Personal summary of nurses in hemodialysis room 1 As a nurse in hemodialysis room, we should be sympathetic to patients, especially those with maintenance hemodialysis. They have to tie the dialysis surface to survive. In fact, this is a more painful life. Great changes have taken place in their social life, work and family relations, and they are worried about their life, prognosis, career and future. In addition, the pain, repeated puncture, economic burden, sexual dysfunction and other problems caused by blood access surgery can be transformed into mental burden, which makes patients appear depression and rebellious behavior. Therefore, we must do a good job in their psychological care and help them build confidence in overcoming the disease.
As a nurse in hemodialysis room, we should have a strong sense of responsibility. There is nearly 200 ml of blood in the extracorporeal circulation pipeline of dialysis patients, which runs continuously for four or five hours at a speed of more than 200 ml per minute. Each pipeline has several connectors and side holes. A little negligence will make the patient lose blood and even lead to more serious consequences. As we all know, every patient with renal insufficiency has anemia in different degrees, so every drop of blood lost is not only the patient himself, but also us. The dosage of heparin is even more sloppy, and large doses will lead to bleeding tendency in patients; Small doses can not only prevent coagulation, but also lead to blood loss. This requires our nurses to closely observe the patient's vital signs, machine conditions and whether the management connection is intact at any time and anywhere. When going to work, you must concentrate and maintain a high sense of responsibility to ensure the safety of patients in several rooms.
As nurses in hemodialysis room, we should have a scientific service attitude. As nursing workers, we should not only relieve patients' pain, but also patiently do their ideological work, communicate with them, and make them believe in science and trust us. Let them know that after chronic renal insufficiency enters uremia, apart from kidney replacement and peritoneal dialysis, hemodialysis is the only way and there is no choice. Warn them not to take detours, not to believe in ghosts and gods, not to waste money and spoil things. There are many patients who are particularly disgusted with hemodialysis before starting dialysis and are unwilling to accept it. They mistakenly think that dialysis is similar to smoking. Once they live in seclusion, it's hard to quit. In fact, the dialysis machine is equivalent to our kidneys. For a kidney that has lost its renal function, it just plays a substitute role. For patients undergoing dialysis for the first time, their condition, the necessity of dialysis and the methods of dialysis should be explained. If necessary, show your patients around the dialysis room, and the dialysis patients will introduce the situation to ease the tension.
As a nurse in hemodialysis room, sympathy, responsibility, care and love for patients are of course essential, and skilled technology is the guarantee for our nurses to help patients overcome diseases. Only skilled technology can really alleviate the pain of patients. Therefore, we must practice dialysis and various operation techniques, such as arterial puncture, internal fistula puncture and femoral vein puncture.
As a nurse in the hemodialysis room, her work seems to be very regular. In fact, she often has to work overtime and can't turn off her mobile phone for 365 days a year. Because of the particularity of our work, we have to go to work one hour early every day. We are used to such days, and we are more used to the feeling of being with hemodialysis patients on holidays. When we encounter special tasks such as critical patients and drug poisoning, we have no choice but to rush to the hospital as soon as the patient calls, and the next day we have to be busy with the patients who are already lying on the hemodialysis bed.
As nurses in the hemodialysis room, these are our unshirkable responsibilities, and we are very pleased to be able to do our job well. The task we face in the future is still arduous, but we have the correct leadership of hospital leaders at all levels, and we are confident and capable of doing a better job. In the future work, we will continue to study new knowledge and master new technologies to better serve the people and contribute to hospital construction.
Personal summary of nurses in hemodialysis room 2 Last week, I was just appointed as the deputy head nurse in hemodialysis room. As a nursing management position, although I have worked in the clinical front line for many years and my business is skilled, there is still a big gap between the scope of work and the duties of the head nurse. When I was at a loss and didn't know where to start, Director Wan of the Nursing Department seemed to find my mind. She smiled and said to me kindly, "You are the head nurse, and it doesn't matter if you have no bottom. We will hold a training class for head nurses next week. You must arrange the work of the department and be sure to participate! " . Great! I seem to see a light in the dark. What am I afraid of? I have Director Wan of the Nursing Department and many excellent head nurses as my role models. There is nothing I can't overcome to train the head nurse (hemodialysis room).
Back to the department, I looked at the duty watch. The employees in our department are very nervous. There is also a nurse on maternity leave. The head nurse changed shifts normally. Four nurses have to work in two shifts a week. The former head nurse is going to be transferred, and the schedule is even more tense. How can I have time to attend the training class? While I was meditating, Cory's teacher said to me, "It doesn't matter, just go to the training class, there are us in the department!" " "Really, this sentence makes me very moved. I will cherish this learning opportunity, improve my management ability and make our department an excellent department.
The first class of the training is Director Wan's class. Director Wan's classroom language is humorous and easy to understand. I have always enjoyed listening to her classes. Among them, Director Wan introduced "What kind of head nurse do nurses like?" I feel deeply because I really want to be a good head nurse who can treat me as a bosom friend. After listening to Director Wan's introduction, I made up my mind to do a good job in humanized management, respect, love, care and understand nurses, so that every nurse can grow up in our collective. The second class is a special training meeting of West Point School of Administration of Hong Kong Liancheng International Education Group, and Professor Deng Chengwei, a senior lecturer, was invited to the school. That class is very helpful for me to think about ways to solve problems, emphasizing the implementation of results, analyzing what the results are with typical cases, and drawing three important conclusions: tasks are not equal to results, attitudes are not equal to results, and responsibilities are not equal to results; Next, director Wu Wenxiu gave a speech. Director Wu taught us the art of nursing management with many philosophical stories. Director Wu's lecture was very comfortable and enlightening. Next, Director Zhang Fengqin and Director Zhang Ailian gave us two lessons on nursing quality management and daily management of head nurses, which gave me an intuitive understanding of the specific work of head nurses.
This training will teach me how to behave and how to do things. In short, the highlights and inspirations in my study are profound and many. Through this training, I have gained a lot and greatly improved myself.
First, there is a new understanding of the art of nursing management;
Second, many of them can be used as my motto to inspire me to make achievements in ordinary jobs;
Third, it is of great help and guidance to my present work.
Personal summary of nurses in hemodialysis room 3. 20xx, which is unique to me, is coming to an end. Looking back on this unique year, it seems vivid. In this year's work, I will not be late and leave early, and I can abide by all the regulations of the hospital, respect the leaders and unite my colleagues. Actively complete the tasks assigned by leaders at all levels. In addition to successfully completing the advanced study of "hemodialysis", we also successfully established a hemodialysis room under the leadership of the department director and head nurse, and carried out and maintained hemodialysis work well.
People say that everything is difficult at the beginning. Since the opening of the hemodialysis room, assist the head nurse to formulate the post responsibilities, work flow, operation specifications, ledger management, emergency plan, etc. of the hemodialysis room, so as to plan ahead, ensure that the problems encountered in the work can be well documented and solved in time, and ensure the smooth development of the hemodialysis room.
In my work, I adhere to the people-oriented service concept, strengthen service consciousness, strengthen nurse-patient emotion with cordial and patient discourse exchange, carefully explain dialysis knowledge, give dietary guidance, eliminate patients' fear and blindness to diseases, and enhance patients' confidence in treatment. I often take the initiative to seek the opinions of patients and constantly improve my service. During the dialysis process of dialysis patients without family members, I can assume the responsibilities of family members, such as delivering water, heating meals, helping others, changing clothes, assisting defecation, etc., and never complain that I am dirty and tired.
I have a high sense of responsibility for my work. I am bold and cautious. Hemodialysis is risky. As a nursing operator, I have both risk awareness and subjective initiative to control and avoid risks to the maximum extent, thus improving the quality of nursing. In addition, I also have a high degree of marketing awareness and sensitivity to the economic benefits of the hospital, so as to serve every fixed patient well, retain every consulting patient, promote the software and hardware of the hospital and attract more patients. Actively participate in various off-campus studies, constantly enrich themselves, and actively participate in the development of "two new technologies" in the department. Since the opening of the hemodialysis room, * * * has completed 465,438+00 hemodialysis units, including 20 hemodialysis filtration units (two new technologies), 2 hemoperfusion units and 65,438+065,438+0 heparin-free dialysis units. No nursing safety accidents and errors occurred throughout the year.
As the person in charge of hospital infection in hemodialysis room, besides the daily dialysis work, I have to complete the regular maintenance of water dispenser and dialysis machine, and the regular supervision of dialysis water, dialysate and dialysis environment. Finally, I was named "excellent hospital infection quality controller"; The hemodialysis room managed by me won the honorary title of "excellent hospital sensory department" and ended successfully this year.
Looking back on all this, this is only a small beginning. I will wholeheartedly assist the director and head nurse to make the hemodialysis room in our hospital more distinctive and stronger.
Personal summary of nurses in hemodialysis room 4 20 18 hemodialysis room follows the overall development plan and requirements of the hospital, further deepens the service concept of "patient-centered", continuously improves quality nursing, deepens nursing reform, fully performs nursing duties, strengthens the construction of nursing connotation, improves the level of specialized nursing, and strives to expand extended services. At the same time, according to the spirit of the nursing department, with the goal of "patient safety", risk management is carried out to ensure medical safety, improve patients' medical experience and promote the harmony between doctors and patients. Over the past year, under the leadership, care and support of hospital leaders, department directors, nursing department and head nurses, and with the joint efforts of the majority of medical staff, all the clinical tasks undertaken have been successfully completed, and no mistakes, accidents and adverse events have occurred throughout the year.
The annual nursing work is summarized as follows:
First, the business volume of clinical work has gradually increased.
In 20 18, all kinds of treatment services in hemodialysis room kept growing, and the number of dialysis patients, the number of dialysis cases and the workload of various blood purification treatments increased significantly compared with the same period in 20 17, with a growth rate of 7.7% (Figure 1). In particular, the number of patients treated by hemodiafiltration (HDF), hemoperfusion (HP) and continuous blood purification (CRRT) increased significantly, which brought great pressure to the daily work of departments and the manpower of nurses, but also met the treatment needs of patients and improved the treatment effect of patients. Through the concerted efforts of general practitioner Qi Xin's Qi Xin, we have successfully completed countless rescue tasks for critically ill patients and successfully implemented the monthly nursing work. At present, 28 dialysis machines have been opened, and more than 20 patients/kloc-0 have been admitted to maintenance hemodialysis clinics, three shifts a day. With the increase of dialysis patients in three shifts at night, more beds will be opened in the future to meet the treatment needs of patients. But at the same time, it is necessary to do a good job in medical manpower allocation and job training to ensure the nurse-patient ratio, meet clinical needs and avoid adverse events.
Two, the implementation of nursing core system and quality indicators, and promote the continuous improvement of quality.
According to the requirements of the nursing department, the sensitive quality indicators of specialized nursing in our department were determined, including the incidence of dialysis catheter infection and the incidence of blood leakage in the puncture site of hemodialysis patients, and the data were continuously monitored, summarized and analyzed, and the corresponding rectification measures were actively implemented, which achieved good results (Figure 2 and Figure 3). Actively carry out quality control circle (QCC) activities, complete the quality improvement project with the theme of "reducing the incidence of acute complications of hemodialysis", carry out project implementation and evaluation, and formulate and improve three standardized workbooks, such as health education path table for hemodialysis patients, hemodialysis monitoring and nursing flow chart, and emergency treatment process for common complications of hemodialysis. The project has achieved satisfactory results, achieved the expected goals, significantly improved the treatment effect of patients and the comprehensive quality of nursing staff, and the research results participated in academic conferences and exchanges.
According to the requirements of the nursing department, we completed the revision of the nursing quality control standard of undergraduate department on 20 18, actively participated in and carried out the training of the new system of nursing department, and decomposed, refined and implemented the work priorities of undergraduate department. The nursing quality control group of the department regularly monitors various nursing quality indicators and carries out continuous quality improvement, so that weekly monitoring, monthly analysis and everyone's responsibility are achieved. In the first half of the year, it successfully passed the quality counterpart inspection of North and South hospitals, the special inspection of district health supervision office and the supervision of hospital sensory department. In the second half of the year, it passed the grade evaluation survey of the top three hospitals and the quality control inspection of hemodialysis in the city. According to the evaluation rules, inspection standards and inspection results, actively listen to experts' opinions and suggestions, further improve various rules and regulations and work processes, consult and sort out the latest industry standards, laws and regulations and clinical practice guidelines, standardize specialist nursing operation procedures, actively implement various improvement measures after inspection, and continuously improve nursing service quality and patient satisfaction.
Third, strengthen the cultivation of nurses' core competence and improve the overall quality of the team.
Established and improved the training plan, training objectives and performance appraisal system of existing specialist nurses, strengthened the training of young and junior nurses through various forms, and completed the standardized training of two new nurses. We carry out graded training and assessment, give full play to the strengths of nurses at all levels, tap their potential, and actively mobilize nurses in our department to participate in a series of activities such as training plan for outstanding young talents, pre-job competition for nursing management positions, selection of high-quality nursing service talents, and selection of innovative nursing research groups. After selection, 1 person was selected into the excellent young nurse program, and 1 person was selected into the clinical nursing expert program. Organize the study of new knowledge and new theories, and conduct 32 times of specialized business training throughout the year, all of which are taught by nurses in this department, so as to improve nurses' learning enthusiasm and promote their growth. Send nursing backbones to study abroad, attend academic conferences on blood purification at all levels and all over the country, learn new ideas and knowledge, bring them back to departments to share and exchange, promote the progress of all staff, and improve the professional ability and comprehensive quality of general nurses.
Fourth, strengthen ward management and implement department safety supervision.
Implement various safety inspections before the festival, and strengthen fire safety and patient health education during various festivals. At the same time, ensure that all first-aid articles and instruments are on standby to ensure the medical safety of patients. Actively cooperate with and participate in the "Nursing Safety Month" organized by the nursing department, implement the safety supervision of departments, eliminate the hidden dangers of safety in departments, and effectively avoid the occurrence of adverse events. In addition, according to the 6S standardized management requirements of the nursing department, all kinds of articles, medicines and consumables in the office, treatment room and warehouse in the ward were standardized, the relevant systems were revised, the responsible person was clarified, and the effective management was standardized.
Five, improve scientific research ability, carry out innovative practice.
Organize department staff to learn and exchange new knowledge and technology of specialized nursing, understand the progress of the discipline and pay attention to the latest trends. Actively participate in nursing scientific research training organized by the nursing department, and at the same time increase the relevant content of scientific research in the business study of the department, popularize scientific research knowledge, and lay the foundation for clinical nursing scientific research projects in the future. Actively participate in the application of new nursing technology. This year, the application projects are extracorporeal membrane oxygenation and CRRT online treatment and nursing. The project implementation plan and technical operation flow have been determined, so as to prepare for the later development. In the first half of the year, we completed the innovative nursing project of HDF treatment online, carried out general practice training and promotion, and achieved good clinical results. In addition, actively participate in the activities of scientific research innovation group of nursing department, mobilize department personnel to pay attention to the cultivation of scientific research consciousness, be good at finding clinical nursing problems, and actively participate in project declaration at all levels. This year, we have completed the establishment of the bureau-level project of 1 continuous care for maintenance hemodialysis patients, and will gradually promote the implementation, evaluation and summary of the project in the future.
VI. Shortcomings and deficiencies
Over the past year, with the support and efforts of staff at all levels, the nursing work of various departments has made certain achievements, but there are also some shortcomings that need further improvement:
Extended nursing service is still in the primary stage. In the future, it will cooperate with the development and implementation of the project to provide patients with comprehensive, full-course, professional, humanized and continuous high-quality nursing service through various channels and forms.
The professional quality of nurses needs to be improved, the awareness of active service is not strong, and the communication between doctors, nurses and patients is not in place. In the future, it is necessary to further strengthen the multi-dimensional ability training of specialist nurses, improve nurses' sense of responsibility and professional beliefs, increase related learning contents such as humanities, psychology and law, and carry out collective activities of doctors, nurses and patients to further enhance team cohesion and trust.
Management ability needs to be further improved, lacking innovation. In the future, it is necessary to continue to learn the theory and methods of nursing management, improve managers' own level and ability, master the application of quality management tools (such as QCC, RCA and FMEA), and innovatively carry out quality improvement projects to promote the improvement of clinical nursing quality and the development of specialized nursing.
Finally, reviewing the work in the past year, we always adhere to the service concept of "patient-centered", actively promote high-quality nursing services, fully implement the spirit of hospitals and nursing departments, continuously strengthen basic theory and operation training, and revise and improve specialist management processes and related regulatory standards to ensure nursing safety and improve nursing quality. By summarizing and constantly discovering the shortcomings in the work, improving and perfecting in time, making new goals and plans, and constantly improving the work efficiency and service quality, the nursing culture, nursing quality and nurse-patient satisfaction of the department will reach a new height.
Personal summary of nurses in hemodialysis room 5 hemodialysis is the main treatment for uremia patients. Dialysis patients actually lead a very abnormal life. They are "tied" to dialysis machines to a large extent, and they have to rely on medical equipment and medical staff to survive all their lives. The financial burden of patients and their families is very heavy, and long-term pathological factors also make patients emotionally unstable and irritable. With the change of medical model, hemodialysis patients should be given not only psychological comfort, but also humanistic care, advocate the concept of people-oriented nursing service, and improve the quality of life of dialysis patients. The so-called "small hemodialysis room" actually carries all the hopes of dialysis patients and is also an indispensable treatment for acute renal failure and various poisoning patients. This paper summarizes the nursing experience of hemodialysis room in 20xx years:
1. Define the post responsibilities, workflow and operation specifications of the dialysis center, and formulate the dialysis risk plan and emergency response plan.
Study hard to make hemodialysis nurses master it skillfully. Problems encountered in the work are well documented and can be solved in time. Rules and regulations are constantly supplemented and improved in the work. Work in strict accordance with the rules and regulations and workflow, and strictly check the system, including the setting of pre-flushing pipeline, blood vessel puncture, dialysis treatment and patient's treatment parameters, to ensure that there must be more than two nurses on duty in each shift to check each other, including whether there is blood leakage at the puncture site, whether the treatment parameters set by the machine are accurate, the dosage of anticoagulant and other drugs, and the patient's vital signs. Actively participate in business study and training in hospitals, and learn hemodialysis once a month. Support and encourage nursing staff to participate in specialized study, improve the comprehensive quality of nurses, fully mobilize their enthusiasm, enrich their knowledge and broaden their horizons.
Improving the quality of nurses is not only the professional level, but also the humanistic cultivation based on professional theory, including language cultivation, interpersonal cultivation, ethics cultivation, rational thinking cultivation and so on. Care about nurses in life and try to solve practical difficulties for them. Let nurses feel the warmth and friendship of the group. To establish the concept of people-oriented nursing service, we should not only have humanistic care between doctors and patients, but also have the relationship between nurses and colleagues, and more importantly, the relationship between nurses and friends. Mutual understanding, trust and communication can create a good medical and working atmosphere, lay a good environmental foundation for further improving the quality of medical services and work efficiency, and play a multiplier role in the management of hemodialysis rooms. In the process of daily dialysis, nurses cooperate tacitly, and there is no shift dispute; During emergency dialysis, everyone can arrive at the first time. No matter whether it is emergency dialysis at night or dialysis on Sunday, there is no shirking phenomenon, and overtime will not affect the normal work of the next day.
2. Establish a people-oriented nursing management model and strengthen service awareness.
After patients start dialysis, they often have a lot of stress, such as the risk, pain and freedom of dialysis, the influence of the disease itself on the body, the cost of dialysis, the change of family relationship and so on. And their psychological problems are depression, anxiety, despair, and some even hate society and medical staff. Friendly and patient language communication can make patients feel safe, explain dialysis knowledge carefully, eliminate patients' fear, explain the dialysis effect of other patients and enhance patients' confidence in treatment. Try to reduce the burden of patients, make dialysis plans for them, and try to make them not dwell on the pain of disease and the length of life, but pay attention to the quality of life and laugh at life.
Dialysis patients have long-term contact with medical staff and have strong dependence on medical staff. At the same time, I am familiar with the staff, treatment environment, dialysis procedures and methods, and even regard the hemodialysis room as my second home, and have obvious awareness of participating in management. In this regard, we communicate with patients at any time, explain and explain the new progress of hemodialysis treatment, and take the initiative to solicit opinions. When other diseases occur, contact patients actively for treatment and establish a smooth medical channel. Provide contact information, contact in time when encountering problems, and strive to solve them in the first time. For patients with serious illness, let a family member accompany them, so that patients can feel family affection, increase their sense of security, reduce psychological pressure and better cooperate with treatment. In the absence of family members, we also assume the responsibility of family members. In the long-term treatment process, we hand over water, feed, help and influence patients. Patients with bad mood and bad attitude should report to hospital leaders in time, and work out practical and relevant measures with various departments to gradually dispel their extreme thoughts of revenge on society.
3. Work hard and be careful.
Hemodialysis is risky. As a nursing operator, we should establish a correct and positive awareness of nursing risks, strengthen the concept of legal system, give full play to subjective initiative, control and avoid risks to the maximum extent, improve nursing quality and better serve patients. During dialysis, blood pressure is measured and recorded every hour, and vital signs are measured and monitored at any time when the condition changes. Some patients, especially those prone to hypotension during dialysis, need to be closely observed and their blood pressure should be measured every 5 minutes. Dialyzer parameters should be adjusted in time, such as temperature, conductivity, ultrafiltration rate and blood flow. Concentrate on your spirit and energy at work, and a little negligence may cause patients' losses and accidents.
Diabetic patients are prone to hypoglycemia because of sugar-free dialysis, so we should pay attention to the changes of consciousness, especially when sleeping. Because the edema is reduced after dialysis and drainage, and the skin at the puncture site is slack, it is easy to cause needle eye bleeding or needle removal, especially in winter, when the patient's arm is in the quilt, it often bleeds instantly and in a large amount. In addition to diligent observation, we should also explain the patient well and call in time if there is any abnormality. 20xx dialysis for more than 600 times a year, and there has never been a medical error accident. And how to observe blood sugar and prevent hypoglycemia shock in hemodialysis of diabetic patients, and gained some experience; Analyze the hypotension in dialysis and take preventive measures to ensure adequate dialysis.
4. Humanized care.
In line with the values of "patients first" in our hospital, we will continue to advocate the concept of people-oriented nursing service and give patients humanized care. We have given several poor dialysis patients 1000 yuan in aid, and given them care and help in food and clothing. These are undoubtedly a drop in the bucket for dialysis patients, and they can't improve their life and dialysis situation at all, but they express our concern and encouragement to patients to some extent.
In addition to our efforts and achievements, we also had some slack this year, such as poor professional and technical level, poor medical equipment and environmental management, poor service attitude and communication, and imperfect system. At the same time of reflection, we also put forward opinions and suggestions to attract the attention of hospital leaders and nursing departments.
1, business technical level:
First, the problem of arterial puncture, especially for patients undergoing first dialysis and emergency dialysis, is generally poor in conditions, high in toxins, and difficult to puncture the artery, making it difficult to ensure dialysis blood flow. First, the experience of arterial puncture is still lacking, and we blindly choose to re-puncture when the blood flow is not enough.
Second, the overall level of the hospital is not enough to do deep vein catheterization, which increases the pain of patients and easily causes patients' dissatisfaction.
Secondly, this year, the medical staff in the hemodialysis room did not have the opportunity to go out for further study, the dialysis work remained basically unchanged, no new business and technology were developed, and no papers were published. Because the work of hemodialysis room is closely related to doctors, such as deep vein catheterization, ascites reinfusion, hemoperfusion and so on. , all need the guidance of doctors and the cooperation of doctors and nurses, but also need practical experience to learn, it is impossible to build a car behind closed doors. I hope hospital leaders can give us some opportunities to visit and study, and take a step further in improving professional level, strengthening disinfection and isolation measures, and developing new dialysis projects.
2. Medical equipment:
Dialysis patients rely on dialysis equipment, including dialysis instruments, water treatment equipment, perfect water and electricity supply, high-quality dialysis supplies and so on. This year, the route reuse and disinfection of dialyzers and dialysis tubes will be completed, and the conversion to disposable use will be completed. This transformation is the case.