分稿-手術(shù)室的管理(中英對(duì)照)

1、手術(shù)室的管理1.有完善的各項(xiàng)規(guī)章制度并得到有效落實(shí)建立手術(shù)室核心工作制度:人員進(jìn)出管理制度(參觀制度等;消毒隔離制度;查對(duì)制度;病人安全管理制度:包括接送轉(zhuǎn)運(yùn)安全、手術(shù)病人評(píng)估、手術(shù)病人和手術(shù)部位的核對(duì)、手術(shù)體位安全等;標(biāo)本處理制度;手術(shù)器械管理制度;交接班制度;感染手術(shù)管理制度;接臺(tái)手術(shù)管理制度;手術(shù)登記記錄制度等十項(xiàng)。其他工作制度包括:質(zhì)量評(píng)價(jià)和考核制度;值班制度;差錯(cuò)事故登記報(bào)告制度;手術(shù)器械及物品借用制度;職業(yè)安全防護(hù)制度;物品進(jìn)出和管理制度;儀器管理制度;培訓(xùn)制度;會(huì)議制度;業(yè)務(wù)學(xué)習(xí)制度等。2.有停水停電、緊急手術(shù)綠色通道、急用手術(shù)器械處理、多臺(tái)急診手術(shù)等各種突發(fā)事件的應(yīng)急處理預(yù)案,

2、并定期進(jìn)行模擬演練。3.手術(shù)室設(shè)護(hù)理質(zhì)量管理與持續(xù)改進(jìn)評(píng)價(jià)小組。有專職或兼職的質(zhì)量監(jiān)督員。定期對(duì)質(zhì)量問(wèn)題進(jìn)行分析,提出改進(jìn)措施,并有相關(guān)資料記錄,體現(xiàn)質(zhì)量持續(xù)改進(jìn)。4.建立各崗位、各專業(yè)手術(shù)工作流程與質(zhì)量標(biāo)準(zhǔn)。5.術(shù)中護(hù)理記錄單應(yīng)嚴(yán)格按照有關(guān)規(guī)范書寫和記錄。6.手術(shù)室的人員與物品進(jìn)出管理:手術(shù)人員進(jìn)入手術(shù)室:由專用通道更換消毒的衣褲、鞋子,帽子后進(jìn)入手術(shù)室。手術(shù)人員不能戴手飾、搽亮甲油或戴假指甲。不允許有自已的衣服外露。潔凈區(qū)和清潔區(qū)工作的人員不得直接進(jìn)入污物清洗區(qū),出入時(shí)應(yīng)洗手,必要時(shí)更鞋。其他人員進(jìn)入手術(shù)室:嚴(yán)格控制進(jìn)入手術(shù)室內(nèi)的人員。除必要的手術(shù)醫(yī)生、護(hù)士、麻醉師外,應(yīng)限制進(jìn)入手術(shù)室的其

3、他人員,參觀人員必須經(jīng)主管部門批準(zhǔn),并應(yīng)控制人數(shù)(2-4人,按指定手術(shù)間參觀手術(shù),不得隨意走動(dòng)和出入,不得距手術(shù)臺(tái)過(guò)近,應(yīng)與手術(shù)者和手術(shù)無(wú)菌臺(tái)保持30CM以上的距離。手術(shù)病人進(jìn)入手術(shù)室:運(yùn)送病人的內(nèi)、外平車必須嚴(yán)格區(qū)分使用,外出平車嚴(yán)禁進(jìn)入潔凈區(qū),手術(shù)病人進(jìn)出需在交換區(qū)進(jìn)行內(nèi)外平車架交換。平車每天清潔消毒并更換被服,工作人員外出,必須更換外出衣與外出鞋。手術(shù)使用的物品進(jìn)出手術(shù)室:無(wú)菌物品經(jīng)潔凈走廓進(jìn)入手術(shù)室,所有進(jìn)入潔凈區(qū)的物品、設(shè)備,均應(yīng)拆除外包裝,擦拭干凈方可進(jìn)入。手術(shù)結(jié)束后,器械用包布覆蓋或打包后方可通過(guò)清潔通道送出手術(shù)間。手術(shù)后的廢物就地有效封口或打包后,通過(guò)清潔通道,進(jìn)入污染區(qū)。手術(shù)

4、室進(jìn)出通道:手術(shù)室門、分區(qū)隔斷門保持關(guān)閉狀態(tài),術(shù)前各項(xiàng)準(zhǔn)備工作要提前做好,術(shù)中盡量減少人員在室內(nèi)走動(dòng)及出入手術(shù)室;勿在手術(shù)室內(nèi)抖動(dòng)各種敷料;巡回護(hù)士、麻醉醫(yī)生應(yīng)在手術(shù)結(jié)束后再作整理工作。7.手術(shù)室的環(huán)境管理。保潔制度實(shí)施落實(shí)。清潔工人分工明確,有工作質(zhì)量的要求、培訓(xùn)及質(zhì)量評(píng)價(jià)記錄。不同區(qū)域的清潔工具不能混用,需有明顯標(biāo)志。手術(shù)室用物必須保持整齊、清潔,物面無(wú)塵,地面無(wú)碎屑、無(wú)污跡。定期清洗與保養(yǎng),保持地板清潔、光亮。污染區(qū):污染區(qū)地面干燥,清潔。清潔區(qū):入室環(huán)境清潔,室內(nèi)外鞋及物品分開(kāi)放置,每日清潔;衛(wèi)生間無(wú)異味。無(wú)菌區(qū):每日保潔:當(dāng)天手術(shù)結(jié)束后進(jìn)行徹底清潔消毒,包括壁柜、無(wú)影燈、儀器、器械車

5、、手術(shù)床、操作臺(tái)面、地面。在無(wú)明顯污染情況下,物體表面用清水擦拭,內(nèi)外走廓、輔助間地面每天濕式拖抹二次,(上午第一場(chǎng)手術(shù)開(kāi)始后和當(dāng)天手術(shù)結(jié)束后各一次。每周保潔:室內(nèi)外環(huán)境衛(wèi)生徹底清潔,包括天花板、窗戶、墻壁、空調(diào)機(jī)濾網(wǎng)等每周清潔擦拭一次。接臺(tái)手術(shù)之間的環(huán)境衛(wèi)生。手術(shù)結(jié)束后迅速清理手術(shù)床、使用的物品,更換或清潔手術(shù)床、床單、手術(shù)臺(tái)、麻醉車、無(wú)影燈手柄、吸引器、工作臺(tái)表面、污物容器等,可疑被病人血液或體液污染的環(huán)境及物品進(jìn)行有效消毒。潔凈手術(shù)室清理手術(shù)用物后,關(guān)閉手術(shù)間自凈15分鐘后,進(jìn)行下一臺(tái)手術(shù)。術(shù)中感染性廢物、損傷性廢物等醫(yī)療廢物直接放入收集容器,手術(shù)切除的殘肢、組織按病理性廢物處理。傳染性

6、疾病手術(shù)的感染性廢物用雙層黃色塑料袋,保持手術(shù)過(guò)程的環(huán)境清潔、不污染,術(shù)后有效封口并注明疾病名稱送出手術(shù)間。術(shù)中被手術(shù)病人血液或體液污染的物面和地面,應(yīng)用及時(shí)用醇類或含氯消毒液進(jìn)行擦拭,消毒液的濃度根據(jù)感染類型進(jìn)行選擇。清潔的順序應(yīng)遵循從相對(duì)清潔到污染的原則,避免污染擴(kuò)散。潔凈手術(shù)間(部空氣凈化管理。潔凈度級(jí)別達(dá)到設(shè)計(jì)要求,細(xì)菌濃度符合GB 15982醫(yī)院消毒衛(wèi)生標(biāo)準(zhǔn)的標(biāo)準(zhǔn)。設(shè)施維護(hù):回風(fēng)口初級(jí)濾網(wǎng)每周進(jìn)行清潔一次,必要時(shí)更換,終極濾網(wǎng)每年更換一次。手術(shù)室清潔工作應(yīng)在每天手術(shù)結(jié)束后及凈化空調(diào)系統(tǒng)運(yùn)行前進(jìn)行。設(shè)施維護(hù):回風(fēng)口濾網(wǎng)每周進(jìn)行清潔一次,必要時(shí)更換。粗效、中效、高效過(guò)濾器有更換記錄。手術(shù)

7、室清潔工作應(yīng)在每天手術(shù)結(jié)束后及凈化空調(diào)系統(tǒng)運(yùn)行時(shí)進(jìn)行。環(huán)境空氣質(zhì)量監(jiān)測(cè):每月對(duì)手術(shù)間的空氣、物體表面進(jìn)行生物監(jiān)測(cè)一次,工作人員洗手效果每月一次,取樣數(shù)量,結(jié)果符合要求,潔凈手術(shù)部綜合性能指標(biāo)測(cè)定(靜壓差、截面風(fēng)速、換氣次數(shù)、自凈時(shí)間、溫濕度、噪聲、照度、新風(fēng)量、潔凈度級(jí)別和細(xì)菌濃度等技術(shù)指標(biāo)醫(yī)院每年進(jìn)行一次,結(jié)果符合相關(guān)規(guī)定要求。有記錄。8.手術(shù)器械及物品的管理。手術(shù)器械日常管理。所有在手術(shù)室使用的產(chǎn)品在進(jìn)貨之前必須經(jīng)過(guò)醫(yī)院采購(gòu)部門負(fù)責(zé)驗(yàn)三證(產(chǎn)品注冊(cè)證、經(jīng)營(yíng)許可證或生產(chǎn)許可證、生產(chǎn)廠家和經(jīng)營(yíng)廠家的營(yíng)業(yè)執(zhí)照,無(wú)菌器材除有以上證件外,每一滅菌批次須有無(wú)菌檢測(cè)合格報(bào)告;消毒劑還必須有衛(wèi)生許可證,由

8、醫(yī)院采購(gòu)部門驗(yàn)證和購(gòu)入,手術(shù)室統(tǒng)一領(lǐng)取和保管。手術(shù)器械分類登記管理,根據(jù)不同手術(shù)器械的性能要求,正確放置。備有足夠的各類手術(shù)器械及物品的數(shù)量,能滿足急診手術(shù)的需要,有手術(shù)器械準(zhǔn)備指南和標(biāo)識(shí),包括名稱、包裝及滅菌方法。手術(shù)護(hù)士掌握各類手術(shù)器械的用途、清洗滅菌方法、保養(yǎng)方法等。手術(shù)器械包標(biāo)識(shí)清晰、項(xiàng)目齊全,包括器械包名稱、與滅菌方法相符的合格的滅菌指示帶、滅菌時(shí)間、過(guò)期時(shí)間、器械打包人簽名,由消毒供應(yīng)中心負(fù)責(zé)高壓蒸汽滅菌的器械包和敷料包還需要有滅菌爐次。腔鏡類手術(shù)器械管理:硬鏡與軟鏡的清洗、存放符合相關(guān)技術(shù)規(guī)范的要求。精密、易損壞及價(jià)格昂貴的手術(shù)器材專人保管、定期檢查及保養(yǎng)。外來(lái)手術(shù)器械必須重新清

9、洗、包裝、滅菌。用后須清潔。無(wú)菌手術(shù)器械及物品管理。手術(shù)器械及物品必須一用一滅菌,耐溫、耐濕物品首選高壓蒸汽滅菌方法,對(duì)于不能用高壓滅菌的物品應(yīng)采用低溫氣體滅菌,盡量減少使用化學(xué)消毒劑浸泡滅菌的方法。禁止使用福爾馬林自然蒸發(fā)熏箱作為滅菌方法。無(wú)菌器械存放環(huán)境和條件符合衛(wèi)生部消毒技術(shù)規(guī)范要求。術(shù)前無(wú)菌手術(shù)器械包必須在手術(shù)間環(huán)境和空氣清潔后放入。使用后器械清洗消毒管理。使用后手術(shù)器械置于密閉箱內(nèi)送消毒供應(yīng)室統(tǒng)一管理,若在手術(shù)室處置,則手術(shù)室的器械清洗、包裝及消毒滅菌質(zhì)量必須符合廣東省醫(yī)療機(jī)構(gòu)消毒供應(yīng)室審核驗(yàn)收標(biāo)準(zhǔn)。使用后腔鏡器械的清洗必須符合內(nèi)鏡清洗消毒技術(shù)規(guī)范的有關(guān)要求。特殊感染(如破傷風(fēng)、氣性

10、壞疽、朊毒體等手術(shù)必須制定一套嚴(yán)格的環(huán)境、物品、使用后器械和病人的消毒隔離措施。手術(shù)使用后布類和手術(shù)衣裝入膠袋內(nèi),有效封口并在袋外做好標(biāo)記,作為醫(yī)療垃圾處理,一般感染按標(biāo)準(zhǔn)預(yù)防措施。消毒劑及滅菌設(shè)備管理。手術(shù)室使用的各種滅菌設(shè)備(高壓蒸汽滅菌爐、小型快速滅菌爐、環(huán)氧乙烷滅菌爐等應(yīng)嚴(yán)格按照國(guó)家消毒技術(shù)規(guī)范的要求進(jìn)行監(jiān)測(cè),所有滅菌儀每月至少做一次生物監(jiān)測(cè),每次檢測(cè)時(shí),應(yīng)同時(shí)送對(duì)照檢測(cè)菌管一只,高壓蒸汽滅菌儀,每日使用前做BD測(cè)試,并做好登記?？焖贉缇魇褂梅椒▏?yán)格按照儀器用說(shuō)明書?？焖贉缇挥糜诩毙杵餍禃r(shí)使用,不可作為常規(guī)滅菌方法?？焖贉缇笃餍挡荒苈懵兜膫魉?。使用的消毒劑、監(jiān)測(cè)用的化學(xué)指示物等要

11、在有效期內(nèi)使用。浸泡器械的消毒液每次使用前要進(jìn)行化學(xué)監(jiān)測(cè),濃度達(dá)標(biāo)才可使用,有記錄。9.病人安全管理9. Patient Safety Management手術(shù)病人術(shù)前安排。 Preoperative Arrangement for the Patient Scheduled for the Operation.護(hù)士長(zhǎng)或組長(zhǎng)負(fù)責(zé)手術(shù)病人、手術(shù)間、手術(shù)人員的工作安排。擇期手術(shù)按照手術(shù)類別、手術(shù)間潔凈度分級(jí)等要求分配和安排。 The head nurse or team leader shall take the responsibility of the working arrangement

12、for the patient, operation room and surgical staff. The selective operation shall be arranged in accordance with the surgical category and requirements for the cleanliness classification of the operating room.擇期手術(shù)應(yīng)在術(shù)前一天送手術(shù)通知單,通知單內(nèi)容包含:患者姓名、性別、年齡、住院號(hào)、病區(qū)、床號(hào)、感染情況、診斷、手術(shù)名稱、麻醉方式、手術(shù)主刀、助手。 For the selective

13、operation, the notice of the operation shall be provided on the day before the operation, the content of which includes: the patients name, gender, age, hospital No., endemic area, bed number, infection condition, diagnosis, operation name, anesthesia way, operator during the operation and assistant

14、.做好手術(shù)器械及物品的準(zhǔn)備。 The surgical instruments and objects shall be well prepared.病人到手術(shù)室后,手術(shù)前病人的評(píng)估和查對(duì)。 After the patient is in the operating room, the preoperative assessment and inspection for the patient shall be conducted.核實(shí)病區(qū)術(shù)前準(zhǔn)備項(xiàng)目:病人服裝應(yīng)該清潔、無(wú)穿內(nèi)衣褲、無(wú)活動(dòng)假牙、無(wú)眼鏡或隱型眼鏡,不帶首飾、手表及錢財(cái),不涂口紅、指甲油,術(shù)前醫(yī)囑護(hù)士是否簽名、術(shù)前用藥及病人反應(yīng)、

15、如停留胃管、尿管或靜脈補(bǔ)液等其它引流管應(yīng)觀察其是否通暢并妥善固定。 Verification for the Preoperative Preparation Items in the Endemic Area: clean patients clothing without underclothes, denture, glasses or contact lens, jewelry, watch and money, lipstick and nail polish, nurses signature shall be conducted in the medical order befo

16、re the operation, preoperative medication and patients Response, and circulation and fixation of the staying Gastric tube, catheter or intravenous fluid and other drainage tube.據(jù)病情種類和麻醉方式,認(rèn)真評(píng)估病情、手術(shù)受壓部位皮膚情況及手術(shù)中可能采取的治療措施和備器械物品。必要時(shí)運(yùn)用壓瘡量表進(jìn)行評(píng)估,采取針對(duì)性的保護(hù)措施。 In accordance with the disease type and anesthesi

17、a mode, the patients condition, situation of the crushed skin in the operation and therapeutic measures that may be taken during the operation and relevant instruments shall be carefully assessed. If necessary, the pressure sore scale shall be used to conduct the assessment, and the corresponding pr

18、otection measures shall be taken.查對(duì)內(nèi)容:病人姓名、性別、年齡、住院號(hào)、診斷、手術(shù)名稱、手術(shù)部位、側(cè)向、手術(shù)方式、輸血八項(xiàng)的結(jié)果、藥物過(guò)敏試驗(yàn)結(jié)果、術(shù)中使用藥物、術(shù)中標(biāo)本的驗(yàn)單、X光片及病房帶入的藥物等物品。需做過(guò)敏試驗(yàn)的藥物要核對(duì)病歷過(guò)敏試驗(yàn)結(jié)果,手術(shù)護(hù)士親自詢問(wèn)核實(shí)病人的藥物過(guò)敏反應(yīng)、手術(shù)部位和側(cè)向。 Checking Content: patients name, gender, age, hospital No., diagnosis, operation name, operation site, side direction, operation

19、mode, results of the eight transfusion items, result of the drug allergy test, drugs used during the operation, verification certificate of the specimen collected in the operation and x-ray film, medicine brought from the ward and other objects. For the medicine required to do allergy test, the alle

20、rgy test result in the case history shall be verified, and the nurse responsible for the operation shall enquire and verify the patients drug allergy reaction, operation site and side direction in person.查對(duì)時(shí)機(jī):接病人時(shí)由病區(qū)護(hù)士與接手術(shù)的護(hù)士共同查對(duì);進(jìn)入手術(shù)室時(shí)由接手術(shù)病人的人員與巡回護(hù)士共同查對(duì),進(jìn)入手術(shù)間后,巡回護(hù)士再次查對(duì)。 Verification Opportunity: th

21、e nurse in the endemic area shall do the verification with the surgical nurse together; When arriving in the operating room, the worker receiving the surgery patient shall do the verification with the circulating nurse together, and after arriving in the operating room, the circulating nurse shall d

22、o the verification again.查對(duì)根據(jù):通知單、病歷、病人手帶,影像資料、病人口述或病人家屬代口述。Verification Bases: letter of notice, case history, patients hand strap, video data and patients dictation or familys dictation of the patient.無(wú)菌手術(shù)器械質(zhì)量確認(rèn)與數(shù)量的清點(diǎn)Quality Confirmation and Amount Counting for Sterile Surgical Instruments嚴(yán)格遵守?zé)o菌技術(shù)

23、操作原則,手術(shù)開(kāi)始前、關(guān)閉體腔前、體腔完全關(guān)閉后,皮膚完全縫合后,對(duì)手術(shù)臺(tái)上所有的手術(shù)器械、敷料及特殊用物,進(jìn)行器械數(shù)量、化學(xué)指示卡與移植物標(biāo)識(shí)的核對(duì)。由巡回護(hù)士、洗手護(hù)士、醫(yī)生共同核對(duì),按照手術(shù)護(hù)理單的器械欄目逐一進(jìn)行核對(duì)記錄并分別簽名。對(duì)容易脫落的螺釘螺帽分別登記。 The operating principles for the aseptic technique shall be strictly obeyed, before the commencement of the operation and the closure of the body cavity, after the

24、complete closure of the body cavity and the complete suture of the skin, and for all surgical instruments, dressing and special objects on the operating table, the verifications of the device number, chemical indicative card and transplant identification shall be conducted. In accordance with the in

25、strument column in the surgical nursing sheet, the circulating nurse, scrub nurse and doctor shall do the verification together, verify the records in sequence, and respectively sign their names. The screw and nut easy to fall shall be registered separately.器械臺(tái)上器械擺放安全,使用方便,便于清點(diǎn)及確保不易污染。 The medical d

26、evices on the instrument table shall be safely placed, easy to use and count, and ensured not to be polluted easily.手術(shù)過(guò)程中增減的物品應(yīng)及時(shí)清點(diǎn)并記錄,手術(shù)臺(tái)上失落的物品,及時(shí)放于固定位置,以便清點(diǎn)。 The objects increased and decreased during the operation shall be counted and recorded timely, and the objects lost on the operating table s

27、hall be placed at fixed position timely, to facilitate counting.進(jìn)入體腔內(nèi)的紗布類物品,必須有顯影標(biāo)記,不得剪開(kāi)使用,引流管等物品剪下的殘端不得留在臺(tái)上,應(yīng)立即棄去。 The objects such as gauze taken into the body cavity must be provided with the developing mark, and can not be cut off. The residual ends cut off from the drainage tube and other objec

28、ts shall be discarded immediately, rather than left on the operating table.關(guān)閉體腔前發(fā)現(xiàn)點(diǎn)數(shù)物品與術(shù)前數(shù)不相符時(shí),應(yīng)及時(shí)告知主刀醫(yī)生并不得關(guān)閉體腔,認(rèn)真查找。同時(shí)必須記錄及分析發(fā)生的可能原因及改進(jìn)措施。 Before the closure of the body cavity, in the case that the number of the calculated objects is not consistent with the number before the operation, the operato

29、r shall be informed timely, the body cavity is not required to close up, and scrutinized search must be performed. Simultaneously, possible causes and improvement measures shall be recorded and analyzed.與當(dāng)次手術(shù)無(wú)關(guān)的手術(shù)器械不得進(jìn)入該手術(shù)間。 The surgical instruments unrelated to the operation cannot be taken into th

30、e operation room.手術(shù)中用藥和用血的查對(duì)。 Check for the Drug and Blood Used in the Operation.根據(jù)醫(yī)囑用藥,用藥前應(yīng)核對(duì)藥品名稱、濃度、劑量和有效期,并檢查藥品澄明度,有無(wú)沉淀、變色及包裝有無(wú)裂隙等。Medicine shall be taken in accordance with medical orders. Before using drugs, the name, concentration, dose and the validity period of the medicine shall be checked,

31、 and the clarity of the medicine shall be examined as well, that is, to verify whether precipitation or discoloration is found in the drug, and whether crack exists in the packaging.手術(shù)過(guò)程中執(zhí)行口頭醫(yī)囑用藥時(shí)要當(dāng)場(chǎng)復(fù)述確認(rèn)藥品名稱、劑量、用藥時(shí)間、用藥途徑并做好記錄。術(shù)后及時(shí)通知醫(yī)生補(bǔ)開(kāi)醫(yī)囑。In the process of operation, verbal medical orders shall be f

32、ollowed; in the process of using drugs, the name and dose of medicine, as well as the administration time and route shall be reposted, rectified and recorded on the spot. After operation, the doctor shall be informed timely to give medical orders.手術(shù)臺(tái)上有兩種以上藥物時(shí)應(yīng)使用不同的容器盛放,并做好標(biāo)記,以免混淆。When two or more th

33、an two kinds of drugs are on the operating table, these drugs shall be placed in different containers, which shall be marked clearly, to avoid being mixed up.取血者要認(rèn)真核對(duì)取血單上病人的姓名、住院號(hào)、血型與病歷是否相符和所取血液的種類。Phlebotomists shall verify whether the name of the patient, hospital number, blood type and case histo

34、ry on the blood taking list are consistent with the type of the blood taken.輸血前麻醉醫(yī)生和巡回護(hù)士共同仔細(xì)核對(duì)病人和供血者的姓名、住院號(hào)、血型、血瓶號(hào)、RH因子、交叉配血試驗(yàn)結(jié)果和采血日期,并檢查血液質(zhì)量,若發(fā)現(xiàn)血液顏色改變、沉淀、溶血,不得使用。Before transfusion, the name of the patient and the donor, hospital number, blood type, blood vial number, RH factor, cross-match blood t

35、est and blood sampling date shall be checked carefully by the anesthetist and circulating nurse, and the quality of blood shall also be examined, in the case that the color of the blood changes, or the phenomenon such as precipitation or hemolytic is found, the blood, therefore, can not be used.輸血過(guò)程

36、中密切觀察病人反應(yīng),發(fā)現(xiàn)異常立即停止輸血,及時(shí)處理。In the process of transfusion, the response of the patient shall be placed under close observation, if unusual circumstance is discovered, the process of transfusion shall be stopped, and the abnormalities shall be treated with timely.血袋在手術(shù)間保留至病人離開(kāi),注明科室、病人姓名及時(shí)間送血庫(kù)存放24小時(shí)。The

37、 blood bag shall be kept in the operation room until the patientleaves, the blood bag shall be indicated with the department, name of the patient and the time clearly, and then delivered to the blood bank to be stored for 24 hours.術(shù)中安全護(hù)理。 Safe Nursing in the Operation.術(shù)前病人的體位擺放正確。擺放體位時(shí),清醒的病人可詢問(wèn)其感覺(jué),做

38、好解釋工作,病人的肢體置于功能位,并能良好暴露手術(shù)視野,同時(shí)避免可能發(fā)生的皮膚壓瘡、靜脈回流受阻和神經(jīng)損傷等并發(fā)癥。Before operation, the position of the patient shall be placed correctly. When the position is being placed, for the conscious patients, their feelings shall be inquired and the interpretation work shall be conducted well. The patients extremi

39、ty shall be placed in the functional position and shall be exposed well to the surgical field, and simultaneously the possible pressure sores of the skin, venous obstruction, nerve injury and other complications can be avoided.根據(jù)病人手術(shù)時(shí)間、受壓部位、皮膚情況使用抗壓軟墊和其它防護(hù)措施。The pressure-resist cushion and the other

40、 protective measures shall be used in accordance with the patients operation time, pressure position and skin condition.安全約束病人。選擇合適的約束帶固定病人,術(shù)中觀察被約束部位的循環(huán)情況,在不影響手術(shù)的情況下適當(dāng)活動(dòng)病人的肢體,并對(duì)病人的肢端部位進(jìn)行適當(dāng)按摩,促進(jìn)血液循環(huán)。調(diào)節(jié)室溫并注意給病人保暖。The patient shall be restrained safely. The appropriate restraint strap shall be selected

41、 to fix the patient, and the cycling condition of the constrained position shall be observed during the operation. In the condition without influencing the operation, the patients extremity shall be appropriately exercised, and the appropriate massage shall be conducted on the patients acral positio

42、n to promote the blood circulation. The room temperature shall be adjusted and attentions shall be paid to keep the patient warm.全身麻醉病人術(shù)畢復(fù)蘇期,予以適當(dāng)約束,護(hù)士要在旁邊守護(hù),防止病人墜床摔傷。配合麻醉醫(yī)師送病人至復(fù)蘇室。During the recovery period of the patient with the general anesthesia after the operation, the appropriate restraint sha

43、ll be given. The nurse shall conduct side warding to prevent the patient falling off the bed and being hurt. The patient shall be sent to the post-anesthesia care unit in cooperation with the anesthetist.搬動(dòng)和運(yùn)送病人時(shí)動(dòng)作要輕巧穩(wěn)妥,防止推車翻倒。During the moving and delivery of the patient, the action shall be light

44、and stable to prevent the trolley turning over.嚴(yán)格按照操作技術(shù)規(guī)范使用電外科系統(tǒng),正確選擇負(fù)極板的種類和放置的部位。使用高頻電刀時(shí)手術(shù)野必須保持干燥,不得有含酊消毒液殘留,以免起火燃燒。The electro surgical system shall be used strictly in accordance with the operation technological specification, and for the negative plate, the right type and placing position shall

45、be selected. During the using of the high-frequency electrotome, the surgical field shall be dry, and the tincture-containing disinfectant shall not be left to prevent the fire burning.術(shù)中需使用溫水時(shí),必須使用嚴(yán)格控制水的溫度,37-42適宜水溫,免燙傷病人。(溫度是參照基護(hù)書的,術(shù)中是指體內(nèi)使用的溶液請(qǐng)?jiān)俅_認(rèn)溫充范圍During the operation, when the warm water is us

46、ed, the water temperature shall be strictly controlled, and the appropriate water temperature is from 37to 42 to prevent burning patients. (The temperature refers to the requirement of the basic nursing, and the operation process means, for the solution used in body, the temperature-filling range sh

47、all be confirmed again10.手術(shù)標(biāo)本管理10. Management of the Operation Specimen嚴(yán)格標(biāo)本留取及送檢交接制度。 The specimen acquiring and submitting transfer system shall be strictly implemented.手術(shù)中切除的任何組織未經(jīng)主刀醫(yī)生許可不得遺棄或私自取走。Without the operator permission, any tissue resected during the operation shall not be abandoned or se

48、cretly taken away.術(shù)中切下的組織隨時(shí)做好標(biāo)記,防止弄錯(cuò)病人、弄錯(cuò)部位。非新鮮組織送檢的標(biāo)本,要及時(shí)浸泡于10%福爾馬林液中。For the tissue resected in the operation, marks shall be made at any time to prevent mistaking the patient and position. The specimen taken from the non-fresh tissue for inspection shall be soaked in the 10% formalin liquid in ti

49、me.安全存放標(biāo)本,確保標(biāo)本不丟失、不變質(zhì)、不毀損。The specimen shall be stored safely, and for the specimen, no losing, decomposition and damage shall be ensured.負(fù)責(zé)送標(biāo)本的人員再次核對(duì)留取標(biāo)本的名稱、數(shù)量及登記情況,確定無(wú)誤后送病理科。The name, number and registration situation of the reserved specimen shall once be collated by the personnel responsible for

50、 sending specimens and be sent to the pathology department after determination without error.11.護(hù)理風(fēng)險(xiǎn)的管理11.Nursing Risk Management嚴(yán)格遵照有關(guān)法規(guī)和規(guī)章制度執(zhí)行各項(xiàng)護(hù)理操作。The relevant regulations and rules shall be strictly followed to implement all the nursing procedures.有完善的各手術(shù)?？谱o(hù)理操作流程及安全指引Provided with perfect opera

51、ting procedure and safety instruction of various operative specific nursing手術(shù)護(hù)士接待病人及家屬時(shí)應(yīng)熱情有禮,使用規(guī)范性的職業(yè)語(yǔ)言,對(duì)病人的疑問(wèn)要熱情解答。The nurse in the operation room shall be enthusiastic and polite when the patient and their family are received, use normative professional language and passionately answer the patient

52、s question.為清醒病人進(jìn)行各項(xiàng)護(hù)理操作前應(yīng)做好解釋工作,動(dòng)作輕柔,并注意保護(hù)病人的隱私。Before all the nursing procedures for the conscious patient are conducted, the interpretation work shall be completed, the action shall be gentle and the patients privacy shall be protected.術(shù)中應(yīng)保持安靜、嚴(yán)肅,不得在手術(shù)間大聲談笑、喧嘩或隨意談?wù)摬∪说牟∏榕c隱私。The quiet and seriousness shall be kept during operation, loudly chatting, shouting or talking about patients condition and privacy cant be allowed i