中国医院质量安全管理 第 4-9部分：医疗管理 危急值管理 Quality and safety management of Chinese hospital—— Part 4-9: Medical Management—Critical Values ManagementICS 11.020 C 07 团 体 标 准 T/CHAS 10-4-9-2019 2019 -11-08发布 中国医院协会 发 布2020-02-01实施2019-11-08 发布 全国团体标准信息平台 T/CHAS10-4-9-2019 I目 次 前言..................................................................................................................................................................... II 1范围.................................................................................................................................................................... 1 2 规范性引用文件 ............................................................................................................................................... 1 3术语和定义 ........................................................................................................................................................ 1 4关健要素 ............................................................................................................................................................ 2 5要素规范 ............................................................................................................................................................ 2 5.1 管理体系 ............................................................................................................................................... 2 5.1.1 组织体系 ....................................................................................................................................... 2 5.1.2 制度建设 ....................................................................................................................................... 2 5.1.3 管理要素 ......................................................................................................................................... 2 5.1.4 宣教培训 ......................................................................................................................................... 2 5.2 处置规范 ............................................................................................................................................... 2 5.2.1 危急值确认 ..................................................................................................................................... 2 5.2.2危急值报告 .....................................................................................................................................3 5.2.3 危急值处置 ..................................................................................................................................... 3 5.2.4 危急值记录 ..................................................................................................................................... 3 5.3 分析评价 ............................................................................................................................................... 3 5.3.1 评价路径 ......................................................................................................................................... 3 5.3.2 评价要点 ......................................................................................................................................... 3 5.3.3 评价指标 ......................................................................................................................................... 3 5.3.4结果应用 ......................................................................................................................................... 3 5.4 持续改进 ........................................................................................................................................... 4 附录 A.................................................................................................................................................................... 5 参考文献 ..............................................................................................................................................................