醫(yī)院病房護(hù)士長手冊(定稿)

1、病 房 護(hù) 士 長 職 責(zé)1、在護(hù)理部、科護(hù)士長的領(lǐng)導(dǎo)和科主任的業(yè)務(wù)指導(dǎo)下，根據(jù)護(hù)理部及科內(nèi)工作計(jì)劃，制訂本病房具體計(jì)劃，并組織實(shí)施，定期總結(jié)匯報(bào)。2、負(fù)責(zé)本病房護(hù)理人員及環(huán)境、物品、藥品的管理。3、負(fù)責(zé)對本病區(qū)護(hù)理人員的執(zhí)業(yè)指導(dǎo)，教育護(hù)理人員加強(qiáng)責(zé)任心、改善服務(wù)態(tài)度，遵守勞動紀(jì)律，密切醫(yī)護(hù)配合。4、根據(jù)病人的需要和護(hù)理人員的情況合理安排護(hù)士的工作。組織、指導(dǎo)并參與危重病人的搶救及護(hù)理工作。5、督促、檢查護(hù)理人員嚴(yán)格執(zhí)行各項(xiàng)規(guī)章制度和技術(shù)操作規(guī)程，確保護(hù)理安全和護(hù)理質(zhì)量。6、參加科主任查房、科內(nèi)會診、大手術(shù)或新開展手術(shù)、疑難病例、死亡病例的討論。7、檢查、指導(dǎo)護(hù)士正確運(yùn)用護(hù)理程序和開展健康教育

2、。8、組織本病房護(hù)理查房和護(hù)理會診、業(yè)務(wù)學(xué)習(xí)及技術(shù)訓(xùn)練，定期對護(hù)士進(jìn)行考試、考核，完成護(hù)理人員培訓(xùn)計(jì)劃。9、加強(qiáng)護(hù)理質(zhì)量管理，按照護(hù)理質(zhì)量標(biāo)準(zhǔn)督促、檢查和評估護(hù)理工作，重點(diǎn)評價(jià)對病人的護(hù)理效果。10、對護(hù)理人員發(fā)生的差錯(cuò)、事故及時(shí)上報(bào)，并組織本病房護(hù)理人員對差錯(cuò)、事故進(jìn)行分析和總結(jié)，制定并落實(shí)預(yù)防措施。11、根據(jù)教學(xué)計(jì)劃，管理和指導(dǎo)帶教人員及實(shí)習(xí)、進(jìn)修護(hù)理人員，完成臨床教學(xué)任務(wù)。12、組織擬定本病房護(hù)理科研計(jì)劃，積極開展新業(yè)務(wù)、新技術(shù)及護(hù)理科研工作。13、創(chuàng)造良好休養(yǎng)環(huán)境，督促做好衛(wèi)生和消毒隔離工作，定期召開工休座談會，征求意見，改進(jìn)護(hù)理服務(wù)。14、密切與各科室、各部門的聯(lián)系，加強(qiáng)溝通、協(xié)調(diào)和

3、配合。病區(qū)副護(hù)士長協(xié)助護(hù)士長負(fù)責(zé)相應(yīng)的工作。1、護(hù)理人員花名冊姓名出生年月參加工作時(shí)間進(jìn)入本科時(shí)間何時(shí)何校畢業(yè)學(xué)歷職稱晉升時(shí)間注冊情況聯(lián)系電話備注2、護(hù)理人員花名冊姓名出生年月參加工作時(shí)間進(jìn)入本科時(shí)間何時(shí)何校畢業(yè)學(xué)歷職稱晉升時(shí)間注冊情況聯(lián)系電話備注3、病區(qū)護(hù)理人員結(jié)構(gòu)（上半年）年 齡學(xué) 歷職 稱50歲以上4049歲3039歲29歲以下碩士本科大專中專副高中級初級未注冊人數(shù)比例病區(qū)護(hù)理人員結(jié)構(gòu)（下半年）年 齡學(xué) 歷職 稱50歲以上4049歲3039歲29歲以下碩士本科大專中專副高中級初級未注冊人數(shù)比例4、病區(qū)床位與護(hù)理人員比例（上半年）病區(qū)固定床位數(shù)（張）病區(qū)實(shí)際床位數(shù)（張）病區(qū)護(hù)士人數(shù)（人）實(shí)

4、際病床數(shù)：護(hù)士人數(shù)按國家規(guī)范(1：0.4)尚缺護(hù)士人數(shù)病區(qū)床位與護(hù)理人員比例（下半年）病區(qū)固定床位數(shù)（張）病區(qū)實(shí)際床位數(shù)（張）病區(qū)護(hù)士人數(shù)（人）實(shí)際病床數(shù)：護(hù)士人數(shù)按國家規(guī)范(1：0.4)尚缺護(hù)士人數(shù)5、護(hù)士考勤記錄（休假天數(shù)） 月姓 名123456789101112備注（病假、事假等說明）：6、年工作計(jì)劃要點(diǎn)內(nèi)容含護(hù)理質(zhì)控、培訓(xùn)、科研、教學(xué)等7、科室護(hù)理人員“西學(xué)中”培訓(xùn)計(jì)劃要點(diǎn)內(nèi)容含中醫(yī)理論、中醫(yī)操作、疾病護(hù)理常規(guī)、辯證施護(hù)等內(nèi)容。8、第一季度科室工作計(jì)劃和重點(diǎn)重 點(diǎn) 內(nèi) 容調(diào) 整 計(jì) 劃9、每月工作計(jì)劃和重點(diǎn)月份重 點(diǎn) 內(nèi) 容完 成 情 況一月二月三月月份重 點(diǎn) 內(nèi) 容完 成 情 況四月

5、五月六月月份重 點(diǎn) 內(nèi) 容完 成 情 況七月八月九月月份重 點(diǎn) 內(nèi) 容完 成 情 況十月十一月十二 月10、參加業(yè)務(wù)或行政查房記錄(一月)日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 11、一月工作小結(jié)內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因12、護(hù)理部會議記錄（一月）13、參加業(yè)務(wù)或行政查房記錄 (二月)日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 14、二月工作小結(jié)內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因15、護(hù)理部會議記錄（二月）16、參加業(yè)務(wù)或行政查房記錄

6、 （三月） 日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 17、三月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因18、護(hù)理部會議記錄(三月）19、第二季度工作計(jì)劃和重點(diǎn) 重 點(diǎn) 內(nèi) 容調(diào) 整 計(jì) 劃20、參加業(yè)務(wù)或行政查房記錄 (（四月） 日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 21、四月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因22、護(hù)理部會議記錄（四月）23、參加業(yè)務(wù)或行政查房記錄 （五月） 日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科

7、主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 24、五月工作小結(jié)內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因25、護(hù)理部會議記錄（五月）26、參加業(yè)務(wù)或行政查房記錄 （六月） 日期查房主任姓名內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 30、六月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因31、護(hù)理部會議記錄（六月）+32、 年上半年護(hù)理工作總結(jié)1.數(shù)據(jù)統(tǒng)計(jì)：在職培訓(xùn)：外出參加學(xué)術(shù)會議：省級 人次，接收進(jìn)修生 人次，實(shí)習(xí)生 人次。?？茖W(xué)習(xí)：護(hù)理業(yè)務(wù)學(xué)習(xí) 次(小講課 次、專題研討 次)、護(hù)理查房 次、開展新業(yè)務(wù)新技術(shù)

8、項(xiàng)。一般差錯(cuò) 起，嚴(yán)重差錯(cuò) 起。2.文字總結(jié) ：33、第三季度工作計(jì)劃和重點(diǎn)重 點(diǎn) 內(nèi) 容調(diào) 整 計(jì) 劃34、參加主任業(yè)務(wù)或行政查房記錄 （七月） 日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 35、七月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因36、護(hù)理部會議記錄（七月）37、參加主任業(yè)務(wù)或行政查房記錄 （八月） 日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 38、八月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因39、護(hù)理部會議記錄（八月）40、參

9、加主任業(yè)務(wù)或行政查房記錄 （九月） 日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 41、九月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因42、護(hù)理部會議記錄（九月）43、第四季度工作計(jì)劃目標(biāo)和重點(diǎn) 重 點(diǎn) 內(nèi) 容調(diào) 整 計(jì) 劃44、參加主任業(yè)務(wù)或行政查房記錄 （十月）日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 45、十月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因46、護(hù)理部會議記錄（十月）47、參加主任業(yè)務(wù)或行政查房記錄 （十一月） 日期項(xiàng) 目內(nèi)

10、容+指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 48、十一月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因49、護(hù)理部會議記錄（十一月）50、參加主任業(yè)務(wù)或行政查房記錄 （十二月） 日期項(xiàng) 目內(nèi) 容指標(biāo)要求：護(hù)士長每周或每月參加科主任業(yè)務(wù)查房、護(hù)理質(zhì)量檢查記錄。 51、十二月工作小結(jié) 內(nèi)容：月計(jì)劃、臨時(shí)性工作完成情況，存在問題及整改設(shè)想，未完成計(jì)劃及原因52、護(hù)理部會議記錄（十二月）54、臨時(shí)性工作任務(wù)調(diào)配記錄（護(hù)理人員動態(tài)記錄）起止時(shí)間下達(dá)任務(wù)部門任務(wù)內(nèi)容參加人數(shù)參加人員姓名臨時(shí)調(diào)配完成情況備 注何病區(qū)借入借去何病區(qū)55、 好 人 好

11、事 登 記 日期事 件 內(nèi) 容姓 名備 注56、科室護(hù)理人員考核成績登記（理論考試）日期姓名考核項(xiàng)目成績備注57、 科室護(hù)理人員考核成績登記（操作考核）日期姓名考核項(xiàng)目成績備注58、滿意度調(diào)查統(tǒng)計(jì)表 （科室： ）月份發(fā)放份數(shù)滿意份數(shù)滿意度（%）反饋問題合計(jì)59、每周晨會提問記錄日期提問內(nèi)容回答人得分備注日期提問內(nèi)容回答人得分備注60、年度工作總結(jié)1.數(shù)據(jù)統(tǒng)計(jì)：在職培訓(xùn)：外出參加學(xué)術(shù)會議：省級 人次，接收進(jìn)修生 人次，實(shí)習(xí)生 人次。?？茖W(xué)習(xí)：護(hù)理業(yè)務(wù)學(xué)習(xí) 次(小講課 次、專題研討 次)、護(hù)理查房 次、開展新業(yè)務(wù)新技術(shù) 項(xiàng)。一般差錯(cuò) 起，嚴(yán)重差錯(cuò) 起。2.文字總結(jié)：請刪除以下內(nèi)容，o(_)o謝謝！

12、the origin of taxation in the united states can be traced to the time when the colonists were heavily taxed by great britain on everything from tea to legal and business documents that were required by the stamp tax. the colonists' disdain for this taxation without representation (so-called beca

13、use the colonies had no voice in the establishment of the taxes) gave rise to revolts such as the boston tea party. however, even after the revolutionary war and the adoption of the u.s. constitution, the main source of revenue for the newly created states was money received from customs and excise

14、taxes on items such as carriages, sugar, whiskey, and snuff. income tax first appeared in the united states in 1862, during the civil war. at that time only about one percent of the population was required to pay the tax. a flat-rate income tax was imposed in 1867. the income tax was repealed in its

15、 entirety in 1872. income tax was a rallying point for the populist party in 1892, and had enough support two years later that congress passed the income tax act of 1894. the tax at that time was two percent on individual incomes in excess of $4,000, which meant that it reached only the wealthiest m

16、embers of the population. the supreme court struck down the tax, holding that it violated the constitutional requirement that direct taxes be apportioned among the states by population (pollock v. farmers' loan & trust, 158 u.s. 601, 15 s. ct. 912, 39 l. ed. 1108 1895). after many years of d

17、ebate and compromise, the sixteenth amendment to the constitution was ratified in 1913, providing congress with the power to lay and collect taxes on income without apportionment among the states. the objectives of the income tax were the equitable distribution of the tax burden and the raising of r

18、evenue. since 1913 the u.s. income tax system has become very complex. in 1913 the income tax laws were contained in eighteen pages of legislation; the explanation of the tax reform act of 1986 was more than thirteen hundred pages long (pub. l. 99-514, oct. 22, 1986, 100 stat. 2085). commerce cleari

19、ng house, a publisher of tax information, released a version of the internal revenue code in the early 1990s that was four times thicker than its version in 1953. changes to the tax laws often reflect the times. the flat tax of 1913 was later replaced with a graduated tax. after the united states en

20、tered world war i, the war revenue act of 1917 imposed a maximum tax rate for individuals of 67 percent, compared with a rate of 13 percent in 1916. in 1924 secretary of the treasury andrew w. mellon, speaking to congress about the high level of taxation, stated, the present system is a failure. it

21、was an emergency measure, adopted under the pressure of war necessity and not to be counted upon as a permanent part of our revenue structure. the high rates put pressure on taxpayers to reduce their taxable income, tend to destroy individual initiative and enterprise, and seriously impede the devel

22、opment of productive business. ways will always be found to avoid taxes so destructive in their nature, and the only way to save the situation is to put the taxes on a reasonable basis that will permit business to go on and industry to develop. consequently, the revenue act of 1924 reduced the maxim

23、um individual tax rate to 43 percent (revenue acts, june 2, 1924, ch. 234, 43 stat. 253). in 1926 the rate was further reduced to 25 percent. the revenue act of 1932 was the first tax law passed during the great depression (revenue acts, june 6, 1932, ch. 209, 47 stat. 169). it increased the individ

24、ual maximum rate from 25 to 63 percent, and reduced personal exemptions from $1,500 to $1,000 for single persons, and from $3,500 to $2,500 for married couples. the national industrial recovery act of 1933 (nira), part of president franklin d. roosevelt's new deal, imposed a five percent excise

25、tax on dividend receipts, imposed a capital stock tax and an excess profits tax, and suspended all deductions for losses (june 16, 1933, ch. 90, 48 stat. 195). the repeal in 1933 of the eighteenth amendment, which had prohibited the manufacture and sale of alcohol, brought in an estimated $90 millio

26、n in new liquor taxes in 1934. the social security act of 1935 provided for a wage tax, half to be paid by the employee and half by the employer, to establish a federal retirement fund (old age pension act, aug. 14, 1935, ch. 531, 49 stat. 620). the wealth tax act, also known as the revenue act of 1

27、935, increased the maximum tax rate to 79 percent, the revenue acts of 1940 and 1941 increased it to 81 percent, the revenue act of 1942 raised it to 88 percent, and the individual income tax act of 1944 raised the individual maximum rate to 94 percent. the post-world war ii revenue act of 1945 redu

28、ced the individual maximum tax from 94 percent to 91 percent. the revenue act of 1950, during the korean war, reduced it to 84.4 percent, but it was raised the next year to 92 percent (revenue act of 1950, sept. 23, 1950, ch. 994, stat. 906). it remained at this level until 1964, when it was reduced

29、 to 70 percent. the revenue act of 1954 revised the internal revenue code of 1939, making major changes that were beneficial to the taxpayer, including providing for child care deductions (later changed to credits), an increase in the charitable contribution limit, a tax credit against taxable retir

30、ement income, employee deductions for business expenses, and liberalized depreciation deductions. from 1954 to 1962, the internal revenue code was amended by 183 separate acts. in 1974 the employee retirement income security act (erisa) created protections for employees whose employers promised spec

31、ified pensions or other retirement contributions (pub. l. no. 93-406, sept. 2, 1974, 88 stat. 829). erisa required that to be tax deductible, the employer's plan contribution must meet certain minimum standards as to employee participation and vesting and employer funding. erisa also approved th

32、e use of individual retirement accounts (iras) to encourage tax-deferred retirement savings by individuals. the economic recovery tax act of 1981 (erta) provided the largest tax cut up to that time, reducing the maximum individual rate from 70 percent to 50 percent (pub. l. no. 97-34, aug. 13, 1981,

33、 95 stat. 172). the most sweeping tax changes since world war ii were enacted in the tax reform act of 1986. this bill was signed into law by president ronald reagan and was designed to equalize the tax treatment of various assets, eliminate tax shelters, and lower marginal rates. conservatives want

34、ed the act to provide a single, low tax rate that could be applied to everyone. although this single, flat rate was not included in the final bill, tax rates were reduced to 15 percent on the first $17,850 of income for singles and $29,750 for married couples, and set at 28 to 33 percent on remainin

35、g income. many deductions were repealed, such as a deduction available to two-income married couples that had been used to avoid the "marriage penalty" (a greater tax liability incurred when two persons filed their income tax return as a married couple rather than as individuals). although

36、 the personal exemption exclusion was increased, an exemption for elderly and blind persons who itemize deductions was repealed. in addition, a special capital gains rate was repealed, as was an investment tax credit that had been introduced in 1962 by president john f. kennedy. the omnibus budget r

37、econciliation act of 1993, the first budget and tax act enacted during the clinton administration, was vigorously debated, and passed with only the minimum number of necessary votes. this law provided for income tax rates of 15, 28, 31, 36, and 39.6 percent on varying levels of income and for the ta

38、xation of social security income if the taxpayer receives other income over a certain level. in 2001 congress enacted a major income tax cut at the urging of president george w. bush. over the course of 11 years the law reduces marginal income tax rates across all levels of income. the 36 percent ra

39、te will be lowered to 33 percent, the 31 percent rate to 28 percent, the 28 percent rate to 25 percent. in addition, a new bottom 10 percent rate was created. since the early 1980s, a flat-rate tax system rather than the graduated bracketed method has been proposed. (the graduated bracketed method is the one that has been used since graduated taxes were introduced: the percen