rapid development of the market economy environment to explore public rvants ' duty consumption monetization reform has provided a good foundation. The socialization of rear rvice work has been launched, and rapid progress in some places and departments, duty consumption monetization of carrier and approach to management has been resolved. Third, in recent years, exploring the monetization of duty consumption has made some progress, have gained some experience and can provide reference to the comprehensive reform of the system of public rvants ' duty consumption further. Implementing an "honest canteen", standardize official entertaining management; enhancing the telecommunication expen management; elimination of County travel and countryside subsidies; rearch "village officials" capitalization management of corporate spending, and so on. Finally, group ...
18 ssion to be held in Beijing from November 9, 2013 to 12th. 35 years ago blew the third plenary ssion of the reform and opening up in the spring breeze, changed, affect the world; today, 35 years later, in the eyes of the nation and the world expect, again to reform mark China, ushered in the 18 ssion. XI General Secretary pointed out that China's reform has entered a crucial period and the Sham Shui Po District, must be bad on greater political courage and wisdom, lo no time in deepening reform in important fields. Dares to crack a hard nut, dares to question the Rapids, whi
ch dares to break the barrier of ideas, and dare to benefit cure barriers. Deepening reform and opening up is on schedule to achieve institutional safeguards of the moderately well-off. Under the "five in one" the General layout of socialist modernization requirements, 18 ssion of the decision was a "five in one" and the improvement of overall scheme of reform, will promote an integrated and coordinated economic, political, cultural, social and ecological civilization construction of the five reforms and the party's construction in the area of institutional reform. The "five in one" programme is to achieve a comprehensive reform of institutional guarantees for objectives of build a well-off society, the smooth progress of the construction of a well-off society and reform the objectives of the programme. One, holding time and place importance on November 9, 2013 to the 18 ssion of the 12th Beijing since 1978, 35, have been 7 plenary ssion, each time on major issues of political and economic life of the country has made important deployment. In accordance with PRC political practice, often at every ssion of the CPC Central Committee in a plenary ssion was held immediately after the party's Congress, on the theme "personnel", discussing election Central's top leaders, such as the election of the Standing Committee of the political Bureau, through the Central Committee members, decisions, such as members of the Central Military Commission. The cond plenary ssion, is held in two ssions before the general election, mainly to discuss a new State personnel issues. But by the third
提高护理文件书写合格率（持续改进案例）
一、发现问题阶段：
护理文件书写存在的主要问题，如文件涂改较严重，字迹潦草难以辨认，未按规定及时完成病历，缺少客观性、连续性，主观判断性语言较多，不能动态反映病人的病情变化及治疗、护理效果，医护记录不一致，药物试敏结果未记录在护理记录单上；体温单眉栏漏项比较多，如大小便次数、体重、血压、页码漏填；医嘱单中执行人漏签字以及签字不清晰等。因此，为提高护理人员的护理文件书写的合格率，成立以护理部人员和临床护理单元护士长为主的质量改进小组，通过调研、数据收集、总结分析，提出改进措施，并评估改进效果等活动，以提高临床护士护理文件书写合格率并力争达到100%。
二、成立以护理部负责的质量改进小组。
表1 质量改进小组（CQI）成员名单
序号姓名职称分工
三、明确现行制度，查阅相关规范。
plenary ssion, each ssion of the Central Committee of national institutions and personnel problems have been arranged, you can concentrate on national development and reforms. Previous plenary ssion is often branded with a central leading collective, often by looking at the third plenum of the initiative to found the current central leadership collective governance characteristics. From the analysis of the process of economic reform in China, plenary ssion, 12 ssion, 14, 16 plenary ssion have programmatic meaning, respectively, marking the four stages of China's economic reform, and that the start-up pha of reform, reform, construction pha and perfecting the Socialist market economy framework stage of socialist market economy. Previous plenary ssion topics propod to the third plenary ssion of "taking class struggle as the key link," shifted to socialist modernization; 12 ssion marked the change from rural to urban, established with public ownership as the Foundation of a planned commodity economy; 13 ssion at a time when both the old and the new system change, governance and rectify the economic order; 14 ... Fair and efficient and authoritative Socialist judicial system, safeguard the people's interests. Legal authority to uphold the Constitution, deepening the reform of administrative law enforcement, ensure that the right to exerci judicial power independently and impartially according to law the procution, perfecting the running mechanism of judicial power, improve the system of judicial protection of human rights. Plenary ssion, Affairs the right to adhere to the system, and let the peo
ple authority to let the power run in the Sun, is shut up in a cage of the system power policy. Decision Science, implementation should be constructed strong, supervi the running of powerful system, improve the system of punishing and preventing corruption, promoting political integrity, and strive to achieve cadres ' honest and Government integrity, clean politics. To form a scientific and effective coordination of power restriction and mechanisms to strengthen anti-corruption institutional innovation and institutional protection, sound improvement style normal system. Plenary ssion, building a socialist culture in China, enhancing national cultural soft power, must adhere to the orientation of advanced Socialist culture, adhere to the development of Socialist culture with Chine characteristics, adhere to the people-centred work-oriented, further deepening reform of culture. To improve the cultural management system, establish and improve the modern market system and building modern public cultural rvice system, improve the level of culture opening. Plenary ssion, achieving development results more equitable benefit of all people, we must speed up reform of social programs and solve the issues of concern to the people the most direct and real interest, and better meet the needs of the people. To deepen education reform, improve institutional mechanisms for the
图1 护理文件书写不合格率趋势图
一分钟跳绳
rapid development of the market economy environment to explore public rvants ' duty consumption monetization reform has provided a good foundation. The socialization of rear rvice work has been launched, and rapid progress in some places and departments, duty consumption monetization of carrier and approach to management has been resolved. Third, in recent years, exploring the monetization of duty consumption has made some progress, have gained some experience and can provide reference to the comprehensive reform of the system of public rvants ' duty consumption further. Implementing an "honest canteen", standardize official entertaining management; enhancing the telecommunication expen management; elimination of County travel and countryside subsidies; rearch "village officials" capitalization management of corporate spending, and so on. Finally, group ...
18 ssion to be held in Beijing from November 9, 2013 to 12th. 35 years ago blew the third plenary ssion of the reform and opening up in the spring breeze, changed, affect the world; today, 35 years later, in the eyes of the nation and the world expect, again to reform mark China, ushered in the 18 ssion. XI General Secretary pointed out that China's reform has entered a crucial period and the Sham Shui Po District, must be bad on greater political courage and wisdom, lo no time in deepening reform in important fields. Dares to crack a hard nut, dares to question the Rapids, whi
什么的滋味作文400字
ch dares to break the barrier of ideas, and dare to benefit cure barriers. Deepening reform and opening up is on schedule to achieve institutional safeguards of the moderately well-off. Under the "five in one" the General layout of socialist modernization requirements, 18 ssion of the decision was a "five in one" and the improvement of overall scheme of reform, will promote an integrated and coordinated economic, political, cultural, social and ecological civilization construction of the five reforms and the party's construction in the area of institutional reform. The "five in one" programme is to achieve a comprehensive reform of institutional guarantees for objectives of build a well-off society, the smooth progress of the construction of a well-off society and reform the objectives of the programme. One, holding time and place importance on November 9, 2013 to the 18 ssion of the 12th Beijing since 1978, 35, have been 7 plenary ssion, each time on major issues of political and economic life of the country has made important deployment. In accordance with PRC political practice, often at every ssion of the CPC Central Committee in a plenary ssion was held immediately after the party's Congress, on the theme "personnel", discussing election Central's top leaders, such as the election of the Standing Committee of the political Bureau, through the Central Committee members, decisions, such as members of the Central Military Commission. The cond plenary ssion, is held in two ssions before the general election, mainly to discuss a new State personnel issues. But by the third
plenary ssion, each ssion of the Central Committee of national institutions and personnel problems have been arranged, you can concentrate on national development and reforms. Previous plenary ssion is often branded with a central leading collective, often by looking at the third plenum of the initiative to found the current central leadership collective governance characteristics. From the analysis of the process of economic reform in China, plenary ssion, 12 ssion, 14, 16 plenary ssion have programmatic meaning, respectively, marking the four stages of China's economic reform, and that the start-up pha of reform, reform, construction pha and perfecting the Socialist market economy framework stage of socialist market economy. Previous plenary ssion topics propod to the third plenary ssion of "taking class struggle as the key link," shifted to socialist modernization; 12 ssion marked the change from rural to urban, established with public ownership as the Foundation of a planned commodity economy; 13 ssion at a time when both the old and the new system change, governance and rectify the economic order; 14 ... Fair and efficient and authoritative Socialist judicial system, safeguard the people's interests. Legal authority to uphold the Constitution, deepening the reform of administrative law enforcement, ensure that the right to exerci judicial power independently and impartially according to law the procution, perfecting the running mechanism of judicial power, improve the system of judicial protection of human rights. Plenary ssion, Affairs the right to adhere to the system, and let the peo
ple authority to let the power run in the Sun, is shut up in a cage of the system power policy. Decision Science, implementation should be constructed strong, supervi the running of powerful system, improve the system of punishing and preventing corruption, promoting political integrity, and strive to achieve cadres ' honest and Government integrity, clean politics. To form a scientific and effective coordination of power restriction and mechanisms to strengthen anti-corruption institutional innovation and institutional protection, sound improvement style normal system. Plenary ssion, building a socialist culture in China, enhancing national cultural soft power, must adhere to the orientation of advanced Socialist culture, adhere to the development of Socialist culture with Chine characteristics, adhere to the people-centred work-oriented, further deepening reform of culture. To improve the cultural management system, establish and improve the modern market system and building modern public cultural rvice system, improve the level of culture opening. Plenary ssion, achieving development results more equitable benefit of all people, we must speed up reform of social programs and solve the issues of concern to the people the most direct and real interest, and better meet the needs of the people. To deepen education reform, improve institutional mechanisms for the
（2）存在问题：
根据以上调研资料绘制鱼骨图，见下图：
质控护士检查
病历不仔细
科室培训不
够护士对电子病历使用不熟质控护士检查不仔细护士不熟悉输血记
录单书写
科室培训不
够科室护士不重视质控护士未检查
尿量小结书写错
误
田都元帅
床号错误、首页首行无年份
输血记录单空项采油工
及填写错误临床路径单空项
问题原因分析：
⑴各科年轻护士对《江西省护理文书书写规范》不了解，对电子病历系统使
用不熟悉，科室培训不够；
⑵新电子病历系统存在细节问题有待完善；
⑶质控护士把关不严，出院病历质控时不够仔细认真；
⑷各科对护理记录专科内涵方面的培训不够。
诺贝尔文学奖中国五、拟定改进方案
1、改进目标：第二季度护理文件书写合格率超过第一季度并力争达到
100%。左手发麻是怎么回事
2、针对护理文书质控中的问题改进措施：
（1）对存在的问题进行汇总、分析，对于发生较多，较严重的问题质控
会上重点强调，要求全院科室引起注意。
（2）建议各科室针对新电子病历系统使用、江西省护理文书书写规范、护理记录专科内涵等方面加强培训，护士长重点质控。
（3）建议各科护士长针对科室专科情况制定本科室护理记录模板方便
护士使用。
（4）收集各科意见建议与信息科沟通，不断完善电子病历系统。
六、拟定改进计划阶段胆固醇偏低
利用甘特图绘制计划表，见下表：
表5 提高临床护士文书书写合格率质控项目计划表
备注：表5为2014年4月上旬护理文书质控项目计划表，4月中旬、下旬及5月、6月上中下旬与该表基本一致，特殊情况可动态调整。
七、实施阶段
1、四级质控
护理部组织成立以高级职称护理人员组成护理文书质量管理控制小组，，负责全院护理文书质量管理。
各病区建立以护理骨干和护士长组成的护
理文书质量管理小组，负责病区的护理文书质量管理。形成以护理部为核
心，护士、护士长、科护士长、护理部四级质量控制组织。各临床科室、护理部均建立《护理文书检查缺陷登记本》，对护理文书书写缺陷进行登记、排名。在四级质控组织中，护士把好书写关，护士长把好现病历关以及出科病历关，保证不合格的病历不出科。在护理病历形成过程中尤其强调护士的自查自评和护士长的审查，从而减少护理文书带着问题归档，并及时发现和弥补临床工作中治疗护理规范与常规落实过程中的不足与缺陷。
2、知识培训
由护理部组织对各级护理文书质量管理控制小组的成员进行PDCA管理知识培训，使每位成员都熟悉PDCA管理知识，并能熟练运用于护理文书质量管理中。
3、学习法律知识
学会自我保护，医院定期聘请律师来院对护理人员进行法律知识培训，护士长组织科内护理人员认真学习国家颁布的有关法律、法规和各项规章制度，对护理人员进行安全教育，使护理人员能够熟悉法律并能从法律的角度认识到职业的责任，及自己的权利和义务，工作中能够尊重患者的基本权利，依
法保护患者的权益。
4、学习与考核新电子病历系统使用、护理文书书写格式说明、护理文书质量管理制度、护理文书质量控制标准及评分细则打印成册，下发各科室，定期组织学习，并进行理论考核。病区护士长或护理文书质量管理护士负责组织培训学习，使每位护士熟悉护理文书的质量要求，护理部组织护士长根据病区专科情况，制定专科护理文书书写要求及质量管理措施，专科疾病护理文书书写模板。
蒋介石传5、团队精神教育
