病人跌倒坠床管理制度（流程图）

Manipulator is now used as a industrial robots in use, the control objectives often appear often in industrial automation. Industrial automation technology has gradually matured, as mature a technology line has been rapid development in industrial automation as a separate subject. Manipulator application began to filter into welding, logistics, mechanical processing, and other industries. Especially at high or very low temperatures, full of poisonous gases, high radiation case, robot in similar circumstances showed great use also brings great convenience to the staff. Precisely because of this robot to get peoples attention began to be a high degree of development. Labor rates, working conditions, labor intensive aspects of promoting development. Both at home and abroad to develop the PLC (programmable logic controller) is in various special circumstances and under special conditions set for mechanical devices. Now turned on the development of the microelectronics automatic control technology and the rapid development of the trains, the success of PLC hardware software and simulation control win big and successful development, now continues to develop as a factory automation standards. Because robots are good development of the technology makes a good optimization of productive capital, and robot shows this unique advantages, such as: has good compatibility, wide availability, hardware is complete, and programming that can be mastered in a short time, so in the context of industrial PLC applications became ubiquitous. Manipulator in many developed country agriculture and industry has been applied, such as the use of mechanical harvesting large areas of farmland, repeated operations on the high-speed line that uses a robotic arm, and so on. Today, the high level of automation combined with restrictions on the manipulator development level is slightly lower than the international. The design is mainly arm welding machine by PLC Automation control. This of design let designers on in school by learn of has a must of consolidation, understand has some usually didnt opportunities awareness in world range within some leading level of knowledge has has must awareness, hope designers can in yihou of design in the can success of using in this design in the proceeds of experience 1.2 manipulator in both at home and abroad of research profile automation mechanical arm research began Yu 20th century medium-term, after years with with computer and automation technology of development, Makes mechanical arm on the Grand stage of industrial automation and shine, gradually became an industrial evaluation standards, and its importance can be seen. Now original robotic arm spent most of mass production and use on the production line, which is programmed robotic arm. As the first generation of manipulator position control systems main features, although not back several generations that can detect the external environment, but can still successfully complete like welding, painting, delivery as well as for materials simple movements. Second generation mechanical arms are equipped with sensors and manipulators have the environment there is a certain amount of sense, when the mechanical arm is to use the program as a basis. Difference is that the robot begand题目：病人跌倒、坠床管理制度 文件号：xxx人民医院-LC-009 生效日期：2012 年 12 月 01 日 版本号：1.1 修改日期：2012 年 11 月 15 日 1 1.目的 希望通过落实预防措施而减少跌倒发生率，提醒医院员工识别高风险患者，对工作中不安全的因素采取预防措施，防止病人跌倒。 2.适用范围针对所有院内的住院和门诊病人。 3.定义跌倒：是指突发、不自主的、非故意的体位改变，倒在地上或更低的平面上。跌倒包括（1）从一个平面至另一个平面的跌落；（2）同一平面的跌倒。4.职责4.1 护士长严格管理，经常对护士进行如何预防病人跌倒的培训，督促检查病区安全隐患。4.2 责任护士应细心护理病人，认真观察病情变化，及时发现不安全因素，采取预防措施， 做好交接班并记录。 5.标准5.1 凡来院就诊的门诊、急诊、住院成人、新生儿或儿童均需进行跌倒、坠床风险评估。 5.2门诊病人由首诊医生进行跌倒风险评估，需在门诊病历中记录。如跌倒高风险人群，需及时给予预防跌倒健康宣教。成人年龄65岁、使用拐杖、手杖、助行器或扶墙行走、步态不稳或认知障碍，儿童年龄4个月4岁、步态不稳均为跌倒高风险人群。 5.3 住院病人跌倒、坠床风险评估 5.3.1病人新入院后2小时内由责任护士或值班护士进行跌倒、坠床风险初始评估。使用住院病人预防跌倒、坠床评估表评估有无跌倒、坠床风险因素，记录评估分值并填写评估日期、时间及签名，3分及以上为跌倒、坠床高风险人群。 5.3.2 住院病人跌倒、坠床风险再评估：所有住院病人均由责任护士每周进行跌倒、坠床风险再评估。当病人转科、发生病情变化（手术或分娩后当天、意识、活动、自我照顾能力等改变）、特殊检查治疗（包括放疗）、调整治疗（使用易致跌倒药物目录中镇静、止痛、安眠、利尿、降血压及调节血糖等药物）、特殊检查（血液透析、放疗、无痛胃镜肠镜、CT磁共振增强造影、胸腔穿刺、腰椎穿刺、腹腔穿刺等）或发生跌倒、坠床后，需在1小时内完成再评估，并同时对病人及家属进行预防跌倒、坠床再次宣教。 5.3.3 发现有跌倒、坠床风险的住院病人，应通知主管医师，在床头标注警示牌并佩戴黄色腕带，根据病人跌倒、坠床风险因素采取针对性预防措施。 5.4有跌倒、坠床风险病人，需告知病人及家属跌倒、坠床预防措施及健康教育，住院病人需签署住院病人预防跌倒、坠床教育知情书。 5.5全院工作人员对有跌倒、坠床高风险病人应予特别关注，发现引起病人跌倒、坠床高危环境和设备因素时，应及时通知后勤保障部处理。 5.6对各项跌倒、坠床预防措施进行效果追踪，并尽早发现和处理因实施各项预防措施可能造成的其他非预期后果（如使用约束具预防病人坠床可能造成皮肤完整性受损）。 5.7 病人发生跌倒、坠床后，按病人跌倒、坠床后处理措施及流程处理。 5.8 病人发生跌倒、坠床后，护士长于2小时内电话上报大科护士长，24小时填写病人跌倒、坠床报告表网报护理部。一周内组织科室讨论，进行原因分析，确定改进措施。 5.9护理安全质量改进小组每月对全院导致病人跌倒、坠床的因素进行分析，提出改进意见，上报护理部审核并督促科室改进，分析报告及改进成果报医院质量与安全管理委员会。 5.10护理部每年对护士进行预防跌倒、坠床培训，并不断完善预防病人跌倒、坠床指引。 6.流程 6.1病人跌倒、坠床预防与处理流程 7.表单 7.1门诊病人跌倒评估单 7.2病人跌倒、坠床评估单 7.3儿童病人跌倒、坠床评估单 7.4住院病人跌倒、坠床教育知情书 7.5儿童病人跌倒、坠床教育知情书 7.6病人跌倒、坠床报告表 7.7新生儿摔落评估单 7.8新生儿摔落教育知情书 7.9员工跌倒报告单 8.相关文件 8.1预防跌倒、坠床护理措施 8.2病人跌倒、坠床后处理措施 8.3预防新生儿摔落护理措施附件一： 病人跌倒、坠床预防与处理流程附件二： 门诊病人跌倒评估单 1.年龄65岁 是 否 2.年龄4个月4岁 是 否 3.使用拐杖、手杖、助行器或扶墙行走 是 否 4.步态不稳 是 否 5.认知障碍 是 否 注：如果任何一个问题回答为“是”，则即为有跌倒风险。全面落实企业主体责任；持续强化“两重点一重大”、重点地区和特殊作业等重点环节监管，遏制较大以上事故，保持事故总量继续下降，推动两个行业领域安全生产形势持续稳定好转。manipulator control mode and programmable controllers introduction 2.1 Select discussion with manipulator control 2.1.1 classification of control relays and discrete electronic circuit can control old industrial equipment, but also more common. Mainly these two relatively cheap and you can meet the old-fashioned, simple (or simple) industrial equipment. So he can see them now, however these two control modes (relay and discrete electronic circuits) are these fatal flaws: (1) cannot adapt to the complex logic control, (2) only for the current project, the lack of compatibility and (3) not reforming the system with equipment improvements. Spring for the development of Chinas modern industrial automation technology the substantial increase in the level of industrial automation, completed the perfect relay of the computer too much. In terms of controlling the computer showed his two great advantages: (1) each of the hardware can be installed on one or more microprocessors; (2) the official designer of the software writing content control is all about. Now in several ways in the context of industrial automation can often be seen in three ways: (1) Programmable Logical Controller (referred to as IPC); (2) Distributed Control System (DCS for short), and (3) the Programmable Logical Controller (PLC for short). 2.1.2 PLC and the IPC and DCS contrast contrast 1, each of the three technologies of origins and development requirements for fast data processing makes it invented the computer. The men brought in terms of hardware there, using a high level of standardization, can use more compatibility tools, is a rich software resources, especially the need for immediacy in operational systems. So the computer can effectively control is used to control and meet its speed, on the virtual model, real-time and in computational requirements. Distributed system started with a control system for industrial automatic instrument used to control, whereas now it is successfully developed into industrial control computer used as a central collection and distribution system and transition of distributed control system in analogue handling, loop control, has begun to reflect the use of a huge advantage. Though distributed system has great advantages in loop regulation, but only as a means of continuous process control. Optimization of PLC is the corresponding relay needs was born, its main use in the work order control, early primary is replaced relay this hulking system, focused on the switch controlling the running order of functions. Marked by the microprocessor in the early 1970 of the 20th century emerged, micro-electronics technology has developed rapidly, people soon microelectronics processing technology will be used in the Programmable Logical Controller (that is附件三： xxx人民医院 病人跌倒、坠床评估单附件六： xxx人民医院 住院病人跌倒、坠床教育知情书 尊敬的病人（家属）： 您好！感谢您对我们的信任，选择了我院。为了保障您在住院期间的安全，我们针对跌倒、坠床的风险对您进行相关护理安全告知，希望得到您的配合！ 1有跌倒、坠床风险的病人，应留家属24小时陪伴。 2. 请尽快熟悉病房环境，物品放于柜内，常用物品放于易取位置。 3病房、卫生间均有呼叫器，请正确使用，下床、如厕、洗漱或拿物品等需要时，可按呼叫器请求家属、护理员或护士帮助。 4. 请正确使用助行器，穿大小合适的防滑鞋。 5. 请在上下轮椅、平车或上下床等时先确定锁好车轮，防止滑动。 6. 需要更换体位如起床、站立或坐起时，需遵循起床三步曲（床上靠30秒，床边坐30秒，床旁站30秒），如感头昏、眩晕等症状时及时通知护士或不要下床。 7. 沐浴时请使用座椅，沐浴后坐位穿衣服，避免弯腰捡东西。 8. 发生腹泻、尿频或有灌肠、拔除尿管后需要使用便器时，可按呼叫器请护士或护理员帮助。 9. 请正确使用床栏，不要独自下床，下床时请勿跨越床栏。 10.请勿在湿滑的地面行走，如地面潮湿，立即通知护士处理。不要在光线不足的情况下摸索行走，夜间可开地灯或床头灯，保持室内光线充足。 请您务必按照以上告知配合护士工作，若因不配合而发生跌倒、坠床等意外将由您及家属承担责任。若您对以上告知表示理解，请签名表示知情同意！ 科室 床号 住院号 姓名 病人/家属（委托人）签名 年 月 日附件七： xxx人民医院 儿童病人跌倒、坠床教育知情书 尊敬的病人（家属）： 您好！感谢您对我们的信任，选择了我院。为了保障患儿住院期间的安全，我们针对跌倒、坠床的风险对您进行相关护理安全告知，希望得到您的配合！ 1患儿请家属陪伴，勿让患儿离开家属视线。 2. 请随时将床栏拉起，勿让患儿跨越床栏或在床上跳跃。 3. 请为患儿穿上尺码合适的衣裤及防滑鞋，切勿赤脚行走。 4. 勿让患儿在走廊及病房内追逐嬉戏或进入配餐室、处置室。 5. 勿让患儿做可能跌倒的一切危险动作如攀高、跳跃、滑行，5岁以下患儿单独上下楼梯等。 6. 当患儿服用某些药物感到头晕或身体虚弱时，下床由家属搀扶。 7. 请将物品尽量收纳于柜内，生活用品放在患儿不易取到或碰到的地方。 8. 发现地面有水渍或地面弄湿，请立即告诉护士，避免患儿在有水渍处行走。 9. 患儿乘坐婴儿推车时，请扣上安全带并勿让患儿站立于婴儿车上。 10. 如需帮助，请按呼叫铃通知护士。 请您务必按照以上告知配合护士工作，若因不配合而发生跌倒、坠床等意外将由您及家属承担责任。若您对以上告知表示理解，请签名表示知情同意！ 科室 床号 住院号 姓名 患儿家属（委托人）签名 年 月 日附件八： xxx人民医院 预防新生儿摔落教育知情书 尊敬的病人（家属）： 您好！感谢您对我们的信任，选择了我院。为了保障新生儿住院期间的安全，我们针对新生儿摔落风险对您进行相关护理安全告知，希望得到您的配合！ 1、发现地面有水渍或地面弄湿，请立即告诉护士。 2、请在转送新生儿时使用婴儿床或婴儿车，始终保持关闭状态，扣上安全带。 3、在移动新生儿病床时，应握住衔接床体金属部分（不接触床体的部分在移动过程中会滑动）。 4、乘电梯转运时，注意电梯与地面平坦。 5、与新生儿密切接触者有高血压、高血糖等疾病或肢体残疾时，请勿独自抱起新生儿。 6、与新生儿密切接触者使用镇静、镇痛、安眠剂等易致跌倒药物时，请