In 2022, the General Office of the National Health Commission issued Interim Regulations on Quality Management of Day Care in Medical Institutions, which strictly regulated the requirements for medical institutions to carry out day surgery, reflecting that medical quality and safety management is the core principle of day surgery management. Medical quality and safety management is the core foundation of the sustainable development of day surgery, which directly determines the life cycle and continuous vitality of day surgery in the future development of our country. The remarkable achievements of day surgery at West China Hospital of Sichuan University are attributed to a set of scientific and standardized quality and safety management measures based on clinical pathways. These measures not only provide fine management for every link in the surgical process, but also effectively guarantee the medical safety and treatment effect of patients by optimizing the operation norms before, during and after the operation. This article shares the quality and safety management concept of West China Hospital of Sichuan University, which is “proficient in pre-hospital care, cautious in hospital care, skilled in post-hospital care”, for the peers to learn from and share.
ObjectiveTo explore the application and effect of root cause analysis (RCA) in the management of adverse nursing events. MethodsNursing staff members were trained to establish the team of root cause analysis. They collected related materials of adverse nursing events in the infusion room of the Department of Pediatrics, found out the proximal causes and root causes, developed and implemented the corrective measures. RCA was carried out between January 2013 and December 2014. The efficacy was evaluated and the adverse events rate was compared before and after the practice. ResultsAfter the performance of RCA, the reporting rate of adverse events increased, the rate of adverse events decreased, and the reporting rate of potential safety problems also increased. All those changes were significant (P<0.01). ConclusionRoot cause analysis can decrease the rate of adverse nursing events, raise the reporting rate of adverse events. It is an effective guarantee to improve the nursing safety management.
Objective To investigate the application effect of nursing identification in the safety management of operating rooms for elderly patients undergoing ophthalmic day surgery. Methods Elderly patients who underwent day surgery in the operating room of Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University between January and October 2024 were selected. All subjects were randomly divided into a control group and a trial group using a random number table method. The control group only received routine operating room care, while the trial group received a combination of routine operating room care and preoperative nursing identification intervention. The differences in physiological stress indicators, nursing satisfaction, and surgical cooperation rate between two groups of patients were compared. Results This study included 50 cases in both the trial group and the control group, with an age range of 61-79 years old. There was no statistically significant difference in age and gender between the two groups (P>0.05). The systolic blood pressure [(136.72±10.82) vs. (145.70±13.11) mm Hg] (1 mm Hg=0.133 kPa), diastolic blood pressure [(83.48±8.59) vs. (88.54±8.35) mm Hg], and heart rate [(80.34±7.17) vs. (85.12±8.49) beats/min] of the trial group patients were lower than those of the control group, and the satisfaction rate was higher than that of the control group (100.00% vs. 84.00%), with statistical significance (P<0.05). There was no significant difference in surgical cooperation rate between the two groups (P>0.05). Conclusion After applying nursing identification, patients’ objective physiological stress indicators decreased while their subjective cooperation remained stable, resulting in a higher patient satisfaction rate and clinical promotion value.
ObjectiveTo determine the effects of the management mode participated by doctors, nurses and patients on the safety of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit (NICU). MethodsA total of 133 restlessness patients treated between May 17 and November 22, 2013 were included in the study as control group, who were admitted to the NICU before application of the management mode participated by doctors, nurses and patients; another 119 restlessness patients treated between May 17 and November 22, 2014 were included in the study as research group, who were admitted to the NICU after application of the management mode participated by doctors, nurses and patients. Then we compared the accidental extubation situation between the two groups. ResultsThe accidental extubation rate of all kinds of medical tubes in the research group was lower than that in the control group, among which the extubation rate of urethral catheter (0.67% vs. 4.32%), gastric tube (2.26% vs. 10.14%), trachea cannula (1.08% vs. 7.84%), and arterial cannulation pipeline (1.12% vs. 6.93%) was significantly different between the two groups (P<0.05). ConclusionThe management mode participated by doctors, nurses and patients can effectively reduce the accidental extubation rate of medical tubes for restlessness patients, prevent the occurrence of adverse events and ensure the treatment and nursing safety in the NICU.