风险管理在护理管理中的应用

1、According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt风险管理在护理管理中的应用风险管理在护理管理中的应用According to the assessment requirements of party conduct and cle

2、an government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt内内 容容 护理风险护理风险 4R4R危机管理理论危机管理理论 4R4R危机管理理论的应用危机管理理论的应用According to the assessment requirements of party conduct and clean government, combined with the five

3、 regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt护理风险护理风险是指在医院内存在于整个护理过程中的是指在医院内存在于整个护理过程中的不确定性危害因素，直接或间接导致病不确定性危害因素，直接或间接导致病人死亡、损害和伤残事件的不确定性或人死亡、损害和伤残事件的不确定性或可能发生的一切不安全事件。如护理事可能发生的一切不安全事件。如护理事故、差错、缺陷、意外、并发症以及由故、差错、缺陷、意外、并发症以及由上述因素导致的纠纷和诉讼等。上

4、述因素导致的纠纷和诉讼等。“遭受损失的可能性”-美国杜克大学According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt社会心理社会心理因素因素患者患者因素因素护理人员护理人员因素因素医院管理医院管理因素因素护患沟通护患沟通问题问题医护服务系

5、统医护服务系统和组织工作出和组织工作出现的问题现的问题 护理风险相关因素护理风险相关因素护理风险护理风险According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt护理风险护理风险风险水平高风险水平高人的差异性人的差异性治疗多样性治疗多样性和

6、复杂性和复杂性医学科学局限性医学科学局限性风险的不确定性风险的不确定性随时随地发生随时随地发生多处环节均可多处环节均可发生发生风险的复杂性风险的复杂性认识的认识的局限性局限性风险的危害性风险的危害性致残致残致死致死功能功能障碍障碍护理风险特点护理风险特点According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leader

7、s integrity and self-discipline精选ppt与护士沟通与护士沟通询问病人询问病人和家属和家属确定护理风险确定护理风险易发生环节和过程易发生环节和过程明确病人安全上明确病人安全上存在和潜在的危害存在和潜在的危害临床巡查临床巡查工作流程工作流程收集病人收集病人与家属不满意与家属不满意的信息与建议的信息与建议收集护理纠纷收集护理纠纷的事件的事件反思历年反思历年的问题和差错的问题和差错识别护理风险识别护理风险护理风险护理风险护理风险的识别护理风险的识别According to the assessment requirements of party conduct and

8、clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论危机管理理论将组织的危机管理划分为四个阶段将组织的危机管理划分为四个阶段危机管理-罗伯特西斯指减少风险发生的可能性和危害性即在风险发生前对处理各种风险所作的准备，其目的是加强组织对风险的应对能力是组织面对风险情景时的反应指风险问题被控制后，管理者对组织的恢复工作所作的安排及相关经验的归纳总

9、结According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论危机管理理论According to the assessment requirements of party conduct and clean governme

10、nt, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论危机管理理论n 4个阶段既彼此独立，又相互联系、相互影响n 有效的危机管理是对4R4R模式模式所有方面的整合According to the assessment requirements of party conduct and clean government, combined with the five re

11、gulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt案例分析案例分析 4R危机管理理论危机管理理论According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leader

12、s integrity and self-discipline精选pptl要积极地管理风险而不是被动地等待风险转化为危机l较好的危机管理方法是建立一种ABC的结构 A Away(远离)-远离风险或危机的根源 B Better(更好)-比要求做得更好以抵制风险或危机的根源 C Compatible(相容)-与那些最能抵制风险或危机根源的制度相容； 建立有效的CMSS系统(危机管理框架结构)，它由咨询信息系统和决策操作系统组成。4R危机管理理论危机管理理论启示启示建立医疗风险监测与预警体系建立医疗风险监测与预警体系-崭新的课题崭新的课题According to the assessment req

13、uirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论的应用危机管理理论的应用缩减阶段缩减阶段加强护理安全评估管理高危因素According to the assessment requirements of party conduct and clean government,

14、combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt 重重 点点 病病 人人l新病人l危重病人l大手术病人l老年病人l婴幼儿l心理障碍病人l情绪异常病人4R危机管理理论的应用危机管理理论的应用缩减阶段缩减阶段加强护理安全评估管理According to the assessment requirements of party conduct and clean government, com

15、bined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论的应用危机管理理论的应用缩减阶段缩减阶段加强护理安全评估管理l人力配备不足人力配备不足l缺少监管，放任责任缺少监管，放任责任l病区管理病区管理 l仪器、物品、药品检仪器、物品、药品检查不力查不力l危重患者护理质量危重患者护理质量l带教带教l意外事件意外事件 重点重点时段时段l节假日节假日l周六、日周六、日l夜班夜班l交接班交接班l

16、繁忙或特别闲时繁忙或特别闲时l实习、进修后期实习、进修后期l新换岗位新换岗位According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论的应用危机管理理论的应用给予关注、指导、鼓励、帮助给予关注、指导、鼓励、帮助缩减阶段缩减阶

17、段加强护理安全评估管理 重点员工重点员工l责任心不强责任心不强l能力较低能力较低l情绪不稳定情绪不稳定l新上岗或转科护士新上岗或转科护士l进修实习护士进修实习护士l试用期护士试用期护士 According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选p

18、pt4R危机管理理论的应用危机管理理论的应用缩减阶段缩减阶段加强护理安全评估管理加强各环节病人身份与治疗的核查加强各环节病人身份与治疗的核查 重重 点点 环节环节According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选pptl急诊科l重症监护室

19、l新生儿室l手术室l血透室危重病人多特殊检查、治疗多仪器设备使用多没有陪护4R危机管理理论的应用危机管理理论的应用缩减阶段缩减阶段加强护理安全评估管理 重重 点点 科室科室According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管

20、理理论的应用危机管理理论的应用缩减阶段缩减阶段加强护理安全评估管理l系统风险评估 (Systems Assurance and Control, SAC) 矩阵对现存的或潜在的危险因素进行分析，以其量化评估表对风险事件的“严重性”和“发生可能性”进行预测，确定需优先解决和改进的安全问题。l对高危患者实施针对性的安全评估 如用压疮评估表、跌倒评估表等进行评估预测According to the assessment requirements of party conduct and clean government, combined with the five regulations and

21、five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论的应用危机管理理论的应用鼓励几近失误事件的报告国外医疗系统提出了几近失误事件 (near miss) 的概念国内大多数医疗机构采取 “小事化了”的态度几近失误事件是指由于不经意或及时的介入行动，使原本可能导致意外、伤害或疾病的事件或事情并未发生建立以非惩罚性、保密性、时效性、专家分析、针对系统为特征的不良事件报告系统鼓励临床一线人员进行报告缩减阶段缩减阶段According to the assess

22、ment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt 完善护理安全配备建设安全的护理环境保障各种护理仪器设备的正常性能不断完善护理安全的相关制度改进护理操作流程4R危机管理理论的应用危机管理理论的应用缩减阶段缩减阶段According to the assessment requ

23、irements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt 建立风险预警机制,组织安全事件演习4R危机管理理论的应用危机管理理论的应用预备阶段According to the assessment requirements of party conduct and clean government, c

24、ombined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt4R危机管理理论的应用危机管理理论的应用 提升护士风险防范的意识、能力和护理专业水平提升护士风险防范的意识、能力和护理专业水平l熟悉国家医疗法律法规熟悉国家医疗法律法规l加强护理记录的管理加强护理记录的管理l知识更新知识更新l提高兴趣和效果。提高兴趣和效果。预备阶段写你所做写你所做做你所写做你所写超前教育和培训超前教育和培训According

25、 to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline精选ppt 识别其起因、范围、严重程度等，确定风险事件识别其起因、范围、严重程度等，确定风险事件型，型， 及时采取措施进行补救及时采取措施进行补救反应阶段4R危机管理理论的应用危机管理理论的应用According to the assessment requirements of party conduct and clean government, combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-di