Continuous improvement implementation plan for quality nursing service demonstration project

2011 Quality Nursing Service Demonstration Project Continuous Improvement Implementation Plan

Department of Cardiology

Arranged in accordance with the 2011 Nursing Work Plan of the Nursing Department , on the basis of carrying out the high-quality service demonstration project, further carefully summarize the development of high-quality nursing services in the subject, sum up experience, identify shortcomings, analyze the reasons, improve the mechanism, and continuously improve, so that high-quality nursing services can truly be implemented. In practice, we will achieve the satisfaction of society, hospitals, patients and medical staff, and comprehensively improve the quality of nursing services.

1. Leaders pay attention and improve the mechanism

Since the launch of the high-quality nursing service demonstration project in 2010, the department director and head nurse have always attached great importance to it and personally supervised the implementation of this activity. The head nurse is responsible for the planning, implementation, inspection and management of clinical nursing work. General nurses took active steps to participate in this activity. As this work continues to deepen and time goes by, some new problems gradually emerge. In this regard, the department director, head nurse and branch members put forward new requirements for the new situations they will face.

Members of the leading group for high-quality nursing services in the Department of Cardiology: Department Director-Gao Guanghua, Head Nurse-Zhao Yi, Supervising Nurse-..., Nursing Team Leader-...

(1 ) The primary problem is the expansion of the number of patients. The increase in the number of patients requires the addition of more nurses to meet the needs of the increased number of patients. Therefore, we must first do a good job in reserve of nurse human resources. The cardiology department is divided into two wards: military and local wards, with 100 beds. The local ward is divided into three groups, with... serving as the team leader. The military ward has... serving as the team leader. Under the leadership of the head nurse, he is responsible for and participates in the clinical nursing work of the ward, and gives full play to the role of mentoring .

(2) Establish three-level quality control work for department nursing work. Since new nurses join the nursing team every year, the quality of high-quality nursing services faces the risk of decline. Therefore, after research and decision by the department, a three-level quality monitoring mechanism for departmental nursing work is established, namely, the head nurse-responsible team leader-responsible nurse. Level composition, responsible for implementing comprehensive overall care for each patient. Among them, the head nurse is responsible for the overall nursing quality supervision of the entire cardiology ward, the responsible team leader is responsible for the overall implementation of high-quality nursing services for patients in the group, and the responsible nurse is responsible for the implementation of specific nursing work. The department's nursing quality monitoring leading group holds regular meetings to summarize experiences, correct deficiencies, and implement improvements.

2. Strengthen training and improve quality

In order to further strengthen the understanding and understanding of the meaning and connotation of the "Quality Nursing Service Demonstration Project", the department uses various opportunities to provide quality nursing services Quality evaluation, in addition to studying relevant documents, focusing on analyzing new situations and new problems that arise, formulating continuous improvement plans, and further explaining and explaining the specific implementation plan of each step to achieve unanimous approval by all nurses. In particular, we will strengthen the training of basic nursing objectives, content, specifications and other knowledge. Two hours will be set aside every Wednesday afternoon. The nurse in charge will be responsible for training on basic nursing specifications and routine nursing technical operations one by one, and will be assessed every quarter; Conduct specialist disease care ward rounds once a month. Carry out hierarchical training for nursing staff at different nursing levels, focusing on nurses with less than 3 years of experience. The training for new nurses focuses on basic nursing and meeting the basic needs of patients. Through the intensive training of new nurses, nurses can further clarify the connotation of high-quality nursing services, improve the quality of nursing, benefit and satisfy patients, and further consolidate the quality of basic nursing services and enhance the image of nurses through the specific implementation of nursing work. , At the same time, a consensus will be reached among general nurses, the patient-centered nursing work model will be strengthened, and a person-centered nursing management working mechanism will be established.

3. Improving work processes and clarifying job responsibilities is the prerequisite for in-depth and long-term development of high-quality nursing services. The focus of future work should be on improving work processes, using processes to guide and standardize nurses' work behaviors, and using processes to Establish a nursing work model, that is, a patient-centered nursing work model.

On the basis of more than ten established nurse work processes, our department has further improved and established a series of nursing work processes, including; oral care, perineal care, and added basic nursing operation processes such as facial cleaning, shampooing in bed, and warm water Specific operating procedures such as scrubbing and bathing; continuously improve and improve the work processes of nurses in each shift; such as further optimizing the work processes and job responsibilities of responsible team leaders, responsible nurses, night shift nurses, general nurses, office nurses, treatment nurses, and dressing nurses. Maximize the development of nurse human resources.

4. Implement flexible scheduling to develop nurses’ potential

Based on the current staffing situation of the department’s nursing team, further explore new scheduling models to fully develop nurses’ potential. Currently, our department has 100 beds and 22 nurses. According to the bed-nurse ratio requirement, our department should have 40 nurses, nearly twice as many as the current number of nurses.

In the current situation of insufficient nursing staff, we have decided to implement a new working model after repeated research. And a new scheduling model has been studied, that is, the team leader responsibility system is adopted. The team leader is a senior nurse. Each team leader is assigned two nurses to meet the work needs of the ward and thereby improve nursing care. Job satisfaction.

5. Regularly evaluate and evaluate, and continuously improve quality

1. Formulate test questions on specialist nursing theoretical knowledge and evaluate them once a month to promote the improvement of specialist nursing knowledge.

2. Formulate detailed evaluation rules and standards for high-quality nursing services to strengthen the improvement of basic nursing quality.

3. Conduct monthly assessment and scoring of basic nursing quality, ward management quality, nursing safety quality, treatment room management quality, drug delivery quality, dressing room management quality, and department nursing documents. Existing problems are improved in a timely manner and new rectification measures are proposed.

4. The head nurse organizes regular nursing backbone meetings to analyze and study various problems that arise in high-quality nursing service activities and formulate countermeasures.

5. Report the department’s development to the general nursing officer regularly.

Implementation Plan for Continuous Improvement of the 2012 Quality Nursing Service Demonstration Project

Department of Cardiology

The basis for launching the quality service demonstration project in 2011 In 2012, the department summarized its previous work, identified deficiencies, analyzed the reasons, and continued to improve. It will further deepen the connotation of high-quality nursing services this year, so that high-quality nursing services can truly be implemented and comprehensively improve nursing care. Quality of service.

1. Strengthen nursing quality and safety management, implement core systems

Assess and inspect, clarify job responsibilities and work systems, strictly hand over shifts, check the system, and standardize and program all operations , the responsibility lies with people.

Use the shift handover time to put forward preventive measures for hidden dangers in daily nursing work, such as "eliminate lower limb venipuncture on patients, prevent the occurrence of phlebitis in patients with indwelling needles, and strengthen turning over of patients after surgery, Children and elderly patients should control the infusion drip rate and strengthen functional exercises, etc.

Hold a monthly nurse meeting and use the nurse meeting time to analyze the causes of adverse nursing events that occurred in the department one by one and formulate corrective measures to improve work.

New nurses should be given key instructions and follow-up. The head nurse will track and check the quality of their nursing work and conduct training, guidance and assessment.

Establish the "Five Nursing Rounds" system for the head nurse; that is, the ward rounds are implemented before the morning meeting and the doctor's orders are being implemented, before the shift is handed over at noon, after the shift is taken over in the afternoon, and before leaving get off work in the evening to supervise the implementation of the core system , understand the needs of patients and ensure the safety of care.

2. Flexible shift scheduling and implementation of "patient-centered" group management

According to the requirements of the high-quality service demonstration project work model, summarize the experience and shortcomings of the previous year's nursing work , implement hierarchical use of nursing staff and nurse responsibility system, group responsibility system, and divide the nursing unit into two groups. Each group has a nursing team leader. The nursing team leader is a senior nurse with strong sense of responsibility and strong professional ability. He is responsible for taking charge of patients with relatively serious conditions and at the same time, providing help and guidance to the junior nurses in the group.

Before leaving get off work every day, the head nurse inspects and comments on the work quality of the two groups through ward rounds.

In view of the actual situation in the ward, such as the number of major surgeries, the number of serious emergency patients at night, and the number of junior nurses, we have adopted flexible scheduling, a combination of new and old shifts, and a two-person shift system for late and night shifts ( They will take over at the same time at 16:00, take turns to take a rest after 22:00, and get up at 6:00 the next day to complete the night shift work together (and take over at the same time at 8:00 in the morning). A practical basic care work schedule was also formulated. In addition to the original oral care and perineal care time in the morning and evening, the patient's beard cleaning and nail clipping were added every Tuesday and Friday, and Wednesday was designated as the patient's hair washing day.

3. Improve the professional theoretical level and operational skills to provide guarantee for high-quality nursing services

High-quality nursing services are the full-process nursing services of responsible nurses. The professional nursing level and operational skills of responsible nurses are Quality requirements in skills, health education and other aspects have been improved.

This year, the "Morning Questioning" method will be used to improve the level of specialist nursing. The specific arrangements are as follows. Monday: A nurse will be selected to conduct bedside rounds on critically ill or postoperative patients for 10-15 minutes; Tuesday: Learn a commonly used drug in the department; Wednesday: a small lecture by a nurse, with self-selected topics and diverse content, 10 minutes; Thursday: 1-2 questions from the head nurse to clarify the nurse’s professional knowledge, 10-15 minutes; Friday: Nurse The director randomly selected a responsible nurse to report on the "seven things to know" about the patients in charge.

Organize a multimedia specialist knowledge lecture and a nursing ward round (nurse or above organization, head nurse comments) every month; the responsible team leader... will conduct an introduction to the four specialist operating techniques commonly used in the department - Intravenous indwelling needles, perineal care, oral care, and ECG monitoring were trained, not taught, and assessed. The "Hundred Needle Puncture Competition" was held in the second half of the year, and the "Nursing Health Examination Knowledge Competition" was organized at the end of the year to determine whether the health education theme was based on the needs of patients, whether the teaching methods were targeted, whether the auxiliary tools were used appropriately, and whether the education process reflected the correct needs. The first, second and third prizes were awarded based on 12 evaluation criteria such as respect and protection of patients and whether the patient was impressed, etc. using a quantitative scoring method.

Through this year's training and assessment, the professional nursing and health education level of all nurses has been greatly improved.

4. Strengthen the identification of nursing risks and pay attention to the management of nursing details

1. Pay close attention to the observation and care of key patients, including major surgeries, the elderly, children, those with psychological disorders, and those with potential Patients with medical disputes are the focus of observation and are closely monitored by nurses.

2. Do a good job in teaching and supervising key nurses. Focusing on new nurses, intern nurses, and nurses with weak work sense of responsibility, nurses are required to do five "don'ts", that is, they cannot simplify the operation process at will, they cannot ignore every check, they cannot estimate things based on experience, and they cannot Ignore the changes in the condition during the operation, and do not let the interns operate alone without supervision.

3. Pay close attention to the implementation of travel notification obligations, and include safety protection knowledge such as fall prevention, bed fall prevention, and theft prevention into the scope of health education.

4. Pay attention to the management of safety warning signs. Falls, bed falls, pressure ulcers, control of drip speed, etc. are all clearly marked. Promote the use of wristbands and strengthen secondary checks to effectively ensure patient safety.

5. Refine the nursing service process and launch the "five points" service initiative.

2013 Quality Nursing Service Demonstration Project Continuous Improvement Implementation Plan

Department of Cardiology

Through two years of implementation of quality nursing services The achievements and experience gained will allow the connotation of nursing services to be further deepened and continuously improved in 2013. This plan is formulated as follows:

1. Emphasis on the connotation and importance of basic nursing work and actively transform nursing staff The ideological concept of "emphasis on professionalism, light on foundation, heavy on technology, light on service".

There are many patients who cannot be handled by cardiology departments, especially patients with myocardial infarction and heart failure who need more careful care. Many patients with diseases will urinate or become incontinent in bed. Therefore, many nurses will feel psychological resistance to the task of scrubbing and tidying up patients.

Therefore, while strictly demanding work, the head nurse respects and trusts each nurse, emotionally constantly motivates the nurses to pursue progress, and stimulates the nurses' work enthusiasm; the head nurse sets an example in her own work, strictly demands herself, and actively participates in the care of critically ill patients. Provide direct care and professional guidance, implement the influence and appeal of the head nurse into specific work, and use their own words and deeds to inspire nurses to grow and better serve patients.

2. Broaden the theoretical knowledge and professional skills of cardiology nurses through various channels

Before the implementation of high-quality nursing work, the arrangements for professional learning in the cardiology ward were relatively casual. Generally, there were New nurses entering the department are organized to learn the professional knowledge and operations of cardiology. After carrying out high-quality nursing work, our department has planned business learning activities every week, and continuously consolidates the nurses' basic nursing theoretical knowledge through nursing rounds, morning meetings, knowledge lectures, document study and irregular random examinations. , and dispatch nurses in turns to visit and study in hospitals and wards that have performed well in carrying out high-quality nursing service demonstration projects, give certain material rewards to nurses with better practical skills in the general nursing assessment, and organize all nurses to comment on the operation, learn from each other's strengths, and make up for their weaknesses. *** progress together.

3. Provide comprehensive and specific health education for cardiology patients

Health education is an important part of overall care. Due to the particularity of cardiology, rehabilitation training is difficult and patients are bedridden. It takes a long time, and comprehensive and specific health education is particularly important. Before the implementation of high-quality nursing work, the health education provided to patients by our department only mechanically repeated the educational content to patients and their families, and rarely provided other more humane measures and services. After providing high-quality nursing services, health education is provided to each patient, including admission introduction, medication guidance, special cardiology examination instructions, relevant knowledge explanation before and after orthopedic surgery, dietary guidance, functional exercise, discharge guidance, etc. Every week, nurses are provided with specialist knowledge training and disease lectures, especially key lectures on surgery and rehabilitation, which are of greater concern to cardiology patients; draw lessons from and learn from the health education and nursing experience of other hospitals, and provide bedside individual care to patients. Guidance is the main focus, supplemented by various other forms of health education, such as regularly producing and updating health education bulletin boards, distributing promotional materials and playing relevant videos to patients; conducting preoperative behavioral training for cardiology patients on postoperative bed cooperation, Such as: urinating in bed, washing in bed, relaxation training, etc.; conduct rehabilitation function training and self-living ability training for cardiology patients during the rehabilitation period, such as: teaching family members how to carry out home life care, and giving each patient a sheet with basic information when they are discharged from the hospital. A discharge contact card with information and precautions to facilitate future follow-up visits and consultations.

4. Simplify cardiology nursing documents and give time back to patients

Through electronic medical records and canceling unnecessary nursing writing in the cardiology department, such as canceling duplicate content with doctors’ records, Simplify the patient's first admission nursing record and other contents, simplify nursing documents, and reduce the time nurses spend writing nursing documents. At the same time, try to arrange the writing time after caring for the patient, so that more time can be used in the practice of caring for patients.

5. Improve supporting measures and integrate humanistic care into the cardiology ward

Equip daily appliances such as microwave ovens and simple functional exercise equipment, wheelchairs, pain treatment devices, etc. in the cardiology ward; Cardiology patients who have entered the recovery period should actively contact the rehabilitation department for the next stage of treatment and recovery; full-time nurses in the cardiology department will centrally distribute medicines, and full-time nursing staff will be responsible for accompanying the patients; standardize the daily language of nurses and strengthen training in nurse etiquette; Increase communication between nurses and patients and proactive inspection time; hang the names of ward directors and responsible nurses in the ward; the director and head nurse conduct warm ward rounds once a week to understand and meet patients' satisfaction with medical staff and daily needs in a timely manner. Be patient-centered.