Kev Sib Tham Txog Tshuaj Kho Mob Hauv Cov Kev Pabcuam Hauv Tsev Kho Mob
Kev sib piv cov tshuaj yog ib qho txheej txheem uas ua kom ntseeg tau tias daim ntawv teev cov tshuaj ntawm tus neeg mob yog qhov tseeb thiab sib xws thoob plaws txhua qhov kev hloov pauv hauv tsev kho mob. Cov kev hloov pauv no tuaj yeem tshwm sim thaum lub sijhawm nkag mus, hloov chaw, lossis tawm hauv tsev kho mob. Hauv cov kev coj ua hauv tsev kho mob nyuaj - suav nrog ntau tus kws kho mob, kws tu mob, thiab kws muag tshuaj, nrog rau cov mob uas hloov pauv sai - kev sib piv cov tshuaj yog ib qho ntawm cov tswv yim tseem ceeb tshaj plaws rau kev tiv thaiv kev ua yuam kev ntawm cov tshuaj thiab txhim kho kev nyab xeeb ntawm tus neeg mob.
Vim li cas kev sib piv tshuaj thiaj li tseem ceeb?
Kev ua yuam kev ntawm cov tshuaj yog ib qho ua rau muaj teeb meem loj hauv cov chaw kho mob. Tej yam yuam kev me me xws li kev noj tshuaj tsis raug, tsis nco qab noj tshuaj, lossis cov tshuaj ob zaug tuaj yeem ua rau muaj teeb meem loj, nyob hauv tsev kho mob ntev dua, thiab ua rau muaj kev pheej hmoo tuag. Kev sib piv cov tshuaj pab cov tsev kho mob kaw cov qhov sib txawv uas feem ntau tshwm sim thaum cov ntaub ntawv tshuaj txav mus los ntawm ib lub tshuab mus rau lwm lub, lossis los ntawm ib tus kws kho mob mus rau lwm tus.
Cov neeg mob uas muaj feem yuav muaj teeb meem txog tshuaj feem ntau yog cov neeg laus, cov neeg uas muaj ntau yam mob ntev, cov neeg uas noj ntau yam tshuaj (polypharmacy), thiab cov neeg uas muaj xwm txheej ceev—qhov twg cov ntaub ntawv thawj zaug feem ntau tsis tiav. Ntxiv mus, cov neeg mob uas siv cov tshuaj ib txwm muaj , cov tshuaj ntxiv, lossis cov tshuaj uas yuav tsis tas yuav muaj ntawv yuav tshuaj (OTC) kuj muaj feem yuav muaj teeb meem vim tias lawv siv feem ntau tsis tau sau tseg hauv lawv cov ntaub ntawv kho mob.
Kev Txhais thiab Lub Hom Phiaj ntawm Kev Sib Tham Txog Tshuaj
Feem ntau, kev sib piv tshuaj kho mob yog rau:
1. Tau txais daim ntawv teev cov tshuaj rau tus neeg mob kom raug tshaj plaws (Keeb Kwm Tshuaj Zoo Tshaj Plaws/BPMH), suav nrog cov tshuaj uas kws kho mob sau ntawv kom yuav, OTC, tshuaj ntsuab, cov tshuaj ntxiv, thiab lwm yam kev kho mob.
2. Muab cov npe tshuaj piv rau daim ntawv sau tshuaj/kev kho mob uas yuav muab rau hauv tsev kho mob.
3. Txheeb xyuas thiab daws cov teeb meem tsis sib xws uas tsis xav txog, xws li cov tshuaj uas yuav tsum tau txuas ntxiv mus tab sis tau tso tseg lawm, lossis cov tshuaj uas yuav tsum tau tso tseg lawm tab sis tseem muab rau.
4. Qhia meej txog kev hloov tshuaj rau cov neeg mob, tsev neeg, thiab cov chaw pabcuam tom qab.
Lub hom phiaj kawg yog kom ntseeg tau tias cov neeg mob tau txais cov tshuaj zoo, raws li qhov ntau npaum li cas, raws sijhawm, raws li qhov qhia tau zoo, thaum txo qhov kev pheej hmoo ntawm cov kev mob tshwm sim thiab kev sib cuam tshuam ntawm cov tshuaj.
Cov Theem Sib Tham Txog Kev Siv Tshuaj
Kev sib piv tshuaj yuav tsum tau ua tiav ntawm peb lub ntsiab lus tseem ceeb:
1. Thaum Nkag Mus Rau Hauv Tsev Kho Mob
Nyob rau theem no, cov kws kho mob sau cov keeb kwm tshuaj tag nrho los ntawm tus neeg mob thiab/lossis tsev neeg. Cov ntaub ntawv no tuaj yeem lees paub nrog lwm qhov chaw xws li cov ntawv qhia tswj, cov fwj tshuaj uas coj los, cov ntaub ntawv hauv tsev kho mob, lossis cov ntaub ntawv los ntawm lub tsev muag tshuaj hauv zej zog. Daim ntawv teev cov tshuaj no ces muab piv rau cov kev kho mob thawj zaug uas yuav muab rau hauv tsev kho mob.
Cov teeb meem tseem ceeb thaum lub sijhawm nkag mus kawm yog lub sijhawm txwv, tus neeg mob tsis ruaj khov, thiab qhov sib txawv ntawm cov npe tshuaj thiab cov npe dav dav uas tuaj yeem ua rau muaj kev tsis meej pem. Yog li ntawd, lub luag haujlwm ntawm cov kws muag tshuaj hauv tsev kho mob feem ntau yog qhov tseem ceeb hauv kev tau txais cov ntaub ntawv ntxaws ntxaws txog tshuaj.
2. Thaum Tsiv Chav/Hloov Cov Kev Pabcuam (Kev Hloov Chaw)
Kev hloov pauv hauv kev saib xyuas (piv txwv li, los ntawm chav kho mob ceev mus rau chav kho mob, los ntawm ICU mus rau chav kho mob) lossis kev hloov tus neeg saib xyuas tus neeg mob feem ntau ua rau muaj kev hloov pauv hauv cov txheej txheem tshuaj. Yog tias kev sib txuas lus tsis zoo, cov tshuaj tseem ceeb tuaj yeem raug tso tseg lossis siv ob zaug yam tsis tau xav txog - piv txwv li yog tus neeg mob tau txais ob hom tshuaj nrog tib yam khoom xyaw tab sis hom sib txawv.
Thaum lub sijhawm hloov pauv, cov npe tshuaj yuav tsum tau hloov kho tshiab thiab txheeb xyuas, thiab txhua qhov kev hloov pauv yuav tsum muaj qhov laj thawj tseeb ntawm kev kho mob. Cov ntaub ntawv sau tseg kom huv si thiab yooj yim nkag tau thoob plaws hauv cov chav yog qhov tseem ceeb.
3. Thaum Rov Qab Los (Tso Tawm)
Lub sijhawm tawm hauv tsev kho mob feem ntau yog lub sijhawm tseem ceeb tshaj plaws vim tias cov neeg mob yuav tsum txuas ntxiv lawv txoj kev kho mob hauv tsev. Kev sib piv cov tshuaj thaum tawm hauv tsev kho mob ua kom cov neeg mob nkag siab tias cov tshuaj twg yuav tsum txuas ntxiv, tsum, lossis hloov kho. Ntxiv mus, cov neeg mob yuav tsum tau kawm txog yuav siv lawv li cas, lawv lub sijhawm, txhua yam kev mob tshwm sim uas yuav tsum tau saib xyuas, thiab thaum twg yuav rov qab mus ntsib kws kho mob tom qab.
Nyob rau theem no, cov kev ua yuam kev feem ntau suav nrog cov neeg mob rov qab mus rau cov tshuaj qub uas lawv twb tsis noj lawm, lossis tsis noj cov tshuaj tshiab vim lawv tsis nkag siab txog lawv txoj haujlwm. Yog li ntawd, kev qhia txog kev noj tshuaj thiab cov ntawv qhia meej yog qhov tseem ceeb.
Lub Luag Haujlwm ntawm Cov Neeg Ua Haujlwm Saib Xyuas Kev Kho Mob hauv Kev Sib Tham Txog Tshuaj
Kev sib hais haum txog kev siv tshuaj yog ib qho kev sib koom tes ua ke. Lub luag haujlwm ntawm txhua txoj haujlwm tuaj yeem faib ua raws li hauv qab no:
– Kws Kho Mob: txiav txim siab txog kev kho mob, soj ntsuam cov tsos mob ntawm kev kho mob, txiav txim siab txog kev hloov tshuaj, thiab xyuas kom meej tias cov ntawv sau tshuaj raug sau raws li tus neeg mob tus mob (piv txwv li, kev ua haujlwm ntawm lub raum/siab).
– Kws muag tshuaj: sau BPMH, soj ntsuam qhov kev cuam tshuam thiab kev rov ua dua, xyuas kom ua raws li cov tshuaj noj, muab cov lus qhia lwm yam, thiab ua kev qhia txog tshuaj.
- Cov kws tu mob: pab txheeb xyuas cov ntaub ntawv tshuaj, xyuas kom meej tias cov tshuaj raug muab raws li tau hais, saib xyuas cov lus teb ntawm tus neeg mob thiab cov kev mob tshwm sim, thiab txhawb kev qhia rau cov neeg mob.
– Kev tswj hwm tsev kho mob: muab cov cai, SOPs, kev cob qhia, thiab cov ntaub ntawv sau tseg (phau ntawv lossis hluav taws xob) uas txhawb nqa cov txheej txheem kev sib haum xeeb.
Kev koom tes zoo yuav ua rau kev sib hais haum tshuaj tsis yog tsuas yog ib txoj haujlwm tswjfwm xwb, tab sis kuj yog ib feem tseem ceeb ntawm kev saib xyuas kev noj qab haus huv.
Hom Kev Sib Txawv Uas Feem Ntau Pom
Hauv kev sib piv cov tshuaj, qhov sib txawv ntawm cov npe tshuaj ua ntej thiab tom qab kev hloov pauv kev pabcuam tuaj yeem tshwm sim rau ob qho laj thawj uas xav tau thiab tsis xav tau. Qhov sib txawv uas tsis xav tau yog qhov tseem ceeb ntawm kev tiv thaiv, xws li:
1. Kev Tsis Noj: cov tshuaj uas yuav tsum tau noj ntxiv tab sis tsis tau muab tshuaj rau.
2. Kev Them Nqi: ib yam tshuaj uas yuav tsum tsis txhob muab tab sis tseem muab.
3. Kev noj tshuaj/lub sijhawm tsis raug: qhov zaus lossis qhov ntau ntawm cov tshuaj hloov pauv yam tsis muaj laj thawj.
4. Kev kho mob zoo ib yam: ob hom tshuaj uas muaj tib chav kawm lossis cov khoom xyaw nquag.
5. Kev sib cuam tshuam ntawm cov tshuaj: kev sib xyaw ua ke uas ua rau muaj kev pheej hmoo ntawm cov kev mob tshwm sim.
6. Kev siv tshuaj tsis raug: piv txwv li, cov tshuaj noj yog sau ua kev txhaj tshuaj lossis vice versa.
Piv txwv li, ib tug neeg mob ntshav siab uas noj tshuaj amlodipine tas li hauv tsev, tab sis tsis tau sau tseg thaum nkag mus rau hauv tsev kho mob, ua rau nyuaj rau tswj ntshav siab thaum pw hauv tsev kho mob. Los yog ib tug neeg mob ntshav qab zib uas tau txais insulin hauv tsev kho mob , tab sis tsis tau txais cov lus qhia meej thaum tawm hauv tsev kho mob, ua rau muaj ntshav qis lossis ntshav qab zib ntau dhau.
Cov Tswv Yim Siv Kev Sib Tham Txog Kev Siv Tshuaj Zoo
Yuav kom kev sib piv cov tshuaj kho mob ua haujlwm tas li, cov tsev kho mob yuav tsum muaj lub tswv yim ntsuas tau, suav nrog:
1. Cov Cai Ua Haujlwm Kom Tseeb thiab Sib Xws
Cov SOPs yuav tsum piav qhia tias leej twg ua dab tsi, thaum twg, thiab nws tau sau tseg li cas.
2. Cov ntawv lossis cov modules uas siv hluav taws xob raws li tus qauv
Cov txheej txheem sau cov ntaub ntawv kho mob hauv hluav taws xob tuaj yeem pab koom ua ke cov ntaub ntawv tshuaj, txo qhov rov ua dua ntawm cov ntaub ntawv, thiab pab txhawb kev tshuaj xyuas.
3. Kev cob qhia tsis tu ncua rau cov neeg ua haujlwm kho mob
Kev cob qhia suav nrog cov txheej txheem xam phaj tshuaj, kev txheeb xyuas cov tshuaj muaj kev pheej hmoo siab, thiab kev sib txuas lus ntawm cov kws tshaj lij.
4. Qhov tseem ceeb rau cov neeg mob uas muaj kev pheej hmoo siab
Yog tias cov peev txheej muaj tsawg, tsom mus rau kev sib haum xeeb tob rau cov neeg mob polypharmacy, cov neeg laus, cov neeg mob ICU, cov neeg mob uas muaj teeb meem raum/siab, thiab cov neeg mob uas muaj keeb kwm ua xua hnyav.
5. Kev koom tes ntawm tus neeg mob thiab tsev neeg
Cov neeg mob raug txhawb kom nqa daim ntawv teev tshuaj, daim duab ntawm lub thawv tshuaj, lossis daim "daim npav tshuaj" uas tau hloov kho tshiab kom ntseeg tau tias muaj cov ntaub ntawv tseeb dua.
6. Kev tshuaj xyuas thiab cov ntsuas zoo
Cov tsev kho mob tuaj yeem saib xyuas cov ntsuas xws li feem pua ntawm cov neeg mob cov neeg uas tau ua kev sib haum xeeb hauv 24 teev, tus naj npawb ntawm cov kev tsis sib haum xeeb pom, thiab kev txo qis ntawm qhov tshwm sim ntawm kev siv tshuaj yuam kev.
Cov Teeb Meem Hauv Thaj Chaw
Txawm hais tias nws lub tswv yim muaj zog, kev siv tshuaj sib haum xeeb feem ntau ntsib teeb meem: cov neeg ua haujlwm tsawg, cov haujlwm ntau, cov ntaub ntawv sib txawv, thiab kev ua raws li ntau yam hauv cov chav haujlwm. Hauv qee qhov chaw, cov kws muag tshuaj hauv tsev kho mob tsis koom nrog tag nrho hauv cov txheej txheem kho mob, ua rau muaj kev sib haum xeeb tsawg dua. Lwm yam teeb meem suav nrog cov neeg mob uas tsis coj lawv cov tshuaj, tsis nco qab lawv lub npe, lossis nyuaj rau kev xam phaj vim muaj mob hnyav.
Kev daws cov teeb meem no xav tau kev txhawb nqa los ntawm kev tswj hwm, kev txhim kho cov txheej txheem cov ntaub ntawv, thiab kev coj noj coj ua ntawm kev nyab xeeb ntawm tus neeg mob uas muab kev sib haum xeeb ntawm cov tshuaj ua qhov tseem ceeb, tsis yog ua haujlwm ntxiv.
Kev kaw
Kev sib piv cov tshuaj hauv tsev kho mob yog qhov tseem ceeb rau kev ua kom tus neeg mob muaj kev nyab xeeb thaum muaj kev hloov pauv ntawm kev saib xyuas. Los ntawm kev sau cov keeb kwm tshuaj kom raug, piv rau cov kev kho mob uas tau sau tseg, daws cov teeb meem tsis sib xws, thiab sib qhia meej txog kev hloov pauv, cov tsev kho mob tuaj yeem txo qhov kev pheej hmoo ntawm kev ua yuam kev ntawm cov tshuaj thiab txhim kho qhov zoo ntawm kev saib xyuas. Kev sib piv cov tshuaj kom zoo nyob ntawm kev koom tes ntawm cov kws tshaj lij, cov txheej txheem sau ntawv zoo, thiab kev koom tes ntawm tus neeg mob thiab tsev neeg. Thaum kawg, kev sib piv cov tshuaj tsis yog ib qho txheej txheem xwb, tab sis yog ib feem ntawm kev cog lus ntawm tsev kho mob los muab kev saib xyuas kom muaj kev nyab xeeb, zoo, thiab tsom mus rau tus neeg mob.
