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手术室护理实践指南(2023年版)
$42.96
本指南既对手术室护士的日常工作和具体操作行为具有指导作用,也对手术室管理者加强科室管理及相关的教育培训具有重要参考价值。指南编写内容主要依据国家卫生健康委员会的标准和规范,参考国际相关标准,并结合手术室专科护理近年来出现的新技术、新方法和实践经验。
《手术室护理实践指南》在编写内容上主要依据国家卫生健康委员会的标准和规范,参考国际相关标准,并结合手术室专科护理近年来出现的新技术、新方法和实践经验,是手术室专科护理指导用书。《手术室护理实践指南》共分为九篇,增加了疑似或确诊新型冠状病毒肺炎手术室感染防控技术规范(含防护服穿脱视频)、手术无菌物品管理、手术室感染防控监测、职业暴露与防护、手术室核心制度共五部分内容,并对第二篇的手术体位等相关内容进行了修订。其中,每篇内容均包含概述,即对本指南涉及的内容及范围进行说明;术语用于对本指南的理解;专业内容分别介绍无菌技术、手术体位、电外科安全、手术隔离技术、患者安全管理、仪器设备管理、手术物品清点、感染控制管理、手术室人员管理等相关操作的原则、方法与注意事项;规范性引用文件依次列举所参考的标准与规范。同时,增加了主编说、无菌技术操作及手术体位摆放等数字内容。使读者更直观、全面、透彻的了解和学习此书。
郭莉,中华护理学会日间手术护理专业委员会主任委员,中华护理学会学术委员会委员,中国日间手术联盟副主席;亚洲围手术期护理学会ASIORNA副主席,中华护理杂志编委,中华医院感染杂志编委,中华现代护理杂志编委,中国护理管理杂志审稿专家。中华医学会医疗鉴定专家。北京医学会“医疗技术准入”评价专家库成员,北京市护理工作协会《护理专家库》专家,北京市海淀区医学会医疗事故技术鉴定专家。
第一篇技术篇第一章无菌技术/11概述/22术语/23外科手消毒/104穿无菌手术衣/145无接触式戴无菌手套/166铺置无菌器械台/197手术器械、敷料传递/208手术区皮肤消毒/249手术铺单/3310手术无菌物品管理/35第二章手术体位/391概述/402术语/403手术体位安置原则/424仰卧位/435侧卧位/486俯卧位/537截石位/568膝胸卧位/57第三章电外科安全/591概述/602术语/603单极电刀/634双极电凝/675体内植入物患者的电外科设备安全使用/696超声刀/717能量平台/73第四章手术隔离技术/751概述/762术语/763手术隔离技术/804常见隔离手术/825恶性肿瘤手术/836妇科手术/857空腔脏器手术/878创伤手术/879同期手术/8810移植手术/8911内镜下肿瘤手术/90第五章手术物品清点/931概述/942术语/943物品清点要求和原则/964注意事项/975手术敷料清点/986清点意外情况的处理/997手术器械、手术敷料、手术用一次性低值耗材命名/99第二篇管理篇第六章手术室管理/1011概述/1022术语/1023负压手术室管理/1054手术室信息化管理/1085复合手术室安全管理/114第七章手术室人员管理/1191概述/1202术语/1203巡回护士职责/1204洗手护士职责/1235手术室核心制度/1256手术室护士分层培训规范/129第八章感染控制管理/1451概述/1462术语/1463手术人员着装/1574手术室环境表面清洁与消毒/1595低温灭菌技术/1646手术室废物的管理/1677手术室感染防控监测/1718职业暴露与防护/1789手术烟雾的预防与控制/183第九章患者安全管理/1891概述/1902术语/1903术中低体温预防/2024手术患者转运交接/2055术中输血护理操作/2066手术标本管理/2117手术室火灾应急预案/2148围手术期下肢深静脉血栓预防的术中护理/2199手术患者十大安全目标/22310手术室质量控制指标/23011手术患者意外伤害预防/23812手术室药品管理/24313手术医用耗材管理/24614术中获得性压力性损伤预防/249第十章仪器设备管理/2551概述/2562术语/2563充气式加温仪/2624外来手术器械管理/2645间歇式充气压力装置/2666气压止血仪/2697手术无影灯/2728手术床/2759除颤仪/27710医用激光设备/28311手术显微镜/285附录/289附录1医务人员洗手方法/290附录2Caprini血栓风险因素评估表/292附录3CORN术中获得性压力性损伤风险评估量表/294附录4CORN术中获得性压力性损伤风险评估量表评定细则/296附录5手术体位皮肤及皮下组织受压部位一览表/299附录6常用手术器械命名/300附录7常用手术敷料命名/306附录8常用手术用一次性低值耗材命名/307附录9常见传染病传染源、传播途径及隔离预防/311规范性引用文件/313
护理工作是医疗卫生工作的重要组成部分,在推进健康中国建设、深化医药卫生体制改革、改善人民群众就医体验及促进社会和谐方面发挥着重大作用。为全面贯彻落实党的二十大精神,激励广大护士心向党、跟党走,深入实施健康中国战略,进一步改善护理服务,要求我们需要不断提升手术室护理服务质量,以增强群众健康获得感。中华护理学会手术室护理专业委员会紧密围绕中华护理学会理事会提出的“凝心聚力、再攀高峰”的工作精神,秉承“以学术为本、搭建平台、辐射全国、走向世界、有所作为”的指导思想,2013 年8 月在中华护理学会领导的支持下及中华护理学会学术部的组织下,启动了编写《手术室护理实践指南》(以下简称指南)一书的学术项目工作,由手术室护理专业委员会负责组织编写,并开展学术推广活动。中华护理学会手术室护理专业委员会组织了全国31 个省、自治区、直辖市的手术室护理专家针对“手术室护理实践指南”的规范性进行研究、讨论,全国手术室护理同仁进行大量调研,汇总了包括手术室无菌技术、手术体位、电外科安全、手术隔离技术、感染控制管理、仪器设备管理等迫切需要规范、统一的手术室护理操作内容。最终,经过手术室护理专业委员会专家们的讨论,决定将全部内容分批次完成。希望通过《手术室护理实践指南》的编写,可以及时为全国手术室护理工作提供参考10意见,为患者提供周到、科学、严谨的术中护理。同时,完善手术室专科护士培训相关教材,加强手术室护理队伍的建设。本指南既对手术室护士的日常工作和具体操作行为具有指导作用,也对手术室管理者加强科室管理及相关的教育培训具有重要参考价值。指南编写内容主要依据国家卫生健康委员会的标准和规范,参考国际相关标准,并结合手术室专科护理近年来出现的新技术、新方法和实践经验。随着我国2023 年1 月起对新型冠状病毒感染实施“乙类乙管”,2023 年版指南将新型冠状病毒感染相关防控技术规范删除,同时,将全书内容整合成技术篇和管理篇,其中技术篇包括无菌技术、手术体位、电外科安全、手术隔离技术、手术物品清点相关操作的原则、方法与注意事项,管理篇包括手术室管理、手术室人员管理、感染控制管理、患者安全管理、仪器设备管理相关内容。对部分内容进行完善如气压止血带改为气压止血仪等。文末依然附有规范性引用文件,以二维码的形式呈现。本指南编写工作由医疗领域的多专业专家共同参与完成。编写组进行广泛地调查研究,认真总结实践经验,积极采纳科研成果,参照有关国际标准和国内外技术标准,并在广泛征求意见的基础上,通过反复讨论、修改和完善,最后经审查定稿。在编写过程中,我们征求了手术室护理专业委员会全体委员、感染控制专家及神经外科、麻醉科、骨科、妇科、血管外科、肿瘤科、输血科、保卫科等临床医学专家、护理专家及消防专家的建议与意见,得到了中华护理学会领导及同仁们的积极支持与帮助。特别感谢中国人民解放军总医院刘景汉教授对指南撰写给予的精心指导与帮助。在此谨代表编委会全体成员一并表示最衷心的感谢。“其作始也简,其将毕也必巨。”2023 年版指南内容上根据医疗、护理技术的不断创新,已进行了修订与完善。今后我们将做到不断循证,每年更新、完善内容,促进我国手术室护理向着同质化方向发展,这是任重而道远的。全国手术室护理同仁们,让我们一起为推动我国手术室护理事业的高质量发展而不懈努力!本书在编写内容上难免会出现疏漏与欠缺,希望广大读者批评指正,我们会不断完善提高。郭 莉2023 年8 月
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