The first part: further study and personal experience

I am very grateful to the hospitals and departments for giving me such a good opportunity to study in Shizuishan Second People's Hospital. Although two months is very short, I am very busy and tired, and I have worked a lot of night shifts, but these short two months have broadened my horizons, increased my knowledge and gained a lot.

The emergency department of the Second City Hospital is mainly divided into four areas: emergency room, rescue room, infusion room and blood transfusion room. I mainly work in emergency room and emergency room. The workflow and advantages of emergency department.

First, the emergency room and emergency room work

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2. Patients entering the intensive care unit will generally take measures such as ECG monitoring, oxygen inhalation, blood sugar measurement and venous access according to the situation.

3, rescue patients to fill in the emergency nursing records of critically ill patients, to ensure that the rescue records are complete, timely and accurate.

4. When escorting critically ill patients, carry a first-aid kit (including adrenaline, atropine, dopa, injection equipment and other rescue materials) and an ECG monitor.

5. General medical personnel are experienced and skilled in rescue, carefully observe the condition, and handle the abnormal situation in time. After the critically ill patients are treated, please consult the relevant departments and then send them to the ward for further treatment.

6. Establish a return visit system for inpatients, understand patients' satisfaction with emergency work, listen to opinions and suggestions, and better carry out emergency work.

7, in critically ill patients, doctors in various departments help each other, help each other, * * * cooperate to rescue patients.

8, new and old medical staff shift, mentoring spirit is better.

Second, the infusion room

1, the workload is very heavy, there are one or two hundred patients every day, but there are only three nurses, so they are very busy and have no free time.

2. Although the manpower is relatively small, the check system is very strict, and the doctor's advice will not be implemented until two people check it. Every step of the operation (dispensing, injection, inspection, etc.). ) must be scanned and confirmed by PDA before it can be executed to prevent errors.

3. Disinfection and sterility are very strict. One towel for injection. Soak the tourniquet for disinfection after use and send it to the supply room for plastic sealing.

4. The drug is now on the market to avoid failure.

5. Put a red label on the last bag of liquid for infusion to prevent the liquid from leaking.

Third, other aspects.

1, strictly implement the responsibility system for first diagnosis, register outpatient logs one by one, carefully write emergency medical records, and strictly sign for confirmation in special circumstances. In order to avoid medical disputes, but also to better protect themselves.

2. Domestic waste and medical waste should be strictly classified, disinfected, collected and transported in time.

3. Fees: All patients who enter the rescue room are charged bed fees, grade nursing fees, rescue fees for critically ill patients, etc. The charge is relatively fine, and it will not be collected again, nor will it be missed.

4. The learning and working atmosphere of the department is very good. The department organizes business study such as operation training once a week, and the teacher is serious and responsible for every student.

Fourth, new technology.

1, Application of oropharyngeal ventilation tube.

Indications:

(1) airway obstruction caused by weakened vomiting reflex or jaw muscle relaxation in comatose patients.

(2) When the unconscious patient fails to open the airway by other methods, such as head and back chin support or chin extension.

(3) When the patient gives oxygen through the simple breathing bladder, the oropharyngeal snorkel can support the soft tissue after swallowing, which is beneficial to lung ventilation and prevent flatulence.

(4) To prevent oral intubation from biting endotracheal tube.

(5) It is necessary to suck out the patient's pharyngeal secretions.

2, blood gas (2ml syringe heparin sodium 1ml- hit in the needle sleeve-arterial blood-needle sleeve-test).

3. Patients with hypoxia and low blood oxygen saturation are given oxygen storage masks for oxygen supply.

Through these two months of study, I realized my own shortcomings. In my future work, I will continue to learn medical knowledge, improve the emergency rescue ability and disposal level of critically ill patients, and better serve patients.

Chai Cun she 20XX. 12. 10

Part II: Work Report of Supply Room

Dear leading comrades,

Time flies, the past is gone forever, and 20XX years have passed. Under the' correct leadership' of Guangyuan Fa Group Company and hospital leaders, I strictly abide by the rules and regulations formulated by the hospital, strive to improve work efficiency and quality, "serve the outpatient department and care about the window", and make a fuss about active service to ensure the normal development of supply room work. I strictly abide by labor discipline, didn't arrive late and leave early, and always stuck to my post. In order to better carry out next year's work, I made the following debriefing report according to the job responsibilities of the head nurse. Please criticize and correct me.

Take the department as the home, unite and lead the nursing staff in the department to complete the task with high standards.

Over the past year, as a middle-level cadre at work, I have always been strict with myself in accordance with the duties of the head nurse, being diligent and dedicated, and taking the department as my home. Arrange nurses' shifts in strict accordance with the operating specifications. The scheduling of supply room is different from that of clinical departments, which is based on disinfection technical specifications, hand hygiene, occupational protection system and hospital sense monitoring system. It is divided into cleaning, packaging, sterile goods distribution, sterilization and dressing. These shifts are held by registered nurses, among which at least two people are on duty in the cleaning class, packaging, distribution and sterilization class, and at least two people are on duty in the dressing change class. Nurses in the cleaning class and the packing, distribution, disinfection and dressing change class must not be on duty with each other. Each class has formulated job responsibilities, and the specific division of labor is specific to one person. After rescheduling, in order to make undergraduates adapt to and understand the significance of this kind of scheduling as soon as possible, I led everyone to seriously study the three standards of CSSD and the core system related to hospital feeling, and asked everyone to master the new job responsibilities and strictly implement various operations in their work.

Specifications. Cultivate the comprehensive quality of nursing staff, so that they can complete their work well.

Second, set an example, do your duty and do everything first.

Over the past year, I insisted on setting an example, leading all the nursing staff in the department to work in an orderly manner according to the work arrangements and requirements of the department, always ahead of the comrades, asking them to do what they do first, and not to do what they don't do first, insisting on leaving early and returning late every day, and checking and urging them to do a good job in disinfection and sterilization in the supply room together. I insist on keeping the communication tools open 24 hours a day, whether it is holidays or sundays, or even one or two in the morning. As long as the phone rings and surgical instruments need to be disinfected, I will try my best to get to the hospital in the shortest time, and make all kinds of instruments needed in clinic as quickly as possible to ensure that I can be on call.

Insist on continuous business knowledge learning, hand in hand to do a good job of passing, helping and guiding new nurses.

Over the past year, while doing a good job, we have paid special attention to the business learning and skills training of nursing staff in departments at the right time, and passed on, helped and brought the business knowledge and skills training of new employees hand in hand. Through our joint efforts, although some nurses in the department can't fully master all kinds of instruments and equipment sets because of short time, I believe they can do it well as long as they work hard.

The achievements come from the care and support of the leaders and the unremitting efforts of the comrades in the department. I am determined to continue to maintain and carry forward this work next year. At the same time, we should also see that there is still a certain gap in achievements. To sum up, there are the following points:

1 In practical work, sometimes the ways and means of working by yourself are not appropriate, impatient and eager for success.

Most of the work is simply to carry out tasks, do routine work well, and the spirit of innovation and the consciousness of striving for the first place are not enough.

The concept of self-protection and sterility is not strong, which needs to be improved.

4. Registration and marking are not standardized.

IV. Next Work Plan

1 Strengthen the study of political theory and improve one's moral cultivation.

Be sincere and earnest, and be practical. Don't relax your study of political thought, so that you can keep up with the development of the times ideologically. Maintain a modest and prudent work style and resolutely implement the instructions and regulations of the hospital leaders. Strictly abide by the rules and regulations of the hospital and obey the leadership and management.

2 improve organizational and leadership skills

3 to further strengthen the study of business knowledge and further study and training of personnel, and further familiarize themselves with professional skills. Safe operation, according to the rules, quality and development. Strengthen the awareness of quality management in departments, strengthen the awareness of safety service of each nurse, and do a good job in disinfection and sterilization. Strictly operate aseptic technology and improve the new concept of disinfection and isolation knowledge. Make the greatest contribution to the prevention and control of hospital accidents.

4. Open source and reduce expenditure to improve economic benefits. Supply room is an important part of hospital cost accounting, and many expenses are paid from supply room. Therefore, in the new year, we should be diligent and thrifty, reduce hospital expenses and increase hospital income. Specifically, we should start from the following aspects:

(1) We should start with saving every drop of water and electricity, such as consumables we use, such as masks, hats, latex gloves and lubricating oil. We should double our savings, such as lubricating oil, which can be used three times and cannot be thrown away at once. For example, latex gloves, we used to use at least four pairs of washing tools every day, but now we are determined not to use them anymore, at least we can give them.

The hospital saves ten dollars a day, which is more than three thousand dollars a year. This is just one of them, and there are still many things that we need to save. I will list them here, so we must be diligent and take the hospital as our home.

(2) streamline personnel. We should never fool lazy people. Never do what two people can do.

(3) Do everything possible to increase medical income. For example, it is suggested that hospitals buy disposable dressing change kits for patients, which can increase profits several times. Not only can we not charge for the dressing change package for patients now, but we also use our consumables to increase the hospital's expenses, which is neither profitable nor income.

Keep the department equipment intact and maintain it regularly. Learn to troubleshoot and ensure normal operation. Create maximum economic benefits for the department.

We must pay special attention to the hygiene of the supply room. Hygiene is the life of the supply room, so it should be kept clean and tidy at all times. Further strengthen the management of the department, unite with all the staff of the department, and overcome difficulties and difficulties. Chengyang Third Hospital attaches great importance to the overall situation, strengthens its internal quality and builds its external image, continuously improves the level of nursing technology, and effectively provides high-quality supply services for the clinic, and has achieved remarkable results. In the future work, I will continue to work hard, forge ahead, better serve patients and make my new contribution to the standardized construction of hospitals.

Chen Nina

20XX-02- 19

Chapter 3: Learning experience of disinfection supply center.

Strengthening professional connotation and improving service quality

20xx65438+1October 1 1 to 17, attended the post training course for disinfection and supply in Henan province, and the study time was one week, ***60 hours. The speakers are the director of the provincial health department, the director of the nursing department of Henan Provincial People's Hospital, the chief of the infectious diseases department of the First Affiliated Hospital, and several disinfection supply experts in Henan Province. The course covers a wide range of contents, including a detailed analysis of the evaluation standards of disinfection supply specialty in tertiary hospitals, how to build a high-quality and efficient service team, an analysis of laws and regulations of disinfection supply specialty, the cleaning quality and continuous improvement of endoscopes, and how to standardize cleaning, packaging, sterilization and distribution. Through this study, I have a deeper and broader cognitive understanding of the work of disinfection supply center. Now I will summarize my learning gains as follows and share them with you.

1. Centralized management must be implemented in the disinfection supply center: the provincial health department requires centralized management in the disinfection supply center of the hospital, otherwise it will affect the grade evaluation of the hospital and the special acceptance (review) of the disinfection supply room. At present, centralized management is divided into two forms: the first form is to build or expand a disinfection supply center with special facilities for hard endoscope cleaning. The outpatient department has a special soft endoscope cleaning center, and all reusable instruments, dressings, stomatology and endoscopes in the hospital must be returned to the disinfection supply center for centralized treatment. The second form is that all reusable instruments and dressings in the hospital must be returned to the existing disinfection supply center for treatment. The scattered cleaning facilities such as stomatology, ophthalmology, hard endoscope in operating room and soft endoscope in outpatient department meet the national industry standards, and the staff must be trained in disinfection supply. Disposable sterile articles, syringes and infusion sets from the newly-built disinfection supply center will be distributed to the medical equipment department (the equipment department and the procurement department will be merged into one), so that the medical equipment department will be merged into one.

2, hospital infection is no small matter, everyone starts with small things: we often say that "a citizen must abide by the law." We must also abide by the law in our work. Our medical behavior must abide by the relevant laws and regulations of the state, and irregular medical behavior must be corrected. Once there is a medical accident, we can't solve it with tears, and we will be punished by law. As the staff of disinfection supply center, they should be familiar with relevant laws and regulations, standardize procedures, standardize behaviors and standardize systems.

Fan management. Any work, should leave a standardized record. Otherwise, once something happens, we will not be able to produce well-founded information and will pay a painful price. Because our medical quality and safety will be related to the stability of a family and a society. We should realize that the responsibility of work quality and safety is greater than the sky, always establish the idea of "quality first" and "patient first" and create the concept of total quality management.

3. Scientific and standardized work and continuous quality improvement: the work of disinfection supply center is very complicated, and any work must have processes, systems and operating procedures. To manage work with processes and systems, as a manager, we should standardize the work of department employees to the maximum extent, abide by laws and regulations, and constantly improve our work. According to the difficulty of the work, we should implement hierarchical management, formulate detailed grading job responsibilities and work quality standards, compete for posts, and truly realize scientific performance distribution. Improve job responsibilities, standardize job training, strengthen scientific management, increase quality control, and ensure medical safety.

4. Strengthen the professional connotation and improve the service quality: With the expansion of the working radius of the disinfection supply center and the minimally invasive development of advanced high-tech surgery and operating instruments, the number of precision instruments is increasing, and the cleaning work is becoming more and more difficult, which requires disinfection supply professionals to keep learning, update their knowledge and set high standards for themselves, otherwise it will be difficult to keep up with the development of disinfection supply specialty. The scope of disinfection supply center has been expanded, which requires us to fully communicate and coordinate with clinical departments, always take patients as the center, go out of departments to go deep into clinic, find clinical needs, especially follow up the development of new clinical business and new technology, and solve the disinfection and sterilization problems for clinic in time.

Through this study, I deeply realized that the disinfection supply center is the "heart" of the hospital and an important department to control hospital infection. Under the high-quality service mode, the disinfection supply center must strengthen the total quality management system, take "precision" as the goal and "precision" as the means to realize the transformation of specialty management from empirical to scientific, from extensive to refined management, and ensure medical safety. So as to better provide full-course, comprehensive, active, safe and professional high-quality services for clinic, escort the all-round development of high-quality nursing services in hospitals, and build a harmonious doctor-patient relationship.

Although the study time is very short, it broadens my mind. I deeply realized that disinfection and supply specialty is a very professional specialty. At the end of this year, Henan Provincial People's Hospital Disinfection Supply Center

Facing the acceptance of national key specialties, Henan province will choose several key specialties of disinfection supply center in the next step, which is thought-provoking We are confident that we can take this opportunity to make our new disinfection supply center reach a new level.

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