medical simulator

Twelfth lunar month, afternoon, 35:[-].

Zhou Cheng is taking the opportunity to take a nap in the doctor's lounge. He finished today's routine consultation and an emergency department at [-]:[-], and he sorted out all the discharged medical records in the department yesterday, so even if he does not quality control the discharged medical records today, he will not There will be delays.

With more than ten days of general hospitalization experience, Zhou Cheng understands very well that the general hospitalization must survive, sleep if you can sleep, rest if you have time to rest, and eat when you can. It is best to eat at the time of meal. , Hurry up and eat as soon as possible after surgery.

Don't be entangled, don't procrastinate, otherwise, you will have nothing to eat, not only one meal, but the next meal.

Zhou Cheng tried it one day, from noon of one day to four o'clock in the afternoon of the next day, except for two glasses of water, there was no drop of rice.Wanting to open a bottle of sugar water, but afraid of being photographed and making a fuss on the Internet, Zhou Chengcheng held back and almost had hypoglycemia.

Still couldn't help it, An Ruo sent him a few chocolates through the remote control, so that he was able to continue his life without fainting!

At 37:[-], Zhou Cheng's phone rang.

It wasn't the magical ringtone of the total hospitalization, but his own mobile phone.The caller ID is Ding Changle.

"Zhou Cheng, where are you now?" Ding Changle's tone was very urgent, as if the sky was about to fall.

"I'm in the department, Director Ding." Zhou Chenghui said.

"I don't care where you are. Go to the department immediately. On the operating table, get off the stage immediately, go to the department to sort out all the medical records on the shelf, and check the medical orders of all the patients on the shelf." Ding Changle told very urgently.

"Director Ding, I'm in the department." Zhou Cheng replied again, hoping to calm down Ding Changle's anxious heart.

"I know you're in the department."

"Hurry up and check the on-shelf doctor's orders of all patients. All medications should be taken according to the principles, and all medications outside the principles should be stopped! Inform all residents to call the department! I will go to the department right away."

"Urge the bed doctors of each group to come to work and check all the medical records on the shelf. They should also print them out and put them in the medical record folder for inspection."

"Also notify the nurse and head nurse to remove all the messy dressings that shouldn't be in the department."

Ding Changle's tone became messy.

Huaguo's central inspection team first went to several hospitals in Shashi for several days, and now they have notified the leaders of the Health and Health Committee, which proves that they have some solid evidence, and they can turn from the dark to the clear.

This is no joke!
See gods and kill gods, see Buddhas and kill Buddhas.

Unless it is a feudal official, the deputy feudal official will be killed without fail!

Before Ding Changle arrived at the department, Cai Dongfan and Wang Yunfa had already rushed to the department, with nervous expressions on their faces, but when they entered the office door and found that all the doctors in charge of the bed were at their posts, they felt very worried. breathed a sigh of relief.

The Central Inspection Team has now arrived in Shashi, and even made an unannounced visit to the Affiliated Hospital of Shonan University, and now it has turned from the dark to the clear, it must be here to kill people.

If at this time, there is no more useful inpatient general, and the doctors in charge of the bed cannot be gathered for a while, then many vacancies and loopholes will have to be filled by their superior doctors.

Zhou Cheng saw Professor Wang Yunfa and Cai Dongfan coming to the door, so he went up to greet him, first said to the doctor in charge, "Now you can't modify the doctor's order casually! Everyone must have heard clearly, don't modify the doctor's order casually!"

"First complete all the medical records on the shelf, complete the logical explanation for all medications on the shelf, and complete the supporting reasons for laboratory tests and physical examinations if antibiotics have been used for more than 48 hours. There should be no loopholes. In the medical records, the doctor's order system should be reflected. The indications and reasons for all medications!"

"I have asked you to amend your doctor's orders before, and you are checking them every day. Don't make any amendments now."

"If you don't understand anything, consult the superior doctor in charge of this group, or come to me directly."

"The servants in the department are in charge!" Zhou Cheng gave orders.

A group of people moved one after another, this

At this point, the professor may not be able to keep himself safe, and it is normal for the resident doctor to be pulled out to take the blame...

After speaking, Zhou Chengcheng came to the door and went straight to the director's office.Because Professor Cai Dongfan and Professor Wang Yunfa had already transferred to the director's office after seeing Zhou Cheng in the office.There are only six computers in the doctor's office, and there are twelve doctors in charge, which may not be enough.

The director's office is equipped with three computers that can be connected to the doctor's order system. What they need to do now is to check the doctor's orders of all the patients in the bed.

"Director Ding, Professor Wang, Master." The door of the director's office was ajar, and Zhou Cheng was not polite. He opened the door and called for someone.

"Close the door." Cai Dongfan took a deep breath and said.

Zhou Cheng closed the door naturally, but just as the door was about to close, Ding Changle just arrived at the door and pushed it open again.

Zhou Cheng turned his head and saw Ding Changle, he quickly stepped aside and invited Ding Changle in.

"Director Ding!"

"Director Ding." At this time, Wang Yunfa and Cai Dongfan were extra polite.

Ding Changle is the administrative director of the Trauma Surgery Department. If any problems are found in the Trauma Surgery Department, Ding Changle will be the first person in charge.And no matter how big the problem is, as long as there is no special problem in the individual, then only Ding Changle will be dealt with, and everyone will not be beaten to death with a stick.

Because Trauma Surgery can't function if all the superiors in Trauma Surgery are wiped out.

Ding Changle did not return to Wang Yunfa and Cai Dongfan, but looked at Zhou Cheng, lowered his voice, and said very anxiously: "Do you usually check the doctor's orders in the department?"

When the central inspection team comes to investigate, it is to investigate the trend of injustice.Check that the drug that should not be prescribed to the patient is prescribed to the patient.In other words, some doctors ask patients to go to outside prescriptions to buy medicines at designated places. Both of these are fatal situations.

And there are some junior doctors who like to do this very much.Just for a little kickback.

Zhou Cheng said: "When all the bed doctors entered the department, I had already done pre-admission training, and basically I checked the medical orders of all bed patients in the department every day."

"Director Ding, you also supported me before."

"There are basically no drugs that should not appear in our department. However, in addition to the patients in our group, I also have accounting for the doctor's orders of Director Ding's group and Professor Wang's group."

"But only for this month, the previous medical records and doctor's orders have not been cleared."

"However, I have already sorted out all the discharge medical records, so I shouldn't go to the medical record room to check!"

"In addition, there is protein powder in the medicine we use in trauma surgery. I also check it every day. Basically, those who use protein powder have hypoalbuminemia, but according to the principle, only when it is lower than 30 , you can take protein powder supplements orally, and you can supplement albumin intravenously when it is lower than 25. "

"This point, if you check carefully, there may be problems, because many patients between 31 and 35 have been prescribed protein powder directly in our department."

"In terms of postoperative medication, the main medications we use in trauma surgery are: anti-inflammatory, analgesic, detumescence, tonic, and anticoagulant drugs."

"The use of anti-inflammatory drugs: At present, in addition to the 15 beds in Professor Wang's group, the 2.4 beds in your group, Director Ding, and the 34 beds in our group, piperacillin and sulbactam are used instead of cefuroxime. I also looked at these four beds. The fifteen beds in Professor Wang’s group had fluid exudate from the wound, and had undergone a debridement after the first open fracture.”

"However, the exudate was not sent for bacterial culture after the operation, so the drug has not been stopped until today."

"The 2 beds in Director Ding's group have drug susceptibility results and consultation opinions from the pharmacy department, and the current wound is still infected. The last drug susceptibility culture results were two days ago."

"Bed 4, it belongs to hypoproteinemia wound pus, although there is no consultation opinion from the pharmacy department, but I also called for consultation today, the pus from the patient's wound is sudden, it seems that the doctor on duty sent it yesterday afternoon

present, but not dealt with in a timely manner. "

"Just now, I have called the consultation number of the pharmacy department. Mr. Sun of the pharmacy department said that he will come to our department in an hour. Because there are many people for consultation now."

"The 34 beds in our group, as you know, master, this patient had no exudate after surgery, but had hemorrhage, and the culture result of the exudate was piperacillin sensitive, but cefuroxime was ineffective. The current wound recovery is good. I had a consultation with the pharmacy department, and I can use piperacillin. After checking the laboratory test results two days ago, I asked for a consultation with the pharmacy department, and it is recommended to continue using it.”

"Because the inflammatory indicators are relatively high."

"This is antibiotics, and there are postoperative pain relief drugs. The non-steroidal intravenous drug currently used in our department is Trina (parecoxib sodium) qd, and the oral drug is celecoxib 0.1gbid. At present, our There is no violation of the regulations."

"The stomach-protecting drug is also Lansoprazole, which is commonly used. This is the time of use. It is a little bit longer than the time. It has been used for three days. I stopped the drug when I reminded it, but it should be harmless..."

"Most of the anticoagulant drugs are low-molecular-weight heparin sodium and nadroparin calcium, both of which are included in the guidelines!"

"Low-molecular-weight heparin sodium costs more than ten yuan a piece, and Naqu costs more than 40 yuan. But Naqu is also a routine drug after surgery. I also read it in the guidebook. It is a first-line drug. On the contrary, the low-molecular-weight heparin sodium we use is a second line."

"However, the use of Nadroparin Calcium is mostly used for the treatment of thrombosis and preventive medicine. It seems to be a bit too hard."

"Mannitol is the usual anti-swelling drug. This is nothing special. Other Chinese patent medicines that have been used intravenously before, such as aescin and compound Danshen injection, were temporarily stopped by me."

Zhou Cheng reported everything in detail, not only to explain the problem to Ding Changle and others, but also to reassure them that he really put his heart into it during the period when he was hospitalized as the chief.

However, when Zhou Cheng said this, he was still a little guilty, because he still had something to say, that is, the reason why the junior doctor used Naqu was because a drug representative had found it in private.Although the effect of nagqu is better than that of low molecular weight heparin sodium, it is used in violation of regulations. The prophylactic use of nagqu is a bit too aggressive.

It is estimated that there is a kickback of a few dollars.And it does not rule out that the superior doctors in the department have told the subordinate doctors.

There were only a few people in the department, and Zhou Cheng didn't dare to offend them. After all, in terms of the hospital's hierarchical system, their prescription rights were higher than his own, so it was unreasonable.Moreover, it is written in the guideline that if necessary, intravenous anticoagulation with nadroparin calcium is recommended.

As for Chinese patent medicines such as sodium aescinate and compound salvia miltiorrhiza, although they have the effect of reducing swelling, they are not as intuitive as mannitol. Zhou Cheng himself was not sure, so he stopped immediately.Even though these two drugs were mentioned in the guideline, Zhou Cheng didn't understand their mechanism of action, so he refused to use them.

Ding Changle called Zhou Cheng to come to the department so urgently, and Cai Dongfan and Wang Yunfa also arrived immediately, there must be something wrong.

When the higher authorities come to check hospitals, they are nothing more than checking random fees and prescribing medicines.Are there any cases of illegal drug use?

Fortunately, Zhou Chengyou checked the medical orders of all patients in the department every day, so some people from the general surgery department who came to the orthopedics department were not allowed to bring the applicable medicines for patients after general surgery. Zhou Cheng stopped.

And he also told the nurse station that if any strange drugs were found in the department, he would call me directly.

Hearing this, Ding Changle let out a long sigh of relief: "That's okay, Xiao Zhou, thank you for your hard work."

"Cai Dongfan, Wang Yunfa, a few days ago, the unannounced visit team of the Central Inspection Team came to our hospital, so recently, we must strictly use medication. I know that it is not easy to be a doctor, but you can't offend the mold."

"Later, you will go to the teacher to check the ward, review all the medical orders of the patients on the shelves, stop all the available ones, and stop all the antibiotics that have exceeded 48 hours. If you can't stop, you should ask If you have a consultation, please consult."

"In addition, you should also take some time to review a copy of the medical order standard of your own group, and then submit it to

Give it to Xiao Zhou, let Xiao Zhou transfer it to the bed doctor who will come to the department in the future. "

"Nowadays is an eventful time. If the unannounced visit team turns to the light, there must be people who will suffer. At this time, we can't be a chicken to make an example of others."

Just as Ding Changle was finishing speaking, he saw Fang Xiao and Du Xiaoshen rushing to the door of the director's office.

Du Xiaoshen immediately found Professor Wang Yunfa, and then whispered something.When Wang Yunfa heard this, he scolded: "You too!"

"Forget it, it's too late to talk about this now, so hurry up and fix it. You have to take responsibility. Fortunately, Xiao Zhou is always in the department and has the habit of reviewing all doctor's orders. Otherwise, you will be in bad luck!"

Du Xiaoshen didn't refute, but just glanced at Zhou Cheng, his face full of joy.

In fact, everyone knew what Du Xiaoshen said.

Du Xiaoshen is currently in charge, although he is in charge, the performance distribution is higher than Zhou Cheng's, but it is not as good as Zhou Cheng's.Zhou Cheng now has a talent introduction plan, and his monthly bonus may be much higher than that of Du Xiaoshen.

Moreover, Zhou Cheng also has a secret performance reward, which is not on the surface.

Du Xiaoshen is now the attending doctor of the Affiliated Hospital of Shonan University, and after deducting the five social insurances and one housing fund in one month, it is only about [-].

He is already a wife and father, with a mortgage and a car loan, and the consumption level in Shashi is not low.

Du Xiaoshen seemed to be an employee of the Affiliated Hospital of Shonan University. He had a decent job, but he only had a decent job left.It is estimated that outsiders will not believe that he only has this salary, but it is the truth.

Fang Xiao is much better, because the associate professor can perform many surgeries, so the salary is naturally not bad.

Du Xiaoshen remained silent and could only lower his head.

After Ding Changle, Wang Yunfa and others completed the medical orders and medical records on their respective groups, they left, but before they left, Du Xiaoshen and Fang Xiao both handed over the revision of the medical records to Zhou Cheng.

Du Xiaoshen has already been in the general hospital for four years, and is about to be promoted to deputy high school. He is really not very proficient in medical record management.So even if it is modified, I am afraid that there will be flaws.

Of course, the two of them were quite generous when they told Zhou Cheng to do things. They directly invited everyone in the department to eat and drink. Those who want to drink milk tea drink milk tea, those who want to eat pizza eat pizza, and what kind of Detianshun rice is available. .

And the nurses were also invited to dinner.

Seeing the mess on the table, Zhou Cheng smiled helplessly.

Total hospitalization Total hospitalization, always in the hospital.The chores are naturally done by the general hospital.

However, at six o'clock in the afternoon, Zhou Chengcheng received a call from Ding Changle, and the first sentence he said was: "Xiao Zhou, did you get some notice in advance? And then you didn't tell the hospital?"