Organizational preparation
(A) the establishment of a leading group
(two) held a group meeting to convey the spirit and forward documents.
1, Notice of the Ministry of Health on "20XX" Quality Nursing Service Demonstration Project "
2. Notice of the Ministry of Health on Strengthening Clinical Nursing in Hospitals
3. Guiding principles of graded nursing in general hospitals (for Trial Implementation)
4, "basic nursing service standard"
5. Basic nursing service for inpatients (for Trial Implementation)
6, "common clinical nursing technical service specification"
7. Tianjin 20XX "Quality Nursing Service Demonstration Project" Specific Implementation Plan
8. Notice on Declaring Key Contact Hospitals of Tianjin Quality Nursing Service Demonstration Project
9, "Tianjin" quality nursing service demonstration project "evaluation rules"
(3) convening a mobilization meeting
1, conveying the spirit of the Ministry of Health's 20XX "Quality Nursing Service Demonstration Project"
2, convey our hospital "quality nursing service demonstration project" specific implementation plan.
3. Interpret the theme, goal and clinical nursing focus of the "Quality Nursing Service Demonstration Project" in our hospital for 20XX years.
The representative of the head nurse and a young nurse read out the proposal.
Perfecting nursing management
(a) the nursing department field research.
(two) held a forum for head nurses and nurses to determine the work objectives:
1, to meet the basic needs of patients.
2. Ensure the safety and comfort of patients during hospitalization.
3, to ensure that the patient's diagnosis and treatment measures are effectively implemented.
4. Improve patients' satisfaction with nursing work.
(three) unified standards and assessment content.
(4) Select three pilot wards.
1, recommended by the ward of the head nurse's regular meeting.
2. The head nurse voted by secret ballot.
3. Nursing department is preferred.
(five) to publicize the contents of nursing and service.
1, improve the two-way communication channel between nurses and patients.
2. Establish a nurse-patient communication book in the pilot ward.
3. "Graded nursing standard" and "basic nursing service for inpatients" are on the wall.
Third, strive for the coordination and support of various departments.
(a) in charge of the dean of the organization finance department to coordinate and support, improve the treatment of clinical frontline nurses, extend the time of nurses working in the clinical frontline.
(b) providing human resources support.
1. Supplementary nursing human resources: It is planned to recruit 20 new nurses and 8 assistant nurses this year1.
2, to participate in the work of nurses are related certificates.
3. Clinical frontline nurses account for 95% of the total number of nurses; The ratio of ward beds to nurses is1:0.5; Contract nurses can get equal pay for equal work.
2. Establish a personnel management system to limit nurses to non-nursing posts.
3. Flexible scheduling, manpower allocation, and putting into front-line positions.
4. Let nurses return to the clinical front line.
(3) Give time support
1, drugs enter the intravenous drug allocation center, and all kinds of drugs are sent to the ward; Emergency medicine is delivered to the ward at night. Return the time of the clinical nurse to the patient, and the nurse will go to the patient's bedside for basic nursing;
2. Accelerate the construction of oxygen supply in the center and reduce the time for nurses to carry oxygen cylinders.
3. Set up a transfer center, which is responsible for the accompanying inspection, laboratory examination and delivery of materials (consumable medical materials, articles, common office supplies and sterile articles) of inpatients in various wards of the hospital.
Nursing appliance support
Let the nurse quickly get all kinds of nursing equipment beside the patient's bed and return the time to the patient, such as shampoo car and multifunctional treatment car.
Fourth, the implementation stage.
(a) to meet the basic needs of patients.
1, and formulate standardized standard operating procedures.
Morning and evening care, vital signs measurement, oral care, perineal care, nasal feeding technology, catheterization technology, enema technology.
2. Optimize the service process
Admission process, preoperative workflow (the day before surgery, the morning of surgery), meal assistance process, and pre-and post-examination process.
3. Formulate humanized service measures.
Improve the care of diet details, establish a reliable nurse-patient relationship, and have various forms of health education.
4, create a nursing team atmosphere
Cultivation of professional ability and construction of nursing culture.
5, according to the Ministry of health "basic nursing clothing work service standard" to increase the service content:
Wash your face, comb your hair and feet, assist patients to move in bed, prevent and care for pressure ulcers, care for incontinence, use the toilet in bed, assist in changing clothes, wash your hair in bed, care for fingers/toenails and safety management.
6. According to the Technical Service Standard of General Clinical Nursing issued by the Ministry of Health, the service contents are added: patient admission and discharge nursing, blood sugar monitoring, intravenous injection and physical cooling.
7, according to the international hospital management certification standards to supplement and improve the management system, such as drug management (self-provided drugs use regulations), safety management (patient identity confirmation system), service process (patient transportation system), hospital infection control, etc.
8. Strengthen the training of basic nursing skills.
Develop training plan and training evaluation manual for junior nurses.
9. Simplify the writing of nursing documents
Make form nursing records (obstetrics pilot).
10, according to Tianjin nursing quality basic nursing quality assessment standards, formulate basic nursing quality assessment standards (20 quality assessment standards).
1 1, strengthen the quality control measures of basic nursing.
1) Strengthen the supervision of head nurses' night inspection: The nursing department arranges two head nurses every day to temporarily arrange key inspection work (sampling by monitoring video) according to the clinical critical patients' situation and nursing work priorities.
2) Strengthen supervision through on-site inspection by basic nursing quality control team, asking nurses and visiting patients.
(2) Implement the nurse responsibility system.
1. Communication and cooperation of department heads.
2. Competitive selection of responsible nurses, clear nurse responsibilities, grouping and zoning, relatively fixed nurse beds, and full participation in basic nursing work.
3. The responsible nurse provides continuous whole-course nursing service for patients. According to the number, quality and patient satisfaction of patients that nurses are responsible for.
(3) vertical management of nursing department
Give full play to the creativity and autonomy of nursing managers, avoid the difference of nurses' performance salary distribution and avoid the contradiction of economic distribution in departments.
1, the strong support of the hospital leaders, the understanding and support of the department directors, and the cooperation of various departments.
2. The active participation of nurses.
1) All systems, management regulations and distribution schemes of the nursing department are open and transparent.
2) Publish the e-mail address and telephone number of the nursing department.
3) Seek benefits for nurses.
4) The nursing department has the power of personnel and economic management.
5) Work quality, nursing service, professional evaluation, etc. They are all combined with performance pay, assessment, graduation and promotion.
(d) Pay distribution for nurses based on performance.
1. Distribution principle: distribution according to work, giving priority to efficiency and giving consideration to fairness.
2. Distribution basis: nature of work (clinical frontline, auxiliary department), technical difficulty, risk difficulty and nursing quality.
(5) Improve the supervision and inspection mechanism.
1, improve nursing quality management, and quality standards can pay attention to patients.
2. Establish quality control evaluation standards around patients (effectively implement nursing routine and link all patients' nursing quality standards).
3, the establishment of basic nursing quality management committee regular inspection and irregular inspection, the head nurse of each subject daily self-examination.
4, the nursing department to establish clinical nursing service investigation files:
1) Inpatients' satisfaction survey: Inpatients are surveyed once a month, and the inquiry rate is 40%; Once a quarter for discharged patients, the inquiry rate was15%; Patient satisfaction was 95%.
2) Organize a symposium for patients and their families every quarter, and keep evaluation records.
3) The nursing department conducts appraisal activities by department every quarter, and patients, staff and managers comprehensively select individuals with high quality service and make records.
Verb (abbreviation of verb) stage evaluation
Regular discussion
1, hold a nursing clinical seminar.
2. The responsible nurse regularly reports the progress and feelings of basic nursing.
3, timely discover the shortcomings and defects of clinical basic nursing.
(b) guidelines for mid-term evaluation
1, experts came to the hospital for inspection and guidance.
2. Organize nursing staff to visit and replicate excellent demonstration hospitals.
3. Visit the demonstration hospital in the city.
(3) Establishment of excellence evaluation, evaluation criteria and evaluation methods.
1, evaluation of nurses' day: build a model and build an incentive model.
Star of basic nursing service
Warm angel care award
Pilot advanced departments and individuals
2. Year-end evaluation
advanced collective
advanced individual
Sixth, the summary stage
1, hold a nursing meeting.
Commend outstanding wards and advanced individuals.
2. Welcome inspection work
extreme
First, establish the guiding ideology and clarify the work objectives.
Continue to "take the patient as the center", fully implement the guiding ideology of high-quality nursing service, and continue to implement nurse post management on the basis of fully implementing the responsibility system and holistic nursing according to the requirements of Detailed Rules for the Evaluation of High-quality Nursing Service (20xx Edition), mobilize the enthusiasm of nurses, and provide continuous, safe, high-quality and satisfactory services for patients.
2, the specific plan
(1) Take general actions to strengthen ideological and political education and create an atmosphere of harmony and unity.
1. The department attaches great importance to it, led by the director and the head nurse. They repeatedly stressed through the general meeting, increased publicity, so that general nurses can truly realize the importance of quality service, regard quality service as the duty and obligation of nurses, firmly establish the service concept of "patient-centered", continuously improve ideological and moral education and cultivation, and change passive service into active service.
2. Support each other, understand each other, have a clear division of labor, carry out their duties, unite and be pragmatic, live in harmony, and successfully complete all the work in the hospital.
(2) Pay attention to quality, strive for progress steadily, and earnestly implement new quality care measures.
1. Carry out high-quality nursing in a planned and step-by-step manner, and combine the service concepts of "treating patients as relatives", "being anxious about patients" and "thinking about patients' thoughts" with the characteristics of departments to optimize the medical treatment process and solve various problems for patients as soon as possible.
2. Take the initiative to smile and greet the patient, so as to be "responsible for the first question", answer questions and be amiable.
3. Provide convenient measures, such as boiled water, disposable cups, paper towels, toilets, etc. , and provide full-time escort service for patients without escort in outpatient department. When necessary, they can pay and take medicine on their behalf, reducing the worries of patients and giving maximum care. This year, we plan to buy an electric water heater to provide adequate water supply for patients and facilitate their use.
4. To carry out the family "eight tones" service, it is required that the word "good" begins, the word "please" comes first, and "thank you for your cooperation" never leaves. Patient explanation before operation, gentle greeting during operation, sincere apology during operation, and careful service for patients with body language such as eyes and smiles.
5. Improve environmental sanitation and provide satisfactory services. In view of the unsatisfactory sanitary conditions, the nurses cleaned the ward again before leaving work at five o'clock. The nurses changed the sheets in the observation room and covered them with disposable sheets to prepare for the night nurses to meet the patients.
(3) Strengthen continuous training and improve emergency rescue capability.
1. To grasp the business, we should start from the basics and require general nurses to study the "three basics" seriously. For junior nurses, according to the characteristics of the emergency department, a targeted training plan is formulated, which requires them to master the first aid process, pre-hospital first aid, how to answer the first aid phone, master the use of all first aid instruments, and strengthen theoretical study and assessment.
2. Scientific scheduling, with the old bringing the new, each class with high seniority and low seniority, strong technical ability and strong communication ability, to ensure the overall ability of the nursing team is excellent.
3. Actively and conscientiously study relevant laws and regulations and medical code of conduct, and conscientiously implement various operating procedures and rescue workflow to prevent medical errors, medical disputes and other medical adverse events.
4. In the first aid work, make house calls at any time, get out of the car quickly, and arrive at the first aid site accurately and in time. Always keep the intact rate of first-aid articles and medicines at 100%, and the rescue equipment is in emergency standby state. In the process of pre-hospital and in-hospital first aid, the patient's condition evaluation, pre-examination and triage are correctly diverted to various departments to ensure the life safety of residents in our city.
The emergency department is an important window for hospitals to face the society. The medical level and service quality directly reflect the mental outlook and social image of the hospital. In daily rescue work and pre-hospital rescue, emergency nurses are required to always pay attention to their image, grasp the connotation and set up a window image for the hospital.
(four) to carry out first aid for special patients, green channel Huimin service.
The emergency department is on duty 24 hours a day, receiving and rescuing critically ill patients, especially the "three noes" who are homeless, have no money and have no identity certificate, so as to check, diagnose, rescue and treat them first, and then go through the admission procedures and pay fees. Accompany critically ill patients to check the whole process to ensure that critically ill patients get first aid at the first time.
(5) Improve the quality of health education and strengthen the publicity of departments.
(1) During the treatment of emergency patients, health education should be given to patients or their families. First of all, strengthen the professional knowledge training of nurses, focusing on disease nursing routine, and incorporate it into the department training plan.
(2) Carry out various forms of health education according to patients' different educational levels and different acceptance abilities, and make health education display boards of common disease nursing knowledge and display them on the wall. Make a health education booklet and carry it with you for patients to browse. Health education lectures are held irregularly, and patients are educated in PPT and lively form.
(3) Because outpatients and emergency patients have a great demand for disease-related knowledge, this is a neglected weak link. This year, efforts will be made to improve the satisfaction of outpatients and emergency patients, and the quality management tool "quality control circle" will be used to formulate relevant countermeasures to improve and solve problems.
(six) to strengthen the core system construction, the implementation of nursing safety measures.
(1) Strengthen the implementation of nursing safety core system and various nursing operation norms, processes and routines. We should focus on supervision, inspection and monitoring of newly admitted patients, newly transferred patients, critically ill patients and bedridden patients.
(2) Irregular investigation of nursing safety hazards, and timely treatment when problems are found.
Patient link management: establish and improve the evaluation system of patient transfer, handover and pressure sore nursing management.
Nurse link management: focus on explaining and carefully guiding newly transferred nurses and nurses with thoughts and emotions.
(3) Strengthen the responsibility of safety management to prevent the occurrence of serious adverse events. Spot check the quality of the department, immediately point out the existing problems and make rectification within a time limit.
(7) 6. Regularly monitor related indicators of nursing quality, formulate and implement improvement measures for falls, bed falls and pressure ulcers in departments, evaluate the improvement effect, and realize the sustainable improvement of nursing quality.
(8) Give nurses "humanistic care" and attach importance to psychological care.
The emergency department is the forefront of the hospital to heal the wounded and rescue the dying. As a special professional group, emergency nurses shoulder the heavy responsibilities of pre-hospital first aid, in-hospital rescue, intensive care, emergency rescue and disaster relief, observation and nursing of patients under observation, and are often under pressure from all sides. Besides, there are various stressors, which seriously affect the quality of emergency nursing and bring physical and mental health to emergency nurses? Nurses in emergency department are in poor psychological condition. Therefore, it is very important to maintain the mental health of emergency nurses. Mainly from two aspects: first, the management should create a good professional working atmosphere conducive to physical and mental health for emergency nurses; Secondly, mental health education is given to nurses, so that they can master the knowledge of self-regulation and self-control and enhance their ability to resist all external adverse factors.
(1) Attach importance to human resource management and arrange personnel reasonably.
Nurses are "caregivers" and "cared for". The head nurse should care and understand the difficulties of nurses and solve their problems in work and life in time. Cultivate nurses' team spirit, strengthen close cooperation among colleagues, create a warm and pleasant working environment and enhance nurses' sense of belonging.
(2) scientific scheduling
Because nurses work in three shifts, especially at night, there are few people and many emergencies, especially in case of major rescue, when patients die because of ineffective rescue, it is easy to cause mental tension, impatience and anxiety of nurses. For shifts with high work intensity, the head nurse should let the nurses on duty have a full rest, so that their body and mind can get a full rest to reduce the pressure. Create an orderly working environment, cultivate good psychological quality and establish a correct outlook on life. Relaxation, listening to music, attending friends' parties, taking yoga and exercising can all reduce the mental burden. Optimistic about life, appropriate pressure can be transformed into a driving force for progress.
(3) Establish a nurse support system to relieve psychological stress and fatigue.
Nursing managers should always listen to the psychological feelings and pressures of nurses in their work, comfort and feedback in time, and take corresponding measures in time for existing problems. Actively absorb foreign nursing management experience and establish nursing staff's own support system, such as nursing staff fitness and entertainment center, psychological consultation room, etc. , so that nurses can get proper exercise and relaxation after intense work, especially when they encounter difficulties and feel physically and mentally exhausted, so as to vent in time. Adjust your mood, reduce stress and eliminate fatigue.
(4) create a good interpersonal environment
Nurses have a wide range of contacts and complex interpersonal relationships, so they should actively create a harmonious interpersonal environment, so as to have a natural, harmonious and relaxed living and working environment and a healthy psychological environment, have a sense of security and self-confidence, give full play to their professional talents, learn to use some communication skills, such as being frank and harmonious in interpersonal communication, not closing themselves, actively looking for psychological communication ties and opportunities to exchange information with others, and shortening the psychological distance with others and society. Actively use interpersonal communication, reasonably vent negative emotions and sublimate positive emotions. Actively participate in various beneficial social activities, cultivate a variety of hobbies, and cultivate sentiment in various activities.
Three. Performance management
1. Formulate graded management measures for emergency nurses. Between different levels, according to the growth of work experience and working years, nurses are promoted from low to high, so that they can see their career development prospects. Every nurse can go to a higher level through her own efforts and struggles, and improve her enthusiasm for this profession.
2. According to the characteristics of emergency work, formulate a clear post classification standard and salary coefficient, establish a performance appraisal system based on nursing workload, nursing quality, patient satisfaction, nursing difficulty, technical requirements and other factors, and combine the assessment results with the evaluation, promotion and salary distribution of nurses to achieve excellent work and arouse the enthusiasm of nurses.
3. Improve nurses' legal awareness and abide by the regulations on the management of nurses. Strengthen the communication between nurses and patients, and permeate the concept of practicing law in all directions. This kind of legal consciousness not only protects nurses, but also protects patients, which embodies the people-oriented cultural atmosphere.
4. Improve the continuing education level of nurses. Strengthen the training in departments, send nurses to study in relevant departments and outside the hospital, and strive to improve the theoretical knowledge and operational skills of emergency nurses.
Developing high-quality nursing service is a good measure to improve nursing image and establish a new image of nursing industry. Since the development of high-quality nursing service in our hospital, it has received good results-the nursing outlook has been greatly improved, and the holistic nursing model based on responsibility has gradually penetrated into the hearts of nursing staff. After the emergency department carried out high-quality nursing service, the ward environment was clean, the waiting time of patients was shortened, and the patient satisfaction was improved. We believe that under the guidance of hospital leaders and nursing department, our road to quality nursing service will be more and more stable!
Tisso
I. Guiding ideology
According to the overall deployment of the "Demonstration Project" of the Ministry of Health, on the basis of summing up the experience of quality nursing service for 20XX years, and in accordance with the requirements of the "Work Plan for Promoting Quality Nursing Service" of the Ministry of Health, with "implementing the responsibility system and holistic nursing" as the core content, we will increase the promotion of quality nursing service in breadth and depth, fully mobilize the enthusiasm of nurses, and explore the establishment of a long-term mechanism and performance evaluation mechanism for quality nursing service, so as to provide more patients with safe, professional and full-course quality nursing service. Make this work plan.
Second, the specific plan
(a) unify thinking, raise awareness, and act in the whole hospital.
1, the party and government leaders of the hospital attach great importance to it, and it is planned to repeatedly emphasize through various work meetings at all levels in the hospital, increase publicity, and strive to open a "quality nursing work network" in the first quarter of the hospital, so as to facilitate the staff of the whole hospital to understand and care about the development of nursing work in time.
2, strengthen the organization and coordination between departments, especially to further increase the hospital's investment in nursing support and security system, such as electronic doctor's advice is fully rolled out during the year, the packaging and delivery of oral drugs are gradually promoted, and the supply center covers the supply of all primary disinfection items in the ward. With the help of the whole hospital, nurses can return to patients in all directions and create high-quality nursing services.
3. Nurses are the main body to promote quality nursing service. Through inviting in, going out and unified training, on the basis of the exchange between the two hospitals last year, we will further summarize it in time during the year. In the form of hospital-wide communication, we will continue to give play to the thoughts and functions of nurses in promoting the development of responsible nursing, and comprehensively improve the enthusiasm and active participation consciousness of nurses.
(2) Steady progress, solid implementation and emphasis on quality assurance.
1, the number of high-quality nursing wards will be steadily spread out in a planned and step-by-step manner, and the coverage rate of high-quality nursing wards in the whole hospital will reach over 80% by the end of 20xx. Actively promote the extension of quality nursing activities to outpatient, emergency and operating rooms. As long as there are nurse posts and patients' needs, our philosophy is "all for patients", such as: advocating the patience and enthusiastic service of outpatient nurses; Emphasize the safety of patients during the operation; Strengthen the excellent skills of emergency nurses in pre-examination, triage, first aid and emergency, and let high-quality nursing services spread all over the hospital.
2. On the basis of the success of the pilot ward, the optimized nursing mode and successful experience are gradually extended to the whole hospital: the responsibility system is improved, the patient scheduling mode is flat, the patient is the center, and the basic nursing, disease observation, treatment, communication and health guidance are integrated.
3. According to the Ministry of Health's "Quality Nursing Hospital/Ward Evaluation Standard", the evaluation standard of our hospital's quality nursing wards should be formulated: in addition to the routine quality assessment, the evaluation rules of substantive nursing items such as reasonable scheduling, clinical services embodying specialty characteristics, highlighting nurses' understanding of patients, implementation of nursing measures, and nurse-patient communication should be added.
4. Under the premise of the workload of patients in each nursing unit, we should consider and respect the wishes of nurses and make good use of the existing nursing human resources. Improve the management mode of nurses' technical files and classification management.
5. Improve the performance appraisal system. In the first quarter, the evaluation method based on the comprehensive evaluation results of different positions, different risks, different workloads and patient feedback was revised. It truly embodies the principle of reasonable distribution of more work, high quality and high efficiency, and further improves the enthusiasm and initiative of nursing staff.
6. Self-designed questionnaires of inpatients' satisfaction with the nursing work of the responsible nurses and nurses' satisfaction with the ward doctors were adopted. Increase the feedback to patients and minimize the moisture in internal feedback. Such as: the head nurse's irregular feedback during hospitalization, the monthly planning feedback from the nursing department, and the quarterly sampling petition feedback from the nursing department. The ways to change the feedback are: nurses wearing casual clothes and the third party outside the hospital (college students, etc.). ) ask for feedback. Establish patient satisfaction files of each nursing unit, and dynamically reflect the change curve of satisfaction with intuitive icons for detailed analysis and timely rectification.
(3) lay a solid foundation, pay attention to specialties and go hand in hand.
1, based on professional development, deepen the connotation of quality nursing. Improve and perfect the rules and regulations, technical norms and standards of clinical nursing. On the basis of completing three series of handbooks on patients' health education in "Quality Demonstration Project" last year, we completed nursing and dietary guidance for inpatients before and after special examination.
2. Take various forms of learning methods, such as quizzes, essays and morning meetings. Consolidate nurses' understanding and application of responsible nursing, core system and health education knowledge points.
3. Follow the "people-oriented" holistic nursing concept, organically combine basic nursing with specialized nursing, and further implement specialized nursing measures to improve the quality of basic nursing with the help of the connotation of specialized nursing and extensive contact with patients during the implementation of basic nursing. The connotation of basic, specialized and humanistic nursing, that is, comprehensive evaluation of service, quality and skills, was fully reflected in the supervision of graded nursing quality during the year.
4, the nursing safety throughout the high-quality nursing service, pay attention to the process management of key links, key departments, key objects, pay attention to quality, pay attention to details. Strengthen safety awareness, use scientific means to continuously improve quality and carry out clinical application of evidence-based evidence.
5. Strengthen the construction of specialized nursing team. With the joint efforts of both inside and outside, we will increase the training of specialists in intensive care, emergency, operating room and hemodialysis. Integrate the advantages of hospitals and increase the radiation power.
6. Further conform to the development of the hospital, improve the quality of service for patients, and attach importance to the study, summary and improvement of new disciplines and skills.
(four) timely summary, carry forward the advanced and encourage innovation.
1. On the basis of the achievement award of "nursing sheet writing" of Shanghai Nursing Quality Control Center, our hospital encourages the whole hospital to innovate, give full play to the potential of nurses, and reform the existing nursing instruments and nursing workflow, including the facilities and habits related to nursing work. With the help of small innovation, small invention and small improvement, the connotation of nursing work is enriched. Improve the safety and comfort of patient service and realize time-saving and efficient nursing operation at the same time.
2. Combine advanced wards and individuals with the selection of "excellent nurses" in schools and cities, and select them once every two years to give timely encouragement and recognition. Set an example and sum up experience. Timely publicity and promotion, learn from each other and learn from each other.