Dealing with risks in patient care
Quality management
Melanie Kolkhorst
Qualitätsmanagement
Eschfeldstaße 8
49356 Diepholz
Phone:
05441
-972-130
Mail:
ed.dkl-nekinilk@tsrohklok.m
QM-Abteilung, Geschäftsführung
Conference frequency: monatlich
Risk management
Melanie Kolkhorst
Qualitätsmanagement
Eschfeldstraße 8
49356 Diepholz
Phone:
05441
-972-130
Fax: 05441-972-102
Mail:
ed.dkl-nekinilk@tsrohklok.m
Ärztlicher Dienst (Innere) Ärztlicher Dienst (Chirurgie), MA Funktionsdienst, MA Pflegedienst
Conference frequency: bei Bedarf
Risk management instruments and measures
| No. | Explanation |
|---|---|
| RM02 |
Regular further education and training measures |
| RM04 |
Clinical emergency management Notfallhandbuch Klinik Diepholz (01.02.2021) |
| RM05 |
Pain management VA-PD-007 Schmerz (01.04.2022) |
| RM06 |
Fall prophylaxis VA-PD-008 Sturzprophylaxe (01.07.2021) |
| RM07 |
Use of a standardised concept for pressure ulcer prophylaxis (e.g. “Expert Standard for Pressure Ulcer Prophylaxis in Nursing”) VA-PD-003 Dekubitusprophylaxe (01.07.2021) |
| RM08 |
Regulated handling of custodial measures VA-PD-006 Fixierung (01.03.2020) |
| RM09 |
Regulated handling of occurring malfunctions of devices Organisationshandbuch Medizintechnik (HB-MT-001) (01.08.2019) |
| RM10 |
Structured implementation of interdisciplinary case discussions/conferences Case review conference
|
| RM12 |
Use of standardised information sheets |
| RM13 |
Application of standardised surgical check lists |
| RM14 |
Preoperative summary of predictable critical surgical steps, surgical time and expected blood loss CL-OP-002 OP-Sicherheitscheckliste (01.03.2023) |
| RM15 |
Preoperative, complete presentation of necessary findings CL-OP-001 OP-Sicherheitscheckliste + OP Begleitschein (01.03.2023) |
| RM16 |
Procedure to avoid procedural and patient mix-ups VA-OP-001 OP-Sicherheitscheckliste (01.10.2021) |
| RM17 |
Standards for recovery and postoperative care SOP Standardmappe Anästhesiepflege (01.04.2020) |
| RM18 |
Discharge management VA-KV-006 Entlassungsmanagement (01.04.2022) |
Fault reporting systems
Conference committee
Conference frequency: monatlich
Measures
Verfahrensanweisungen zur Patientensicherheit, Einführung Patienidentifikationsarmbänder
| No. | Explanation |
|---|---|
| IF01 |
Documentation and procedural instructions for handling the error reporting system are available As of: 01.04.2022 |
| IF02 |
Internal evaluation of the received reports taken monatlich |
| IF03 |
Training of employees in handling the error reporting system and in implementing the findings from the error reporting system taken bei Bedarf |
Conference committee
Conference frequency: