臨牀透析 Vol.18 No.3(5)


特集名 透析看護における患者ケアを評価する
題名 リスクマネジメント
発刊年月 2002年 03月
著者 吉瀬 由美 福岡赤十字病院・看護婦
【 要旨 】 患者の高齢化および合併症の多様化に伴い,現在の透析医療はより高度なリスクマネジメントが必要とされる.ここでは,透析室におけるリスクマネジメントを,医療事故防止,感染防止,災害対策の三つの視点から述べる.
医療事故防止対策としては,抜針,回路離断,除水ミスなどの頻度の多い事故や重大な事故を中心に,事故分析に基づきマニュアルを作成し,それの遵守を徹底させている.感染防止対策としては,「透析医療における標準的な機械操作と院内感染予防に関するマニュアル」に基づき,スタッフ教育を継続している.災害対策においては,平素の準備・体制確立とともに,定期的な訓練を実施している.
Theme Evaluation of Caring in Dialysis Patients
Title Risk management in a hemodialysis unit
Author Yumi Kichise Department of Nursing, Fukuoka Red Cross Hospital
[ Summary ] As an increasingly debilited, clinically complicated, or elderly population has been treated with dialysis, the current risk management in dialysis units has become highly strategic. This article will focus on 1) prevention of medical errors and associated incidents, 2) infection control, and 3) disaster planning. To prevent medical errors and other incidents, various guidelines have been developed in our unit, based on the analysis of the reported incidents, including accidental removal of a dialysis needle, disconnection of the blood line, inadequate ultrafiltration, and other common adverse events. Staff members are constantly reminded to follow such guidelines. For infection control, those guidelines implemented by the Japanese Ministry of Health, Labor & Welfare are repeatedly utilized for staff education. For disaster planning, drills are conducted, which have proven to be particularly effective in establishing a high degree of preparedness.
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