Speech on experience exchange of high-quality nursing service demonstration project

Deeply understand the needs of patients and improve the connotation of high-quality nursing service

-* * * Experience of developing high-quality nursing work in hospitals.

20 10- 10 the Ministry of health issued the activity plan of "quality nursing service demonstration project" for 20 10. Taking this opportunity, our hospital has carried out a series of work closely around "striving to provide safe, high-quality and satisfactory nursing services for the people", as follows.

First of all, the first is the renewal of leadership concepts.

At first, some team members thought that the "high-quality nursing demonstration project" was a matter for the nursing department, and their thoughts were not unified. In order to open up the work situation, the hospital department set up a special "quality nursing" leading group in July 20 10, with the current first-class dean as the leader and the vice presidents in charge of nursing and logistics as the deputy heads respectively, responsible for coordinating functional departments and rationalizing the relationship between departments; Supervisors of equipment department, office and general affairs department establish support systems; The nursing department and the head nurses in each ward are members of the nursing service network, responsible for and supervising the implementation of nursing services. Formulate detailed work contents and clarify responsibilities. In the first quarter, the special leading group of "quality nursing" held a working meeting once a month to coordinate and solve the difficulties and contradictions in the work in time, and vigorously promote the specific implementation progress of quality nursing work, and then held a working meeting of the leading group of quality nursing every quarter to coordinate and promote the problems existing in this work.

Second, stick to the theme, understand the needs of patients, and promote the introduction of "quality nursing service demonstration project" series of management measures.

Let patients come to the hospital to relieve pain, restore health and promote health, which is the ultimate goal. In this process, different people have various needs and need our medical workers to provide help. Nurses spend the most time with patients. Without enough people and time, quality care will be just an armchair strategist. How to liberate nurses from heavy non-clinical work and treatment work is the first problem we have to solve.

1, actively introduce nursing staff. In the past two years, our hospital has recruited 64 new nurses. At present, the ratio of beds to nurses is 1: 0.6, and the actual nurse-patient ratio in wards is 1: 0.37. Guide all departments to realize flexible scheduling, rationally use nursing human resources according to the actual situation of each department, put an end to the uneven busy and idle phenomenon, and ensure that the nurse establishment in the demonstration ward reaches 1:0.4-0.5.

2. Establish a hospital logistics service center. In taking and delivering clinical specimens, transporting medicines and materials, maintaining equipment and instruments, accompanying patients for examination and treatment, and assisting head nurses to provide other convenient measures for hospitalized patients,

3. Simplify nursing documents. On September 20 10, the whole hospital unified and simplified the writing of nursing handover report, and cancelled the ordinary care record sheet and the admission nursing evaluation sheet. On September 20 1 1 year, the nursing documents were redesigned to ensure that the writing time of nurses' nursing documents was less than 30 minutes, which better met the requirements of clinical nursing.

4. Improve infrastructure and purchase some life care equipment. On March 20 1 1 year, the overall relocation of the supply room was completed, the workflow was standardized, and the integrated management of manual supply and clinical distribution of aseptic packages were implemented; Reconstruction of outpatient and emergency infusion room and process reengineering. The general ward purchased a shampoo basin, and the ICU purchased basic nursing equipment such as a shampoo truck to facilitate clinical nurses to care for patients.

5. Standardize nursing workflow and improve work efficiency.

Our ward implements a mobile nurse workstation to reduce the distance for nurses to walk back and forth in the ward; Refining some workflow settings, decomposing the infusion process into drug preparation process, centralized dosing process, centralized puncture process and infusion replacement process; Blood transfusion process is divided into blood sample collection process, blood receiving process and blood input process. And improve the admission reception process, health education and nurse-patient communication process from the details; At the same time, the nurses in the whole hospital were organized to carry out all-staff training, and their awareness of active work, active learning and active service was obviously enhanced.

6, the establishment of nurse performance appraisal management system. Based on the field investigation of the Second Hospital of * * and the Hospital of * *, combined with the mature nursing performance management experience in Shanghai and other places, and according to the information management level and working characteristics of our hospital, the draft of nursing performance management of * * * People's Hospital was preliminarily drawn up, which changed that the technical content, responsibilities, post risks and labor intensity were not proportional to the bonus income of nurses in the past, and the monthly bonus of nurses was equal to the post bonus (60%)+ month. ; According to the job responsibilities of nurses at all levels, the quality of work completed, patient satisfaction and other comprehensive indicators. Formulating the corresponding performance appraisal rules, leaning to the front line and night shift, has improved the treatment of clinical front-line nurses, truly embodied the merit of more work and fully mobilized the enthusiasm of nurses, thus improving the quality and efficiency of nursing work.

7. Strive to improve the treatment of contract nurses and implement the policy of equal pay for equal work. The hospital department has issued document * D 20 10 19, which clearly stipulates that contract nurses enjoy the same rights as personnel agents in terms of salary, social security, welfare, promotion of professional titles, post competition and further study. This year, document * D 20 124 "Provisions on the Management of * * * * * * Contract Nurses" has been issued (Provisional

8, close to the clinic, the implementation of nursing "full-hour regular patrol system". Implement strict grading nursing and infusion patrol system to reduce the occurrence of red light. On April 20 1 1 year, our hospital implemented the "hourly patrol timing system" for graded nursing;

(1) Non-critical patients are visited on the hour, that is, nurses visit the wards every hour, such as 8:00 and 09:00 ... to make each nurse's work more planned and strengthen time management;

⑵ According to the requirements of graded nursing: the first-level nursing should be patrolled every hour, the second-level nursing should be patrolled every two hours, and other patients should be patrolled every shift;

(3) Infusion patrol during the day, the implementation of mobile nurse station, each ward personal room patrol, clear responsibilities;

(4) Linked to performance, with clear rewards and punishments. The responsible department that didn't run the red light should increase the reward;

5] night patrol more supervision, require patrol once every hour, the head nurse on duty to supervise at any time, the nursing department regularly and irregularly handed over to the hospital center for monitoring and inspection, and linked the inspection results with the performance of the department.

After a short period of forced orbit, obvious results have been achieved:

(1) The responsibilities are clearer and the work efficiency is higher. Especially during the infusion and dressing change, when there is no patrol, everyone is waiting for the patient's paging and working passively. If there are 100 bottles of infusion in the ward, the nurse will run 100 times. After carrying out personal and room patrol, it is convenient for assessment management, and nurses change passive work into active work, and the work efficiency is obviously improved.

⑵ The red light in the ward drops sharply, and only when the infusion peak is changed, there are individual red lights in each ward.

⑶ It is convenient for patients, and the patient satisfaction rate is over 98%.

9. Implement the responsibility system of 1 nurse taking care of patients with less than 8 people. The nurse in charge is fully responsible for patient care, health education, medical record quality control, discharge medical record arrangement, environmental sanitation and environmental management of the goods storage room. Critical patients are cared by the responsible team leader or senior nurse; The communication time between the responsible nurse and each patient is not less than 10 minutes every day. Strengthen nurse-patient communication and health education, and implement health education in various wards of the hospital in various forms, such as oral, written and demonstration guidance, from ward head nurses, day shift nurses and class three nurses at multiple levels. Each subject has formulated written health education materials in combination with the actual situation of the undergraduate course room, with one book in each room, so as to consolidate the health education effect.

10, providing relevant convenience measures for patients. Issue a "doctor-patient heart-to-heart card" to hospitalized patients, and provide the telephone numbers of the attending doctor and the responsible nurse to facilitate patients' consultation at any time; Pay a phone call back to the discharged patients within one week, get a timely understanding of the patient's condition changes after discharge, including condition changes, medication, self-care, social interaction, etc., answer questions raised by patients and their families in time, give rehabilitation guidance and psychological counseling, and get unanimous praise from all walks of life; All departments have convenient boxes to provide patients with convenient measures such as paper, pen, needle and thread. Our hospital has established a first-class pilot ward of "quality nursing service" in cardiology, general surgery, neurosurgery and oncology. Other wards in the hospital can meet the Grade B standard of high-quality nursing of the Provincial Health Department. The responsible nurses implement flat management for patients and provide life care for patients who can't take care of themselves at all.

1 1. Nursing services should be made public. Publicize all levels of nursing service items, service charging standards and patient admission and discharge procedures in each ward, and introduce the evaluation mechanism of patient and social participation.

12, set up a nursing service quality control group. Formulate detailed assessment rules for high-quality nursing service, and combine regular supervision with irregular follow-up inspection every two months to find and solve problems in time.

13, strive to build excellent nursing team and enhance excellent nursing service ability. This year, four nursing backbones have been arranged to go to higher-level hospitals (* * * * hospitals, * * and other places) for further study, and more than ten head nurses have participated in the special training of excellent nursing demonstration projects at or above the municipal level. Since 2008, our hospital has strictly implemented the standardized rotation training plan for new nurses, organized and carried out the "nursing operation skill competition" for young nurses and five newly hired head nurses, and completed the work goal of the clinical intensive training stage for young nurses. At the same time, we attach great importance to creating a positive cultural atmosphere and hold regular lectures on nursing culture, so that nurses can change their service concepts. Last year, we used the "512" Nurses' Day to organize a literary performance with the theme of "Creating a positive working atmosphere and inspiring the spirit of nursing team", which enhanced the cohesion of nursing team. Use pre-job training to train all nursing staff in instrument behavior norms, nursing skills and communication skills; And using the platform of counterpart support between * * * hospital and our hospital, please invite nursing experts to give lectures in our hospital, improve the comprehensive quality of nursing staff, shape a good service image, and require nursing staff to achieve "six-tone" service when receiving medical treatment, that is, greet patients when they are admitted to hospital or receive medical treatment; Greeting sound when contacting patients; Apologize when misunderstanding occurs; When the patient has questions, there is an explanation sound; There is a voice of thanks when the patient cooperates; There is a blessing when the patient leaves the hospital. This year, special lectures and standardized training will be given to nursing staff on professional image, reception etiquette and nursing service etiquette, and service etiquette will be integrated into clinical work.

In the excellent nursing work, we deeply realize that excellent nursing is not a single nursing work, but a demonstration of the comprehensive service ability and fluency of management links in hospitals. Without the in-depth participation of all the staff, the excellent nursing work in the hospital will not be really fruitful.