Provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps Health and Health Commission, the Civil Affairs Department (Bureau), and the Chinese Medicine Administration:
In order to improve the service quality of China ’s combined medical and nursing institutions and standardize the service content of the combined medical and nursing institutions, the National Health and Health Commission, the Ministry of Civil Affairs, and the State Administration of Traditional Chinese Medicine have formulated the “Guide to the Service of Integrated Medical and Nursing Institutions (Trial)” (available from the National Health Download from the Health Commission website). Is issued to you, please follow.
Accessories: Service Guide for Integrated Medical and Nursing Institutions (Trial)
General Office of the National Health Commission
Office of the Ministry of Civil Affairs
State Administration of Traditional Chinese Medicine
December 23, 2019
(Information disclosure form: active disclosure)
Service guide for integrated medical and nursing institutions (for trial implementation)
table of Contents
1. General 1
2. Basic Requirements 1
(1) Requirements for institution setting 1
(B) Requirements for the establishment of institutional departments, staffing, facilities and equipment, and medicines 2
(3) Qualification requirements for service personnel 2
(4) Environmental requirements 3
3. Service content and requirements 4
(1) Basic services 4
(2) Medical services 4
(3) Chinese Medicine Service 8
(4) Nursing services 8
(5) Rehabilitation services 9
(6) Ancillary services 11
(VII) Psychological and spiritual support services 11
(8) Services for demented elderly 12
(9) Other requirements 13
4. Service Process and Requirements 16
(1) General rules of service process 16
(2) Service reception 16
(3) Admission medical examination for the elderly 19
(4) Aged care needs assessment 19
(5) Evaluation of the ability of the elderly 19
(6) Evaluation of traditional Chinese medicine 20
(VII) Develop service plan 20
(8) Sign service agreement 20
(9) Establishment of service files 21
(X) Provide integrated medical and nursing services 21
V. Appendix 22
In order to meet the needs of the development of China ’s integrated medical and nursing institutions, improve its service quality, standardize its service content, after extensive investigation and research, refer to relevant standards and regulations of relevant departments, and follow the principles of comprehensiveness, accuracy, timeliness and practicality, this book is specially formulated guide.
This guide applies to all types of medical and nursing institutions in the country. An integrated medical and nursing institution refers to a medical institution or an old-age institution that has both medical and health qualifications and old-age service capabilities. It mainly includes two forms: the establishment of an old-age institution or the establishment of a medical institution and the establishment of a medical institution. The integrated medical and nursing institutions mainly provide services such as old-age care, medical care, nursing, rehabilitation, assistance and psychological support for the elderly living in the institutions. The medical and health services and old-age services provided by the combined medical and nursing institutions shall be subject to the current norms, standards and management regulations for medical and health services and old-age services, respectively.
This guide regulates the service content and service requirements that medical and nursing institutions should provide. The service content is determined according to the service capabilities of most of the current integrated medical and nursing institutions in China and the needs of the elderly. The integrated medical and nursing institutions can expand the service content based on the institutional qualifications and service capabilities.
The main contents of this guide include: basic requirements, service content and requirements, service processes and requirements.
2. Basic requirements
(1) Requirements for institution setting
1. It should have a medical institution's license to practice or file in the health administrative department (including the competent department of traditional Chinese medicine, the same below), and register in the civil affairs department for pension institutions.
2. Institutions providing integrated catering services for medical and nursing care shall hold food business licenses.
(B) Requirements for the establishment of departmental departments, staffing, facilities and equipment, and medicines
1. In the medical institutions of the combined medical and nursing institutions, the department setting, staffing, facilities and equipment, and medicines should be in accordance with the types of medical institutions and correspondingly meet the "Basic Standards of Medical Institutions (Trial)" and "Basic Standards of Rehabilitation Hospitals (2012 Edition) ) ”,“ Basic Standards for Nursing Homes (2011 Version) ”,“ Basic Standards for Nursing Centers (Trial) ”,“ Basic Standards for Rehabilitation Medical Centers (Trial) ”,“ Basic Standards for Anning Medical Center (Trial) ”,“ Elderly Care Institutions Basic Standards for Medical Offices (Trial), Basic Standards for Nursing Stations in Nursing Agencies (Trial), Basic Standards for Clinics, Basic Standards for Traditional Chinese Medicine Clinics, Basic Standards for Traditional Chinese Medicine (Comprehensive) Clinics, Basic Standards for Integrated Chinese and Western Medicine Clinics Standards ”and other basic requirements of medical institutions.
2. For the elder care institutions in the combined medical and nursing institutions, the "Basic Standards for Elderly Care Institutions" (GB / T 29353), "Basic Standards for Service Quality of Elderly Care Institutions" (GB / T 35796), and "Architectural Design for Elderly Care Facilities" Standards (JGJ450) and other national and industry standards require that medical and nursing institutions providing rehabilitation services should be equipped with rehabilitation equipment commonly used by the elderly.
(3) Qualification requirements of service personnel
1. Medical personnel should hold the qualification certificates issued by relevant departments, and meet the requirements of the relevant national regulations and industry standards on qualifications and conditions for practice.
2. Medical nurses and senior nursing staff shall pass the relevant training and pass the post.
3. Rehabilitation therapists, public nutritionists, psychological counselors, social workers and other relevant personnel hired according to service needs shall hold qualification certificates issued by relevant departments.
4. Catering staff should hold a Class A health certificate.
(4) Environmental requirements
1. The architectural design of the newly-built medical and nursing integration institution should meet the requirements of the "Architecture Design Standards for Elderly Care Facilities" (JGJ450).
2. The building of a combined medical and nursing institution shall meet the relevant requirements of the fire department and be equipped with fire-fighting facilities and equipment. The fire extinguisher should be equipped in accordance with the "Code for the Design of Building Fire Extinguisher Configuration" (GB 50140).
3. For indoor air, the requirements of "Indoor Air Quality Standards" (GB / T 18883) are applicable; environmental noise should meet the requirements of the "Acoustic Environmental Quality Standards" (GB 3096) for the environmental noise limits of category 0 institutions; the lighting level should meet the "building lighting" The requirements for lighting in residential buildings and medical construction sites in the Design Standard (GB 50033).
4. Setting the corresponding place logo pattern applies to the requirements of "Public Information Graphic Symbols for Signs: Part 6: Health Care Symbols" (GB / T 10001.6) and "Graphical Symbol Terminology Part 2: Signs and Guidance System" (GB / T 15565.2); Barrier-free facilities symbols apply to the requirements of "Public Information Graphic Symbols for Signs Part 9: Barrier-Free Facilities Symbols" (GB / T 10001.9).
5. The housing area of the medical institutions in the combined medical and nursing institutions should meet the requirements for the housing area of various medical institutions in the "Basic Standards of Medical Institutions"; the housing area of the pension institutions should meet the requirements of 6.3.1 of the "Basic Standards for the Service Quality of the Elderly Institutions".
6. The facilities and equipment for the elderly living room and the safety and barrier-free facilities are applicable to the "Building Design Standards for Elderly Care Facilities" (JGJ450), "Safety Management for Elderly Agencies" (MZ / T032), and "Basic Standards for Elderly Agencies" (GB / T 29353), "Barrier-Free Design Code" (GB50763) and other relevant standards and requirements.
3. Service content and requirements
The service items that various medical and nursing institutions should provide include but are not limited to: basic services (life care services, meal services, cleaning and sanitation services, washing services, cultural and entertainment services), nursing services, psychological and spiritual support services; The type and qualifications of the institution focus on the provision of other services described in this chapter. For example, the establishment of a general hospital, a traditional Chinese medicine hospital, and a combination of medical and nursing institutions should provide common diseases for the elderly, frequently-occurring Chinese and Western medicine diagnosis and treatment, regular visits, referral for critical illness, For emergency services, such as emergency medical care, the medical and nursing institutions that set up a tranquility care center should provide tranquility care.
(1) Basic services
The requirements such as “Basic Standards for Service Quality of Elderly Care Institutions” (GB / T35796) and “Classification and Evaluation of Elderly Care Institutions” (GB / T37276) are applicable to life care services, meal services, cleaning and sanitation services, washing services and cultural entertainment services.
(2) Medical services
1. Regular visits
(1) According to the health needs of the elderly, doctors should be arranged to visit the room where the elderly live regularly and make records.
(2) Physicians should record the elderly's blood pressure, heart rate and other physical conditions during the rounds, and find out the changes in the elderly's condition in time.
(3) In the process of patrol, health guidance services can be provided for the elderly in need.
2. Diagnosis and treatment of common and frequently-occurring diseases in the elderly
(1) Before the diagnosis and treatment, the old man's medical history should be asked in detail, and a careful physical examination should be carried out. In the process of diagnosis and treatment, it is necessary to carry out the necessary physical examination and auxiliary examination.
(2) The elderly's medical condition, allergy history, medication history, and adverse reaction history should be evaluated.
(3) Before administration, the prescriptions and medicines should be checked, and the elderly should be assisted to use the medicines in accordance with the relevant regulations of the health and administrative department, so as to avoid misuse or missed.
(4) Qualified institutions can provide remote medical services to assist diagnosis and treatment.
(5) Refer to the published clinical route and relevant diagnosis and treatment guidelines to provide diagnosis and treatment services for the elderly with common diseases and frequently-occurring diseases.
3. Emergency Ambulance Service
(1) Qualified institutions should arrange for medical staff to be on duty 24 hours a day to provide emergency medical services in a timely manner.
(2) For the critical and severe diseases that are unable to deal with, follow the principle of nearest referral, immediately call 120 or telephone to notify the superior hospital to send an ambulance to take the elderly to the hospital for rescue, and notify their families. Before the ambulance arrives, the on-site medical staff can perform necessary treatment measures according to the elderly's condition, such as cardiopulmonary resuscitation, cleaning the respiratory tract and mask oxygen.
4. Critical referral services
(1) The combined medical and nursing institutions can establish contractual cooperative relations with surrounding general hospitals and traditional Chinese medicine hospitals, set up green channels for referrals, clarify service procedures, and ensure timely and effective referrals.
(2) If the combined medical and nursing institution encounters unsolvable technical problems during the diagnosis and treatment, or the patient's condition exceeds the professional scope or medical level of the combined medical and nursing institution, it should seek the consent of the family and provide the patient with timely and effective Referral services.
(3) Special medical staff or service personnel familiar with the patient's situation can be arranged to follow the referral or connect with the referral hospital to keep abreast of the patient's condition.
5. Peaceful treatment
(1) Medical personnel mainly provide elderly people with humanistic care services such as pain and other symptom control, comfortable care, psychological, spiritual and social support, etc., and should refer to the content of the "Guide to Practice of Peaceful Nursing (Trial)".
(2) Medical staff mainly control the symptoms of pain, dyspnea, cough, hemoptysis, vomiting, bloody stools, bloating, edema, fever, anorexia, dry mouth, insomnia and other symptoms for the elderly who need peace and care. After the drug treatment, pay attention to observe the drug efficacy and adverse reactions. If any abnormal situation occurs, deal with it in time.
(3) According to the needs of the elderly, it can help patients cope with emotional reactions, seek social support, and provide patients with psychological support and humanistic care services such as death education. The patient ’s values and beliefs should be respected, and the patient ’s privacy and rights should be protected.
6. Health management services