专业护士团队为长辈进行24小时全方位医疗护理服务，护理科目专业化、标准化，保证各项护理操作的规范性，真正解决失能失智长辈家庭的难与苦。

华北医院医养病房护理服务标准                                                                          

每日服务流程                                                                          

一、晨间护理：5:00--6:30                                                                    

晨间护理：是每天清晨起床前后给老人进行的必要护理。对老人一天的心情、生活、健康至关重要，应于早饭前完成。                                                                       

操作流程：                                                                     

1、做好清洗前的准备工作，打好热水，关好门窗，注意室内温度，避免老人着凉。                                                                       

2、检查大小便情况，及时更换尿袋及纸垫并清洗干净、洗手、洗脸、漱口、梳头、喂空腹水、清洗会阴、洗脚。                                                                   

3、翻身、拍背--翻身检查受压部位皮肤、按摩骨突处。                                                                         

4、整理床单位。保持床单位干净、整洁、干燥无渣屑。                                                                       

5、酌情开窗通风，清整房间卫生。                                                                   

6、鼓励安抚老人战胜疾病，做好心理沟通。                                                                   

二、早餐准备：6:30--7:30鼻饲饮食、经口喂饭                                                                        

操作流程：                                                                     

1、需餐前用药老人,协助护士目视服下,逐屋逐人按照食量准备，给老人喂饭。                                                                         

2、需餐后用药的老人，餐后半小时协助护士目视服下。                                                                       

3、喂饭时给老人带好围嘴、洗手、注意保持卫生，以免弄脏衣物及床单位。                                                                   

4、餐后协助老人清洗手及脸部卫生，保持干净并协助老人摆好舒适体位。                                                                       

5、整理卫生清洗餐具并摆放整齐，整理好床单位，做好交接班准备。                                                                       

三、晨交接班及工作重点：8:00--8:30                                                                         

1、床头交接老人的身体情况及病情变化。特殊情况必须重点交接并汇报给护士，避免脱节。                                                                        

2、从头到脚逐一检查各种管路（胃管、气管切开套管、中心静脉导管、尿管，留置针套管等）是否在位，妥善固定。                                                                   

3、逐一查看老人皮肤是否出现红、肿、破溃现象；查看保护性约束部位皮肤有无破损，红肿，约束松紧是否事宜。                                                                       

4、翻身、拍背并协助患者取舒适卧位，无禁忌症的患者床头抬高30°--45°。                                                                        

5、卫生情况：床单位是否平整、床上有无渣屑、明显污渍；地面是否有便、尿、水、垃圾未清理；床头柜、卫生间是否整洁。                                                                          

四、日常工作：                                                                     

1、8：30--9:00检查大小便情况，及时更换尿袋及纸垫并清洗干净。（必要时打开塞露协助排便）。                                                                       

2、9:00--10:00喂水、鼻饲饮食                                                                   

3、10:00--11:00翻身拍背，翻身检查受压部位皮肤、按摩骨突处（扣手轻拍）整理床单位，保持床单位干净、整洁无渣屑。                                                                          

⑴、病情允许的病人，取半坐卧位，拍背，促进排痰，加强巡视，保证患者安全。                                                                          

⑵、9:00--10:30对部分老人进行床上擦浴。                                                                      

4、11:00--12:00鼻饲饮食、经口喂饭                                                                 

⑴、需餐前用药老人协助护士目视服下，逐屋逐人按照食量准备，给老人喂饭。                                                                     

⑵、喂饭时给老人带好围嘴、洗手、注意保持卫生，以免弄脏衣物及床单位。                                                                          

⑶、餐后协助老人清洗手及脸部卫生，保持干净并协助老人摆好舒适体位。                                                                     

⑷、整理卫生清洗餐具并摆放整齐，整理好床单位。                                                                     

5、12:00--13:00                                                                       

⑴、护工轮流午餐、值班人员巡视病房，处理临时事务。                                                                     

⑵、检查大小便情况，及时更换尿袋及纸垫并清洗干净。                                                                     

⑶、酌情开窗通风，清整房间卫生。                                                                          

⑷、需餐后用药的老人，餐后半小时协助护士目视服下。                                                                     

⑸、翻身、按摩骨突处，取平卧位，做好擦洗前准备工作。                                                                          

6、13:00--14:00午睡时间                                                                      

⑴、协助老人睡前准备，放平床头，盖好被子，检查床档是否安全。                                                                          

⑵、巡视老人的睡眠情况，检查、清理病房、卫生间卫生，动作要轻柔，避免打扰老人休息。                                                                     

⑶、检查患者生活用品，如需补充，统计数量后通知家属或者主班护士，补充患者生活用品。                                                                     

7、14:00--15:00清洗时间                                                                      

⑴、做好清洗前的准备工作，打好热水，关好门窗，注意室内温度，避免老人着凉。                                                                     

⑵、对部分老人进行床上擦浴，擦洗干净，保持皮肤清洁干燥。                                                                          

⑶、清洗后整理好床单位，保持床单位干净、整洁、干燥无渣屑。                                                                     

⑷、检查大小便情况，及时更换尿袋及纸垫并清洗干净。                                                                     

⑸、协助老人摆好体位，盖好被子，检查床档是否安全。                                                                     

8、15:00--15:30 喂老人水果或果汁。                                                                         

9、15:30--16:30巡视病房。翻身、拍背，翻身检查受压部位皮肤、按摩骨突处（扣手轻拍）。                                                                        

⑴、病情允许的病人，取半坐卧位，拍背，促进排痰，加强巡视，保证患者安全。                                                                          

⑵、检查大小便情况，及时更换尿袋及纸垫并清洗干净。                                                                     

10、16:30--18:00晚餐时间（16：30--17:00鼻饲饮食，18:00--18:30经口喂饭）                                                                 

⑴、需餐前用药老人协助护士目视服下，逐屋逐人按照食量准备，给老人喂饭。                                                                     

⑵、喂饭时给老人带好围嘴、洗手、注意保持卫生，以免弄脏衣物及床单位。                                                                          

⑶、餐后协助老人清洗手及脸部卫生，保持干净并协助老人摆好舒适体位。                                                                     

⑷、整理卫生清洗餐具并摆放整齐，整理好床单位。                                                                     

⑸、需餐后用药的老人，餐后半小时协助护士目视服下。                                                                     

11、18:00--19:00 护工轮流吃饭，在岗人员加强巡视，协助经口吃饭的病人刷牙。                                                                  

⑴、检查大小便情况，及时更换尿袋及纸垫并清洗干净。                                                                     

12、19:00--19:30 翻身拍背，翻身检查受压部位皮肤、按摩骨突处（扣手轻拍），喂水。                                                                         

13、19:30--20:30 鼻饲饮食,巡视病房。                                                                     

五、晚间护理：19：30--20:00为老人泡脚，洗脸、洗手、清洗会阴。                                                                         

为老人创造良好得当睡眠环境。                                                                          

1、为避免外界的噪声，强光的刺激，干扰老人的睡眠，调节好室温及光线。                                                                   

2、21:00--21:30 翻身拍背，检查受压部位皮肤、按摩骨突处，协助患者取舒适体位。                                                                    

3、检查大小便情况，及时更换尿袋及纸垫并清洗干净。                                                                       

4、协助睡眠，熟悉掌握每个老人的睡眠习惯，更换好舒适的体位，让老人易于入睡。                                                                   

5、随时巡视，必要时给老人加减毛毯或盖被，检查床档是否安全。                                                                   

6、随时巡视，观察老人的睡眠情况、重症老人的生命体征，发现异常及时报告医护人员。                                                                  

6、21：30--22:00 鼻饲饮食                                                                 

六、夜间护理：22:00--4:30                                                                  

1、在岗人员严格遵守岗位纪律，不准睡岗。                                                                   

2、定时翻身检查受压部位皮肤、按摩骨突处（扣手轻拍，避免影响患者睡眠）。翻身时间0：00--0:30 、3:00--3:30。                                                                      

3、随时巡视，观察老人的睡眠情况、重症老人的生命体征，发现异常及时报告医护人员。及时处理大小便，保持皮肤清洁干燥。                                                                     

4、若遇水、电、暖气、氧气、门窗等故障，及时通知值班护士，以便及时处理解决。                                                                   

七、晨间卫生：4：30--5:00 （消毒痰瓶、擦拭吸痰器表面、气垫泵表面、处理垃圾）                                                                   

医养病房每周护理服务流程：                                                                     

护理员在完成日常工作流程项目时，考虑有些服务项目集中或须各组相互配合完成，故此，对某些服务项目的完成时间作如下要求：                                                                     

周一：洗头发（每周一次）。                                                                       

周二：擦拭暖瓶及暖瓶架、脸盆及脸盆架；消毒大小便器、量杯（TD 500mg/L浸泡30分钟）。                                                                     

周三：协助物业人员移开床头、床头桌、病房椅子，卫生间桌子等可移动家具，便于物业人员彻底清理卫生。清理卫生后家具、物品归位。                                                                          

周四：剃胡须、剪指、趾甲（常规每周一次，必要时随时清理。）；更换被罩、枕套、床单、病员服（每周一次，特殊情况随时更换）。                                                                   

周五：清洗患者约束带，翻身垫外罩。                                                                     

周六：擦拭床底下轱辘、床栏等死角。                                                                     

周日：消毒病人洗漱物品（脸盆，毛巾）（TD 500mg/L浸泡30分钟）。                                                                       

每周床上擦浴两次，时间按照排班表执行                                                                          

理发：新入院病情稳定患者当日理发、擦浴。老患者每月月底25号理发。                                                                        

备注：病情稳定的患者按照此流程执行，病情危重或有特殊情况的患者除外。