The WeChat platform recently invited Mr. Ma Jing, a lawyer who had been engaged in nursing work and understanding the Fa to open a "nursing and law" column to answer questions for clinical nurses.Nurse friends can also pay attention to the micro -signal of "Mr. Ma’s Calligraphy Law" and communicate with Teacher Ma.
Clinical case
In a hospital operating room, a patient was fixed in the left forearm fracture.After the radiation technician placed the position and the filmmaker, the surgeon, anesthesiologist, and patrol nurse quit the surgery room.After leaving the room, the radiolic technician who exited the room at the same time to exit the room to get the remote control. After retreating to the safe area, he pressed the film key.At this point, the instrument nurse hurriedly ran out of the surgery.It is understood that the instrument nurse has been pregnant for 50 days and is worried that the fetus will suffer from radiation. The nurse is under pressure and temporarily rests at home.
The department reported to bad events, and the hospital involved in the investigation.After the incident, the surveillance video of the operating room was taken, and the situation was found that the situation was as follows: Before the postoperative patient was radiation, the staff of the surgery room withdrew, and a person in the surgery asked the surgical material.Delay exit.
question
1. In the bad incident, which hospital management issues are exposed, and how should the hospital avoid the occurrence of such bad events?
2. If the instrument nurse is damaged by the health of his or fetal health due to the non -protective radiation irradiation, who should bear the responsibility, is it a patrol nurse who holds a remote control or a radiation technician?
case analysis
1. Cooperations that do not sacrifice safety at the cost of sacrificing safety should not be denied
In this case, the patrol nurse helped the radiation technician holding the remote control of the remote control how to qualitatively press the film key, and there are different sounds inside the hospital.Some hospital managers believe that the nurse is over -the -scale practice.I don’t agree with the opinion.According to the law, over -the -scale practice refers to engaging in medical, prevention, and health care business beyond the practice category and the scope of practice.In this incident, the radiological technician is not an active physician. The film behavior is different from the reading behavior. Its practice behavior is also different from the practicing behavior of a practicing physician.The strict prohibition of the law for over -range practice is because of the high degree of professionalism and risk of the practice behavior itself, and the behavior of pressing the remote control nurse is not highly professional and risk.Hyper -range practice.
The reason why the adverse incident failed was not who pressed the remote control, but whether the personnel were verified before whether the remote control was pressed.The radio technicians who enter the operating room for radiation film operation have a higher understanding of radioactive hazards in professionalism. They have the obligation to prevent the operating staff from suffering from radiation hazards. Of course, according to the "land management principle"The responsibilities of environmental safety management cannot be completely exempted.
In clinical work, as a group of cooperation, medical staff is very common in coordination and cooperation with "helping each other".Whether matters are engaged in certain types of irreplaceable personnel categories are not helping; no, you can help.Just like this incident, I don’t think that the patrol nurse helped the radiation technicians get the remote control and press the shooting key. If this kind of thing is also deducted from the hat, how can I talk about medical skills cooperation.
2. Evaluation of radioactive damage due to this incident
Because I am not a radiation professionals, I consulted relevant experts for the safety of pregnant women who are most concerned about in this incident.First of all, due to the critical period of embryonicization and formation of various organs in the early stages of pregnancy, the unsafe factors of any internal and external environment may cause abnormalities or abortion of embryo.Internal causes mainly refer to the health of the pregnant woman themselves, such as genetic diseases, and the external causes are very wide, such as taking teratogenic drugs, virus infections, and ionizing radiation.However, attaching importance to the safety of pregnancy does not mean that the embryo itself has no resistance itself, and a trace of wind blows the grass.In this case, although pregnant women have a short -term radio radiation contact history, the irradiation does not directly illuminate the pregnant woman itself, and the part of the patient’s exposure is the limbs with a smaller irradiation dose.Relatively safe.Therefore, pregnant women are unlikely to cause abnormal fetal development due to this irradiation.
3. Reflection that hospital management should have
This incident is not complicated, and it is not easy to evaluate the negative impact of the incident. However, as a hospital manager, you should think about and try to prevent similar incidents. Hospital safety includes patient safety, but employee safety is also the core of hospital safety.Essence
For surgery, radiological surgery is generally orthopedic surgery. It is recommended that the department make some adjustments on the arrangement of the staff. Female staff during pregnancy can be adjusted to other professional surgery or engaged in equipment and materials management to reduce the risk of radiation damage.
It can be seen through the surveillance video that eventually the instrument nurse did not withdraw from the surgery room. A foreign personnel entering the surgery room.
Finally, if the output defects of pregnant women in the future, the hospital should bear the liability for infringement compensation when it is not excluded from this irradiation.Because the radioactive damage suffered by pregnant women occurs after the end of its work nurse, and it has nothing to do with their own work, it should not belong to the category of work injury.
The case is true. To protect the privacy of the parties, the relevant information has gone.
This article only represents the author’s personal opinions. If you have different views, please leave a message to discuss.
About the Author
"Teacher Ma Calls Medical Law" WeChat subscription number founder Ma Jing is a hospital managers who have long -term work in the front line of doctoral disputes. The work experience includes clinical care, nursing management, medical safety management, and nursing college teachers and lawyers.There is both practical experience and theoretical level for hospital safety management.Pushing articles include typical case analysis, core system of medical care safety, and interpretation of hospital management related laws and regulations.
