In August, I was lucky enough to come to Queen Mary Hospital in Hong Kong to study neonatal intensive care. Because this learning opportunity is very rare, it took the hospital more than half a year to get it. So before I come here, I think I must seriously study their advanced nursing concepts and techniques, and make this trip to glad you came. But after coming to Hong Kong, I found that apart from studying, the most important thing is to experience the cultural differences between Hong Kong and the mainland. In just one month, I deeply felt it.
First, humanized management is first of all good teamwork and diversified nursing staff echelon. The nursing team in each ward is equipped with ward manager, head nurse, specialist nurse and clinical nurse. Everyone cooperates with each other while completing their own work to ensure the nursing quality of the ward. In addition, they also have an organic section chief who is responsible for the daily management, debugging, maintenance and repair of instruments and the purchase of spare parts. Health service assistant, responsible for the replacement, replenishment and storage of nursing supplies; Ward assistant, responsible for terminal disposal and going out to do chores; Medical secretary, responsible for the reception, internal and external communication, statistics, sorting and storage of medical documents; Hygienist, responsible for ward hygiene (spotless effect required). Through the careful arrangement of personnel, everyone performs their duties, so that patients have a sense of security after admission, and everything is under the care of medical staff. Secondly, every new employee of Queen Mary Hospital should be trained in occupational safety, health and infection control. All the aisles in the ward are posted with various exercises on how to lift heavy objects and relieve fatigue, instructing employees how to protect themselves at work to prevent accidents. Wear gloves when touching blood and body fluids, handle needles and sharp tools carefully, and wash your hands frequently to avoid cross infection. During the study, we learned that Queen Mary Hospital also trains the quality of its staff. At the beginning of the year, nurses set their own goals, and the head nurse will provide corresponding learning opportunities according to the goals set by nurses. The Hospital Authority will organize various types of learning classes every month to improve the quality of employees. For the clinical audit of nursing staff, the most classic sentence that Manager Cai said is that when a nurse makes a mistake, it is not a human problem, but a system problem. They will revise and improve the system according to this matter, instead of punishing nurses. Only in this way, mistakes will be reported in time, not concealed, which is conducive to improving nursing quality and reducing accidents. The work in the hospital is tense and heavy. In order to reduce the work pressure of employees, the hospital has carried out a series of lectures, such as psychological counseling and how to decompress. In addition, it also organizes employees to do physical exercises, and provides employees with Internet access, fitness and even clubs including karaoke.
2. Advanced equipment and technical level, excellent service and scientific and effective equipment setting are an obvious feature of Queen Mary Hospital. With the sickbed as the center, embedded devices such as negative pressure suction, oxygen, compressed air and power supply are installed on the wall with the height of bedside1m. All kinds of monitoring equipment, central suction equipment and central oxygen supply equipment can be moved at will, and medical instruments and resuscitation emergency tubes are placed in a fixed position on the instrument rack in a standardized way, which is convenient to use. Each sickbed is equipped with a set of wall-mounted central monitoring equipment, which is connected with the central monitoring system of the nurse station. ECG, central venous pressure, invasive and noninvasive blood pressure, arterial pressure and oxygen saturation can be monitored at any time, and the monitoring items that can be changed by any plug-in can be changed. Others increase according to the patient's condition, such as nervous system monitor, pca analgesic syringe, B-ultrasound, gastrointestinal nutrition infusion set, arteriovenous catheterization system, etc. All subjects may be involved in the equipment needed for the disease and keep it in good condition at any time. In addition, there are experienced doctors and nurses in the neonatal intensive care unit, who have advanced medical standards, such as the application of curosurf, arterial blood pressure monitoring, umbilical artery and vein intubation, picc and so on. They successfully saved a baby weighing only 430 grams. They do rop for premature babies under 32 weeks, do hearing screening for each baby and check whether the baby is congenital as soon as possible.
Blind and deaf, early treatment. Their hospital attaches great importance to humanized service. For example, when cpap is used, a pad will be cut between the nose and the stuffy nose to prevent skin damage and pig nose. When you need to put tape on your face, you will put a protective film on it, and every incubator will have a cover cloth. All treatments will focus on reducing light and various external stimuli, which is conducive to the growth and development of children. For babies with special problems, there are professional physiotherapists and occupations to serve them, and for babies who continue to recover after discharge, they are referred to other hospitals for treatment. The whole hospital has developed a family-centered nursing model. The spacious game area in the general ward brings children an environment without strangeness; The arrival of the game ambassador every day brings joy to the children; Full-time Red Cross teachers have relieved school-age children of their academic worries; Parents actively participate in the care of their children under the guidance of nursing staff. In nicu, nurses encourage parents to visit their babies and do what they can, which reduces parents' anxiety of not seeing their babies, promotes the intimacy between newborns and their parents, and embodies a strong family atmosphere. Before the premature infants leave the hospital, parents will be given a pre-natal course, and special nurses will explain and guide them, so that parents can bathe, change clothes and change diapers for premature infants until they are competent, and then they can safely hand them over to their parents. After the child was discharged from the hospital, he was followed up in the outpatient clinic within two years and regularly examined by a specialist. Express concern and sympathy to the parents of children through standardized and appropriate service methods, and reflect the service level of the hospital. Naturally integrate service norms into service consciousness and apply them to medical practice. The ward has set up a hotline for discharged patients, which is responsible for providing all kinds of consulting services 24 hours a day, so that patients can keep in touch with the hospital through the hotline and get professional guidance of medical services at any time; Every department has pamphlets on medical knowledge of various professional diseases for people to consult for free.
Third, rigorous work style In order to prevent accidents, the hospital stipulates that the dose of medical treatment must be checked by the pharmacy and can only be used on patients after being checked by two nurses; Special treatments, such as blood transfusion and application of curosurf, must be examined by both doctors and nurses before being implemented by doctors; In treatment, you can take it orally, and don't use intravenous therapy. Most antibiotics use penicillin, so stop taking it as soon as possible. The newly assigned students and senior nurses should be taught by specialized nurses. First of all, they should understand the environment of the ward and the storage places of various items, learn the use and precautions of various equipment, and various nursing techniques applied to clinical work. Only by passing the exam can they be appointed as teaching teachers. All kinds of articles used in the ward adopt the method of ××× (regular sorting, regular cleaning, regular rectification, regular standardization and regular self-discipline), and the labels are fixed and readily available; First aid kit, thermometer, stethoscope, etc. It should be prepared before each child goes to bed and disinfected at last after discharge. Hospitals advocate breastfeeding, but their requirements for breast milk are strict, and they will do bacterial culture, requiring that breast milk must be frozen before eating (except direct feeding). If the child finds any discomfort during breastfeeding, he should stop immediately and wait until the mother fully grasps the essentials of breast milk collection and passes the breast milk test before eating. There are corresponding flow charts in various nursing operations, and these processes have assessment standards; Every year, the specialized nurses in the department and the staff in the nursing department discuss whether these operations need to be improved; Doctors and nurses wash their hands strictly before and after the operation, and each patient is equipped with hand disinfectant before going to bed. During the operation, if the operation fails, the medical supplies must be replaced and never reused. Because they know that if they don't abide by the rules and regulations, they will increase the probability of infection, thus endangering the lives of patients and their own health. The hospital has an independent infection control department, which continuously monitors the infection situation of each department, and at the same time counts the surgical infection rate of each doctor, so as to point it out individually. Hospital infection control is well done. There is an independent negative pressure isolation ward in the ward, which is isolated if it is determined to be an infectious disease, and the infected and non-infected patients are strictly treated in separate wards. Because of this, Queen Mary Hospital has done a very good job in infection control. Even during the SARS period, there was no nosocomial infection in their hospital.
Fourth, the enthusiasm and sincerity of Hong Kong people. When they first came to Hong Kong, they often asked others for directions because they didn't know the way. Although the local people's Mandarin is not very good, they can.
Tell you enthusiastically, even draw a map, what's more, show us the way in person. When we first came to Queen Mary Hospital, because it was already late at night, we only asked the security nurses how to get to the dormitory. They actually asked if you were from XXX and took us to the dormitory in person. When I arrived at the dormitory door, I found a note posted on the door to show us the way. At that time, I was really touched and felt that their work arrangements were really meticulous. The next day, the administrator's aunt led us to buy telephone cards and Octopus cards to guide our daily life. The manager of nursing department took time out of his busy schedule to invite us to dinner and asked us what difficulties we had in our study and life.
A month passed quickly. Here, I am very grateful to the hospital leaders for providing me with such a valuable learning opportunity, so that I can contact and learn the advanced medical technology and nursing concept of Queen Mary Hospital in Hong Kong and feel the civilization and advancement of Hong Kong. At present, Dushanzi is in a period of great development. In order to meet the needs of great development, hospitals have continuously sent medical staff to the mainland and Xinjiang to learn advanced management models and medical technologies. I believe that through the joint efforts of all medical staff, Dushanzi Hospital will definitely become a unique brand hospital in the Golden Triangle and better serve the people of Dushanzi!
The aisles and wards in the pediatric ward are brightly colored, and there are also game rooms and toy cards.
High frequency ventilator and closed thoracic drainage were used to treat children with meconium aspiration syndrome.
All items shall be placed neatly according to the method of ××××, and the labels shall be obvious.
(2) Nurse Zhang's feelings about studying in Queen Mary Hospital in Hong Kong.
Recently, I was honored to be sent to Queen Mary Hospital in Hong Kong for further study. During the short contact of one month, I personally experienced and felt a hospital operation mode with advanced management experience and excellent service system, and got to know a beautiful Hong Kong with its own characteristics, a quintessence of combining Chinese and Western cultures.
General situation of Queen Mary Hospital
Most of the funds for public health care in Hong Kong come from government subsidies. Queen Mary Hospital is a public hospital under the Hospital Authority of Hong Kong, which was established in 1937. It is also the teaching hospital of the University of Hong Kong. Is an emergency general hospital, including: emergency department (24 hours), internal medicine, surgery, children and adolescents, obstetrics and gynecology, otolaryngology, oral and maxillofacial surgery, dentistry, ophthalmology. Full-time medical treatment includes: physical therapy department, occupational therapy department, medical and social service department, prosthetic and orthopedic department/podiatric diagnosis and treatment department, clinical psychology department, speech therapy department, nutrition department and pharmacy department. Queen Mary Hospital is also a tertiary referral center for many advanced technologies, such as radiotherapy, organ transplantation, neonatal intensive care, plastic surgery and brain surgery. Queen Mary Hospital implements a series of patient-centered community and support services, such as patient care support in cancer center, palliative care consultation and cancer consultation service, diabetes center care and support service, community care and community volunteer service, patient resource center and patient cooperation service. There are * * * beds in the hospital, and the number of employees is * *, including nurses 1625, doctors 383, full-time medical staff 475 and others 1702. The average hospitalization time was ××5 days.
Queen Mary Hospital has a core value: professional diagnosis and treatment, compassionate care and quality service.
Nurse training and nursing audit and standards
Nurses are divided into registered nurses, registered nurses, specialist nurses and nursing directors. The highest level is the general manager of nursing, and there are several department managers and ward managers. Nurses' continuing education is highly valued. Every year, nursing administration will set up many related courses for nurses to choose according to their majors, so as to accumulate credits. It is required to accumulate enough 45 points for three consecutive years before you have the opportunity to continue your promotion or raise your salary. These studies are all done by me in my spare time under the supervision and help of the ward nursing manager.
Help, if a nurse doesn't finish, the superior specialist nurses and managers will try their best to create more opportunities to help her finish.
The Hong Kong Hospital Authority has issued two versions of nursing standards and one version of patient care practice guidelines. According to these standards, the hospital has also formulated many ward workbooks, including standardized written materials on crisis management, disaster response plan, ward operation, nursing operation and infection control, with nursing quality audit forms attached. To evaluate and compare the nursing quality of various departments. The hospital has a special clinical audit department, which comprehensively evaluates and audits all medical staff, checks and supervises every clinical medical procedure, so as to ensure professional responsibility and behavior, which is part of the clinical code. The purpose of clinical audit is not to punish medical staff because they believe. 85% of medical errors are caused by the system, and there is no name-calling punishment. Only in this way can we ensure that the facts are not concealed, so that auditors can quickly understand the truth, accurately discover the imperfections in the system and improve them.
Infection control
This is what I learned the most. The infection control in Queen Mary Hospital is quite good, and each department has special infection control doctors and nurses to continuously monitor the infection control in the department. There is a negative pressure isolation device in the ward to ensure that infected patients are strictly isolated, and patients are admitted to the hospital in strict partitions, and cross-infection in the hospital is never allowed. What impressed me most was the hand washing of medical staff. Doctors come to make rounds every day, and each patient has special medical equipment beside his bed, which will never be used interchangeably. Every time a doctor touches another patient after seeing one patient, he will wash his hands first. Each ward has a washbasin equipped with a washpad and disinfectant. After washing his hands, he will wipe them with a special paper towel. There are also many hand washing devices in the escalators and halls of hospitals, and there are special personnel to supplement the contents in time. In the outpatient clinic, we also see doctors wash their hands after seeing one patient and then invite another patient in. We had the opportunity to attend an international lecture during our study. The content of the lecture was hand washing, which shows how much they attach importance to such a seemingly simple problem! He said this when talking about the importance of hand washing, because a lot of hand washing will inevitably increase a lot of medical expenses, which will easily make this measure difficult to implement. However, according to their investigation, if an infected case is added due to hand problems, the medical expenses will increase by 1500 USD. Therefore, hand washing is the cheapest and most effective way to control infection. In the aspect of infection control, they made the work as detailed and specific as possible, thus making the work fruitful.
Staff quality evaluation
Every employee of Queen Mary Hospital should write a review of employee development and evaluate the core talents of employees every year, just like us. It is evaluated from ten aspects: medical care, clinical care, application of knowledge and skills, quality and risk management, personal characteristics, professional characteristics, teamwork, personnel training, service development, and legal and professional ethics standards, so as to provide basis for the future development of employees according to their work performance and overall performance. Therefore, their evaluation of an employee's quality is comprehensive. During our study, we will also communicate with the nurses below. I found that many of their nurses are ordinary nurses, but they have a high sense of responsibility and ownership.
Humanized nursing runs through patients and employees.
Their concern for patients is by no means verbal, but actually implemented in their work. They don't talk big and empty, but the ultimate goal of their work is to ensure the accuracy and accuracy of nursing work. For example, their children's ward environment is very beautiful, and there are lovely cartoon patterns on the roof and walls, which is very warm. There is a place for games and reading in one corner of the ward. In addition, a game ambassador comes to the ward every week to play games with the children and give gifts. The Red Cross will also arrange teachers to make up for the children's lack of learning in class. All these make children's ward life not boring and scary, but interesting. We are here.
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