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1
Cam nang thc hanhBang kiem an toan phau thuat
Phau thuat an toan cu song ngi benh
World HealthOrganization
Patient SafetyA World Alliance for Safer Health Care
World Health Organization 20 Avenue AppiaCH 1211 Geneva 27 Switzerland Tel: +41 (0) 22 791 50 60
Email: [email protected] visit us at: www.who.int/patientsafety/en/www.who.int/patientsafety/safesu rgery/en
T chc Y t Th gii 20 i l Appia CH - 1211 Geneva 27 - Thy S in thoi: +41 (0) 22 791 50 60
Email: [email protected] vui lng gh thm chng ti ti:www.who.int/patientsafety/en/www.who.int/patientsafety/safesurgery/en
World HealthOrganization
Patient SafetyA World Alliance for Safer Health Care
Cam nang thc hanhBang kiem an toan phau thuatPhau thuat an toan cu song ngi benh
D liu n phm theo mc lc th vin ca WHO
Cm nang thc hnh Bng kim an ton phu thut WHO nm 2009Phu thut an ton cu sng ngi bnh.
1.Quy trnh phu thut, tiu chun phu thut. 2. Nhim khun vt thng do phu thut - ngn nga v kim sot. 3. Chm sc ngi bnh - tiu chun. 4. Qun l an ton. 5. Sai st y khoa - ngn nga v kim sot. 6. Nhim khun cho - ngn nga v kim sot 7. m bo cht lng, Chm sc sc khe tiu chun. 8. Khoa phu thut t chc v hnh chnh. 9. Hng dn. I. An ton ngi bnh ca WHO. II .WHO.
ISBN 978 92 4 159859 0 (Phn loi NLM: WO 178)
T chc Y t Th gii nm 2009Tc gi gi bn quyn c cc n phm ca T chc Y t Th gii (WHO), cc t chc c th tip cn b phn Bo ch ca WHO, ti a ch: s 20 Avenue Appia, 1211 Geneva 27, Thy S (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Vic xin php ti bn, hoc dch thut hoc bn li mt phn hoc phn phi phi li nhun tt c ni dung trong cc n phm ca WHO phi c thng bo ti b phn qun l n phm theo cng a ch nh trn (fax: +41 22 791 4806; email: [email protected]). Th t v ni dung trnh by ca cc ti liu trong n phm ny khng ng ngha vi bt c mt quan im no v pha (WHO) c lin quan ti tnh trng php l ca bt c quc gia, vng lnh th, thnh ph hoc a gii no hoc c lin quan ti s phn chia cc ng ranh gii gia cc quc gia. Cc ng ranh gii th hin trn bn mang tnh cht tng i, c th cn c nhng im bt ng v tnh chnh xc ca cc ng bin gii ny.Vic nu tn c th mt s cng ty hoc doanh nghip sn xut khng ng ngha vi vic WHO hu thun hoc khuyn khch s dng sn phm ca cc doanh nghip ny so vi cc sn phm tng t khc khng c cp. Nhng sai st v thiu st c loi tr, tn ca cc sn phm c bn quyn c phn bit bng vic vit hoa ch ci u tin trong tn ca sn phm .T chc Y t Th gii thc hin tt c nhng bin php cn thit xc minh nhng thng tin c trong n phm ny. Tuy nhin ti liu n hnh c ph bin m khng c s m bo v bt c loi thng tin no, biu hin hoc ng . Trch nhim din gii v s dng ti liu thuc v ngi c. T chc Y t Th gii s khng chu trch nhim trong bt c trng hp no c ny sinh nhng tn hi do vic s dng ti liu ny gy raIn ti Php
3
Cm nang hng dn thc hnh Bng kim An ton phu thut
T chc bin dch v hiu nh:TS. Lng Ngc Khu Cc trng Cc Qun l Khm, cha bnh-B Y tGS.TS Kim Sn Ch tch Hi Ngoi khoa Vit NamGS. Nguyn Th Ch tch Hi Gy m-Hi sc Vit NamThS. Phm c Mc Ph Cc trng Cc Qun l Khm, cha bnh-B Y tTS. Nguyn c Chnh Bnh vin Hu ngh Vit cTrnh by:TS. Trn Quang Huy Cc Qun l Khm, cha bnh-B Y tThS. Ng c Th Hi iu dng Vit Nam
Cm nang thc hnh Bng kim an ton phu thut ca WHO nm 2009 Gii thiu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Cch s dng cm nang ny . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Cch p dng Bng kim (tm tt) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Cch p dng Bng kim (chi tit) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Tin m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Trc khi rch da . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Trc khi ngi bnh ri phng m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Lu b sung - ci thin vn ha an ton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
iu chnh bng kim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
a Bng kim vo trong phng m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
nh gi chm sc phu thut . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Mc lc
4 5
Cm nang hng dn thc hnh Bng kim An ton phu thut
Gii thiu
Chng trnh phu thut an ton cu sng ngi bnh c WHO thit lp l mt phn n lc ca t chc ny nhm gim s ca t vong do phu thut trn ton th gii. Mc ch ca chng trnh l nhm kt ni gia cam kt chnh tr v y t v thc hnh an ton trong gy m, phng trnh nhim trng phu thut v thng tin lin lc cha tt gia cc thnh vin nhm phu thut. Nhng iu ny l ph bin, nguy hi n tnh mng ngi bnh v c th ngn nga c ti tt c cc nc v c s y t. Nhm h tr cc nhm phu thut gim s lng nhng bin chng ny, Chng trnh an ton ngi bnh ca WHO, c s tham vn ca cc nh phu thut, gy m, iu dng v chuyn gia v an ton ngi bnh trn ton th gii ra nhng mc tiu c bn ca an ton phu thut. Nhng kin thc ny c a vo trong Bng kim an ton phu thut ca WHO. Mc ch ca bng kim ny (c ti a ch www.who.int/safesurgery) nhm tng cng thc hnh an ton v thc y qu trnh trao i thng tin gia cc thnh vin trong mt nhm phu thut v trong phm vi cc nguyn tc v thc hnh lm sng. Bng kim d kin l mt cng c cc nh lm sng s dng vi mc ch ci thin an ton trong qu trnh phu thut v gim nhng ca t vong khng ng c do phu thut v cc bin chng lin quan. ng dng ca bng kim c chng minh qua con s thng k v s gim cc ca t vong v bin chng ti bnh vin v cc c s y t vi s ci thin mc tun th cc tiu chun chm sc sc khe c bn.
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