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{"instruction": "不良事件报告表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p align=\"center\"><span lang=\"EN-US\">XXX</span><b><span>医院</span></b></p>\\n<p align=\"center\"><b><span>医疗安全<span lang=\"EN-US\">(</span>不良<span lang=\"EN-US\">)</span>事件报告单</span></b></p>\\n<p><b><span>编号：</span></b><b><u><span lang=\"EN-US\">2019-02-014</span></u></b><u> </u> <b><span>报告日期：</span></b>\\n<u> </u> <b><span>事件发生日期：</span></b> <u> </u></p>\\n<table align=\"left\" border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"100%\">\\n<p><b><span lang=\"EN-US\">A、患者资料</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p><b><span lang=\"EN-US\">科室</span></b></p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p><span lang=\"EN-US\">住院号</span></p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"19%\">\\n<p><span lang=\"EN-US\">患者姓名</span></p>\\n</td>\\n<td valign=\"top\" width=\"5%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p><b><span lang=\"EN-US\">性别</span></b></p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p><span lang=\"EN-US\">年龄</span></p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"19%\">\\n<p><span lang=\"EN-US\">入院时间</span></p>\\n</td>\\n<td valign=\"top\" width=\"5%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><b><span lang=\"EN-US\">临床诊断</span></b></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p><span lang=\"EN-US\">》</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><b><span>在场相关人员或</span></b> <b><span>相关科室</span></b></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p><span lang=\"EN-US\">》</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"100%\">\\n<p><b><span lang=\"EN-US\">B、不良事件情况</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><b><span lang=\"EN-US\">事件发生场所</span></b></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p><b><span>不良后果<span lang=\"EN-US\">(</span>如有</span></b></p>\\n<p><b><span>请填写具体内</span></b></p>\\n<p><b><span lang=\"EN-US\">容</span></b> <b><span lang=\"EN-US\">)</span></b></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p><span lang=\"EN-US\">》</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><b><span lang=\"EN-US\">事件经过</span></b></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p><span lang=\"EN-US\">》</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"100%\">\\n<p><b><span lang=\"EN-US\">C</span></b><b><span lang=\"EN-US\">、</span></b><b><span lang=\"EN-US\">不良事件类别</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"100%\">\\n<p> </p>\\n<p> </p>\\n<p><b><span>〇信息传递错误事件：医师、护理、医技判定意见错误、医嘱错</span></b><b><span>误<span lang=\"EN-US\">(</span>口头及书面<span lang=\"EN-US\">)</span>、其它传递方式错误</span></b></p>\\n<p><b><span>〇治疗错误事件：患者、部位、器材、剂量等选择错误；不</span></b><b><span>认真查对事件</span></b></p>\\n<p><b><span>〇方法技术错误事件：遗忘、未治疗、延期、时间或</span></b><b><span>程序错误、不必要的治疗、灭菌<span lang=\"EN-US\">/</span>消毒错误、体位错误等</span></b></p>\\n<p><b><span>〇</span></b><b> </b><b><span>药物调剂分发错误事件：医嘱、处方、</span></b><b><span>给药、调剂等不良事件</span></b></p>\\n<p><b><span>〇输血事件：医嘱、备血、传送及输血不当引起的不良事件</span></b></p>\\n<p><span>〇</span><b><span>设备器械使用事件：医疗材料故障、设备故障或使用不当导致的不良事</span></b><span>件</span></p>\\n<p><b><span>〇静脉输液事件：静点滴漏惨、输液反应</span></b></p>\\n<p><span>〇导管操作事件：导管脱落、断裂、堵塞、连接错误等</span></p>\\n<p><b><span>〇医疗技术检查事件：检查人员无资质、标本丢失或弄错标本、试剂管理、医疗信息沟通错</span></b><b><span>误；迟报、漏报、错报结果等</span></b></p>\\n<p><b><span>〇基础护理事件：如跌倒、坠床、院��压疮、误吸室息、咽入异物、未按医嘱执行禁食禁水、无约束固定、烧烫伤、咬破体</span></b><span>温</span> <span>计、自杀、走失、擅自离院事件等</span></p>\\n<p><b><span>〇</span></b><b><span>营养与饮食事件：如饮食类别错误、未按医嘱用餐或禁食等</span></b></p>\\n<p><b><span>〇运送事件：物品运送如延迟、遗忘、丢失、破损、未按急需急送、品种规格</span></b><b><span>错误等、运送中病情变化</span></b></p>\\n<p><b><span>〇放射安全事件：如放射线泄露、放射性物品丢失、未行防护</span></b><b><span>、误照射等</span></b></p>\\n<p><span>〇诊疗记录事件：包括诊疗记录丢失、未按要求记录、记录内容失实或涂改、无资质人员书写记录等</span></p>\\n<p><b><span>〇知情同意事件：如知情告知不准确、未行知情告知、未告知先签字同意、告知与书面记</span></b><b><span>录不一致、未行签字同意等</span></b></p>\\n<p><b><span>〇</span></b><b><span>非预期事件：非预期重返</span></b><b><span lang=\"EN-US\">ICU</span></b> <b><span>或延长住院时间</span></b></p>\\n<p><b><span>〇医护安全事件：包括针刺、锐器刺伤、接触化疗药、传染病等导</span></b><b><span>致损害的不良事件</span></b></p>\\n<p><b><span>〇不作为事件：医疗护理工作中已发现问题，但未及时处理机汇报，导致的不良后果加重等事件</span></b></p>\\n<p><b><span>〇</span></b><b><span>其它事件：火灾、失窃、蓄意破坏、争吵打架、非上列</span></b><b><span>之异常事件</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"100%\">\\n<p><b><span lang=\"EN-US\">D</span></b><b><span>、</span></b><b><span>事件发生后及时处理与分析</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><b><span lang=\"EN-US\">导致事件的可能</span></b></p>\\n<p><span lang=\"EN-US\">原</span> <span lang=\"EN-US\">因</span></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td width=\"20%\">\\n<p align=\"center\"><span>事件处理情况</span> <span lang=\"EN-US\">(</span><span>提供补救措施</span></p>\\n<p align=\"center\"><span lang=\"EN-US\">或改善建议)</span></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"100%\">\\n<p><b><span lang=\"EN-US\">E</span></b><b>\\n<span lang=\"EN-US\">、</span></b> <b><span lang=\"EN-US\">选</span></b> <b><span lang=\"EN-US\">择</span></b> <b><span lang=\"EN-US\">性</span></b> <b><span lang=\"EN-US\">填</span></b> <b><span lang=\"EN-US\">写</span></b> <b><span lang=\"EN-US\">项</span></b><span lang=\"EN-US\"> <b>目</b></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p><span lang=\"EN-US\">报告人</span></p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p><b><span lang=\"EN-US\">当事人的类别</span></b></p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"19%\">\\n<p><b><span lang=\"EN-US\">职称</span></b></p>\\n</td>\\n<td valign=\"top\" width=\"5%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p><span lang=\"EN-US\">报告人科室</span></p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"36%\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"18%\">\\n<p><b><span lang=\"EN-US\">联系电话</span></b></p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"24%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">F、</span> <span lang=\"EN-US\">不良事件的等</span><span lang=\"EN-US\"> 级</span></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p><b><span>〇一级事件<span lang=\"EN-US\">(</span>警告事件<span lang=\"EN-US\">):</span>非预期的死亡，或是非疾病医疗过程中是因诊疗活动而非疾病本身造成的病</span></b><span>人</span> <span>机体与功能损害。</span></p>\\n<p><b><span>〇二级事件<span lang=\"EN-US\">(</span>不良后果事件<span lang=\"EN-US\">):</span>在疾病医疗过程中是因诊疗活动而</span></b><b><span>非疾病本身造成的病人机体与功能损</span></b></p>\\n<p><span>害。</span></p>\\n<p><b><span>〇三</span></b><b><span>级事件<span lang=\"EN-US\">(</span>未造成后果事件<span lang=\"EN-US\">):</span>虽然发生的错误事实，但未给病人机体与功能造成任何损害，或有轻微</span></b> <b><span>后果而不需任何处理可完全康复。</span></b></p>\\n<p><b><span>〇四</span></b><b><span>级事件<span lang=\"EN-US\">(</span>隐患事件<span lang=\"EN-US\">):</span>由于及时发现错误，但未形成事实</span></b></p>\\n<p><b><span>〇五</span></b><b><span>级事件：无定义。</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><span lang=\"EN-US\">G</span> <span>、</span> <span>医疗质量管</span><span> <span>理科意见</span></span></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><span lang=\"EN-US\">H</span><span>、 </span><span>其他职能部</span><span> <span>门意见</span></span></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><span lang=\"EN-US\">I</span><span>、</span><span>科室质控小组</span> <span>意见</span></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"20%\">\\n<p> </p>\\n<p><span lang=\"EN-US\">J</span> <span>、</span> <span>医院质量管理</span><span> <span>委员会意见</span></span></p>\\n</td>\\n<td colspan=\"5\" valign=\"top\" width=\"79%\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"100%\">\\n<p><b><span lang=\"EN-US\">1</span></b><b><span>、不良事件定义：是指在临床诊疗活动中以及医院运行过程中，任何可能景响病人的诊疗结果、增加病人的痛苦和负担并可能引</span></b> <b><span>发医疗纠纷或医疗事敌，以及影响医疗工作的正常运行和医务人员人身安全的</span></b><b><span>因素和事件。不良事件包括可预防的和不可预防的两</span></b></p>\\n<p><span>种。</span></p>\\n<p><b><span lang=\"EN-US\">2</span></b><b><span>、报告范围：凡在医院内发生的或在院外转运病人时发生的不良事件均属主动报告的范围。</span></b></p>\\n</td>\\n</tr>\\n</table>\\n<p> </p>\\n</div>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<div>\\n<p> </p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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{"instruction": "公共设施安全不良事件报告表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p><b><span lang=\"EN-US\">XXX</span></b><b><span lang=\"EN-US\">医院医疗安全(不良)事件报告表</span></b></p>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">填报日期：2017年11月13日</span> <span lang=\"EN-US\">(在下面项目合适的</span> <span lang=\"EN-US\">内打</span><span lang=\"EN-US\">\"</span> <span lang=\"EN-US\">√</span> <span lang=\"EN-US\">\")</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span><span><img height=\"18\" src=\"1.11公共设施安全(不良)事件报告表_10_11.files/image001.jpg\" width=\"31\"/></span></span><span lang=\"EN-US\">科室：核磁共振室</span> \\n <span lang=\"EN-US\">选科室</span><span lang=\"EN-US\">姓名：请输入</span> <u> </u> <span lang=\"EN-US\">性别：请输入年龄： \\n </span> <span lang=\"EN-US\">住院号：请输人</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">一、事件概况</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">(一)基础信息</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">1.发生日期</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span lang=\"EN-US\">2017-11-1300:37:31</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">2.</span> <span lang=\"EN-US\">日期类型</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span>〇</span><span lang=\"EN-US\">工作日</span> \\n <span>〇</span><span lang=\"EN-US\">周末 ○节假日</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">3.发生时段</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span>〇</span><span lang=\"EN-US\">上午</span> \\n <span>〇</span><span lang=\"EN-US\">中午 </span><span>〇</span><span lang=\"EN-US\">下午</span> \\n <span>〇</span><span lang=\"EN-US\">晚上</span> <span>〇</span><span lang=\"EN-US\">下班前半小时</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">4.发生地点</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span lang=\"EN-US\">〇急诊 </span>〇<span lang=\"EN-US\">门诊 〇病房 \\n </span>〇<span lang=\"EN-US\">监护室 \\n </span>〇<span lang=\"EN-US\">手术室</span></p>\\n<p><span lang=\"EN-US\">〇其他(写明具体地点):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">5.事件类型</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span lang=\"EN-US\">□A诊疗问题</span> <span lang=\"EN-US\">□B用药方面</span> <span lang=\"EN-US\">□C意外事件</span> <span lang=\"EN-US\">□D辅助诊查问题</span></p>\\n<p><span lang=\"EN-US\">□E手术相关问题</span> <span lang=\"EN-US\">□F医患沟通</span> <span lang=\"EN-US\">□G其他非上</span><span lang=\"EN-US\">列导致医疗不良后果的事件</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">6.事件分级</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span>〇</span><span lang=\"EN-US\">级(警告)</span>〇 <span lang=\"EN-US\">II<span>级(不良)</span></span>〇 <span lang=\"EN-US\">III<span>级(未造成后果)</span></span>〇<span lang=\"EN-US\">IW<span>级(隐患)</span></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p align=\"right\"><span lang=\"EN-US\">7.涉及</span><span lang=\"EN-US\">其他科室名</span><span lang=\"EN-US\">称</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">(二)事件起因、具体经过和疾病诊断</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">事件经过描述需包含如下要素：事件发生的时间、地点、起因、涉及人员、用药<span>情况、手术基本情</span> 况、原有疾病、合并症、诊疗过程、患者损<span>害、争议焦点等方面</span></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">(三)不良事件可能的缺陷分析</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">1.诊断缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span lang=\"EN-US\">□询问病史不全面 口体格检查缺陷</span> <span lang=\"EN-US\">口实<u>验室检</u>查缺陷</span> \\n <span lang=\"EN-US\">□影像检查缺陷</span></p>\\n<p><span lang=\"EN-US\">□特殊检查缺陷</span> <span lang=\"EN-US\">□其他检查缺陷(请注明):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">2.治疗缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span lang=\"EN-US\">手术缺陷：□手术前准备不足(或不充分)□手术适应症掌握不严(或错误)</span><span lang=\"EN-US\"> <span>□手术方式选择不当(或错误)□手术中操作(或治疗)不当(或失误)</span> <span>□手术后治疗、监护不当□其他手术缺陷：<u> \\n </u></span> 口麻醉缺陷□其他治疗缺陷(请注明): <u> </u></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">3.制度执行缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span lang=\"EN-US\">□告知制度执行缺陷 \\n □用血缺陷 □会诊制度执行缺陷</span></p>\\n<p><span lang=\"EN-US\">□交接班制度执行缺陷 □消毒隔离制度缺陷</span> <span lang=\"EN-US\">□转院制度执行缺陷</span></p>\\n<p><span lang=\"EN-US\">□科室管理脱节</span> <span lang=\"EN-US\">□其他问题(请注明):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">4.其他缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p><span lang=\"EN-US\">□病人辨识事件</span> <span lang=\"EN-US\">口烧烫伤事件□非预期事件：非预期重返ICU或延长住院时间</span></p>\\n<p><span lang=\"EN-US\">□检验病理放射等技术诊查中，丢失或弄错标本，拍错部位，配错血；漏报、错报、</span> <span lang=\"EN-US\">迟报结果等引起的不良事件</span></p>\\n<p><span lang=\"EN-US\">□输血事件：医嘱开立、备血、传送及输血不当引起的相关不良事件</span></p>\\n<p><span lang=\"EN-US\">□特殊药品管理事件：病人在院内自行服用或注射管制药品</span></p>\\n<p><span lang=\"EN-US\">□跌倒事件：因意外跌至地面或其它平面</span></p>\\n<p><span lang=\"EN-US\">□公共设施事件</span><span lang=\"EN-US\"> \\n <span>□治安事件</span></span></p>\\n<p><span lang=\"EN-US\">□患者约束事件：不适当约束或执行合理约束导致的不良事件</span></p>\\n<p><span lang=\"EN-US\">□不作为事件：医疗护理工作中已经发现问题，但未及时处现导致的不良事件</span></p>\\n<p><span lang=\"EN-US\">□其他事件(请注明):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">科</span><span lang=\"EN-US\">室</span><span lang=\"EN-US\"> <span>原因</span> <span>分</span><span>析</span></span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">科</span><span lang=\"EN-US\">��</span><span lang=\"EN-US\"> <span>改进</span> <span>措</span><span>施</span></span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">科室</span><span lang=\"EN-US\"> <span>参与</span> <span>讨论</span> <span>人员</span></span></p>\\n</td>\\n<td valign=\"top\" width=\"385\">\\n<p> </p>\\n</td>\\n</tr>\\n</table>\\n<p><span lang=\"EN-US\">上报人签字：</span> <span lang=\"EN-US\">科主任签字：</span></p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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{"instruction": "其他不良事件上报表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p><b><span lang=\"EN-US\">其他不良事件上报表</span></b></p>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p><span lang=\"EN-US\">科室</span></p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"143\">\\n<p><span lang=\"EN-US\">核磁共振室</span> <b><span lang=\"EN-US\">选取</span></b></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"258\">\\n<p><span lang=\"EN-US\">当事人层级</span><span>〇</span><span lang=\"EN-US\">N0-</span> <span lang=\"EN-US\">1</span><span>〇</span><span lang=\"EN-US\">N0-2</span><span>〇</span><span lang=\"EN-US\">N1</span><span>〇</span><span lang=\"EN-US\">N2</span><span>〇</span><span lang=\"EN-US\">N3</span><span>〇</span><span lang=\"EN-US\">N4</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"153\">\\n<p><span lang=\"EN-US\">工作年限</span> <span lang=\"EN-US\">年</span></p>\\n</td>\\n<td colspan=\"4\" valign=\"top\" width=\"312\">\\n<p><span lang=\"EN-US\">学历○中专○大专○本科〇硕士及以上</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p><span lang=\"EN-US\">班次</span></p>\\n</td>\\n<td valign=\"top\" width=\"89\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"54\">\\n<p><span lang=\"EN-US\">诊断</span></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"258\">\\n<p><span lang=\"EN-US\">峭输人</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p><span lang=\"EN-US\">患者姓名</span></p>\\n</td>\\n<td valign=\"top\" width=\"89\">\\n<p><span lang=\"EN-US\">峭输人</span></p>\\n</td>\\n<td valign=\"top\" width=\"54\">\\n<p><span lang=\"EN-US\">住院号</span></p>\\n</td>\\n<td valign=\"top\" width=\"83\">\\n<p><span lang=\"EN-US\">清输人</span></p>\\n</td>\\n<td valign=\"top\" width=\"60\">\\n<p><span lang=\"EN-US\">床号</span></p>\\n</td>\\n<td valign=\"top\" width=\"115\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p align=\"right\"><span lang=\"EN-US\">发现/杜绝者</span></p>\\n</td>\\n<td valign=\"top\" width=\"89\">\\n<p><span lang=\"EN-US\">峭输人</span></p>\\n</td>\\n<td valign=\"top\" width=\"54\">\\n<p><span lang=\"EN-US\">发生时间</span></p>\\n</td>\\n<td valign=\"top\" width=\"83\">\\n<p><span lang=\"EN-US\">晴射入</span></p>\\n</td>\\n<td valign=\"top\" width=\"60\">\\n<p><span lang=\"EN-US\">上报日期</span></p>\\n</td>\\n<td valign=\"top\" width=\"115\">\\n<p><span lang=\"EN-US\">峭输人</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">类型：</span>〇<span lang=\"EN-US\">血标本采集错误○标本丢失〇手术身份识别错误〇饮食指导<span>不到位〇输血错误</span> <span>○其他</span></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">分级：</span>〇<span lang=\"EN-US\">I级警告事件</span>〇<span lang=\"EN-US\">Ⅱ级不良后果事件</span>〇<span lang=\"EN-US\">III级未造成后果<span>事件</span></span><span>〇</span><span lang=\"EN-US\">IV级隐患事件</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">发生经过及后果(当事人填写)</span></b></p>\\n<p><span lang=\"EN-US\">输人</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">原因分析(当事人填写，护士长完善)</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">科室处理意见及改进措施(护士长填写)</span></b></p>\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">护士长签字：</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">科护士长意见</span></p>\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">科护士长签字：</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"6\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">护理部意见：</span></b><span lang=\"EN-US\">提示：意见在点击流程处理后的批复内容��中录入。</span></p>\\n</td>\\n</tr>\\n</table>\\n<p> </p>\\n<p> </p>\\n<p><b><span lang=\"EN-US\">不良事件分级：</span></b></p>\\n<p><span lang=\"EN-US\">I</span> <span lang=\"EN-US\">级事件(警告事件):非预期的死亡，或是非疾病自然进展过程中造成永久性功能丧失。</span></p>\\n<p><span lang=\"EN-US\">I</span><span lang=\"EN-US\">级事件(不良后果事件):在疾病医疗过程中是因诊疗活动而非疾病本身造成的病人机体与功能</span><span lang=\"EN-US\">损害。</span></p>\\n<p><span lang=\"EN-US\">Ⅲ级事件(未造成后果事件):虽然发生了错误事实，但未给病人机体与功能造成任何损害，或有轻微后</span> <span lang=\"EN-US\">果而不需任何处理可完全康复。</span></p>\\n<p><span lang=\"EN-US\">IV</span><span lang=\"EN-US\">级事件(隐患事件):由于及时发现错误，未形成事实。</span></p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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{"instruction": "医疗安全（不良）事件处理反馈表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p><b><span lang=\"EN-US\">医疗安全(不良)事件处理反馈表(主管部门用)</span></b></p>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p><span lang=\"EN-US\">报告科室</span></p>\\n</td>\\n<td valign=\"top\" width=\"128\">\\n<p align=\"right\"><b><span lang=\"EN-US\">选<u>科</u></span></b><b><span lang=\"EN-US\">室</span></b></p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"73\">\\n<p><span lang=\"EN-US\">报告时间</span></p>\\n</td>\\n<td valign=\"top\" width=\"81\">\\n<p><span lang=\"EN-US\">2017-11-13</span></p>\\n</td>\\n<td valign=\"top\" width=\"49\">\\n<p><span lang=\"EN-US\">报告人</span></p>\\n</td>\\n<td valign=\"top\" width=\"72\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p><span lang=\"EN-US\">主管部门</span></p>\\n</td>\\n<td valign=\"top\" width=\"128\">\\n<p><span lang=\"EN-US\">□医务处</span> <span lang=\"EN-US\">□护理部</span></p>\\n<p><span lang=\"EN-US\">□医学工程处□党办</span></p>\\n</td>\\n<td valign=\"top\" width=\"66\">\\n<p><span lang=\"EN-US\">□药学部</span><span lang=\"EN-US\"> <span>□总务处</span></span></p>\\n</td>\\n<td colspan=\"4\" valign=\"top\" width=\"208\">\\n<p><span lang=\"EN-US\">□物资采购供应处 <span>口保卫处</span></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p> </p>\\n<p><span lang=\"EN-US\">报告事件</span></p>\\n</td>\\n<td colspan=\"6\" valign=\"top\" width=\"402\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">核查情况</span></p>\\n</td>\\n<td colspan=\"6\" valign=\"top\" width=\"402\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"64\">\\n<p> </p>\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">反馈意见</span></p>\\n</td>\\n<td colspan=\"6\" valign=\"top\" width=\"402\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"4\" valign=\"top\" width=\"265\">\\n<p><span lang=\"EN-US\">王管部门负责人签字：</span></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"201\">\\n<p><span lang=\"EN-US\">反馈科室负责人签字：</span></p>\\n</td>\\n</tr>\\n<tr height=\"0\">\\n<td width=\"64\"></td>\\n<td width=\"128\"></td>\\n<td width=\"66\"></td>\\n<td width=\"7\"></td>\\n<td width=\"81\"></td>\\n<td width=\"49\"></td>\\n<td width=\"72\"></td>\\n</tr>\\n</table>\\n<p><span lang=\"EN-US\">注：此表一式两份，一份科室存档，一份主管部门存档</span></p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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| 5 |
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{"instruction": "可疑医疗器械不良事件报告单", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p align=\"center\"><b><span lang=\"EN-US\">XXX</span></b><b><span lang=\"EN-US\">医院可疑医疗器械不良事件报告表</span></b></p>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td colspan=\"7\" valign=\"top\" width=\"466\">\\n<p><span lang=\"EN-US\">报告科室： \\n 报告日期：</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"7\" valign=\"top\" width=\"466\">\\n<p><span lang=\"EN-US\">患者资料</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"63\">\\n<p><span lang=\"EN-US\">姓名</span></p>\\n</td>\\n<td valign=\"top\" width=\"83\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"65\">\\n<p><span lang=\"EN-US\">年龄</span></p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"82\">\\n<p> </p>\\n</td>\\n<td valign=\"top\" width=\"84\">\\n<p><span lang=\"EN-US\">性别</span></p>\\n</td>\\n<td valign=\"top\" width=\"89\">\\n<p><span>〇</span> <span lang=\"EN-US\">男</span> <span>〇</span> <span lang=\"EN-US\">女</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"63\">\\n<p> </p>\\n<p><span lang=\"EN-US\">预期治疗疾</span></p>\\n<p><span lang=\"EN-US\">病或作用</span></p>\\n</td>\\n<td colspan=\"6\" valign=\"top\" width=\"403\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"7\" valign=\"top\" width=\"466\">\\n<p><span lang=\"EN-US\">不良事件情况</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"63\">\\n<p> </p>\\n<p><span lang=\"EN-US\">事件</span></p>\\n<p><span lang=\"EN-US\">主要表现</span></p>\\n</td>\\n<td colspan=\"6\" valign=\"top\" width=\"403\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"63\">\\n<p><span lang=\"EN-US\">事件</span></p>\\n<p><span lang=\"EN-US\">发生日期</span></p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"148\">\\n<p> </p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"82\">\\n<p><span lang=\"EN-US\">发现或者</span></p>\\n<p><span lang=\"EN-US\">悉时间</span></p>\\n</td>\\n<td colspan=\"2\" valign=\"top\" width=\"173\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"63\">\\n<p><span lang=\"EN-US\">医疗器械实 际使用场所</span></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"192\">\\n<p><span>〇</span><span lang=\"EN-US\">医疗机构 </span><span>〇</span><span lang=\"EN-US\">家庭 </span><span>〇</span><span lang=\"EN-US\">其它(请注明):</span></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"211\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr height=\"0\">\\n<td width=\"63\"></td>\\n<td width=\"83\"></td>\\n<td width=\"65\"></td>\\n<td width=\"44\"></td>\\n<td width=\"38\"></td>\\n<td width=\"84\"></td>\\n<td width=\"89\"></td>\\n</tr>\\n</table>\\n<p> </p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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| 6 |
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{"instruction": "手术室护理不良事件上报表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p><b><span lang=\"EN-US\">手术室护理不良事件上报表</span></b></p>\\n<p> </p>\\n</div>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<div>\\n<p><span lang=\"EN-US\">科室核磁共振室</span></p>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<p></p>\\n<p> </p>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<p></p>\\n<p><span lang=\"EN-US\">上报时间2017-11-130</span></p>\\n</div>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<div>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">患者一般情况：</span></p>\\n<p><span lang=\"EN-US\">姓名请输入</span> <u> <span lang=\"EN-US\">性别：○男○</span></u> <span lang=\"EN-US\">女住院号：<u>靖输人 </u>床号：<u> \\n </u></span><u> </u></p>\\n<p><span lang=\"EN-US\">年龄<u> \\n </u></span><span lang=\"EN-US\">岁诊断：<u> \\n </u></span><u> </u><span lang=\"EN-US\"> <span>事件基本资料：</span></span></p>\\n<p><span lang=\"EN-US\">发生时间</span> \\n <span lang=\"EN-US\">医师：</span> \\n <span lang=\"EN-US\">洗手护士： \\n 巡回护士：_</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"35\">\\n<p> </p>\\n<p><span lang=\"EN-US\">事件</span><span lang=\"EN-US\"> <span>类型</span></span></p>\\n</td>\\n<td valign=\"top\" width=\"430\">\\n<p><span lang=\"EN-US\">○器械碎片残留 ○物品丢失 ○跌倒/坠床 \\n ○<span>压疮</span> <span>○灼伤</span></span></p>\\n<p><span lang=\"EN-US\">〇体位性损伤○输血/用药不良反应○标本处理不当○器械或设备损坏</span></p>\\n<p><span lang=\"EN-US\">O手术物品准备不足，拖延手术30分钟以上○管<span>路滑脱○其他_</span> <u> </u></span></p>\\n<p><span lang=\"EN-US\">○物品清点不齐全，拖延手术时间30分钟以上</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">事件具体描述：</span></b></p>\\n<p><span lang=\"EN-US\">靖输人</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">事件原因分析：(事件过程中护理人员存在缺陷同时报护理缺陷上报表)</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">目前病人情况及采取的措施：</span></b></p>\\n<p> </p>\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">事件���关人员签名：</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">科室讨论意见及整改措施：</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">科护士长随访记录：</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">护理部意见：</span></b></p>\\n</td>\\n</tr>\\n</table>\\n<p> </p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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| 7 |
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{"instruction": "服务及医德医风安全不良事件报告表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p><b><span lang=\"EN-US\">XXX</span></b><b><span lang=\"EN-US\">医院医疗安全(不良)事件报告表</span></b></p>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">填报日期：2017年11月13日</span> <span lang=\"EN-US\">(在下面项目合适的</span> <span lang=\"EN-US\">内打</span><span lang=\"EN-US\">\"</span> <span lang=\"EN-US\">√</span> <span lang=\"EN-US\">\")</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span><span><img height=\"19\" src=\"1.10服务及医德医风安全(不良)事件报告表_9_10.files/image001.jpg\" width=\"32\"/></span></span><span lang=\"EN-US\">科室：核磁共振室</span> \\n <span lang=\"EN-US\">选科室姓名：请输入</span> <u> </u> <span lang=\"EN-US\">性别：请输入年龄： \\n </span><span lang=\"EN-US\">住院号：请输人</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">一、事件概况</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">(一)基础信息</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">1.发生日期</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span lang=\"EN-US\">2017-11-1300:34:25</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">2.</span> <span lang=\"EN-US\">日期类型</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span>〇</span><span lang=\"EN-US\">工作日</span> \\n <span>〇</span><span lang=\"EN-US\">周末 ○节假日</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">3.发生时段</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span>〇</span><span lang=\"EN-US\">上午</span> \\n <span>〇</span><span lang=\"EN-US\">中午 </span><span>〇</span><span lang=\"EN-US\">下午</span> \\n <span>〇</span><span lang=\"EN-US\">晚上</span> <span>〇</span><span lang=\"EN-US\">下班前半小时</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">4.发生地点</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span lang=\"EN-US\">〇急诊 </span>〇<span lang=\"EN-US\">门诊 〇病房 \\n </span>〇<span lang=\"EN-US\">监护室 \\n </span>〇<span lang=\"EN-US\">手术室</span></p>\\n<p><span lang=\"EN-US\">〇其他(写明具体地点):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">5.事件类型</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span lang=\"EN-US\">□A诊疗问题</span> <span lang=\"EN-US\">□B用药方面</span> <span lang=\"EN-US\">□C意外事件</span> <span lang=\"EN-US\">□D辅助诊查问题</span></p>\\n<p><span lang=\"EN-US\">□E手术相关问题</span> <span lang=\"EN-US\">□F医患沟通</span> \\n <span lang=\"EN-US\">□G其他非上</span><span lang=\"EN-US\">列导致医疗不良后果的事件</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">6.事件分级</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span>〇</span><span lang=\"EN-US\">I<span>级(警告)</span></span>〇 <span lang=\"EN-US\">II<span>级(不良)</span></span>〇 <span lang=\"EN-US\">III<span>级(未造成后果)</span></span>〇<span lang=\"EN-US\">IW<span>级(隐患)</span></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p align=\"right\"><span lang=\"EN-US\">7.涉及</span><span lang=\"EN-US\">其他科室名</span><span lang=\"EN-US\">称</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">(二)事件起因、具体经过和疾病诊断</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">事件经��描述需包含如下要素：事件发生的时间、地点、起因、涉及人员、用药<span>情况、手术基本情</span> 况、原有疾病、合并症、诊疗过程、患者损<span>害、争议焦点等方面</span></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">(三)不良事件可能的缺陷分析</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">1.诊断缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span lang=\"EN-US\">□询问病史不全面 口体格检查缺陷</span> <span lang=\"EN-US\">口实验室检查缺陷</span> <span lang=\"EN-US\">□影像检查缺陷</span></p>\\n<p><span lang=\"EN-US\">□特殊检查缺陷</span> <span lang=\"EN-US\">□其他检查缺陷(请注明):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">2.治疗缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span lang=\"EN-US\">手术缺陷：□手术前准备不足(或不充分)□手术适应症掌握不严(或错误)</span><span lang=\"EN-US\"> <span>□手术方式选择不当(或错误)□手术中操作(或治疗)不当(或失误)</span> <span>□手术后治疗、监护不当□其他手术缺陷：_<u> \\n </u></span> 口麻醉缺陷□其他治疗缺陷(请注明): <u> </u></span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">3.制度执行缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span lang=\"EN-US\">□告知制度执行缺陷 \\n □用血缺陷 <span>□会诊制度执行缺陷</span></span></p>\\n<p><span lang=\"EN-US\">□交接班制度执行缺陷 □消毒隔离制度缺陷</span> <span lang=\"EN-US\">□转院制度执行缺陷</span></p>\\n<p><span lang=\"EN-US\">□科室管理脱节</span> <span lang=\"EN-US\">□其他问题(请注明):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p><span lang=\"EN-US\">4.其他缺陷</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p><span lang=\"EN-US\">□病人辨识事件</span> <span lang=\"EN-US\">口烧烫伤事件□非预期事件：非预期重返ICU或延长住院时间</span></p>\\n<p><span lang=\"EN-US\">□检验病理放射等技术诊查中，丢失或弄错标本，拍错部位，</span><span lang=\"EN-US\">配错血；漏报、错报、</span><span lang=\"EN-US\"> <span>迟报结果等引起的不良事件</span></span></p>\\n<p><span lang=\"EN-US\">□输血事件：医嘱开立、备血、传送及输血不当引起的相关不良事件</span></p>\\n<p><span lang=\"EN-US\">□特殊药品管理事件：病人在院内自行服用或注射管制药品</span></p>\\n<p><span lang=\"EN-US\">□跌倒事件：因意外跌至地面或其它平面</span></p>\\n<p><span lang=\"EN-US\">□公共设施事件</span><span lang=\"EN-US\"> \\n <span>□治安事件</span></span></p>\\n<p><span lang=\"EN-US\">□患者约束事件：不适当约束或执行合理约束导致的不良事件</span></p>\\n<p><span lang=\"EN-US\">□不作为事件：医疗护理工作中已经发现问题，但未及时处现导致的不良事件</span></p>\\n<p><span lang=\"EN-US\">□其他事件(请注明):</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p align=\"center\"><span lang=\"EN-US\">科</span><span lang=\"EN-US\">室原因</span><span lang=\"EN-US\">分析</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p align=\"center\"><span lang=\"EN-US\">科</span><span lang=\"EN-US\">室</span><span lang=\"EN-US\">改进</span><span lang=\"EN-US\">措</span><span lang=\"EN-US\">施</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"80\">\\n<p align=\"center\"><span lang=\"EN-US\">科室</span><span lang=\"EN-US\">参与</span><span lang=\"EN-US\">讨论</span><span lang=\"EN-US\">人员</span></p>\\n</td>\\n<td valign=\"top\" width=\"386\">\\n<p> </p>\\n</td>\\n</tr>\\n</table>\\n<p><span lang=\"EN-US\">上报人签字：</span> <span lang=\"EN-US\">科主任签字：</span></p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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| 8 |
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{"instruction": "每月季度医疗安全（不良）事件汇总表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p><b><span lang=\"EN-US\">每月/季度医疗安全(不良)事件汇总表(主管部门用)</span></b></p>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td valign=\"top\" width=\"117\">\\n<p><span lang=\"EN-US\">主管部门</span></p>\\n</td>\\n<td valign=\"top\" width=\"117\">\\n<p><span lang=\"EN-US\">核磁共振室</span></p>\\n</td>\\n<td valign=\"top\" width=\"115\">\\n<p><span lang=\"EN-US\">报告时间</span></p>\\n</td>\\n<td valign=\"top\" width=\"117\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"117\">\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">每月/季度</span></p>\\n<p><span lang=\"EN-US\">不良事件分</span></p>\\n<p><span lang=\"EN-US\">类、汇总</span></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"348\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"117\">\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">原因分析</span></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"348\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"117\">\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">整改建议</span></p>\\n</td>\\n<td colspan=\"3\" valign=\"top\" width=\"348\">\\n<p> </p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"4\" valign=\"top\" width=\"466\">\\n<p><span lang=\"EN-US\">王管部门负责人签字：</span></p>\\n</td>\\n</tr>\\n</table>\\n<p><span lang=\"EN-US\">注：此表一式两份，经主管部门负责人签字后，</span> <span lang=\"EN-US\">一份主管部门存档，</span> <span lang=\"EN-US\">一份交质量管理处存档；</span><span lang=\"EN-US\"> <span>如若不够，可另加附页。</span></span></p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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{"instruction": "消毒供应中心护理不良事件上报表", "input": "", "output": "```html\n<html>\\n<head>\\n<meta content=\"text/html; charset=utf-8\" http-equiv=\"Content-Type\"/>\\n<meta content=\"Microsoft Word 15 (filtered)\" name=\"Generator\"/>\\n\\n</head>\\n<body lang=\"ZH-CN\">\\n<div>\\n<p><b><span lang=\"EN-US\">消毒供应中心护理不良事件上报表</span></b></p>\\n<p> </p>\\n</div>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<div>\\n<p><span lang=\"EN-US\">科室核磁共振室</span></p>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<p></p>\\n<p><span lang=\"EN-US\"><img height=\"20\" src=\"1.9消毒供应中心护理不良事件上报表_8_9.files/image001.gif\" width=\"43\"/></span></p>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<p></p>\\n<p><span lang=\"EN-US\">上报时间： </span><span lang=\"EN-US\">2017-11-1300:13:30</span></p>\\n</div>\\n<span lang=\"EN-US\"><br clear=\"all\"/>\\n</span>\\n<div>\\n<p> </p>\\n<table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\">\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">事件基本资料：</span></p>\\n<p><span lang=\"EN-US\">发生时间<u> \\n </u>护理人员：<u> \\n </u> 床号：<u> \\n </u></span></p>\\n<p><span lang=\"EN-US\">护理人员层级： ON0-1 </span><span lang=\"EN-US\">ON0-2 \\n O<span>N1</span> <span>ON2</span> <span>ON3</span> <span>ON4</span></span></p>\\n<p><span lang=\"EN-US\">消毒员： 其他人员： 器械、物品(包)的名称：</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td valign=\"top\" width=\"34\">\\n<p> </p>\\n<p align=\"right\"><span lang=\"EN-US\">类</span><span lang=\"EN-US\">堡</span></p>\\n</td>\\n<td valign=\"top\" width=\"432\">\\n<p>〇<span lang=\"EN-US\">无菌物品发放错误，延误临床使用 </span>〇<span lang=\"EN-US\">器械、物品丢失 \\n </span>〇<span lang=\"EN-US\">器械、物品损坏 <span>〇发放的无菌物品不合格 </span></span><span>〇</span><span lang=\"EN-US\">无菌物品供应不及时</span><span lang=\"EN-US\">，延误临床使用30分钟以上</span></p>\\n<p><span>〇</span><span lang=\"EN-US\">职业暴露</span> \\n <span lang=\"EN-US\">〇</span> <span lang=\"EN-US\">其</span> <span lang=\"EN-US\">他</span> <span lang=\"EN-US\">_</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">事件具体描述：</span></p>\\n<p><span lang=\"EN-US\">靖输人</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">事件原因分析：(事件过程中护理人员存在缺陷同时报护理缺陷上报表)</span></b></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><b><span lang=\"EN-US\">目前病人情况及采取的措施：</span></b></p>\\n<p> </p>\\n<p> </p>\\n<p> </p>\\n<p> </p>\\n<p><span lang=\"EN-US\">事件相关人员签名：_</span><u> \\n </u></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">科室讨论意见及整改措施：</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">科护士长随访记录：</span></p>\\n</td>\\n</tr>\\n<tr>\\n<td colspan=\"2\" valign=\"top\" width=\"465\">\\n<p><span lang=\"EN-US\">护理部意见：</span><span lang=\"EN-US\">提示：意见在点击流程处理后的批复内容框中录入。</span></p>\\n</td>\\n</tr>\\n</table>\\n<p> </p>\\n</div>\\n</body>\\n</html>\\n\n```"}
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