手术过程管理规范

手术过程管理 甘洛县人民医院手术过程管理规范 一、凡需住院手术的患者,应做好手术前各项检查,明确诊断,选择好手术适应证后,方可决定手术,科室要严格遵照各级医师手术范围合理安排手术人员。 二、手术前,主管医师填写好手术知情同意书,患者填写委托书者,可由被委托人签署。病情危重急需手术,但无行为能力且家属不在时,由科室或急诊值班医师报告医务科或院总值班批准后方可手术,但病历中必须详细以便备查。 三、凡住院施行的手术,手术前主管医师都要写好术前,并由上级医师阅批后签字。 四、重大、疑难、复杂手术、致残手术以及新开展的手术、外宾和州、县级领导手术,均应采取慎重态度,填写《重大、特殊手术审批表》报医务科,经院领导审批后方可实行。此类手术必须进行术前讨论,由科主任或主任,副)医师主持,手术医师、麻醉师、护士长及有关人员参加。讨论内容由负责医师记入病历,并报告医务科,必要时医务科派人参加术前讨论。 五、手术前1天,手术医师填写手术通知单,科主任或副主任医师签字后送手术室,由手术室安排手术。 六、急症手术,主管医师填写急诊手术通知单,科主任或副主任医师签字后送手术室,手术室或麻醉科应积极主动配合急诊手术,不准无故刁难、推脱或拒绝。 七、术前麻醉师必须检查手术患者,如术前准备不符合麻醉要求,麻醉师有权决定延期手术。 Details of green to introduce "the art of bonsai" concept, plant morphology, leaf color, aromas to create different moods and charms. (B) improving air pollution prevention and control. …… Air pollution sources in the four areas, a dust pollution and industrial enterprises of coal-burning pollution. A significant proportion of gypsum, stone processing enterprises and use of glass furnace standards of environmental protection facilities. Second, poor dust control, wide range of construction dust, road dust capacity. Three is to build coal-fired boilers in the region, particularly within the city's outdoor barbecue gas discharge seriously. Four motor vehicle exhaust is not inIn particular the greening of urban areas, it is necessary to carefully select the species suited to local soils, reflecting ... ... Features also allow for the evergreen trees, so that people walking in the shade. On one handTo expand green areas, improve planting quality fuss; but also to focus on simplicity and generosity of the green on the other hand, to enhance the Visual effect of green scale. Big green landscape according to the terrain the moderate, plant communities in natural, varied colors, flowers and clear principles, reflect the level, color and seasonal change. 八、各级医师要严格按照制定的“各级医师手术范围”进行手术。 九、进修医师及实习生参加的手术,必须有本院医师参加并负责进行指导,手术中出现的任何问,均由本院医师负责。 十、参加手术人员要严格执行手术室的各项规定,术前认真核对患者姓名、性别、床号、诊断、手术部位后,方可手术。对违反以及不按无菌技术进行操作的医务人员,护士长有权停止手术,并根据情节及造成的后果追究个人责任。 十一、手术中,术者和助手应密切配合。参加手术人员在术中对患者应高度负责,不得谈论与手术无关的话题,在患者紧张状态下更应严格执行医疗保护性制度。台上会诊时,有关人员应随请随到,如发生意外,台上和台下医务人员要积极采取措施,由主刀医师负责组织抢救,并酌情请示上级医师或报告有关领导协助处理。手术当中主刀或助手发生意外(如晕倒等情况),由在场的最高职称人员决定替代人员或启动人员紧急替代程序,手术中若发生手术人员～尤其是术者因某些意外情况不能坚持完成手术时～由第一助手替代其完成手术,如后者没有能力资质完成该手术～则需向其所在的科主任或二线报告～请求派相应的医师上台～必要时汇报医务科协调解决,。 Details of green to introduce "the art of bonsai" concept, plant morphology, leaf color, aromas to create different moods and charms. (B) improving air pollution prevention and control. …… Air pollution sources in the four areas, a dust pollution and industrial enterprises of coal-burning pollution. A significant proportion of gypsum, stone processing enterprises and use of glass furnace standards of environmental protection facilities. Second, poor dust control, wide range of construction dust, road dust capacity. Three is to build coal-fired boilers in the region, particularly within the city's outdoor barbecue gas discharge seriously. Four motor vehicle exhaust is not inIn particular the greening of urban areas, it is necessary to carefully select the species suited to local soils, reflecting ... ... Features also allow for the evergreen trees, so that people walking in the shade. On one handTo expand green areas, improve planting quality fuss; but also to focus on simplicity and generosity of the green on the other hand, to enhance the Visual effect of green scale. Big green landscape according to the terrain the moderate, plant communities in natural, varied colors, flowers and clear principles, reflect the level, color and seasonal change. 十二、严格执行查对制度,防止差错事故。缝合前,术者和助手应仔细检查术野内是否有活动出血和异物存留。手术结束,要对患者的全身情况和手术情况做一全面严格检查。 十三、患者手术后如病情允许,由手术室护士、主管医师一同送回病房,全麻或重危患者及麻醉师或手术医师认为有必要的患者,麻醉师应陪同送回病房。手术医师应开好术后医嘱,并向病房值班人员交待注意事项。 十四、手术前应由麻醉科会诊,填写《麻醉知情同意书》～由患者本人签字,患者填写委托书者,可由被委托人签字。手术后,麻醉医师在将患者送回病房前应与病房医师、护士交待手术、麻醉经过及注意事项,当面测血压、脉搏、呼吸。 Details of green to introduce "the art of bonsai" concept, plant morphology, leaf color, aromas to create different moods and charms. (B) improving air pollution prevention and control. …… Air pollution sources in the four areas, a dust pollution and industrial enterprises of coal-burning pollution. A significant proportion of gypsum, stone processing enterprises and use of glass furnace standards of environmental protection facilities. Second, poor dust control, wide range of construction dust, road dust capacity. Three is to build coal-fired boilers in the region, particularly within the city's outdoor barbecue gas discharge seriously. Four motor vehicle exhaust is not inIn particular the greening of urban areas, it is necessary to carefully select the species suited to local soils, reflecting ... ... Features also allow for the evergreen trees, so that people walking in the shade. On one handTo expand green areas, improve planting quality fuss; but also to focus on simplicity and generosity of the green on the other hand, to enhance the Visual effect of green scale. Big green landscape according to the terrain the moderate, plant communities in natural, varied colors, flowers and clear principles, reflect the level, color and seasonal change.