như bác sĩ tâm thần, dược sĩ, nhân

như bác sĩ tâm thần, dược sĩ, nhân viên xã hội, nhà tâm lý học. Tuy nhiên, đội có thêm người nhà bệnh nhân. Khi thực hiện mô hình CSBN theo đội, người nhà bệnh nhân thực hiện CSBN dưới sự quản lý, hướng dẫn, giám sát của điều dưỡng phụ trách. Đây chính là điểm mới mà Bệnh viện đã điều chỉnh khi áp dụng mô hình CSBN theo đội từ thế giới vào cho phù hợp với điều kiện, hoàn cảnh thực tế của Việt Nam. Bệnh viện còn hỗ trợ nhiều bệnh viện ở các tỉnh, thành trong nước và các bệnh viện tuyến huyện trong tỉnh như: Đa khoa Vân Đồn, Đa khoa Quảng Yên, Đa khoa Hoành Bồ, Đa khoa Khu vực Tiên Yên triển khai mô hình. Đây là mô hình thể hiện rõ hiệu quả của sự phối hợp giữa thầy thuốc và điều dưỡng.
3. Áp dụng mô hình chăm sóc theo đội trong chăm sóc loét tì đè cho người bệnh ở Bệnh viện Quận Thủ Đức- nơi tôi làm việc
Trước đây, chăm trong sóc NB loét do tì đè thì công việc chính của bác sĩ là cho thuốc kháng sinh, kháng viêm và chủ yếu chỉ quan tâm đến điều trị bệnh chính mà thôi. Và công việc của điều dưỡng và thay băng vết loét theo chỉ định. Từ khi áp dụng mô hình chăm sóc theo đội này thì tỉ lệ người bệnh bị loét giảm rõ rệt. Mỗi sáng thăm bệnh theo đội thì người điều dưỡng trưởng đội báo cáo về tình trạng vết loét, bác sĩ thăm khám rồi thảo luận với điều dưỡng và cả với người nhà về cách chăm sóc vết loét, sau đó đưa ra quyết định điều trị phù hợp. Điều dưỡng có thể quyết định dung dịch chăm sóc vết loét, băng vết loét, thời điểm và cách xoay trở người bệnh, cắt lọc vết loét đơn giản, hướng dẫn giáo dục cho người bệnh và người nhà và thảo luận với bác sĩ về việc sử dụng thuốc trong điều trị. Người nhà người bệnh cũng là thành phần quan trọng trong mô hình chăm sóc theo đội này. Ở mô hình này điều dưỡng thể hiện rõ hơn chức năng độc lập của mình và làm rõ hơn khái niệm điều dưỡng và điều trị, điều dưỡng tham gia điều trị cùng bác sĩ, bác sĩ tham gia chăm sóc cùng điều dưỡng. Để đánh giá nguy cơ loét tì của người bệnh, chúng tôi sử dụng thang điểm của Braden, điểm càng thấp thì nguy cơ càng cao: Nguy cơ thấp: >20 điểm; Nguy cơ trung bình: 16 – 20 điểm; Nguy cơ cao: 11 – 15 điểm; Nguy cơ rất cao:

Results (English) 1:

as psychiatrists, pharmacists, social workers, psychologists. However, the team have more patients. When taken according to the CSBN model team, patients make CSBN under the management, guidance, supervision of the nurse in charge. This is the new point that hospitals have to adjust when applying the CSBN model according to the team from the world in accordance with the actual circumstances, conditions of Vietnam. The hospital also supports many hospitals in the provinces in the country and the district line in the hospital such as: van Don vu, Vu Quang Yen, the raging General Bo, the first general deployment model Yen. This pattern is clearly shown the effectiveness of the coordination between nursing and physician.3. Apply care models by the team in care of ulcers in ill billion Thu Duc District Hospital-where I workPreviously, health care in NB ulcers due to major work billion of doctors for antibiotics, anti-inflammatory and mostly only interested in primary treatment only. And the work of nursing and instead of ice cold sores as directed. From when applying model of care according to this team, then the ratio of the patient suffering from ulcers markedly reduced. Every morning the team visiting the head nurse team reports on the condition of cold sores, the doctor visit and then discussed with the nursing home with and about how to care for cold sores, then treatment decisions accordingly. Nursing can decide the solution take care of sores, ulcers, ice time and turn patients, cut simple sores filter, guide and educate the patient and family and discuss with your doctor about the use of drugs in treatment. The sick people is also an important component in the model of care according to this team. In this model clearly nursing than its independent functions and clarified over the concept of nursing and treatment, nursing treatment along the doctor, the doctor taking the same care nursing. To assess the risk of ulcer sufferer's fin, we use a scale of Braden, the lower the score, the higher the risk: low risk: > 20 points; Medium risk: 16-20 points; High risk: 11-15 points; Very high risk: < 10 points and the clock turn to help control turn the patient. Nursing assessment and turning frequently to prevent and treat ulcers effectively. According to statistics of the Ministry of health, reason why can not make good this model is overloaded in hospitals, lack of human resources, particularly the lack of nursing, dependent habits of people nursing, nursing should still low level of the ability to review and independent decisions in health care are limited , administrative work, nursing's papers occupy the time rate of the equivalent direct care time with the patient, the system lacks medical Secretary. So want to maintain and develop this model requires the attention of the competent authorities.To develop this model, the first is to strengthen the role of the nurse-who has the ability to be proactive clinical decision based on knowledge and skill would like to then create the conditions for people to study nursing and professional capacity to confidence and change the look of the doctor the second is, who the doctor is responsible for coordination with the nurses rather than ordered want then the hospital must have clearly defined responsibility and authority, the third is support from the hospital manpower, manpower and financial resources to develop this model. Therefore, the important thing that I can do that is after masters degree nursing, I must be a pioneer nursing support have the right perspective on the profession of nursing, nursing is the independent activity and active in the work of patient care and coordinate with doctors in the treatment rather than the doctor's Assistant. In addition, the need to actively advised the Board of Directors in raising the efficiency of care across health care model according to the team. Moreover, the need to actively cultivate learning and enhance the knowledge to contribute to changing the look of your doctor about nursing.REFERENCESVietnam Nursing Association, with nursing care in Vietnam, retrieved from http://hoidieuduong.org.vn/tin-tuc/dieu-duong-voi-cong-tac-cham-soc-toan-dien-tai-viet-nam-a353.html on October 28, 2016Vietnam-Sweden hospital Uong bi, effective patient care model according to the team, visiting from http://vsh.org.vn/Details.aspx?opt=Tintuc & IID = Sukien-351 on October 28, 2016Hoang Le Phuong Anh (2014), Prevention, Nursing care for patients with Pressure ulcers at Icu (ICU) and Cardiac Icu (CICU) at Thu Duc district hospital in 2014, the medical magazineThe Ministry of health (2014), the continuous training document patient care comprehensive

Results (English) 2:

as psychiatrists, pharmacists, social workers, psychologists. However, the home team more patient person. When performing model CSBN in teams, the patients performed the CSBN under management, guidance and supervision of nurses in charge. This is the new Hospital where applicable adjusted according CSBN models from the world team in accordance with the conditions and the actual situation of Vietnam. The hospital also supports many hospitals in the provinces in the country and the district hospitals in the province, such as: General Van Don, Quang Yen Polyclinic, Polyclinic Hoanh Bo, Tien Yen Area Polyclinic model deployment . This is the model demonstrated the effectiveness of the coordination between physicians and nurses.
3. Applicable models of care under the care team crushed spleen ulcers for patients in Thu Duc Hospital where I worked
previously in the care of NB ulcers take billions to the main job of the physician is to drugs birth, anti-inflammatory and mainly only interested in treating the disease alone. And the work of nurses and sores dressing changes as ordered. Since the application of models of care in accordance with this team, the rate of ulcer patients significantly reduced. Every morning, the medical consultation in accordance with nursing team captain status report on the sores, the veterinarian and then discussed with the nursing home and all the people on how to take care of the ulcer, then treat decision making fit. Nurses can decide care solution sores, ulcers tape, when and how to maneuver the patient, simple excision of lesions, guidance and education to patients and family members to discuss with your doctor the use of medication in treatment. A patient who is also an important component in the model of care under this team. In this model nursing functions further demonstrate his independence and clarify the concept of nursing and therapy, nursing in treatment with your doctor, doctors involved in your care and nursing. To assess the risk of the patient's spleen ulcers, we use the Braden scale, the lower the score the higher the risk: Low risk:> 20 points; Moderate risk: 16-20 points; High risk: 11 - 15 points; The stakes are high: <10 points and turning the clock to help control the patient maneuver. Nurses need to assess and turning frequently to prevent and treat ulcers effectively.
According to statistics from the Ministry of Health, why can not implement this model is overload in hospitals, lack human especially nursing shortage, dependence habit of nursing, nursing degree is low, the ability to identify and make decisions independently in limited care, administrative work, papers nursing proportion of time equivalent to the time directly caring for patients, lack of medical secretarial system. So measures to maintain and develop this model requires the attention of the competent authorities.
In order to develop this model, the first is to strengthen the role of the nurse-who are able to actively place clinical decisions based on the knowledge and skills that they want to create conditions for the nursing learning and capacity building expertise to confidently and change the look of the doctor, the second is that the doctor must are responsible for coordinating with nurses in the work and not want to do, ordered the hospital to have clear rules on the responsibilities and powers, the third is the support from the hospital staff and material resources and financial resources to develop this model. Therefore, it is important that I can do it after nursing master degree, I must be the first to support nurses with the correct view of the nursing profession, nurses who work alone established and proactive in the care of patients and coordinate with doctors in the treatment rather than the physician's assistant as the past. In addition, the need to actively advise the board of directors effective in improving care through team-based care model. Moreover, the need to actively cultivate learning and improving knowledge to contribute to change the look of the doctor of nursing people.
REFERENCES
Vietnam Nursing Association, Nursing with comprehensive care in Vietnam, accessible from http://hoidieuduong.org.vn/tin-tuc/dieu-duong-voi-cong-tac-cham-soc-toan-dien-tai-viet-nam-a353.html, dated accessed October 28, 2016
Hospital Vietnam - Sweden Uong Bi, effective patient care models in teams, visiting from http://vsh.org.vn/Details.aspx?opt=Tintuc-Sukien&IID = 351, date accessed October 28, 2016
Hoang Le Phuong Anh (2014), Prevention, Nursing Care for patients with Intensive Care Unit at Pressure ulcers (ICU) and Cardiac Intensive Care Unit (CICU) at Thu Duc district hospital in 2014 , the medical journal
of Health (2014), continuous training material comprehensive patient care