卓越護理ppt課件-資料下載頁
2025-01-05 08:28本頁面
【正文】 happened from your point of view? ? 護理部主任：小林，你知道，你的病人吳先生在晚上被轉到 ICU，因為病人有呼吸困難，要用呼吸機，護理記錄單上顯示下班前你意識到這種變化 ,并記錄病人呼吸頻率很快，但沒有記錄你通知了醫(yī)生或護士長，從你的角度你能告訴我發(fā)生什么。 Illustration 7, cont. ? Xiao Lin: That is correct. I did notice his respiratory rate had gone up to 24 per minute so I wrote it down. I was going to call the resident but then I got a phone call from my friend and I fot to call or tell anyone before I left. But other nurses knew he was breathing fast too. ? 小林：是這樣的，我注意到病人的呼吸上升到 24次 /分，因此我就把它記錄下來了，我正要傳呼或告訴其他人的時候，我接了一個朋友來的電話 ,當我下班前 ,我忘記叫醫(yī)生或其他人了 ,但其他護士也應當知道病人呼吸很快。 ? Nursing director: Xiao Lin, you know it was your responsibility to pass on this information. Is it not true you and the nurse manager have had two similar discussions in the past three months? ? 護理部主任：小林，你知道這是你的責任將這些信息告訴別人，在過去三個月里，類似的問題護士長曾與你討論過 ? Xiao Lin: Yes, and I am really very sorry. ? 小林：是的，我很抱歉。 Illustration 8,pliance problem? 例 8．遵從問題 ? Nursing Director: I understand we are having a problem with the new policy on nutritional assessment, is that why you wanted to see me? ? 護理部主任：我了解到對營養(yǎng)評估新制度實施方面有些問題，這是你想見我的原因嗎？ Illustration 8, cont. ? Nurse Manager: I am not sure whether it is a pliance problem or a lack of staffing. The dieticians say they are willing to e and consult but the reality is they are not ing to consult on all the patients with nutritional problems. And so far I haven’t figured out exactly why. The nurses are putting the assessment report on the front of the chart when there is a problem, but the doctors rarely ask for the dietary consult. They just write they have taken care of it or it isn’t needed and sometimes they fet to deal with it altogether unless I push them. ? 護士長：我不知道這是遵守制度的問題，還是人力不足的問題，營養(yǎng)師說他們愿意來會診，但事實上他們沒有來會診所有營養(yǎng)問題的病人，目前我還不知道究竟為什么，護士把有營養(yǎng)問題的篩選評估單放在醫(yī)生病歷的首頁，但醫(yī)生很少請營養(yǎng)師會診，他只是說已處理了或者不需要，有時醫(yī)生忘記去處理它，除非我催他們。 Illustration 8, cont. ? Director: Sounds to me like we need more information. Why don’t we ask for a meeting with the director for graduate medical education, he is the one most familiar with the residents and most of these orders for dietary consultation would be written by the residents. ? 護理部主任：聽起來我們需要更多的信息，為什么你不問一下醫(yī)務科科長在行政會議上強調一下，讓醫(yī)生今后更關注這一問題。 Summary, OnTheLevel總結 ? Guide lines and goals, not policy ? 是指導和目標，而不是制度 ? Best done one on one, face to face ? 最好一對一、面對面的做 ? Anticipate need for change ? 預測改變的需要 ? Anticipate a positive experience ? 預測積極的體驗 ? Anticipate improvement in skill ? 預測技能上的改進 ? Anticipate gratification ? 預測滿意
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