護(hù)理質(zhì)量與持續(xù)改進(jìn)課件

護(hù)理質(zhì)量管理與持續(xù)改進(jìn)護(hù)理部王曉鳳護(hù)理質(zhì)量管理與持續(xù)改進(jìn)1案例1:手術(shù)物品清點(diǎn)交接·手術(shù)室夜班同白班護(hù)士交接,因持續(xù)X線照射,未按要求在臺(tái)上交接,而在手術(shù)間外,未清點(diǎn)紗布手術(shù)結(jié)束時(shí)用過的止血紗布地上與垃圾袋內(nèi)都有,手術(shù)醫(yī)生口頭確認(rèn)“傷口內(nèi)無紗布”,認(rèn)為既然在持續(xù)放射線下的手術(shù),如有紗布會(huì)顯影,所以未能按要求清點(diǎn)。術(shù)后第二天檢查時(shí)發(fā)現(xiàn)腿部傷口內(nèi)存留紗布案例1:手術(shù)物品清點(diǎn)交接2案例2:患兒身份識(shí)別與核查兩名同名同姓產(chǎn)婦的新生兒等待治療護(hù)士推過其中一輛嬰兒車,查看床頭卡姓名,出生時(shí)間,便在孩子左上臂接種了卡介苗0.1ml,并在醫(yī)囑執(zhí)行單及疫苗接種本上簽字推到下一個(gè)新生兒時(shí),看床頭卡也叫一樣的姓名,便立即查看疫苗注射本,發(fā)現(xiàn)給前一名孩子接種了二次卡介苗,剛注射部位下方已有一個(gè)小紅包案例2:患兒身份識(shí)別與核查3案例3:燙傷患者術(shù)后第十六天,訴右肩部疼痛隨即向主管護(hù)士要熱水袋熱敷護(hù)士檢查熱水袋完好無破損并進(jìn)行相關(guān)指導(dǎo)后,將熱水袋交予患者家屬家屬灌入約40攝氏度溫水,包裹后將熱水袋放置于右肩處,約1分鐘熱水袋突然破裂案例3:燙傷4案例4:手術(shù)部位錯(cuò)誤一左腎支架手術(shù)做成右腎原告案例4:手術(shù)部位錯(cuò)誤一5案例5:輸錯(cuò)藥(張冠李戴)“換藥的時(shí)候根本沒有掃描條形碼”輸錯(cuò)藥物案例5:輸錯(cuò)藥(張冠李戴)6護(hù)理安全隱患隨處可見用藥錯(cuò)誤輸血事故病人燙傷管路滑脫醫(yī)囑處置身份識(shí)別病情觀察采血硫忽護(hù)理安全隱患隨處可見7質(zhì)量就是生命每天10%剛?cè)朐夯颊咴庥鲠t(yī)院不良事件20%患者住院期間遭遇過至少一件不良事件每年幾千萬患者殘疾甚至死亡每年醫(yī)療費(fèi)用增漲高達(dá)幾百億美金質(zhì)量就是生命8病人安全是根本安全病人安全是根本9三級(jí)護(hù)理質(zhì)控管理架構(gòu)護(hù)理部·護(hù)理部主任、臨床副主任總護(hù)士長(zhǎng)(兼職)護(hù)士長(zhǎng)(專職)科室總護(hù)士長(zhǎng)護(hù)士長(zhǎng)病房護(hù)士長(zhǎng)骨干護(hù)士三級(jí)護(hù)理質(zhì)控管理架構(gòu)10護(hù)理質(zhì)量與持續(xù)改進(jìn)課件11護(hù)理質(zhì)量與持續(xù)改進(jìn)課件12護(hù)理質(zhì)量與持續(xù)改進(jìn)課件13護(hù)理質(zhì)量與持續(xù)改進(jìn)課件14護(hù)理質(zhì)量與持續(xù)改進(jìn)課件15護(hù)理質(zhì)量與持續(xù)改進(jìn)課件16護(hù)理質(zhì)量與持續(xù)改進(jìn)課件17護(hù)理質(zhì)量與持續(xù)改進(jìn)課件18護(hù)理質(zhì)量與持續(xù)改進(jìn)課件19護(hù)理質(zhì)量與持續(xù)改進(jìn)課件20護(hù)理質(zhì)量與持續(xù)改進(jìn)課件21護(hù)理質(zhì)量與持續(xù)改進(jìn)課件22護(hù)理質(zhì)量與持續(xù)改進(jìn)課件23護(hù)理質(zhì)量與持續(xù)改進(jìn)課件24護(hù)理質(zhì)量與持續(xù)改進(jìn)課件25護(hù)理質(zhì)量與持續(xù)改進(jìn)課件26護(hù)理質(zhì)量與持續(xù)改進(jìn)課件27護(hù)理質(zhì)量與持續(xù)改進(jìn)課件28護(hù)理質(zhì)量與持續(xù)改進(jìn)課件29護(hù)理質(zhì)量與持續(xù)改進(jìn)課件30護(hù)理質(zhì)量與持續(xù)改進(jìn)課件31護(hù)理質(zhì)量與持續(xù)改進(jìn)課件32護(hù)理質(zhì)量與持續(xù)改進(jìn)課件33護(hù)理質(zhì)量與持續(xù)改進(jìn)課件34護(hù)理質(zhì)量與持續(xù)改進(jìn)課件35護(hù)理質(zhì)量與持續(xù)改進(jìn)課件36護(hù)理質(zhì)量與持續(xù)改進(jìn)課件37護(hù)理質(zhì)量與持續(xù)改進(jìn)課件38護(hù)理質(zhì)量與持續(xù)改進(jìn)課件39護(hù)理質(zhì)量與持續(xù)改進(jìn)課件40護(hù)理質(zhì)量與持續(xù)改進(jìn)課件41護(hù)理質(zhì)量與持續(xù)改進(jìn)課件42護(hù)理質(zhì)量與持續(xù)改進(jìn)課件43護(hù)理質(zhì)量與持續(xù)改進(jìn)課件44護(hù)理質(zhì)量與持續(xù)改進(jìn)課件45護(hù)理質(zhì)量與持續(xù)改進(jìn)課件46護(hù)理質(zhì)量與持續(xù)改進(jìn)課件47護(hù)理質(zhì)量與持續(xù)改進(jìn)課件48護(hù)理質(zhì)量與持續(xù)改進(jìn)課件49護(hù)理質(zhì)量與持續(xù)改進(jìn)課件50護(hù)理質(zhì)量與持續(xù)改進(jìn)課件51護(hù)理質(zhì)量與持續(xù)改進(jìn)課件52護(hù)理質(zhì)量與持續(xù)改進(jìn)課件53護(hù)理質(zhì)量與持續(xù)改進(jìn)課件54護(hù)理質(zhì)量與持續(xù)改進(jìn)課件55護(hù)理質(zhì)量與持續(xù)改進(jìn)課件56護(hù)理質(zhì)量與持續(xù)改進(jìn)課件57護(hù)理質(zhì)量與持續(xù)改進(jìn)課件58護(hù)理質(zhì)量與持續(xù)改進(jìn)課件59護(hù)理質(zhì)量與持續(xù)改進(jìn)課件60護(hù)理質(zhì)量與持續(xù)改進(jìn)課件61護(hù)理質(zhì)量與持續(xù)改進(jìn)課件62護(hù)理質(zhì)量與持續(xù)改進(jìn)課件63護(hù)理質(zhì)量與持續(xù)改進(jìn)課件64護(hù)理質(zhì)量與持續(xù)改進(jìn)課件65護(hù)理質(zhì)量與持續(xù)改進(jìn)課件66護(hù)理質(zhì)量與持續(xù)改進(jìn)課件67護(hù)理質(zhì)量與持續(xù)改進(jìn)課件68護(hù)理質(zhì)量與持續(xù)改進(jìn)課件69護(hù)理質(zhì)量與持續(xù)改進(jìn)課件70護(hù)理質(zhì)量與持續(xù)改進(jìn)課件71護(hù)理質(zhì)量與持續(xù)改進(jìn)課件72護(hù)理質(zhì)量與持續(xù)改進(jìn)課件73護(hù)理質(zhì)量與持續(xù)改進(jìn)課件74護(hù)理質(zhì)量與持續(xù)改進(jìn)課件75護(hù)理質(zhì)量與持續(xù)改進(jìn)課件76護(hù)理質(zhì)量與持續(xù)改進(jìn)課件77護(hù)理質(zhì)量與持續(xù)改進(jìn)課件78護(hù)理質(zhì)量管理與持續(xù)改進(jìn)護(hù)理部王曉鳳護(hù)理質(zhì)量管理與持續(xù)改進(jìn)79案例1:手術(shù)物品清點(diǎn)交接·手術(shù)室夜班同白班護(hù)士交接,因持續(xù)X線照射,未按要求在臺(tái)上交接,而在手術(shù)間外,未清點(diǎn)紗布手術(shù)結(jié)束時(shí)用過的止血紗布地上與垃圾袋內(nèi)都有,手術(shù)醫(yī)生口頭確認(rèn)“傷口內(nèi)無紗布”,認(rèn)為既然在持續(xù)放射線下的手術(shù),如有紗布會(huì)顯影,所以未能按要求清點(diǎn)。術(shù)后第二天檢查時(shí)發(fā)現(xiàn)腿部傷口內(nèi)存留紗布案例1:手術(shù)物品清點(diǎn)交接80案例2:患兒身份識(shí)別與核查兩名同名同姓產(chǎn)婦的新生兒等待治療護(hù)士推過其中一輛嬰兒車,查看床頭卡姓名,出生時(shí)間,便在孩子左上臂接種了卡介苗0.1ml,并在醫(yī)囑執(zhí)行單及疫苗接種本上簽字推到下一個(gè)新生兒時(shí),看床頭卡也叫一樣的姓名,便立即查看疫苗注射本,發(fā)現(xiàn)給前一名孩子接種了二次卡介苗,剛注射部位下方已有一個(gè)小紅包案例2:患兒身份識(shí)別與核查81案例3:燙傷患者術(shù)后第十六天,訴右肩部疼痛隨即向主管護(hù)士要熱水袋熱敷護(hù)士檢查熱水袋完好無破損并進(jìn)行相關(guān)指導(dǎo)后,將熱水袋交予患者家屬家屬灌入約40攝氏度溫水,包裹后將熱水袋放置于右肩處,約1分鐘熱水袋突然破裂案例3:燙傷82案例4:手術(shù)部位錯(cuò)誤一左腎支架手術(shù)做成右腎原告案例4:手術(shù)部位錯(cuò)誤一83案例5:輸錯(cuò)藥(張冠李戴)“換藥的時(shí)候根本沒有掃描條形碼”輸錯(cuò)藥物案例5:輸錯(cuò)藥(張冠李戴)84護(hù)理安全隱患隨處可見用藥錯(cuò)誤輸血事故病人燙傷管路滑脫醫(yī)囑處置身份識(shí)別病情觀察采血硫忽護(hù)理安全隱患隨處可見85質(zhì)量就是生命每天10%剛?cè)朐夯颊咴庥鲠t(yī)院不良事件20%患者住院期間遭遇過至少一件不良事件每年幾千萬患者殘疾甚至死亡每年醫(yī)療費(fèi)用增漲高達(dá)幾百億美金質(zhì)量就是生命86病人安全是根本安全病人安全是根本87三級(jí)護(hù)理質(zhì)控管理架構(gòu)護(hù)理部·護(hù)理部主任、臨床副主任總護(hù)士長(zhǎng)(兼職)護(hù)士長(zhǎng)(專職)科室總護(hù)士長(zhǎng)護(hù)士長(zhǎng)病房護(hù)士長(zhǎng)骨干護(hù)士三級(jí)護(hù)理質(zhì)控管理架構(gòu)88護(hù)理質(zhì)量與持續(xù)改進(jìn)課件89護(hù)理質(zhì)量與持續(xù)改進(jìn)課件90護(hù)理質(zhì)量與持續(xù)改進(jìn)課件91護(hù)理質(zhì)量與持續(xù)改進(jìn)課件92護(hù)理質(zhì)量與持續(xù)改進(jìn)課件93護(hù)理質(zhì)量與持續(xù)改進(jìn)課件94護(hù)理質(zhì)量與持續(xù)改進(jìn)課件95護(hù)理質(zhì)量與持續(xù)改進(jìn)課件96護(hù)理質(zhì)量與持續(xù)改進(jìn)課件97護(hù)理質(zhì)量與持續(xù)改進(jìn)課件98護(hù)理質(zhì)量與持續(xù)改進(jìn)課件99護(hù)理質(zhì)量與持續(xù)改進(jìn)課件100護(hù)理質(zhì)量與持續(xù)改進(jìn)課件101護(hù)理質(zhì)量與持續(xù)改進(jìn)課件102護(hù)理質(zhì)量與持續(xù)改進(jìn)課件103護(hù)理質(zhì)量與持續(xù)改進(jìn)課件104護(hù)理質(zhì)量與持續(xù)改進(jìn)課件105護(hù)理質(zhì)量與持續(xù)改進(jìn)課件106護(hù)理質(zhì)量與持續(xù)改進(jìn)課件107護(hù)理質(zhì)量與持續(xù)改進(jìn)課件108護(hù)理質(zhì)量與持續(xù)改進(jìn)課件109護(hù)理質(zhì)量與持續(xù)改進(jìn)課件110護(hù)理質(zhì)量與持續(xù)改進(jìn)課件111護(hù)理質(zhì)量與持續(xù)改進(jìn)課件112護(hù)理質(zhì)量與持續(xù)改進(jìn)課件113護(hù)理質(zhì)量與持續(xù)改進(jìn)課件114護(hù)理質(zhì)量與持續(xù)改進(jìn)課件115護(hù)理質(zhì)量與持續(xù)改進(jìn)課件116護(hù)理質(zhì)量與持續(xù)改進(jìn)課件117護(hù)理質(zhì)量與持續(xù)改進(jìn)課件118護(hù)理質(zhì)量與持續(xù)改進(jìn)課件119護(hù)理質(zhì)量與持續(xù)改進(jìn)課件120護(hù)理質(zhì)量與持續(xù)改進(jìn)課件121護(hù)理質(zhì)量與持續(xù)改進(jìn)課件122護(hù)理質(zhì)量與持續(xù)改進(jìn)課件123護(hù)理質(zhì)量與持續(xù)改進(jìn)課件124護(hù)理質(zhì)量與持續(xù)改進(jìn)課件125護(hù)理質(zhì)量與持續(xù)改進(jìn)課件126護(hù)理質(zhì)量與持續(xù)改進(jìn)課件127護(hù)理質(zhì)量與持續(xù)改進(jìn)課件128護(hù)理質(zhì)量與持續(xù)改進(jìn)課件129護(hù)理質(zhì)量與持續(xù)改進(jìn)課件130護(hù)理質(zhì)量與持續(xù)改進(jìn)課件131護(hù)理質(zhì)量與持續(xù)改進(jìn)課件132護(hù)理質(zhì)量與持續(xù)改進(jìn)課件133護(hù)理質(zhì)量與持續(xù)改進(jìn)課件134護(hù)理質(zhì)量與持續(xù)改進(jìn)課件135護(hù)理質(zhì)量與持續(xù)改進(jìn)課件136護(hù)理質(zhì)量與持續(xù)改進(jìn)課件137護(hù)理質(zhì)量與持續(xù)改進(jìn)課件138護(hù)理質(zhì)量與持續(xù)改進(jìn)課件139護(hù)理質(zhì)量與持續(xù)改進(jìn)課件140護(hù)理質(zhì)量與持續(xù)改進(jìn)課件141護(hù)理質(zhì)量與持續(xù)改進(jìn)課件142護(hù)理質(zhì)量與持續(xù)改進(jìn)課件143護(hù)理質(zhì)量與持續(xù)改進(jìn)課件144護(hù)理質(zhì)