危重患者的風(fēng)險(xiǎn)評估及安全防范措施

1、rapid development of the market economy environment to explore public servants duty consumption monetization reform hasprovided a good foundation. Thesocialization of rear service workhas b een launched, and rapid progress in some places and departme nts, duty consumption monetization of carrier and

2、 appr oach to management hasbee n resolve d. Third, in recent years, exploring the monetization of duty consumption has made some progress, have gained some experience and can provi de reference to thecompre hensive reform of the system of public serva nts dutyconsumption further. Implementing an ho

3、nest canteen, standardize official e ntertaining management; enhancing the telecommunication expense management; eliminationof County travel andcountryside subsi dies; research village officials capitalization ma nagement of corporate spendi ng, a nd so on. Finally, group .18 session tobe he ld inBe

4、ijing from November 9, 2013 to 12th. 35 years ago blew the third plenary session of the reform and opening up in thespri ng breeze, changed, affect the world; today, 35 years later, in the eyesof the nation a nd the world expe ct, again to reform mark China, usheredin the 18sessi on. XI General Secr

5、etary pointedout that Chinas reform has entered acrucial peri od and the Sham Shui Po District, must be based on greater politicalcourage and wisdom, lose no time in deepening reform in important fields. Dares to cra ck a hardnut, dares to questi on the Rapids,which dares to break the barrierof idea

6、s, and dare to benefit cure barriers. Deepeni ng reform andopening up is on schedule to achieve institutional safeguards of the moderately well-off. Under the five in one the General layout of socialist moder nization requirements,18 session of thedecision was a five in one and the improvement of ov

7、erall schemeof reform, will promoten integrated and coor dinatedeconomic, political,cult ural, socialand ecologicalcivilization construction of the five reforms and the party s construction in the areaof institutional reform.The five in one programme is to achieve acompr ehensive reform of instituti

8、onal guarantees for objectives of build a well-off society, thesmooth progressof the constructionof a well -off society and reform the objectives of theprogramme.One, hol ding time and place importance on November 9, 2013 to the18 session of the 12t h Beijingsince 1978, 35, havebeen 7 plenary sessi

9、on, each time on majorissues of political and economic lifeof the country has made importantdepl oyment. In accorda nce with PRC politicalpracti ce, often at every session of the CPC Central Committee in aple nary session washel d immediately after thepartys Congress, on t he theme personnel, discus

10、sing electionCentrals top leaders, such as the election of the StandingCommittee of the politicalBure au, throug h the Central Committeemembers, decisi ons, such as members of theCentral Military Commission.The secondplenary session, is held in two sessions before the general election, mainly to di

11、scuss a new State personnel issues. But by the third一、危重患者護(hù)理的高風(fēng)險(xiǎn)因素1. 觀察病情不細(xì)致、 預(yù)見性不強(qiáng)所造成的風(fēng)險(xiǎn)：由于危重患者的病情危重，病情較復(fù)雜、變化快、并發(fā)癥多，如果護(hù)士?？浦R不足，經(jīng)驗(yàn)缺乏、粗心大意、責(zé)任意識淡薄、對病情沒有預(yù)見性，沒有發(fā)現(xiàn)病情變化，如患者猝死、突發(fā)上消化道出血、昏迷患者躁動墜床以至處理不及時(shí)，失去最佳搶救時(shí)機(jī)，容易造成醫(yī)療糾紛。2. 社會心理因素： 由于疾病發(fā)展到不可逆性導(dǎo)致患者死亡，突然喪失親人可導(dǎo)致極度悲痛的反應(yīng)，例如拒絕接受、憤怒或抑郁。初期的打擊可使親屬感到麻木和意識紊亂， 隨后情緒可能轉(zhuǎn)化為

12、憤怒， 有時(shí)甚至?xí)虼诉w怒于醫(yī)護(hù)人員， 親屬往往對導(dǎo)致患者死亡的每個細(xì)節(jié)都十分關(guān)注，而這種強(qiáng)烈的情緒可能進(jìn)一步加深醫(yī)護(hù)人員和親屬之間的誤會，引起醫(yī)療和護(hù)理的糾紛。3. 護(hù)患溝通不良所造成的風(fēng)險(xiǎn)：由于病情危重，清醒患者的恐懼和家屬的焦慮很容易對病情過于緊張， 對醫(yī)護(hù)人員的治療護(hù)理過分關(guān)注，工作稍有不慎，會引致家屬的誤解和不滿，同時(shí)，病情的發(fā)展和轉(zhuǎn)歸關(guān)系到患者的生命安全及患者家庭的穩(wěn)定， 患者患病的自然過程或治療、檢查過程的風(fēng)險(xiǎn)都可使患者病情出現(xiàn)反復(fù)或加重。4人為的失誤（ 1）規(guī)章制度落實(shí)不嚴(yán)，沒有嚴(yán)格按照醫(yī)療護(hù)理操作規(guī)程處理。如常用搶救設(shè)備沒定時(shí)檢測，當(dāng)患者出現(xiàn)病情變化，搶救時(shí)儀器、機(jī)械突然故障

13、，危重患者轉(zhuǎn)送時(shí)，救護(hù)車中急救器械、物品及護(hù)理人員準(zhǔn)備不足。lenarysessi on, each session of the Central Committee of national institutions and personnelproblems havebeen arranged, youcan concentrate onnational developme nt and reforms.Previous plenarysession i s often brande d with acentral leadingcoll ective,often by looking at

14、 the thirdplenum of the initiative to found thecurrent ce ntral leadershipcollective gover nancecharacteristics.From the analysis of the process of economic reform in China, plenary session, 12 session, 14, 16plenary sessionhave programmatic meaning, respectively, marking the four stagesof Chi nas e

15、conomic reform , and that the start-up phase of reform, reform, construction phase and perfecting the Socialist market economy framework stage of socialist market economy.Previousplenarysessi on topi cs propose d to the third pl enary sessi on of taking class struggle as the key link,shifted to soci

16、alist modernizati on;12 session marked thecha nge from rural to urban, established with publicownershi p as the Foundation of aplannedcommodity economy;13 session at a time when both t he old and the newsystem change, governance and rectify the economi c order; 14 . Fair and efficient and authoritat

17、ive Socialist judicial system, safeguard the peoples interests.Legal authority to uphold the Constitution, deepening the reform of administrative lawenforcement, ensure that the right to exerci se judicial power independently and impartially according to la w theprosecuti on, perfecting the running

18、mecha nism of judicial power, improve the system of judicial protectionof human rights.Ple nary session, Affairs the right to adhere to the system, and let the people authority to let the power run in the Sun, isshut up in acage of thesystem power policy. Decisi on Science, implementation shouldbe c

19、onstructed strong, supervise the r unningof powerful system, improve the system of punishing andpreventing corrcadres honest and Government integrity, clean politics.To form a scientific and effective coordination of power restriction a nd mecha nisms to strengthen anti-corruption institutional inno

20、vation and institutional protection, sound improvement stylenormal system.Plenary sessi on, building a sociali st culture inChi na, e nhancing national cultural soft power, must adhere to the orientation of advanced Sociali st culture, adhere t o the development of Socialistculture with Chinese char

21、acteristics, adhere to the people-centred work-oriented, furtherdeepeni ng reform of culture.o improve the cultural management system, establish and improve the modern market system and building modern public cultural servicesystem, improve the level of cultureope ning. Plenary session, achievingdev

22、el opment re sults moreequitablebenefit of allpeople, we must speedup reform of socialprograms and solve the issues ofconcern to the people the most direct and real interest, and better meetthe needs of thepeople.To deepe n educati on reform, improve institutional mecha nisms for therapid developmen

23、t of the market economy environment to explore public servants duty consumption monetization reform hasprovided a good foundation. Thesocialization of rear service workhas been launche d, and rapid progress in some places and departme nts, duty consumption monetization of carrier and appr oach to ma

24、nagement hasbee n resolve d. Third, in re cent years, exploring the monetization of duty consumption has made some progress, have gained some experience and can provi de reference to thecompre hensive reform of the system of public serva nts dutyconsumption further. Implementing an honest canteen, s

25、tandardize official e ntertaining management; enhancing the telecommunication expense management; eliminationof County travel andcountryside subsi dies; research village officials capitalizati on management of corporate spendi ng, and so on. Finally, group .18 session tobe he ld inBeijing from Novem

26、ber 9, 2013 to 12th. 35 years ago blew the third plenary session of the reform and opening up in thespri ng breeze, changed, affect the world; today, 35 years later, in the eyesof the nation a nd the world expe ct, again to reform mark China,usheredin the 18sessi on. XI General Secretary pointedout

27、that Chinas reform has entered acrucial peri od and the Sham Shui Po District, must be based on greater politicalcourage and wisdom, lose no time in deepening reform in important fields. Dares to cra ck a hardnut, dares to questi on the Rapids,which dares to break the barrierof ideas, and dare to be

28、nefit cure barriers. Deepening reform andopening up is on schedule to achieve institutional safeguards of the moderately well-off. Under the five in one the General layout of socialist moder nization requirements,18 session of thedecision was a five in one and the improv eme nt of overall schemeof r

29、eform, will promote an integrated and coor dinatedeconomic, political,cult ural, socialand ecologicalcivilization construction of the five reforms and the party s construction in the areaof institutional reform.The five in one programme is to achieve acompr ehensive reform of institutional guarantee

30、s for objectives of build a well-off society, thesmooth progressof the constructionof a well -off society and reform the objectives of theprogramme.One, hol ding time and place importance on November 9, 2013 to the18 session of the 12t h Beijingsince 1978, 35, havebeen 7 plenary sessi on, each time

31、on majorissues of political and economic lifeof the country has made importantdepl oyment. In accordance with PRC politicalpracti ce, often at every session of the CPC Central Committee in aple nary session washel d immediately after thepartys Congress, on t he theme personnel, discussing electionCe

32、ntrals top leaders, such a s the election of the StandingCommittee of the politicalBure au, throug h the Central Committeemembers, decisi ons, such as members of theCentral Military Commission.The secondplenary session, is held in two sessions before the general election, mainly to di scuss a new St

33、ate personnel issues. But by the third（ 2）護(hù)理文書書寫不規(guī)范 護(hù)理記錄必須保證全面、真實(shí)、完整、及時(shí)、準(zhǔn)確，是反映患者病情變化、疾病治療護(hù)理經(jīng)過及其治療效果的原始記錄， 也是斷定醫(yī)護(hù)人員醫(yī)療行為是非以及診療措施實(shí)施情況的憑證。同時(shí)為舉證倒置提供了重要依據(jù)。 一旦發(fā)生醫(yī)療糾紛，護(hù)理記錄即成為法律上的一種證據(jù)。（ 3）專業(yè)技術(shù)、護(hù)理操作不熟練。二、護(hù)理風(fēng)險(xiǎn)的防范措施1高度重視，轉(zhuǎn)變觀念，加強(qiáng)業(yè)務(wù)學(xué)習(xí)護(hù)理人員必須高度重視護(hù)理風(fēng)險(xiǎn)的重要性和必要性，從根本上轉(zhuǎn)變觀念， 提高執(zhí)業(yè)風(fēng)險(xiǎn)意識及法律意識，堅(jiān)持不斷學(xué)習(xí)法律教育及醫(yī)療事故處理?xiàng)l例，牢固樹立“安全第一，質(zhì)量第

34、一”觀念。做到有預(yù)見性，對潛在的不安全因素重點(diǎn)防范， 如成立護(hù)理風(fēng)險(xiǎn)小組， 對與護(hù)理相關(guān)的各種風(fēng)險(xiǎn)種類進(jìn)行了分析與評估， 確定可能發(fā)生的風(fēng)險(xiǎn)種類， 制定各種護(hù)理緊急風(fēng)險(xiǎn)預(yù)案。2制定完善醫(yī)療護(hù)理規(guī)章制度科學(xué)完善合理的規(guī)章制度是防范差錯事故及糾紛的良好基礎(chǔ)，制定各種護(hù)理質(zhì)量關(guān)鍵流程及護(hù)理缺陷管理措施，護(hù)理人員嚴(yán)格執(zhí)行規(guī)章制度是防范差錯事故的保證。（1）護(hù)理等級制度必須落實(shí)護(hù)理等級要求，危重患者15min- 30min 巡視 1 次，對病情進(jìn)展做到心中有數(shù)。（ 2）急救室工作制度成立專人管理小組，包括急救物品管理、使用、保養(yǎng)、供應(yīng)等，使急救室設(shè)備及藥品完好率達(dá) 100%，熟練掌握各種急救設(shè)備的使用。

35、 加強(qiáng)護(hù)理操作訓(xùn)練， 掌握多科業(yè)務(wù)知識lenarysessi on, each session of the Central Committee of national institutions and personnelproblems havebee n arranged, youcan concentrate onnational developme nt and reforms.Previous plenarysession i s often brande d with acentral leadingcoll ective,often by looking at the third

36、plenum of the initiative to found thecurrent ce ntral leadershipcoll ective governancecharacteristics.From the analysis of the process of economic reform in China, plenary session, 12 session, 14, 16plenary sessionhave programmatic meaning, respectively, marking the four stagesof Chi nas economic re

37、form, and that the start-up phase of reform, reform, construction phase and perfecting the Socialist market economy framework stage of socialist market economy.Previousplenarysessi on topi cs propose d to the third pl enary sessi on of taking class struggle as the key link,shifted to socialist moder

38、nizati on;12 session marked thecha nge from rural to urban, established with publicownershi p as the Foundation of aplannedcommodity economy;13 session at a time when both t he old and the newsystem change, governance and rectify the economi c order; 14 . Fair and efficient and authoritative Sociali

39、st judicial system, safeguard the peoples interests.Legal authority to uphold the Constitution, deepening the reform of administrative lawenforcement, ensure that the right to exerci se judicial power independently and impartially according to la w theprosecuti on, perfecting the running mecha nism

40、of judicial power, improve t he system of judicial protectionof human rights.Ple nary session, Affairs the right to adhere to the system, and let the people authority to let the power run in the Sun, isshut up in acage of thesystem power policy. Decisi on Science, implementation shouldbe constructed

41、 strong, supervise the r unningof powerful system, improve the system of punishing and preventing corrcadres honest and Government integrity, clean politics.To form a scientific and effective coordination of power restriction a nd mecha nisms to strengthen anti-corruption institutional innovation an

42、d institutional protection, sound improvement stylenormal system.Plenary sessi on, building a sociali st culture inChi na, e nhancing national cultural soft power, must adhere to the orientation of advanced Sociali st culture, adhere t o the development of Socialistculture with Chinese characteristi

43、cs, adhere to the people-centred work-oriented, furtherdeepeni ng reform of culture.o improve the cultural management system, establish and improve the modern market system and building modern public cultural servicesystem, improve the level of cultureope ning. Plenary session, achievingdevel opment

44、 results moreequitablebenefit ofall people, we must speedup reform of socialprograms and solve the issues of concern to the people the most direct and real interest, and better meetthe needs of thepeople.To deepe n educati on reform, improve institutional mecha nisms for therapid development of the

45、market economy environment to explore public servants duty consumption monetization reform hasprovided a good foundation. Thesocialization of rear service workhas been launche d, and rapid progress in some places and departme nts, duty consumption monetization of carrier and appr oach to management

46、hasbee n resolve d. Third, in re cent years, exploring the monetization of duty consumption has made some progress, have gained some experience and can provi de reference to thecompre hensive reform of the system of public serva nts dutyconsumption further. Implementing an honest canteen, standardiz

47、e official e ntertaining management; enhancing the telecommunication expense management; eliminationof County travel andcountryside subsi dies; research village officials capitalization management of corporate spendi ng, and so on. Finally, group .18 session tobe he ld inBeijing from November 9, 201

48、3 to 12th. 35 years ago blew the third plenary session of the reform and opening up in thespri ng breeze, changed, affect the world; today, 35 years later, in the eyesof the nation a nd the world expe ct, again to reform mark China, usheredin the 18sessi on. XI General Secretary pointedout that Chin

49、as reform has entered acrucial peri od and the Sham Shui Po District, must be based on greater politicalcourage and wisdom, lose no time in deepening reform in important fields. Dares to cra ck a hardnut, dares to questi on the Rapids,which dares to break the barrierof ideas, and dare to benefit cur

50、e barriers. Deepeni ng reform andopening up is on schedule to achieve institutional safeguards of the moderately well-off. Under the five in one the General layout of socialist moder nization requirements,18 session of thedecision was a five in one and the improvement of overall schemeof reform, wil

51、l promote an integrated and coor dinatedeconomic, political,cult ural, socialand ecologicalcivilization construction of the five reforms and the party s construction in the areaof institutional reform.The five in one programme is to achieve acompr ehensive reform of institutional guarantees for obje

52、ctives of build a well-off society, thesmooth progressof the constructionof a well -off society and reform the objectives of theprogramme.One, hol ding time and place importance on November 9, 2013 to the18 session of the 12t h Beijingsince 1978, 35, havebeen 7 plenary sessi on, each time on majorissues of political and economic lifeof the country has made importantdepl oyment. In accorda nce with PRC