How to write the commitment letter of medical malpractice responsibility? The concept of service, strengthen the awareness of quality, excellent service, medical safety and occupational risk, eliminate hidden dangers of medical safety, put an end to medical accidents, improve medical quality, improve service quality and ensure medical safety. According to the Regulations on the Handling of Medical Accidents, the Law of People's Republic of China (PRC) on Medical Practitioners, the Regulations on the Management of Nurses, the Implementation Plan and Inspection Rules of Hospital Management Year and the relevant documents of our hospital's two-level management system, the Commitment on Medical Quality, Medical Safety and Excellent Service is formulated. The details are as follows: 1. Taking the department as the unit and the director of the department as the first person responsible for medical safety, we should earnestly perform our duties, establish and improve various rules and regulations centered on post responsibility system, and do a good job in quality management of the department in strict accordance with the overall requirements of the hospital. Accidents and disputes caused by violation of regulations shall be borne by the parties concerned. 2, strengthen the implementation of various rules and regulations, especially the implementation of the core system. Those who can't strictly abide by it should be trained to be laid off. Those responsible for delaying the rescue and treatment of patients and causing medical accidents and disputes should be dealt with severely in accordance with relevant regulations, and the heads of their departments should be held jointly and severally liable. 3. Medical personnel should strictly abide by laws, regulations and technical operation specifications, strictly perform the responsibility system of first diagnosis, inquire about medical history in detail, carefully examine patients, scientifically formulate diagnosis and nursing plans, closely observe the changes of illness, truthfully inform patients and their families, and strictly keep patients' privacy. Before implementing medical treatment, prevention and health care measures and signing relevant medical certificates, you must personally check and investigate, and fill in medical documents in time according to regulations, and you must not conceal, forge or destroy medical documents and. 4, medical personnel at all levels must be engaged in practice activities with a scientific attitude, scientific diagnosis, reasonable treatment, adhere to the principle of inspection and reasonable treatment. 5. The emergency and inpatient medical records must be written in strict accordance with the requirements of the 20 10 version of the Medical Records Writing Guide of our hospital. The written contents should be true, complete, accurate, scientific and orderly, and the records should be timely and clear. Single disease, dominant disease, key disease must be written in accordance with the requirements of integrated traditional Chinese and western medicine medical records (medical records must have the content of traditional Chinese medicine, and the records of superior doctors' rounds must reflect the guidance of traditional Chinese medicine diagnosis and treatment). Actively carry out the pilot work of clinical pathway, implement the implementation plan of clinical pathway in our hospital, and carefully write the clinical pathway table. The director of the department and the quality controller should strictly control, and the medical records with serious defects are not allowed to leave the department. 6. Communicate the doctor-patient relationship in time and strictly implement the doctor-patient communication system. Every communication should be recorded in the medical record in detail (including the time and place of communication, the names of medical staff, patients and their families, the specific content of communication, and the results of communication), and the patients and their families should be required to sign their opinions, and both doctors and patients should sign them; When communicating with doctors and patients, we should try our best to use ways and languages that are easy for patients and their families to accept. Investigate all the responsibilities of the parties who violate the rules. 7, resolutely implement the consultation system. In case of difficult, critical and unidentified cases, please consult outside the hospital in time and apply for consultation as soon as possible. Emergency consultation must be on call, and no one can postpone it for any reason. Door (emergency) diagnosis and rescue must be carried out in accordance with the door (emergency) diagnosis and rescue process. If the patient's condition changes, gets worse or has an accident (such as respiratory and cardiac arrest), he should be rescued on the spot, promptly notify the emergency department and relevant departments to participate in the rescue, and be escorted to the emergency department by medical staff for further treatment and observation when conditions permit. Need to be hospitalized, after the condition is stable, escorted by medical staff to the comprehensive ICU ward or related department ward; Each department shall not refuse the patient to see a doctor for any reason, and report to the medical department, outpatient office and other relevant departments. After the critically ill patient is admitted to the hospital, the attending physician should treat him immediately, complete the treatment within 5 minutes, establish venous access, and report to the superior doctor in time. The attending physician or (and) the director of the department must immediately check the patient and guide the rescue and treatment work. 8. Strengthen the management of perioperative patients, conscientiously implement the grading management system and safety verification system, conscientiously complete the safety verification and risk assessment before, during and after the operation, and do a good job in the double inspection of surgical patient identification and surgical site identification from the beginning of filling out the operation notice, especially for coma patients, critically ill patients, the elderly and children. Strengthen the safety management of surgical patients' posture to prevent patients from causing secondary injuries due to improper posture. The tissues and organs taken out during the operation should be handed over to the patient's family for pathological examination, and the handover registration should be made. 9, all departments to carry out new business, new technology and major surgery, must be in accordance with the provisions, signed by the director of the medical department, department director, approved before implementation; Such as emergency surgery patients, in the absence of family members and related personnel and other special circumstances, should report to the director of the department, the medical department and the total value monitor, and implement the operation after approval by the authorized person, but the preoperative conversation should be detailed and comprehensive, and all kinds of complications and risk factors should be explained clearly, and the signing procedures should be fulfilled; If you need to change the operation mode during the operation, please show it to the director of the department, and inform and explain to the patient's family again, and you must perform the signing procedures. 10, seriously implement the check system. Medical, nursing and technical personnel should conscientiously implement various inspection systems. Doctors' orders, prescriptions, medicines, surgery, blood transfusion, specimen collection and various reports issued should be carefully checked in accordance with relevant regulations to ensure accuracy and patient safety. Pharmacists should conscientiously implement the system of "four checks and ten pairs" when dispensing drugs; Nurses should do a good job of "three checks and ten pairs", patrol the ward in time, carefully observe the patient's condition and accurately reflect the changes of the patient's condition to the doctor. Especially when rescuing patients and carrying out doctors' oral orders, nurses must repeat it and carry it out after it is confirmed. All empty bottles of drugs are kept during the rescue, and they can be destroyed only after checking and registering at the end of the rescue. Violators shall be fully responsible by the parties concerned. Provide nursing measures for patients according to the grading nursing system. Patrol in time as required, observe the changes of the condition, notify the doctor at the first time, and give treatment measures according to the doctor's advice. Emphasize the patient's range of activities, and critically ill patients are not allowed to get out of bed; First-class nursing patients can move in the ward; Secondary and tertiary nursing patients can move in the ward. 1 1. All departments must strengthen the management of interns and interns. Trainers and interns must write medical documents under the personal guidance of the teaching teacher in accordance with the requirements of relevant regulations, and participate in the operation and various diagnosis and treatment operations. Teachers are not allowed to let students and interns take the place of duty at will, and offenders are responsible. All departments should pay special attention to the continuing learning, business training and management of new employees. If it is really competent for the work alone, the application shall be made by the department where it belongs, and it will be on duty alone after being approved by the Medical Department. In addition to the direct responsibility of the parties, the superior doctors and department directors should bear the main responsibility for the offenders. 12, each department should keep the rescue equipment, instruments and medicines by special personnel, check them regularly, maintain them in time, and make records to ensure the needs of saving patients. Accidents and disputes caused by inadequate rescue equipment, medicines and other rescue items shall be borne by the parties concerned. 13, in case of disputes between doctors and patients, relevant departments should properly keep copies of original materials, such as needles, residual fluids and blood products. , sealed medical records (no one may alter, exchange, destroy or lose them), and shall not cover up or conceal them, and report to the medical department in time. Disputes arising from other departments or personnel shall not be disclosed to patients and their families at will and prematurely, so as to avoid the expansion and complication of disputes, and offenders shall be held accountable according to the seriousness of the case. 14, all kinds of hospital staff should support each other, unite and help each other, don't undermine each other, don't provoke the doctor-patient relationship, and don't expose their different opinions or contradictions to patients and their families. Otherwise, the resulting disputes will be handled by inspection, suspension, administrative sanctions, etc. It depends on the situation and consequences. 15, the authority and time limit of the person who fills in the relevant documents in the medical record: (1) The medical record of outpatient (emergency) consultation should be filled in when the doctor visits; (2) The admission record should be completed within 24 hours after the patient is admitted to the hospital; (3) Record the first course of the disease, which is completed within 8 hours of the patient's admission; (4) Record the course of disease, with at least 1 time per day for severe cases; Record 1 severe illness for at least 2 days; The patient was stable for at least 3 days and recorded 1 time; (5) the attending physician's first visit record, within 24 hours of the patient's admission; (6) The handover record shall be completed within 8 hours after the succession; (7) Transfer-out records shall be completed before being transferred out of the department (except in case of emergency); (8) Handover records shall be completed within 24 hours after handover; (9) Stage summary, at least 1 time per month; (10) Complete preoperative summary and discussion before treatment. (1 1) The operation record shall be completed by the operator within 24 hours after operation, and shall be reviewed and signed by the operator under special circumstances; (12) Visit records before and after anesthesia, which were completed before and after anesthesia; (13) The first course after operation was recorded immediately by the operator or a helper; (14) Record the course of disease on the third day after operation, at least once a day, and the patient rounds should be recorded by the operator or superior doctors; (15) The invasive operation was recorded and completed immediately after the operation; (16) Complete the consultation record within 48 hours, and complete the emergency consultation within 10 minutes; (17) The discussion record of difficult cases should be completed immediately by the attending physician and signed by the superior physician; (18) The discharge (death) record shall be completed within 24 hours after the patient leaves the hospital (death); (19) The discussion record of death cases shall be completed within one week after the death of the patient; (20) Oral medical advice during the rescue, and truthfully supplement the records immediately after the rescue; (2 1) rescue records, which shall be truthfully supplemented within 6 hours after the rescue; (22) The operation safety verification record should be completed before anesthesia, before operation and before the patient leaves the room. According to the above requirements, functional departments will inspect clinical departments from time to time, and the inspection results will be included in the hospital performance appraisal in real time. I consciously abide by the above commitments, and I am willing to take responsibility if I violate them. This letter of commitment shall come into effect as of the date of signing. The director of the department and the dean sign, and the individual and the department sign to show their responsibility. This responsibility letter shall come into effect from the date of signature and shall be valid for 3 years. Dean: Department: Department Director: Head Nurse: Deputy Director: Medical Students: There is no uniform format in the legal system for nurses to stipulate the commitment letter of medical accident responsibility, which is basically formulated by medical institutions themselves. Medical staff should take this letter of commitment as their working principle. If the medical staff can perform their work according to the agreement in the Commitment of Liability for Medical Accidents, the occurrence of medical accidents will definitely be greatly reduced.