4.6.2.7单病种质量控制指标

4.6.2.7单病种质量控制指标 第一批单病种质量控制指标 国际疾病分类 标准 excel标准偏差excel标准偏差函数exl标准差函数国标检验抽样标准表免费下载红头文件格式标准下载 编码ICD-10采用《疾病和有关健康问 题 快递公司问题件快递公司问题件货款处理关于圆的周长面积重点题型关于解方程组的题及答案关于南海问题 的国际统计分类》第十次修订本第二版,北京协和医院、世界卫生组织、国际分类家族合作中心编译,。 一、急性心肌梗死,ICD-10 I21.0-I21.3,I21.4,I21.9, ,一,到达医院后即刻使用阿司匹林(有禁忌证者应给予氯吡格雷) 。 ,二,实施左心室功能评价。 ,三,再灌注治疗,仅适用于ST段抬高型心肌梗死,。 1. 到院30分钟内实施溶栓治疗, 2. 到院90分钟内实施PCI治疗, 3. 需要急诊PCI患者,但本院无条件实施时,须转院。 ,四,到达医院后即刻使用β受体阻滞剂,有适应证,无禁忌证 者,。 ,五,有证据 表 关于同志近三年现实表现材料材料类招标技术评分表图表与交易pdf视力表打印pdf用图表说话 pdf 明住院期间使用阿司匹林、β受体阻滞剂、血管 紧张素转换酶抑制剂,ACEI,或血管紧张素?受体阻滞剂,ARB,、 他汀类药物,有明确适应证,无禁忌证。 ,六,有证据表明出院时继续使用阿司匹林、β受体阻滞剂、 ACEI/ARB、他汀类药物,有明确适应证,无禁忌证。 ,七,血脂评价与管理。 ,八,为患者提供急性心肌梗死的健康教育。 scope of the entire project. (2) should include: semi-finished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) construction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intact. 2.16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partition the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, record, replacing the original data measuring elevation ,九,患者住院天数与住院费用。 二、心力衰竭,ICD-10 I50, ,一,实施左心室功能评价。 ,二,到达医院后即刻使用利尿剂和钾剂,有适应证,无禁忌证者,。 ,三,到达医院后即刻使用ACEI或ARB。 ,四,到达医院后使用β受体阻滞剂,有适应证,无禁忌证者,。 ,五,重度心衰使用醛固酮受体阻滞剂,有适应证,无禁忌证者,。 ,六,有证据表明住院期间维持使用利尿剂、钾剂、ACEI或ARB、β受体阻滞剂和醛固酮拮抗剂,有明确适应证,无禁忌证。 ,七,有证据表明出院时继续使用利尿剂、ACEI或ARB、β受体阻滞剂和醛固酮受体阻滞剂,有明确适应证,无禁忌证。 ,八,非药物治疗临床应用符合适应证。 ,九,为患者提供心力衰竭的健康教育。 ,十,患者住院天数与住院费用。 三、肺炎,ICD-10 J13-J15,J18, ,一,符合住院治疗标准,实施病情严重程度评估。 ,二,氧合评估。 ,三,病原学诊断。 1. 在首次抗菌药物治疗前,采集血、痰培养, scope of the entire project. (2) should include: semi-finished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) construction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intact. 2.16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partition the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, record, replacing the original data measuring elevation 2. 住院24小时以内,采集血、痰培养。 ,四,入院4小时内接受抗菌药物治疗。 ,五,起始抗菌药物选择。 1. 重症患者起始抗菌药物选择, 2. 非重症患者起始抗菌药物选择, 3. 目标抗感染药物的治疗选择。 ,六,初始治疗后评价与处理。 ,七,抗菌药物疗程,用药天数,。 ,八,为患者提供戒烟咨询与肺炎的健康教育。 ,九,符合出院标准及时出院。 ,十,患者住院天数与住院费用。 四、脑梗死,ICD-10 I63, ,一,接诊流程。 1. 按照脑卒中接诊流程, 2. 神经功能缺损评估, 3. 完成头颅影像学检查,CT/MRI,、实验室检查,血常规、 急诊生化、凝血功能检查,、心电图,ECG,等项检查。 ,二,静脉应用组织纤溶酶原激活剂,t-PA,或应用尿激酶的 评估。 1. 实施静脉t-PA或尿激酶应用评估, 2. 应用静脉t-PA或尿激酶治疗。 ,三,到院48小时内抗血小板治疗。 lacing the original data measuring elevationd, repon the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, recor16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partitict. 2.truction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intafinished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) cons-scope of the entire project. (2) should include: semi- 3 - ,四,吞咽困难评价。 ,五,血脂评价与管理。 ,六,住院1周内接受血管功能评价。 ,七,预防深静脉血栓。 ,八,康复评价与实施。 ,九,为患者提供戒烟咨询与脑梗死的健康教育。 ,十,出院时使用阿司匹林或氯吡格雷。 ,十一,出院时伴有房颤的脑梗死患者口服抗凝剂,如华法林, 的治疗。 ,十二,患者住院天数与住院费用。 五、髋关节置换术,ICD 9-CM-3 81.51-52, 膝关节置换术,ICD 9-CM-3 81.54, ,一,实施手术前的评估与术前准备。 ,二,预防性抗菌药物选择与应用时机。 ,三,预防手术后深静脉血栓形成。 ,四,单侧手术输血量小于400ml。 ,五,术后康复治疗。 ,六,内科原有疾病治疗。 ,七,手术后并发症治疗。 ,八,为患者提供髋、膝关节置换术的健康教育。 ,九,切口?/甲愈合。 ,十,住院21天内出院。 scope of the entire project. (2) should include: semi-finished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) construction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intact. 2.16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partition the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, record, replacing the original data measuring elevation ,十一,患者住院天数与住院费用。 六、冠状动脉旁路移植术,ICD 9-CM-3 36.1, ,一,实施手术前的评估与术前准备。 ,二,手术适应证与急诊手术指征。 ,三,使用乳房内动脉,胸廓内动脉,。 ,四,预防性抗菌药物选择与应用时机。 ,五,术后活动性出血或血肿的再手术。 ,六,手术后并发症治疗。 ,七,为患者提供冠状动脉旁路移植术的健康教育。 ,八,切口?/甲愈合。 ,九,住院21天内出院。,十,患者住院天数与住院费用。 第二批单病种质量控制指标 适用病名ICD-10编码采用《疾病和有关健康问题的国际统计分类》第十次修订本第二版,北京协和医院、世界卫生组织、国际分类家族合作中心编译,,人民卫生出版社。 适用手术与操作ICD-9-CM-3编码采用《国际疾病分类手术与操作》第九版临床修订本2008版,刘爱民主编译,,人民军医出版社。 一、围手术期预防感染质量控制指标 lacing the original data measuring elevationd, repon the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, recor16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partitict. 2.truction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intafinished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) cons-scope of the entire project. (2) should include: semi- 5 - ,一,手术前预防性抗菌药物选用符合规范要求, ,二,预防性抗菌药物在手术前一小时内开始使用, ,三,手术时间超过3小时或失血量大于1500ml,术中可给予第二剂, ,四,择期手术在结束后24、48、72小时内停止预防性抗生素使用的时间, ,五,手术野皮肤准备与手术切口愈合。 适用手术与操作ICD-9-CM-3编码, ,一,单侧甲状腺叶切除术ICD-9-CM-3,06.2 ,二,膝半月板切除术ICD-9-CM-3,80.6 ,三,经腹子宫次全切除术ICD-9-CM-3,68.3 ,四,剖宫产术ICD-9-CM-3,74.0,74.1,74.2 ,五,腹股沟疝单侧/双侧修补术ICD-9-CM-3,53.0,53.1 ,六,阑尾切除术ICD-9-CM-3,47.0 ,七,腹腔镜下胆囊切除术ICD-9-CM-3,51.23 ,八,闭合性心脏瓣膜切开术ICD-9-CM-3,35.00-35.04 ,九,动脉内膜切除术ICD-9-CM-3,38.1 ,十,足和踝关节固定术和关节制动术ICD-9-CM-3,81.11-81.18 ,十一,其他颅骨切开术ICD-9-CM-3,01.24 ,十二,椎间盘切除术或破坏术ICD-9-CM-3,80.50 二、肺炎,儿童、住院,质量控制指标 scope of the entire project. (2) should include: semi-finished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) construction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intact. 2.16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partition the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, record, replacing the original data measuring elevation ,一,住院时病情严重程度评估, ,二,氧合评估, ,三,病原学检测, ,四,抗菌药物使用时机, ,五,起始抗菌药物选择符合规范, ,六,住院72小时病情严重程度再评估, ,七,抗菌药物疗程,天数,, ,八,符合出院标准及时出院, ,九,疗效、住院天数、住院费用,元,。 适用病名ICD-10编码,ICD-10 J13-J15,J18,不含新生儿及1-12个月婴儿肺炎。 第三批单病种质量控制指标 ,征求意见稿, 适用病名ICD-10编码采用《疾病和有关健康问题的国际统计分类》第十次修订本第二版,北京协和医院、世界卫生组织、国际分类家族合作中心编译,,人民卫生出版社。 适用手术与操作ICD-9-CM-3编码采用《国际疾病分类手术与操作》第九版临床修订本2008版,刘爱民主编译,,人民军医出版社。 lacing the original data measuring elevationd, repon the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, recor16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partitict. 2.truction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intafinished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) cons-scope of the entire project. (2) should include: semi- 7 - 一、剖宫产质量控制指标 ,一,产前风险评估 ,二,剖宫产指征选择 ,三,预防性抗菌药物选择与应用时机 ,四,胎儿娩出Apgar评分结果 ,五,产后出血量评估 ,六,产后并发症与再次手术 ,七,新生儿并发症 ,八,提供母乳喂养与产后康复健康教育 ,九,切口?甲愈合 ,十,住院天数与费用、疗效 ,十一,患者对服务的体验与评价 ,十二,妊娠合并HBV实施母婴阻断,可选, 适用手术与操作ICD-9-CM-3编码,子宫下段剖宫产术 ICD-9-CM-3,74.1 适用临床路径,剖宫产临床路径,卫生部2009年版 二、慢性阻塞性肺疾病,COPD,急性加重期住院质量控制指标 ,一,病情严重程度评估与分级 ,二,收住院/或ICU符合指征 ,三,控制性氧疗 ,四,抗菌药物选择与应用适当 ,五,支气管舒张剂、糖皮质激素选择与应用符合指征 ,六,合并症处理适当 1.合并右心衰竭时可选用利尿剂 2.合并有左心室功能不全时可选用强心剂 3.合并肺动脉高压和右心功能不全时可选用血管扩张剂 4.有高凝倾向可选用抗凝药物 5.危重患者,如出现PaCO明显升高时,可选用呼吸兴奋剂 2 scope of the entire project. (2) should include: semi-finished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) construction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intact. 2.16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partition the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, record, replacing the original data measuring elevation ,七,重症患者可根据病情需要选用无创或有创机械通气 ,八,提供戒烟、减少危险因素疾病自我管理教育服务 ,九,住院天数与费用、疗效 ,十,患者对服务的体验与评价 适用病名ICD-10编码,慢性阻塞性肺疾病急性加重期ICD-10, J144.0/1 适用临床路径,慢性阻塞性肺疾病临床路径,卫生部2009年版 三、围手术期预防深静脉血栓质量控制指标 ,一,有冠心病史患者术前使用β-阻滞剂,无禁忌症, ,二,有糖尿病史患者术前、术后控制血糖 ,三,术后24小时实施预防深静脉血栓措施,无禁忌症, ,四,术后24小时内拔除留置导尿管 ,五,住院天数与费用、疗效 ,六,患者对服务的体验与评价 适用手术与操作ICD-9-CM-3编码, 1.心脏瓣膜置换术 ICD-9-CM-3 35.2 35.21001 主动脉瓣生物瓣膜置换术 35.21002 Ross手术 35.22001 主动脉瓣机械瓣膜置换术 35.23001 二尖瓣生物瓣膜置换术 35.24001 二尖瓣机械瓣膜置换术 35.25001 肺动脉瓣生物瓣膜置换术 35.26001 肺动脉瓣机械瓣膜置换术 35.27001 三尖瓣生物瓣膜置换术 35.28001 三尖瓣机械瓣膜置换术 lacing the original data measuring elevationd, repon the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, recor16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partitict. 2.truction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intafinished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) cons-scope of the entire project. (2) should include: semi- 9 - 2.搭桥吻合术 ICD-9-CM-3 36.1 36.10001 主动脉-冠状动脉搭桥术 36.11001 主动脉-一支冠状动脉搭桥术 36.12001 主动脉-二支冠状动脉搭桥术 36.13001 主动脉-三支冠状动脉搭桥术 36.14001 主动脉-多支冠状动脉搭桥术 36.15001 单侧乳内动脉-冠状动脉搭桥术 36.16001 双侧乳内动脉-冠状动脉搭桥术 36.17001 胃网膜动脉-冠状动脉搭桥术 3.全髋关节置换术ICD-9-CM-3 81.51 81.51003 全髋关节置换术 4.全膝关节置换术ICD-9-CM-3 81.54 81.54002 膝关节三间室置换术 81.54004 膝关节单间室置换术 81.54005 膝关节部分置换术 81.54007 膝关节双间室置换术 5.脊柱融合术 ICD-9-CM-3 81.35、81.36 81.35001 后入路胸椎再融合术 81.35002 后入路胸腰椎再融合术 81.36001 前入路腰椎再融合术 81.36002 前入路腰骶再融合术 scope of the entire project. (2) should include: semi-finished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) construction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intact. 2.16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partition the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, record, replacing the original data measuring elevation lacing the original data measuring elevationd, repon the whole project, baseline measurements, benchmarking measurement axis, identify key points, put the line, measure, recor16 l measurement, process description the process: become familiar with the structure and design of curtain wall map, partitict. 2.truction, construction of clearly marked sections, axis. (5) the draw details. (6) the covert acceptance record perfect, intafinished products, quality of materials, installation quality. (3) must be marked with the date, personnel, quality. (4) cons-scope of the entire project. (2) should include: semi- 11 -