Khoi dong nhanh — Danh sach kiem tra ca nang
| # | Ai | Hanh dong |
|---|---|---|
| 1 | Dieu duong | Phan loai DO → uu tien cao nhat |
| 2 | Bac si | Kham → quyet dinh phau thuat → tao ho so phau thuat |
| 3 | Gay me | Danh gia tien phau → ghi chep gay me → theo doi trong mo |
| 4 | Ngan hang mau | Xac nhan nhom mau → cap phat don vi mau → ghi nhan truyen mau |
| 5 | Ky thuat y sinh | Xuat bo dung cu → tra sau mo → ghi nhan tiet trung |
| 6 | Thu ngan | Tong hop tat ca hang muc → dong ho so thanh toan |
Hanh trinh benh nhan: Thuong binh phan loai DO
4 gio chieu, mot benh nhan chay mau nhieu duoc dua vao tren cang. Dieu duong ngay lap tuc gan muc phan loai DO (Cap cuu).
Khac voi benh nhan gay xuong on dinh trong bai truoc, truong hop nay can phau thuat, can truyen mau va can nhieu vai tro lam viec dong thoi.
Giai doan 1: Phan loai DO
Trong Nurse Station PWA, DO co nghia la "dieu tri ngay hoac co nguy co tu vong."
Sau khi chon DO, benh nhan nay xuat hien o dau hang doi bac si, duoc to do. He thong dam bao benh nhan DO khong bao gio bi day xuong duoi benh nhan VANG hoac XANH.
Giai doan 2: Bac si quyet dinh phau thuat
Sau khi danh gia, bac si Nguyen xac dinh can phau thuat cap cuu. Trong Doctor Station PWA, ong:
- Ghi nhan chan doan va quyet dinh phau thuat
- Tao ho so phau thuat — chon loai thu thuat, nhap ten phau thuat vien
- He thong danh dau trang thai benh nhan la "Dang phau thuat"
Tu thoi diem nay, nhieu vai tro can hanh dong song song.
Giai doan 3: Gay me (Anesthesia Station PWA)
Bac si gay me mo Anesthesia Station PWA va thay truong hop nay can ho tro gay me.
Danh gia tien phau:
- Thong tin benh nhan (tu dong dien)
- Xac nhan di ung
- Phan loai ASA
- Phuong phap gay me du kien
Ghi chep trong mo:
- Thuoc su dung (dinh dang PIO: thuoc/lieu/duong dung)
- Dau hieu sinh ton trong mo (ghi moi 5-15 phut)
- Thoi gian bat dau va ket thuc phau thuat
Giai doan 4: Truyen mau (Blood Bank PWA)
Benh nhan chay mau nhieu va can truyen mau. Ky thuat vien ngan hang mau mo Blood Bank PWA.
Quy trinh truyen mau:
- Kiem tra ton kho — xac nhan don vi mau co san cua nhom mau can thiet
- Cap phat mau — chon don vi cu the va xac nhan cap phat
- Ghi nhan truyen mau — ai cap phat, cho ai, khi nao va tui mau nao
He thong ngan hang mau theo doi toan bo vong doi cua moi don vi mau: tiep nhan → luu tru → cap phat → truyen. Day goi la chuoi giam sat (chain of custody). Tai bat ky thoi diem nao, ban co the truy vet vi tri cua mot tui mau va ai da xu ly no.
O am tinh trong tinh huong khan cap: Neu khong co thoi gian xac nhan nhom mau, mau O am tinh (nguoi cho pho quat) co the duoc cap phat truc tiep. He thong cho phep dieu nay nhung danh dau la "cap phat khan cap" de kiem tra sau.
Giai doan 5: Quan ly dung cu (BioMed PWA)
Phau thuat can bo dung cu. Ky thuat vien y sinh mo Equipment Management PWA:
- Xuat — chon bo dung cu tu kho, ghi nhan phau thuat nao su dung
- Dang su dung — bo dung cu duoc danh dau "dang su dung" trong luc phau thuat
- Tra — sau mo, bo dung cu duoc tra lai
- Tiet trung — ghi nhan hoan tat tiet trung, bo dung cu tro lai trang thai san sang
Bo dung cu phai o trang thai SAN SANG moi co the xuat. Neu hien thi "Dang bao tri" hoac "Dang tiet trung," bo dung cu tam thoi khong kha dung.
Chu trinh nay goi la chu trinh SPD (Supply Processing Distribution). Trong moi truong da chien voi so luong bo dung cu han che, viec theo doi trang thai tung bo la cuc ky quan trong.
Giai doan 6: Thanh toan (Cashdesk PWA)
Sau phau thuat, tat ca cac hang muc dieu tri can duoc tong hop de thanh toan. Cashdesk PWA tap hop toan bo chi phi cho benh nhan nay trong mot giao dien:
- Phi phau thuat
- Phi gay me
- Che pham mau da su dung
- Thuoc da su dung
- Bo dung cu da su dung
Thu ngan khong phai de thu tien benh nhan trong vung tham hoa — ma de ghi nhan muc tieu thu tai nguyen. Du lieu nay phuc vu cho yeu cau bo sung vat tu, bao hiem va quyet toan hanh chinh.
Nhung dieu can biet ve quan ly mau
Che pham mau la loai vat tu y te nhay cam nhat. Cac nguyen tac chinh:
Quan ly han su dung: Blood Bank PWA hien thi ngay het han cua tung don vi. Don vi sap het han duoc canh bao. Don vi het han khong the cap phat.
Xuat truoc, het han truoc: Khi cap phat, uu tien don vi gan het han nhat de giam lang phi.
Bao ve khoang cach hien mau: Neu tram cua ban van hanh Walking Blood Bank (hien mau tai cho), he thong theo doi ngay hien mau cuoi cung cua moi nguoi hien va tu dong chan hien mau lap lai trong vong 56 ngay.
Nhiet do va van chuyen: He thong ghi nhan tinh trang khi tiep nhan, nhung giam sat nhiet do can thiet bi vat ly (nhiet ke tu lanh). He thong co the ghi nhan chi so nhiet do nhung khong the do truc tiep.
Cau hoi thuong gap
Ton kho mau hien thi bang khong? Che pham mau, giong nhu thuoc, phai duoc "nhap kho" truoc khi xuat hien trong ton kho. Vao Blood Bank PWA, chon "Nhap mau" va nhap nhom mau, so luong va ngay het han.
Xuat bo dung cu that bai? Xac minh trang thai cua bo la SAN SANG. Neu hien thi "Dang su dung" hoac "Dang bao tri," can hoan tat quy trinh tra hoac bao tri truoc.
Xem ho so phau thuat o dau? Doctor Station PWA hien thi tat ca ho so phau thuat trong trang chi tiet benh nhan. Vai tro Admin co the xem thong ke phau thuat toan tram tren Bang dieu khien.
Ghi chep gay me co the bo sung sau khong? Co. Trong tinh huong cap cuu, tap trung dieu tri benh nhan. Ghi chep co the hoan tat sau. He thong ghi nhan ca "thoi gian thu thuat thuc te" va "thoi gian nhap" de dam bao kha truy vet.
Co the bo qua thanh toan khong? Co the hoan nhung khong nen bo qua. Du lieu thanh toan la co so cho yeu cau bo sung vat tu. Thieu du lieu nay, ban khong the tinh chinh xac toc do tieu thu tai nguyen cua tram.
Dieu huong loat bai
Day la bai viet thu ba trong loat Huong dan van hanh tram y te xGrid. Toan bo loat bai:
- Ba phut khoi dong — Tu cap nguon den tram y te van hanh day du
- Hanh trinh benh nhan — Tu phan loai den xuat vien
- Phau thuat va truyen mau — Xu ly ca nang (bai nay)
- Y hoc chien truong LSCO — So tay van hanh cho quan y tien tuyen
- Van hanh hang ngay — Kho, ngan hang mau va ban giao ca
Bai nay da bao gom kich ban dieu tri phuc tap nhat trong tram y te. Tiep theo, chung ta roi tram va xem cach quan y tien tuyen su dung he thong LSCO.