group, orthopedics group, neurosurgery group and so on. Nine teams are divided into three districts with three district heads. The heads of these groups are the nurse in charge or practical nurse, and the district heads are the senior group heads and the nurse in charge, which rotate once every six months, so that the group heads and district heads can participate in the management of the department. In other words, we will change the management from head nurse to three-level management of head nurse, district head and team leader. Organize a monthly spot check on the quality control work of the responsible person of the district and the core team of the department, and evaluate the work of the three districts and various professional groups. Usually the head nurse checks the work according to the quality control standard. When the head nurse is not in class, the district head is in charge.
1.2 management methods of quality control In order to ensure the safety of patients' operation, we should focus on the operation and do a good job of double inspection and three inspections. The first three levels, namely preoperative preparation, intraoperative cooperation and postoperative treatment: www.med66.com of Medical Education Network.
(1) preoperative preparation should be closed, and "eight checks" should be done to check the patient's name, gender, department, surgical diagnosis, surgical name, surgical site, blood type and article preparation;
(2) intraoperative cooperation, to achieve three strict, that is, strict aseptic technology operating procedures, serious working conditions, to prevent errors and accidents;
(3) Post-operative treatment to achieve "three determinations", that is, determination, quantification and positioning.
The last three levels are the three levels before operation:
(1) After the middle shift staff bring all patients into the operating room, the middle shift nurses check them one by one according to the notice and the shift schedule;
(2) The visiting nurse checks the medical records according to the operation notice, and checks the implementation of the preoperative doctor's orders; Www.med66.com Medical Education Network
(3) The head nurse checked again before operation. These three levels are mainly aimed at taking patients to the wrong operating room and opening the wrong knife.
1.3 quality spot check of work quality evaluation method is mainly conducted by the head nurse or head nurse (or individual district head) every day according to the responsibilities and quality standards of nurses, including: disinfection and isolation, rescue of articles, positioning of articles in the operating room, cleanliness and hygiene, responsibilities of each shift, etc. The next morning, the results of the spot check will be evaluated, and the well-managed district heads, team leaders and comrades who have completed their work will be praised and encouraged at the meeting; For the existing problems, the end of the month will be linked with personal care evaluation and monthly bonus.
1.4 The warden who manages well by the reward and punishment method will be rewarded with 3 points per month, the nurses who complete their duties in each shift will be rewarded with 100% per month, and the nurses whose work quality is not completed will be rewarded with 100% per month. At the end of the year, the team leader and team members who have completed the whole year's work will be rewarded (funds will be obtained from the director's fund). 10% of the bonus distribution scheme is title award and 90% is performance award. Whether the work is done well or not is reflected in the performance award. Deduct 1 point, that is, the bonus is 1%.
See table 1 ~ 3 for the inspection items on duty and deduction standards of each shift.
Table 1 Working Quality Standard for Hand-washing Visiting Nurses
Check the standard deduction description of project deduction.
Equipment and materials are ready. 1 ~ 3 score is incomplete. Damage and loss
This instrument has been thoroughly cleaned. 1 min found blood on the instrument.
Sample retention registration is complete, and 1 score is not enough.
Carefully count the equipment column 1 point is not enough.
Items are placed by location: 1 suction device, rice cooker, stool, etc. Not enough.
Table 2 Quality Standard of Nurses' Equipment Preparation
Check the standard deduction description of project deduction.
Accurately prepare equipment with good performance; 1 min indicates that one item is unqualified. Less main instruments affect the operation. 15 minute is wrong.
The qualified rate of sterile articles is 100%, 1. Found an overdue article.
Sterile items are placed in a neat and orderly manner. Routine examination showed that 1 dot was disordered.
It is not enough to record 1 minute for changing items regularly.
Table 3 Quality Standards for Cleaning and Hygiene Work
Check the standard deduction description of project deduction.
The operating room is not clean enough to do three sweeps and three tows every day.
After the operation, clean the operating room and mop the floor. 0.5 points will be deducted for incompleteness.
Ensure that 0.5 o'clock shadowless lights, operating tables, doors, windows and footstools are out of reach.
No blood or dust.
Deduction standard for organizational discipline: 0.5 points will be deducted for leaving early and being late for 5 minutes. The personnel on duty who stick to their posts and leave their posts without reason will be dealt with according to the seriousness of the case, and the patient's rescue will be delayed, and a bonus of 1 ~ 3 months will be deducted. Absenteeism 1d will deduct the bonus of the month.
Two results
Our department carries out quality control management through the above methods, and the nursing quality evaluation of operating room has won the first place in all departments of the hospital for three consecutive years, and won the floating prize of 5% monthly bonus of the hospital.
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To improve the quality management of departments, it is necessary to reform the personnel system. In the past, regardless of major issues, business or administrative affairs were handled by the head nurse, who was busy with major issues all day and had to attend surgery in person. When he arrived at the hospital, he was either not thoroughly hygienic, or the staff were not proficient in answering their duties in each class, and their stress ability was poor. After repeated discussions by the core group of the department, the single head nurse management was changed to three-level management of head nurse, district head and group leader, so as to give full play to the role of senior nursing backbone management, achieve division of labor and cooperation, check at all levels, and find the district head and group leader for technical operation and business. The head nurse randomly checks the job responsibilities of each class at ordinary times, asking more questions, making the staff in a state of tension, answering questions, and being busy without chaos, so that the system is implemented, the management of departments is standardized and standardized, hospitals and nursing departments randomly check the work at any time, and the operating room environment is kept clean and tidy, and the nursing work is orderly. Www.med66.com Medical Education Network
The responsibilities of each class are linked to the bonus, so as to reward the diligent and punish the lazy, with clear rewards and punishments, and fully mobilize and give play to the enthusiasm of nurses. In the past, the duties of each class were linked to bonuses, with good or bad work, more work and less pay, average bonuses at the end of the month, and low enthusiasm of employees. Since the establishment of the reward and punishment system, it has been linked to the monthly nursing assessment and bonus. Whether the duties of each class are completed well can be reflected in the bonus and nursing evaluation. Every time there is a task, comrades scramble to do it.
In order to ensure the safety of patients' surgery, we should strictly control the two-stage and three-stage surgery. In view of the lax control of other medical units, the wrong patient took the wrong knife. Therefore, we believe that medical accidents can be completely prevented as long as this inspection system is strictly implemented.