Chapter 392: Zhou Cheng is the lucky star of our department
The 12th day of the twelfth lunar month, afternoon, 3:35.
Zhou Cheng was taking a nap in the doctor's lounge. He finished today's regular clinic and an emergency room at 2:40. He also sorted out all the discharge medical records in the department yesterday, so even if he did not quality control the discharge medical records today, he would not
There will be delays.
After more than ten days of general hospitalization experience, Zhou Cheng understands very well that to survive a general hospitalization, sleep when you can, rest when you have time, and eat when you can. It is best to eat at meal time. If it is past meal time,
, I hurriedly had the surgery and had a meal right away.
Don't get entangled or procrastinate, otherwise, you won't have anything to eat, not only for one meal, but also for the next meal.
Zhou Cheng tried it one day. From noon one day to four o'clock the next afternoon, he didn't touch any rice except two glasses of water. He wanted to open a bottle of sugar water, but he was afraid of being photographed and causing trouble on the Internet. Zhou Cheng couldn't bear it.
I almost suffered from hypoglycemia.
I couldn't help it anymore, so I used the remote control to send Anruo a few chocolates in the middle, and he was able to stay alive without fainting!
At three thirty-seven, Zhou Cheng's phone rang.
It's not the magic ringtone of the Chief Hospitalist, but my 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 Cheng replied.
"I don't care where you are, go to the department immediately, get on the operating table, get off the stage immediately, go to the department to sort out all the medical records on file, and check the medical orders on file for all patients." Ding Changle informed very urgently.
"Director Ding, I'm in the department." Zhou Cheng replied again, hoping to calm Ding Changle's anxious mind.
"I know you are in the department."
"Hurry up and check the existing medical orders for all patients. All medications should be taken according to the principles. All medications outside the principles should be stopped! Inform all resident doctors to call the department! I will be in the department immediately. "
"Supervise the doctors in charge of each group to come to work and check all existing medical records. They must print them out and put them in the medical record folder for inspection."
"In addition, notify the nurse and head nurse to remove all the messy dressings that should not be in the department."
Ding Changle's tone became confused.
China's Central Inspection Team first visited several hospitals in Shashi for several days undercover. Now they have openly informed the leaders of the Health Commission, which proves that they have obtained some ironclad evidence and can turn from covert to clear.
This is no joke!
Kill gods when you see them, kill Buddhas when you see them.
Unless he is a high-ranking official in the border area, all the deputy border officials 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. However, when they entered the office door and found that all the bedside doctors were at their posts, they felt very sad.
He breathed a sigh of relief.
The Central Inspection Team has now arrived in Shashi, and has also come to the Shonan University Affiliated Hospital for an unannounced visit. And now it has become clear that they are definitely here to kill people.
If there is no more effective inpatient general at this time and the bedside doctors are not fully gathered at the same time, many vacancies will have to be filled by their superior doctors.
When Zhou Cheng saw Professor Wang Yunfa and Cai Dongfan arriving at the door, he went up to them and said to the doctor in charge: "You can't change the doctor's orders casually now! You must have heard clearly, don't change the medical orders casually!"
"First complete all existing medical records. All medications in the existing medical records should be supplemented with logical explanations. If antibiotics have been used for more than 48 hours, complete the supporting reasons for laboratory examinations and physical examinations. There should be no loopholes. The medical records should reflect the doctor's order system.
All indications and reasons for taking medications!"
"I have asked you all to modify the medical orders before. I will check them every day. Don't make any modifications now."
"If you don't understand anything, please consult the superior doctor in charge of this group, or come to me directly."
"The general resident who is the follower in the department should take charge!" Zhou Cheng gave the order.
A group of people started to move one after another.
At this point, the professor may not be able to keep his integrity. It is normal for the resident doctor to be dragged out to take the blame...
After saying that, Zhou Cheng 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 when they saw Zhou Cheng entering the office. There were only six computers in the doctor's office, and there were only six computers in the doctor's office.
There are twelve bedside doctors, which may not be enough.
The director's office is equipped with three computers that can be connected to the medical order system. What they have to do now is to check the medical orders of all the patients in the bed.
"Director Ding, Professor Wang, Master." The door to the director's office was ajar. Zhou Cheng was not polite and pushed the door open first, then called someone directly.
"Close the door." Cai Dongfan took a deep breath and said.
Zhou Cheng naturally closed the door, but just as he was about to close it, Ding Changle arrived at the door and opened it again.
Zhou Cheng turned around and saw Ding Changle, quickly stepped aside and invited Ding Changle in.
"Director Ding!"
"Director Ding. "At this time, Wang Yunfa and Cai Dongfan were particularly polite.
As the administrative director of the Trauma Surgery Department, Ding Changle is the first person in charge if any problems are discovered in the Trauma Surgery Department. And no matter how big the problem is, as long as there are no special problems on the individual, then the person who is to be dealt with will
There must be only Ding Changle, and he won't beat everyone to death with a stick.
Because if all the superiors of the trauma surgery department were taken away, the trauma surgery department would not be able to function.
Ding Changle did not reply to Wang Yunfa and Cai Dongfan, but looked at Zhou Cheng, lowered his voice and said anxiously: "Do you usually follow the medical orders in the department?"
The Central Inspection Team came to investigate to check for unhealthy practices. To check for drugs that should not be prescribed to patients, but they were prescribed to patients. Or some doctors asked patients to go to designated prescriptions outside to buy medicines. These two types,
They are all doomed.
And some lower-level doctors like to do this just for a little kickback.
Zhou Cheng said: "When all the bedside doctors enter the department, I have already done pre-admission training, and basically I check the medical orders of all the patients in the department every day."
"Director Ding, you have supported me before."
"There are basically no drugs like that that shouldn't appear in our department. However, in addition to the patients in our group, I also have accounting for the medical orders from Director Ding's group and Professor Wang's group."
"But it's only for this month. The previous medical records and medical orders will not be cleared."
"But I have sorted out all the discharge medical records, so I won't go to the medical record room to check!"
"In addition, the medicine we use in trauma surgery is protein powder. I also check it every day. Basically, those who use protein powder have hypoalbuminemia. But in principle, only when it is lower than 30
, can only take oral protein powder for supplementation, and can only take intravenous supplementation of albumin if it is below 25."
"If we examine this carefully, there may be a problem, because many patients aged 31-35 are directly prescribed protein powder in our department."
"Among the post-operative medications, the drugs we mainly use in trauma surgery are: anti-inflammatory, analgesic, swelling, 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, they use piperacillin and sulbactam instead of cefuroxime.
I also looked at these four beds. The fifteen beds in Professor Wang's group had exudate from the wounds and had undergone debridement after the first open fracture."
"But after the operation, the exudate was not sent for bacterial culture, so the medication has not been stopped to this day."
"The two beds in Director Ding's group have drug sensitivity results and consultation opinions from the pharmacy department, and the current wounds are still infected. The last drug sensitivity culture results were two days ago."
"Bed 4 has hypoalbuminemia and wound pus. Although there is no consultation opinion from the pharmacy department, we still requested a consultation today. The patient's wound pus was sudden. It seems that the doctor on duty yesterday afternoon reported it.
It was discovered, but it was not dealt with in time.”
"Just now, I called the pharmacy department for consultation. Teacher Sun from the pharmacy department said that he will come to our department in an hour. Because there are many people asking for consultation now. "
"We have 34 beds in our group. As you know, Master, this patient has no effusion after surgery, but there is oozing of blood, and the culture result of the oozing blood is that it is sensitive to piperacillin and ineffective to cefuroxime. The current wound recovery is OK, please ask before
After a consultation with the pharmacy department, you 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 inflammation index is relatively high."
"These are antibiotics and postoperative analgesic 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, we
There is no illegal use."
"The gastroprotective drug is also commonly used lansoprazole. It was used for this time, but it was a little over the time. It was basically used for three days. I stopped the drug when I reminded it, but it should be harmless..."
"Most of the anticoagulant drugs used 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 is more than forty. But Naqu is also a routine postoperative medication. I also saw it in the guide book that it is a first-line medication. Instead, we use low molecular weight heparin sodium.
Belongs to the second tier."
"However, the use of nadroparin calcium is mostly used for the treatment of thrombosis and preventive medication. It seems to be a bit excessive."
"The conventional anti-swelling drugs are mannitol, but there is nothing special about this. Some people have used other Chinese patent medicines for intravenous injection in the past, such as aescin and compound salvia miltiorrhiza injection, but I temporarily stopped them."
Zhou Cheng reported back everything in detail, not only to explain the problem to Ding Changle and others, but also to reassure them that he was really attentive during his time as chief hospital officer.
However, when Zhou Cheng said this, he still felt a little guilty, because he still had something to say, which was that the reason why lower-level doctors used Naqu was because there was a drug dealer who had found it privately. Although the effect of Naqu was lower than that of
Molecular heparin sodium is better, but its use is illegal, and the preventive use of Natrex is a bit too strong.
It's probably a kickback of a few dollars. And it's not ruled out that the senior doctor in the department told the junior doctor.
There are only a few people in the department, and Zhou Cheng doesn't dare to offend him. After all, in terms of the hierarchy in the hospital, their prescription power is higher than his own, so this cannot be discussed. Moreover, what is written in the guide is 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 was not sure about taking them, so he stopped them directly. Even the guide said that these two
There were several kinds of medicines, but Zhou Cheng didn't understand how they worked, so he refused to use them.
Ding Changle called Zhou Cheng to the department in such an urgent manner, and Cai Dongfan and Wang Yunfa also arrived immediately. There must be something wrong.
When the hospital is inspected, it is nothing more than checking for arbitrary charges, arbitrary prescribing of drugs, and illegal use of drugs.
Fortunately, Zhou Chengyou checked the medical orders of all patients in the department every day, so he did not ask some people from the general surgery department to come to the orthopedics department to bring the appropriate drugs for patients after general surgery. Even if they did, they would be taken away immediately.
Zhou Cheng stopped.
Moreover, he also told the nursing station that if any unfamiliar drugs are found in the department, he will call me directly.
When Ding Changle heard this, he breathed a long sigh of relief: "That's okay, Xiao Zhou, thank you for your hard work."
"Cai Dongfan, Wang Yunfa, and an undercover investigation team from the Central Inspection Team came to our hospital a few days ago, so in the recent period, we must strictly take medication. I know it is not easy to be a doctor, but we cannot offend."
"You will go to the doctor to check the ward later, review the medical orders of all the patients on the shelf, and stop all the ones that can be used or not. If the antibiotics have been used for more than 48 hours, stop them all. If you can't stop them, you should ask for help.
If you want a consultation, please consult me.”
"In addition, you should also quickly take some time to review a copy of your own medical order standards, and then submit it.
Give it to Xiao Zhou and ask him to transfer it to the bedside doctor who will come to the department later."
"These are troubled times. As the secret investigation team turns from dark to bright, someone is bound to suffer. At this time, we can't be a chicken that kills the chicken to scare the monkeys."
Just as Ding Changle finished speaking, he saw Fang Xiao and Du Xiaoshen rushing to the door of the director's office.
Du Xiaoshen found Professor Wang Yunfa immediately and whispered something. When Wang Yunfa heard this, he cursed: "You too!"
"Forget it, it's too late to talk about this now, hurry up and make up for it. You also 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 big trouble!"
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 now the attending physician. Even though he is the attending physician, the performance distribution is higher than that of Zhou Cheng, but it is actually not as good as Zhou Cheng. Zhou Cheng now has a talent introduction plan, and the bonus given to him every month is much higher than that of Du Xiaoshen.
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Moreover, Zhou Cheng also has secret performance rewards, which are not revealed openly.
Du Xiaoshen is now the attending physician at the Shonan University Affiliated Hospital. After deducting five insurances and one housing fund, Du Xiaoshen can only get about 15,000 yuan a month.
He is already a married father, has a house loan and a car loan, and the consumption level in Shashi is not low.
Du Xiaoshen seems to be an employee of the Shonan University Affiliated Hospital. He has a decent job, but only a small salary. I guess outsiders don't believe him when he says that his salary is only this small amount, but this is the fact.
Fang Xiao is much better, because the associate professor can be the chief surgeon and can perform many surgeries, so the salary is 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 of their respective groups, they left. But before leaving, Du Xiaoshen and Fang Xiao handed over the modification of the medical records to Zhou Cheng.
Du Xiaoshen has already passed the four years of being a general resident and is about to be promoted to associate professor. He is really not very skilled in medical record management. Therefore, even if he changes it, he is afraid that there will be flaws.
Of course, the two of them were quite generous when they asked Zhou Cheng to do the work. They directly invited everyone in the department to have dinner and drinks. Those who wanted to drink milk tea had milk tea, and those who wanted to eat pizza had pizza. Detianshun rice dumplings were all provided.
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And the nurses were also invited to dinner.
After seeing the mess on the table, Zhou Cheng also smiled helplessly.
The chief resident always lives in the hospital. The chores are naturally done by the chief resident.
However, at six o'clock in the afternoon, Zhou Chengcheng received a call from Ding Changle. The first sentence he said was: "Xiao Zhou, did you get any notice in advance? And then you didn't tell the hospital?"