As we all know, the work of emergency department is heavy and complicated, and all kinds of patients are treated every day. The implementation of its treatment and nursing requires accuracy and rapidity, and a little carelessness will lead to adverse consequences; The following contents are the emergency medical papers I carefully arranged for you. Welcome to refer to them!
Nursing disputes in emergency medical papers refer to all kinds of contradictions between nurses and patients, patients' families or companions in the process of clinical diagnosis and treatment.
As we all know, emergency patients are seriously ill, change rapidly and have a high mortality rate. Improper diagnosis, treatment and nursing, or poor skills and humanistic quality of nurses will all induce nursing disputes, which will directly affect the nursing effect and hospital image. On the basis of summarizing the previous nursing work, the emergency department of our hospital implemented standardized management from June 5, 2008 to 2009 10, which effectively prevented nursing disputes. The summary report is as follows:
1 standardized management measures
1. 1 general information
In September 2009, the emergency department of our hospital analyzed the causes of nursing disputes in recent years, summed up experiences and lessons, and formulated standardized management measures. Through one year's implementation, practice has proved that standardized management measures have effectively avoided and curbed the occurrence of nursing disputes.
1.2 causes of nursing disputes
1.2. 1 nurse's factors mainly include: ① weak sense of responsibility, unclear concept of receiving and triage, indifferent service consciousness or poor language expression, disorganized and unfocused work, which leads to confusion in triage. ② The consciousness of pre-hospital first aid is indifferent, and they make a house call without preparation; Answering the call for help is unknown, or the visit is slow; The patients and their families were not informed of the possible risks during transportation. ③ Lack of solid professional knowledge and skilled professional first aid skills; There are no first-aid articles or first-aid medicines; Insufficient adaptability. ④ Lack of humanistic quality, communication skills between doctors and patients, insufficient attention to psychological counseling of patients and their families, or lack of awareness of self-protection; Failing to fulfill the obligation of informing and signing the informed consent; When rescuing patients, they are in a hurry, or have no clue and focus, and even the necessary treatment or nursing measures have not been implemented; The writing of nursing records is not timely or standardized.
1.2.2 the factors of patients and their families mainly include: ① patients and their families are at a loss in sudden emergencies, feel fear and panic, and have psychological barriers. (2) impatient or very dissatisfied with others due to sudden illness and economic difficulties. (3) Insufficient health education, patients and their families lack proper health knowledge, and speak ill of medical staff or lack due respect. ④ The diagnosis, treatment and nursing of diseases are not coordinated.
1.3 evaluation criteria for nursing disputes
According to the causes and solutions of nursing disputes in our hospital, the evaluation criteria are formulated and divided into three grades. Grade I: general contradiction, which can be solved after nurses communicate with patients and their families; Level 2: Prominent contradictions can only be solved through personal coordination of department leaders or head nurses, and both parties can understand them afterwards; Level 3: The contradiction is acute and can only be solved through the coordination of hospital leaders.
1.4 preventive measures for nursing disputes
1.4. 1 Nurses' own preventive measures mainly include: ① strengthening the construction of nurses, improving their own quality, renewing service concepts, mastering the diagnosis and differential diagnosis of common diseases and frequently-occurring diseases, and rescue nursing measures. ② It is necessary to strengthen nurses' humanistic quality, establish people-oriented nursing consciousness, constantly improve their own quality, standardize nursing behavior [1], and do a good job of psychological counseling for patients and their families at the same time of emergency treatment. ③ Strengthen the awareness of pre-hospital first aid, carefully answer the call for help, and prepare first aid articles and medicines at the same time; Record the specific contents of the call for help in detail, including the patient's detailed address, the patient's current situation, the pre-hospital first aid process, the departure route and the approximate arrival time, and inform the possible dangers and precautions on the way, and file the phone records. (4) As soon as the distress call arrives, the emergency department immediately calls the emergency personnel to be in place immediately, and checks whether the rescue equipment, equipment and medicines are complete and in place, and prepares for first aid at any time to be foolproof; At ordinary times, the above-mentioned articles and drugs must be fixed in four places (fixed point, positioning, quantification and special person management), and they should be counted, supplemented, handed over and recorded at any time. ⑤ Strengthen professional knowledge, improve first aid skills and resilience, grasp the changes and outcomes of diseases in time, relieve patients' pain with skilled technology, serve the society with the concept of health economics, and reduce the economic burden of patients as much as possible. ⑥ Strengthen self-protection awareness, and do not do or talk about things unrelated to work during first aid; Pay attention to communication skills and methods, implement protective treatment and nursing, and do not publicize patients' privacy; Timely, accurate and standardized records, including the implementation of diagnosis, examination, treatment and nursing measures, and the signing of informed consent. ⑦ Strengthen the management and system construction of emergency department, update the concept of pre-hospital first aid, strengthen the first aid technical training of ambulance personnel, and improve the first aid ability [2]. (eight) the implementation of continuing medical education: the development of nurse training plan, regular assessment or first aid drills; Cultivate the love and professionalism of emergency nurses, solve their practical difficulties, and make them serve and obey contemporary emergency work with a brand-new attitude.
1.4.2 patients and their families mainly include: ① strengthening the health education of the whole people, improving the health awareness of the whole people and the concept and function of social first aid, actively popularizing the knowledge of first aid, so that the people can initially master the general first aid skills and help themselves and each other correctly and timely when acute patients or accidents occur [2]. (2) According to the patient's disease and condition, as well as the age and social background of patients and their families, inform them of the occurrence, development law and possible problems of the disease, and introduce the treatment and nursing knowledge related to the disease and its rehabilitation process. At the same time, they should be informed about the time and funds needed for the whole treatment and nursing process. (3) To influence patients and their families with friendly attitude and words, and try to meet their reasonable requirements, so that they can directly feel superb nursing skills and high-quality nursing service attitude, so that they can establish confidence in overcoming diseases and successfully complete treatment and nursing plans.
Two results
Comparison of nursing disputes before and after standardized management: From June 2008 to September 2009, there were 3680 emergency patients in the emergency department of our hospital, including 52 cases of grade I nursing disputes/kloc-0, 54 cases of grade II nursing disputes and 27 cases of grade III nursing disputes. From June to September, 2009, there were 3960 emergency patients in our hospital, including 32 cases of grade I nursing disputes, 8 cases of grade II nursing disputes 18 cases, and 9 cases of grade III nursing disputes. After x2 test, the difference was statistically significant (P < 0.05).
3 discussion
As we all know, the work of emergency department is heavy and complicated, and all kinds of patients are treated every day. The implementation of its treatment and nursing requires accuracy and rapidity, and a little carelessness will lead to adverse consequences; At the same time, due to the emergency patients' acute condition, rapid change and high mortality rate, if the diagnosis and treatment mistakes, nursing mistakes or improper communication, as well as poor nursing skills and service attitude, nursing disputes may be induced, which will directly affect the nursing effect and hospital image. How to solve this problem better, the emergency department of our hospital comprehensively analyzed the nursing disputes that occurred in recent years, summed up the experience and lessons, explored and updated the nursing management system in the emergency department, and formulated standardized management measures. Through one year's implementation, practice has proved that standardized management measures have effectively curbed the occurrence of nursing disputes. First of all, we should implement the responsibility from the first diagnosis responsibility system and implement the accountability system. At the same time, strengthening the construction of nursing connotation, updating service concept, establishing people-oriented nursing consciousness and concept, constantly improving their own quality and standardizing nursing behavior are reliable guarantees for doing emergency nursing work well and preventing nursing disputes. In emergency nursing work, we must follow the people-oriented nursing principle, respect individual differences and personality characteristics, strengthen individualized treatment and nursing objectives, make nursing work become passive and active, and truly reflect the responsibility of nursing work as the main body of nursing between patients and treatment [4]. It is worth mentioning that only by constantly learning professional knowledge, enhancing humanistic quality, improving first-aid skills and resilience, grasping the changes and outcomes of illness in time, and serving patients with skilled technology and high-quality attitude, can we actively avoid and resolve various contradictions and make emergency nursing work enter a virtuous circle. Therefore, it is also an important link to prevent nursing disputes to strengthen first aid training, evaluate regularly and allocate resources such as manpower and material resources at the same time. It should be emphasized that emergency nursing documents are an objective record of patients' health information and diagnosis and treatment, involving patients' laws, medical insurance, compensation and other issues. They are also important materials for nursing research and teaching, and are also the first-hand materials for the identification of medical disputes or technical accidents. Therefore, it is necessary to pay attention to the standardized writing and detailed records of emergency nursing documents in practical work.
;