| 从病历书写论实习、试用期医务人员的监管成效 |
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| 引用本文： | 杨波,梁庆宇,刘文青,贾宏亮,陈刚. 从病历书写论实习、试用期医务人员的监管成效[J]. 医学与哲学(人文社会医学版), 2009, 0(6): 67-69 |
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| 作者姓名： | 杨波 梁庆宇 刘文青 贾宏亮 陈刚 |
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| 作者单位： | [1]上海市卫生局卫生监督所,上海200050 [2]复旦大学公共卫生学院卫生法学与卫生监督教研室,上海200032 |
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| 摘 要： | 为了了解上海市卫生局卫生监督所对医疗机构实习、试用期医务人员书写病历监督检查的成效，通过分层抽样的方法对纠纷高发科室运行病历的检查，就实习、试用期医务人员病历书写情况进行分析。结果显示，实习试用期医务人员书写病历及出具医嘱未经上级医务人员审阅修改签名的缺陷情况获得明显改善。说明各级医疗机构和医务人员已逐步树立了依法执业的理念，卫生监督部门监管工作切实有效。
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| 关 键 词： | 病历书写 实习试用期医务人员 监管 |
To Elevate the Effect of Inspections on Medical Records Written by Interns |
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| Affiliation: | YANG Bo, LIANG Qing-yu, LIU Wen-qing, et al.(School of Public Health, Fudan University, Shanghai 200032, China) |
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| Abstract: | To elevate the effect of inspections on medical records written by interns. Method： Analysis the defects of medical records written by interns in the high rate medical dispute department through stratified sampling method. Result：The defects of medical records written by interns without Signed by superiors have significantly improved. Conclusion： medical personnel have been gradually established a law practice concept. The supervision of Health Departments is effective. |
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| Keywords: | medical records interns supervision |
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