Nursing safety management in the neonatal intensive care unit

Nursing safety management in the neonatal intensive care unit

Abstract According to the safety hazards existing in the nursing work of the neonatal intensive care unit, safety management is introduced into the management of the neonatal ward to determine the nursing safety management content, improve and formulate various systems. By strengthening management, we can improve the nursing safety awareness of nursing staff, implement quality supervision, grasp every nursing safety link, and use modern scientific management methods to standardize and standardize the nursing management system, so that we can provide safe, satisfactory and high-quality services to children. .

Keywords NICU nursing safety

Nursing safety means that during the entire process of implementing nursing services, patients do not violate laws and statutory regulations. Damage, disorder, defect or death in psychology, body structure or function beyond the scope allowed by the system [1]. It is the basis for ensuring the quality of nursing care, an important measure to improve the spirit of teamwork, and the guarantee of the hospital's social and economic benefits. The neonatal intensive care unit of our hospital was established in February 2010. It is an unaccompanied closed management ward. It adopts 24-hour full care by nurses and mainly treats children within 28 days after birth. These children have no self-care ability and language function. Their condition is critical and changes rapidly. Nursing staff work every day without the supervision of the patient. Moreover, the rescue equipment is complex and the nursing operations are many. There are many hidden dangers that affect the quality of medical care. . Under such conditions, how to scientifically implement nursing safety management and avoid the occurrence of nursing defects and errors has become an issue that cannot be ignored in nursing management work. Discussed below.

1 Common nursing safety hazards in nursing work

1.1 Nursing staff

1. 1. 1 Weak safety awareness and weak sense of responsibility

Nurses in the neonatal department basically work in a relatively closed environment, lacking the supervision of the children’s family members. Some nurses lack the spirit of independence and do not ask for instructions or report when they encounter difficult problems. They do not know how to pretend to understand, and they do not understand some possibilities. Insufficient awareness of safety hazards that occur. Epidermal necrosis caused by leakage of intravenous infusion of irritating medicinal solutions due to untimely observation; improper breastfeeding leading to choking, aspiration and even suffocation and aspiration diseases; excessive milk temperature leading to oral mucosal damage; covering or lying down Improper positioning may result in suffocation due to obstruction of breathing in the mouth and nose; reducing the number of inspections for children with relatively stable conditions, resulting in the failure to detect changes in the children's condition in time and losing opportunities for rescue.

1.1.2 Lack of legal awareness and lack of awareness of self-protection. The nursing record in the neonatal intensive care unit is the most accurate and valuable record of changes in the patient's condition. It must be realistic and realistic. It is the first step for patients and medical staff to deal with. Important evidence in disputes must be taken seriously. The specific nursing measures taken during the rescue process must be recorded in a timely, accurate and detailed manner. If the records are not timely or standardized, if there are alterations in the records or if they are inconsistent with the medical records, it will become a hidden danger that affects the safety of neonatology care.

1.1.3 Poor professional knowledge and technical abilities are mainly due to the threats to patient safety posed by nursing staff’s low technical level, lack of experience, weak collaboration ability and other factors. For example, due to the lack of nursing knowledge and experience, the early changes in some children's conditions that turn critical may not be recognized in time, resulting in the children losing the chance of rescue or even dying. With the large-scale introduction and development of new technologies and new projects, nursing work is technically complex. As the level of nursing care continues to improve and the technical requirements for nursing staff continue to increase, nursing safety has been greatly affected.

1.1.4 Violate the nursing system and technical operating procedures and do not strictly implement the nursing system in nursing work (such as not carefully handing over shifts, not conducting bedside handovers, and forgetting the special treatment of special critically ill patients); Violation of routine bathing care operations, resulting in scalds in children; failure to strictly implement medical orders (such as forgetting medical orders, incorrectly executing medical orders, and unclear medication records during the rescue process), incorrect placement of drugs, failure to carefully observe the condition, and failure to strictly implement the check-up system, etc. All may lead to errors and accidents.

1.2 Management aspects

1.2.1 In terms of staffing, there are not enough nurses in the neonatal department, the bed-nurse ratio does not meet the requirements, and it cannot meet the implementation of graded care and the needs of children. safety and life care needs.

In addition to completing a large number of routine treatments and nursing work every day, all the daily care of children (such as bathing once a day, feeding 8 to 12 times a day, and changing diapers, contaminated sheets, scarves, baby clothes, etc.) at any time It is completed by nurses. The workload of nurses is heavy, coupled with frequent shifts, which often leads to physical and mental exhaustion, mood swings, and inability to concentrate. A slight negligence may easily lead to nursing safety problems.

1.2.2 Nosocomial infection management Neonatology department has many patients and complex conditions. Children’s immune systems are immature and their resistance is low. They are prone to various diseases and cross-infection. If disinfection is not strictly implemented, The isolation system, failure to strictly control the disinfection methods of various equipment and items, and failure to strictly implement the hand hygiene system will all lead to the occurrence of hospital infections.

1.2.3 Imperfect management system and lax quality control. Nursing managers lack foresight and proactive prevention of potential unsafe factors, fail to remind nurses in time to pay enough attention, and lack of professional training. Factors such as insufficient professional ethics education and lax management and supervision affect the management of nursing safety organizations. This is not only the main cause of medical disputes and accidents, but also the biggest threat to patient safety.

1. 2. 4 Irresistible ward management: Irresistible or out-of-control ward management is an important factor affecting nursing safety.

For example, various instruments and equipment are not properly maintained and supplies are not adequately prepared.

2 Measures for nursing safety

2.1 Strengthen learning and training to improve the comprehensive quality of nursing staff

2.1.1 Strengthen the training of nursing business Starting from basic nursing care, every nurse is required to be proficient in basic nursing operations such as baby bathing, formulating milk, feeding, changing diapers, umbilical care, and temperature measurement, and conduct training and assessment of specialized technical operations. Facts have proven that only by being proficient in basic nursing theoretical knowledge, mastering neonatal specialist nursing skills, mastering rescue procedures, coordination methods, the use of various commonly used instruments and equipment, and disease observation, can one be calm and orderly in the busy neonatal nursing work , to ensure the safety of children.

　2.1.2 Pay attention to continuing education and comprehensively improve the professional knowledge and literacy of nurses

Encourage nurses to put forward higher requirements for their own business development and strive to become technical backbones; encourage nurses to actively participate Study in nursing college and undergraduate classes, actively adjust the knowledge structure, improve the level of knowledge, and send key nursing personnel to go out to participate in various study classes. Implement a study report system, which stipulates that all nursing staff who go out to visit, study, and receive further education must gather together to learn and impart good experience and new technologies when they return, so that more nurses can understand the new developments and trends in this industry and specialty, and gain new knowledge. Knowledge and new concepts, constantly enriching professional theoretical knowledge and improving the professional level of all nurses. 2.1.3 Improve professional ethics and ensure nursing quality