已完成8.手术安全核查制度

通过实施手术安全核查确保正确的正确的部位和正确的手（操作。Tocarryoutcheckforsurgicalsafetyensurethecorrect-patient,correct-siteandcorrect-operation(procedure).定义DefinitionofsurgicalTofindoutortreathumandiseasesorfunctionaldisturbancesbywayofdiagnosticortherapeuticresection,repairandimntation,including:中心手术室、门诊手术室、产房、整形外科手术室及Operationsperformedincentraloperationtheatre,outpatientoperationroom,deliveryroom,operationroomsofsticsurgeryandfamilynning,whichcanbedividedintotwotypes:withorwithoutparticipationofanesthetist.手术室外的有创操作，包括在DSA进行的介入手术、消化内镜检查治疗、支气管镜检查治疗、B超/CT引导下的穿刺、口腔拔Invasiveoperationsperformedoutsideoperationtheatre, treatmentwithdigestiveendoscopesandbronchoscope,punctureguidedbyultrasonicB/CT,extractionoftooth,eximerlaser,fundusphotocoagulation,skinlaser,thoracentesis,peritoneocentesis,lumbarpuncture,bonemarrowaspiration,tracheotomyandmuscularbiopsyDefinitionofcheckofsurgicalCheckofsurgicalsafetyreferstotheprocessoforderlyconfirmationasper“Checklistofsurgicalsafety”byanesthetist(exceptoperationusinglocalanesthesia),surgicaldoctorandnurse(includingpatientifnecessary)beforecarryingoutanesthesia,beforeoperationandbeforepatientleavingoperationtheatre.Time-outDefinitionoftime-Time-out是指在患者切皮前或操作前麻醉师手术医师护士等所有手术人员共同进行的术前确认程序。Time-outmeansapreoperativeconfirmationprocedurecarriedoutjointlybytheanesthetist,surgicaldoctorandnursebeforecuttingtheskinofpatientorbeforeoperationGeneralSafetycheckshallbeperformedbeforestartingvarioussurgicaloperationsandinvasiveprocedures.Time-outSurgicalsafetycheckincludesmarksatoperationsite,preoperativecheckprocedureandpreoperativesuspensiontime- 具有执业资质的手术医师、麻醉医师和手术室护士（以下简称三方者和手术部位等内容进行核查Thequalifiedsurgicaldoctor,anesthetistandnursesinoperationroom(hereafterreferredtoasthreeparties)shalljointlycheckidentityofthepatientandoperationsitebeforecarryingoutanesthesia,startingoperationandbeforepatientleavingtheoperatingtheatre.Beforestartofinvasiveprocedures,thesurgeon,(excludingoperationwithlocalanesthesia)andnurseshallstoptheirwork,concentratetheirmindtochecktherequireditems,jointlyconfirmrightpatient,rightoperationn,rightoperationsite,rightpostureofthepatientandinrightoperationtheatre,allrequiredmedicalavailable,readyandfunctionalmedicalequipment.MarkatoperationWhenoperationinvolvingbothsides,multi-structures(finger,toeandlesions)ormulti-nes(spine),surgicalmarksshallbemadeonoperationsideorarea. 医用记号笔画“〇”进行标记，否则手术室可以接收。Beforethesurgicalpatientisbroughtintooperationroomorinvasiveprocedurestarts,thesurgeonshallmark“〇”atoperationsitewithmedicalmarkpen,otherwisetheoperationroomcanrefusetoacceptthepatient.Wheretheoperationsiteisdifficulttomarksuchasonfaceorinsidethebodyforendoscopy,markasignonoperationsite手术部位标识应一目了然，确保在为患者铺巾后仍清晰可见。Markofoperationsiteshallbeclearataglance,ensurethatitisstillclearandvisibleaftersterilizationandlayingoftowel.Ifpossible,markasignwhenthepatientisconscious.ThepatientorfamilymemberisrequiredtotakepartinPreoperativecheck5.1术前核查Preoperativecheckin5.1.1术前核查在手术前，术前讨论完成并开出手术通知单后进Preoperativecheckinwardshallbecarriedoutafterpreoperativediscussionisfinishedandsurgicalnoticeiswritten.5.1.2术前核查由主刀医生或其指定的主诊组成员（必须参与手术）进行。核查内容包括的、诊断和拟进行的手术，并确认已经获得该的Preoperativecheckinwardshallbeperformedbytheattendingsurgeonortheappointedmember(participantoperation)ofthetreatmentteam.Checkidentityofpatient,diagnosisandnnedoperation,confirmavailablecasehistory,relatedlabtestresults,pathologicalandimagingdata,consentetc.6与手术室交接确Handoverbetweenwardandoperationand详见《转运交接制度Referto“Systemofpatienttransferandhandover”forContentsandprocessofsafetycheckinoperation（、、、住院号、手术方式、知情同意情况、手术Beforeanesthesis:theanesthetistisinchargeofthecheck(localanesthesiaisperformedbythesurgeonhimself).Thethreepartiesandthepatientshallcheckitemsasper“Checklistofsurgicalsafety”toconfirmidentityofthepatient(name,,ageandadmissionnumber),methodofoperation,consent,surgicalpositionandmark,anesthesiasafety,skinintact,preoperativeskinpreparation,venouspathwayestablishment,allergichistory,skintestresultsofantibiotics,preoperativebloodreserve,falsetooth,imntsandimagingdata.医生读出手术、、、住院号、病区床号、手术名称、不能用“默认、点头或摇头、势等方式代替。未进行术前确认程序，不得进行手术，所有参加手术人员有权进行手术。核对结束后Time-outprocedure:Thesurgicaldoctorshallbeinchargeofit.Heshallreadname, ,age,admissionnumberandwardnumberofthepatient,nameoftheoperation,surgicalsite,postureofthepatient,specialinstrumentsnnedtouse,imntorfalsetooth.Theanesthetistandthenursesinoperationroomshallconfirmthereadinginformationbysaying“yes”.Anydoubtaboutanyinformationbyanybodyshallberaisedatonceonthespot,andallparticipantsshallcheck confirmationshalladoptoralway,includingconfirmationandquestioning,whichcannotberecedbytacitapproval,noddingorshakingone’sheadandmakinggesture.Operationshallnotstartuntilpreoperativeprocedureiscarriedout.Ifnot,allparticipantshavetherighttorefusetheoperation.Theanesthetistshallrecordin“Checklistofsurgicalsafety”afterthecheckisover.，患者离开手术室前：由手术室护士主持并记录共同核查患者，（、、、住院号、实际手术方式，术中用药、输血的核Beforethepatientleavingtheoperationroom:Thenurseshallbeinchargeofthecheck.Threepartiesshalljointlycheckidentityofthepatient(name,,age,admissionnumber),actualmethodofoperation,medicationandbloodtransfusioninoperation,countsurgicalobjects,confirmsurgicalsample,checkskinintegrity,arterialandvenouspathwayanddrainagetube,confirmwheretogo.手术后分别在《手术安全核查表》上签名Threepartiesshallsigntheirnameson“Checklistofsurgical Surgicalsafetycheckshallbecarriedoutasperabovesteps,nextstepcanstartonlyafterthepreviousstepisconfirmed.“Surgicalsafetychecklist”shallnotbefilledinPreoperativeconfirmationprocedurecannotberecedbythecheckconductedbyanesthetistandnursealone.Relatedmedicalstaffshallchecktheitemswithintherangeoftheirdutyasperregulationsindependently. Checkofmedicationduringoperation:Thesurgicaldoctororanesthetistprescribesorderbasedonneedandthecarryingouttheordershallrecordit,thesurgicalnurseoranesthetistshallcheckit. Checkofbloodtransfusionduringoperation:Thesurgicaldoctororanesthetistprescribesorderbasedonneedandthecarryingouttheordershallrecordit,thesurgicalnurseandanesthetistshalljointlycheck患者《手术安全核查表》应归入中保存“Surgicalsafetychecklist”shallbeputintothecase门诊手术室、产房、整形外科、手术室及DSA介入手术在术前应由手（操作医师麻醉医师护士对患者门诊号/住院号操作方式、BeforeoperationperformedinoperationroomofOPD,deliveryroom,sticsurgery,familynningroomandDSAstarts,thesurgicaldoctor(operator),anesthetistandnurseshallchecknameandoutpatientnumber/admissionnumberofthepatient,methodandsiteofoperation,preoperativepreparations,fillin“Surgical(invasiveoperation)safetychecklist”andsigntheirnames.Whenanesthetistdoesnottakepart,thesurgicaldoctorandnursecheck消化内镜下检查治疗、支气管镜下检查治疗、B超/CT引导下的穿刺、准分子激光等有创操作，操作前应由操作医生、护士（功能科室医师或）对患《手术（有创操作）Beforesuchinvasiveoperationsasexaminationortreatmentwithdigestiveendoscopeorbronchoscope,punctureguidedbyultrasonicB/CT,quasimolecularlaserstart,