Equipment for vaccination room. Organization of a vaccination room and vaccinations Equipment of a vaccination room in a clinic

The equipment of the vaccination room in a children's institution must be carried out in accordance with Order of the Ministry of Health of Russia dated 03/07/2019 N 92n “On approval of the Regulations on the organization of primary health care for children.” This page will help you select the necessary equipment, furniture, tools and materials without violating the established requirements and norms.

What do the vaccination room standards include?

The vaccination room of a child care institution, like any other institution, requires daily cleaning, disinfection and ventilation. Its equipment includes cleaning equipment, as well as a bactericidal lamp, the performance of which must correspond to the size of the room. The furniture must include:

• . doctor's desk;
  . medical cabinet;
  . changing table;
  . couches for medical and diagnostic procedures;
  . nurse's desk;
  . at least 2 chairs.
  

The standard equipment for a vaccination room for licensing includes a hand wash, liquid soap dispenser and other hygiene products. Considering the orientation of the premises, it is necessary to create the appropriate level of safety for children and medical staff. For these purposes, the availability of containers for the disposal of medical waste is provided. Vaccines and thermometers are stored in a refrigerator, which is also part of the standard equipment for vaccination rooms in schools, boarding schools, orphanages and other children's institutions.

Special attention should be paid to tools and materials. Their list includes disposable syringes with needles, rubber tourniquets, tweezers, heating pads, packs for sterile material and much more. You need to understand that equipping and licensing a vaccination room must go inextricably together. To obtain official permission, you must comply not only with the list of items, but also with their quantity. So, for example, an office in a children's institution should include 4 kidney-shaped trays, 2 scissors and 5 tweezers.

Equipment for the vaccination room from the specialists of MEDMART LLC

With our help, you can quickly, and most importantly, competently prepare premises for further licensing. When collecting equipment, we are guided by the orders, rules and regulations in force in the Russian Federation. Cooperation with the MEDMART company will provide the opportunity to select products within each position, adapting to the individual characteristics of the premises and the financial capabilities of the organization.

With MEDMART, equipping any medical office will become simple and clear!

Ordering goods to equip a vaccination room in a child care facility

This page contains all the equipment and tools necessary to equip the vaccination room and prepare the premises for the licensing procedure. To order all the necessary products, you should:

• 1. Follow the links of all points.
  2. Select in each category that opens the products that are suitable in terms of cost, type and other characteristics.
  3. Add the selected model to your order by clicking the “Add to cart” button located in the product card. After which the message “Added” should appear.
  4. Click on the “Cart” icon at the top of the site page.
  5. Check the list of all products, if necessary, add additional ones by reopening the catalog or the equipment account page.
  6. Click the “Place an order” button, then create an application by selecting the necessary items and filling out the fields proposed by the system.
  7. Wait for a call from the online store manager

If any actions on our website cause you difficulties, call the toll-free hotline number 8 800 500 84 27, or request a call using the feedback form.

Car - if necessary;

Disinfectants with instructions for their use, approved in accordance with the established procedure;

Accounting forms (form 112/u; form 026/u; form 025/u, etc.).

8. Medical immunobiological preparations used

in a children's clinic, conditions for their storage

8.1. The annual need for medical immunobiological preparations for preventive vaccinations in a children's clinic is determined in accordance with the national calendar of preventive vaccinations and the number of children of decreed ages, as well as taking into account the number of children of non-decreed ages who have not previously received preventive vaccinations within the national calendar.

8.2. Medical immunobiological preparations arrive at the children's clinic from the warehouse where the drugs are stored.

8.3. The children's clinic creates a monthly supply of all declared medical immunobiological drugs with a carryover balance of no more than 30% of the need for the next month. Keep records of receipts, expenditures and write-offs in journals of the established form. A report on the movement of vaccines is submitted quarterly to the warehouse from which they were received, as well as to territorial health authorities, bodies and institutions carrying out state sanitary and epidemiological supervision.

8.4. The following documents are required for all available medical immunobiological drugs:

Annual order application for MIBP;

Explanatory note (justification) for drawing up the annual application;

Copies of requirements for receiving MIBP from the warehouse;

Journal of analysis of the movement of MIBP in the clinic;

Journal of receipt and issuance of MIBP in organizations in the service area of ​​the clinic;

Copies of reports on the movement of MIBP to higher organizations;

Certificates of write-off of MIBP;

Invoices for the received drugs indicating the quantity of each batch, expiration date, manufacturer;

Instructions for use of drugs.

8.5. When using foreign-made vaccines, additionally:

Registration certificate of the Ministry of Health and Social Security of Russia;

Certificate of conformity for each batch of the drug from the State Institute for Standardization and Control of Medical Biological Products named after. L.A. Tarasevich;

Instructions for use in Russian.

8.6. The cold chain system includes:

Specially trained personnel ensuring the operation of refrigeration equipment, storage and transportation of vaccines;

Refrigeration equipment designed for storing and transporting vaccines under optimal temperature conditions;

Mechanism for monitoring compliance with the required temperature conditions.

8.7. Cold chain equipment.

8.7.1. Refrigerators (one with a supply of vaccines for work during the current day in the vaccination room, the other for storing a month’s supply of medical immunobiological preparations).

8.7.2. Health care organizations performing a high volume of vaccinations provide sufficient refrigeration equipment to meet needs.

Refrigerators are installed at a distance of at least 10 cm from the wall, away from heat sources. For each refrigerator, a specialist’s opinion is prepared on the technical condition and the ability to maintain the temperature required for storing vaccines at 2 - 8 C°, the average percentage of wear, the year of manufacture, the date and nature of the repair.

8.7.3. Thermometers (2 in each refrigerator) are placed on the top and bottom shelves, the temperature is recorded 2 times a day in a log.

8.7.4. Cold packs filled with water are stored in the freezer compartment of the refrigerator in case of emergency use, for example during a power outage. When loading cold elements into the freezer, ensure free air circulation between them.

8.7.5. Medical immunobiological preparations are stored on marked shelves: liquid sorbed vaccines and solvents - away from the freezer, liquid lyophilized and oral live polio vaccine - under the freezer.

8.7.6. Reusable thermal containers or cooler bags, equipped with thermoelements, in sufficient quantity for transporting medical immunobiological preparations.

8.7.7. Thermal indicators for objective temperature control.

8.8. Documents: log of receipt and issuance of medical immunobiological preparations.

9. Accounting and reporting documents on the conducted

preventive vaccinations

9.1. To record and report on preventive vaccinations carried out in the children's clinic, medical documents are drawn up to ensure the completeness, accuracy and timeliness of recording the populations subject to vaccination and the vaccinations performed.

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Work report

Nursing

Performed

Muzafarova Natalya Mikhailovna

Toritsk 2011

1. Brief characteristics of health care facilities

Municipal medical treatment and preventive institution "Central District Hospital of Troitsk and Troitsky District."

On April 24, 2008, by decision of the licensing and accreditation commission of the Ministry of Health of the Chelyabinsk Region, license No. LO-74-01-000070 was issued to carry out medical activities, types of services performed as part of the licensed type of activity.

The structure of the bed capacity for 2011 is:

24-hour hospital, 453 beds in total;

Day hospital at the clinic 133 beds;

Dialysis department with 4 beds.

The Central District Hospital is a multidisciplinary hospital with 17 departments: admission department No. 1, admission department No. 2, anesthesiology-resuscitation department, gynecological, cardiological, purulent surgery department, neurological, pediatric, traumatological, therapeutic, maternity, surgical, neonatal department, infectious disease boxing for children, an oncology department, an emergency department, as well as a number of auxiliary departments that provide the diagnostic process.

Outpatient care.

The planned capacity of the clinic is 1,450 visits per shift.

Dental department - 300 visits.

Children's clinic - 300 visits.

Maternity consultation - 150 visits.

Preventive vaccinations are carried out in medical institutions by the state and municipal health care system (MM healthcare facility “CRH of Troitsk and Troitsky district”). Responsible for organizing and conducting preventive vaccinations is the head of the medical institution (Deputy head physician for outpatient service Bobrysheva L.N., Head of Therapeutic Department No. 3 Shchekotova L.A.), and the persons conducting vaccinations (procedural nurse of the vaccination room No. 2 clinics Muzafarov N.M.).

The clinic is located on the street. Krupskaya-3, built in 1972 and designed for 300 visits per shift, is part of the Municipal Medical Treatment and Prevention Institution “Central District Hospital of Troitsk and Troitsky District”.

To carry out preventive vaccinations on the territory of the Russian Federation, vaccines are used that are registered in the Russian Federation and have a certificate from the National Authority for the Control of Medical Immunological Preparations.

Preventive vaccinations are carried out in vaccination room No. 2 of the clinic. The office is located on the second floor of the clinic building. The walls of the office are lined with glazed tiles to the height of the room, the floor is covered with linoleum. The office has natural and artificial lighting. In certain situations, vaccinations are carried out at home or at the place of work by mobile teams.

2. Basic documents defining vaccination work

Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population.”

SanPiN 2.6.1.2612-10 “Sanitary and epidemiological rules and standards.”

OST 42-21-2-85 “Sterilization and disinfection of medical supplies. Methods, means and modes."

SP 3.1.958-00 “Prevention of viral hepatitis. General requirements for epidemiological surveillance of viral hepatitis."

SP 3.3.2.2330-08 “Sanitary and epidemiological requirements for the conditions of transportation, storage and dispensing to citizens of medical immunobiological preparations used for immunoprophylaxis by pharmacies and healthcare institutions.”

SP 3.1.1.2341-08 “Prevention of viral hepatitis”.

SP 3.1.1.2137-06 “Prevention of typhoid and paratyphoid fever.”

Order of the USSR Ministry of Health dated July 12, 1989. No. 408 “On measures to reduce the incidence of viral hepatitis in the country.”

Order of the USSR Ministry of Health dated July 31, 1978. No. 720 “On improving medical care for patients with purulent surgical diseases and strengthening measures to combat nosocomial infections.”

Order of the Ministry of Health of the Russian Federation dated November 26, 1997. No. 345 “On improving measures to prevent nosocomial infections in obstetric hospitals.”

Order of the Ministry of Health of the Russian Federation dated November 26, 1998. No. 342 “On strengthening measures to prevent epidemic typhus and combat pediculosis.”

Order of the Ministry of Health of the Russian Federation dated May 17, 1999. No. 174 “On measures to further improve the prevention of tetanus.”

Order of the Ministry of Health of the Russian Federation dated October 7, 1997. No. 297 “On improving measures to prevent people from getting rabies.”

3. Documents regulating infection safety

Federal Law dated September 17, 1998 No. 157 - Federal Law “On Immunoprophylaxis of Infectious Diseases”.

Order of the Ministry of Health. RF. No. 229 dated June 27, 2001 “On the national calendar of preventive vaccinations and the vaccination calendar for epidemiological indications.”

Order of the Ministry of Health and Social Development of the Russian Federation No. 673 of October 30, 2007. “On introducing amendments and additions to the Order of the Ministry of Health. RF. No. 229 dated June 27, 2001 “On the national calendar of preventive vaccinations and the vaccination calendar for epidemiological indications.”

Order No. 5/N dated January 31, 2011 “On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.”

SP 3.1.1.2341-08 dated 02/28/2008 “Prevention of viral hepatitis B”.

SP 3.1.1.1118-02 “Prevention of polio.”

SP 3.1.1295-03 “Prevention of tuberculosis.”

SP 3.1.2.1176-02 “Prevention of measles, rubella, epidemiological mumps.”

SP 3.1.2.1320-03 “Prevention of pertussis infection.”

SP 3.1.2.2156-06 “Prevention of meningococcal infection.”

SP 3.1.2.1203-03 “Prevention of streptococcal (group A) infections.”

SP 3.3.2367-08 “Organization of immunoprophylaxis of infectious diseases.”

SP 3.3.2342-08 “Ensuring the safety of immunization.”

SP 3.1.2.1108-02 “Prevention of diphtheria.”

SP 3.1.2.1319-03 “Prevention of influenza.”

Order of the Ministry of Health of the Chelyabinsk region dated November 28, 2006. 3 450 “On approval of clinical and organizational guidelines for ensuring biological safety in health care facilities.”

SP 3.1.3.2352-08 “Prevention of tick-borne viral encephalitis.”

SP 3.1.1.2343-08 “Prevention of polio in the post-certification period.”

SP 3.1.1381-03 “Prevention of tetanus”.

MU 3.3.1252-03 “Tactics of immunization of the adult population against diphtheria.”

MU 3.3.1889-04 “Procedure for preventive vaccinations.”

MU 3.3.1891-04 “Organization of the work of the vaccination room, immunoprophylaxis room and vaccination teams.”

MU 3.3.1.1095-02 “Medical contraindications to preventive vaccinations with drugs from the national vaccination calendar.”

4. Documents on HIV prevention

Federal Law of March 30, 1995 No. 38-FZ “On preventing the spread of the disease caused by the human immunodeficiency virus (HIV infection) in the Russian Federation.”

Order of the Ministry of Health of the Russian Federation dated November 24, 1998 No. 338 “On introducing amendments and additions to the order of the Ministry of Health of Russia dated November 26, 1997 No. 345 “On improving measures for the prevention of nosocomial infections in obstetric hospitals.”

Paperwork documents - order of the USSR Ministry of Health dated October 4, 1980 No. 1030 “On approval of forms of primary medical documentation of healthcare institutions.”

5. Equipment for the vaccination room

Refrigerator with a supply of vaccine for 1 day, with labeled shelves. Installed at a distance of 10 cm from the wall, away from heat sources, on the refrigerator - a specialist’s conclusion on the technical condition and the ability to maintain the temperature required for storing vaccines at 2-8 o C, the average percentage of wear, year of manufacture, date and nature of repair. Thermometers-2, placed on the upper and lower shelves, I record the temperature 2 times a day in a log. Cold elements, the number of cold elements corresponds to the standards specified in the instructions for use of the thermal container available. Cooling elements are located in the freezer compartment of the refrigerator, rubber warmers with ice.

Thermal containers - 4 pcs.

Medical couch - 1 pc.

Separate marked tables for types of vaccinations - 2 pcs.

Desk for nurses and document storage - 1 pc.

Chair - 1 pc.

Germicidal lamp - 1 pc.

Sink for washing hands.

Containers - puncture-proof containers with a lid and a “drowner” for disinfection of processed syringes, needles, cotton balls, vaccines.

Needle cutter - 1 piece.

Cabinet for storing medical devices and drugs in emergency conditions.

Class A waste container - 1 pc.

Cleaning equipment (labeled) should be kept in a specialized room.

6. Toolkit

Disposable syringes for vaccinations in sufficient quantities with an additional supply of needles.

Bixes with sterile material (cotton balls in packs of 25 pieces, bandages, napkins).

Tweezers - 5 pcs.

Scissors - 2 pcs.

Rubber band - 2 pcs.

Warmers - 2 pcs.

Kidney-shaped trays - 4 pcs.

Band-Aid.

Towels, diapers, sheets.

Disposable gloves.

Containers with disinfectant solution.

7. Storage and transportation of medical immunobiological preparations

Storage and transportation of medical immunobiological drugs is carried out at temperatures from +2 o C to +8 o C. Transportation and storage of each immunobiological drug is determined by the instructions for this drug.

Medical immunobiological preparations are placed in refrigerators in such a way that access to cooled air is provided to each package. Vaccines are stored on different labeled shelves, drugs of the same name are stored in batches, taking into account expiration date and receipt. The solvent for dry vaccines should be stored in the refrigerator along with the vaccine. There must be a sufficient supply of cold cells in the freezer compartment of the refrigerator.

Not allowed:

Storing other items, food or medicines in the refrigerator together with medical immunobiological preparations.

Storage of medical immunobiological preparations on the refrigerator door panel and tray boxes.

To record the temperature of the refrigerator, mercury thermometers are used. The use of water or alcohol thermometers is not permissible, since they do not have a scale with negative values. Each unit of refrigeration equipment must be equipped with temperature measuring equipment. Facts of emergency or planned shutdown of the refrigerator are recorded in the temperature log of the refrigerator. The vaccination nurse is responsible for the accuracy of the records.

The duration of storage of medical immunobiological preparations at the 4th level of the “cold chain” should not exceed one month. All applicants to M.I.P. institutions The head nurse records in the journal the receipt and consumption of medical immunobiological drugs in the established form. Transportation of medical immunobiological preparations is carried out only in thermal containers that provide a temperature range from +2 o C to +8 o C. Medical thermal containers that have passed state registration are used. Thermal containers must be equipped with a passport, instructions for use and the required number of cold elements. Disinfection of thermal containers is carried out with a passport and instructions for use. The use of cold elements is possible only after they have been conditioned. During transportation, it is necessary to check the tightness of the container closure. Loading and unloading of the thermal container is carried out in the shortest possible time (5-10 minutes). In order to ensure uninterrupted operation of refrigeration equipment, a contract for technical maintenance of equipment was concluded. A passport, instructions for use on the refrigerator and an emergency plan for the “cold chain” in case of a power outage in the clinic are kept at the workplace.

8. Organization of vaccination

To ensure timely implementation of preventive vaccinations, we invite persons subject to vaccination, verbally or in writing, on the day determined for vaccination. Before carrying out a preventive vaccination, a medical examination is carried out, taking into account anamnestic data (previous diseases, tolerability of previous vaccinations, the presence of allergic reactions to medications, products, etc.) in the medical record, a corresponding entry is made by the doctor (paramedic) about the vaccination. If necessary, a medical examination is carried out before vaccination. Immediately before vaccination, thermometry is performed. I carry out all preventive vaccinations with disposable syringes and disposable needles.

I carry out preventive vaccinations in strict accordance with the indications and contraindications for their use according to the instructions included with the drug.

9. Methodology for carrying out preventive vaccinations

Sequence of the procedure:

Prepare sterile syringes and needles for hypodermic injections, ampoules with vaccine, sterile cotton balls, 70% ethyl alcohol solution, soap, towel, sterile gloves, glasses, mask, dishes with disinfectant solution, garbage tray, anti-shock agents;

Psychologically prepare the patient for manipulation;

Perform hand hygiene.

Hand hygiene consists of two stages: mechanical cleaning of hands and disinfection of hands with a skin antiseptic. After completing the mechanical cleaning stage (twice soaping and rinsing), the antiseptic is applied to the hands in an amount of at least 3 ml and thoroughly rubbed into the skin until completely dry (do not wipe your hands). If the hands were not contaminated (for example, there was no contact with the patient), then the first stage is skipped and the antiseptic can be immediately applied. The sequence of movements when processing hands is consistent. Each movement is repeated at least 5 times. Hand treatment is carried out for 30 seconds - 1 minute.

Wear a mask, goggles, sterile gloves;

Visually check the integrity of the ampoule or bottle, the quality of the administered drug and its labeling.

Opening of ampoules and dissolution of lyophilized vaccines should be carried out in accordance with the instructions with strict adherence to the rules of asepsis and cold chain. Parenteral administration of immunobiological drugs should be carried out with a disposable syringe and a disposable needle, observing the rules of asepsis. In case of simultaneous administration of several vaccinations (except BCG), I administer each vaccine with a separate disposable syringe and disposable needle into different parts of the body.

Draw the vaccine into the syringe and remove air from it. The vaccine is administered in a dose that strictly corresponds to the instructions for use of the drug, with the patient lying or sitting to avoid falling in case of fainting.

Wipe gloves with alcohol;

Wipe the injection site twice with cotton balls soaked in alcohol;

The field treated with alcohol must dry;

Grab the skin with subcutaneous tissue at the injection site with the index finger and thumb of your left hand;

Insert a needle into the base of the formed fold (with a quick movement at an angle of 30-45°) two-thirds of its length;

Pull the piston towards you and make sure that the needle does not fall into the lumen of the vessel;

Slowly inject the vaccine by pressing the plunger with your left hand;

Apply a dry cotton ball to the injection site with your left hand;

Pull out the needle quickly;

Disinfect used equipment;

Make a note of the completed manipulation.

A record of the vaccination is made:

In the work log of the vaccination room.

Card of preventive vaccinations (form. 063-u).

Medical record (form 025-u).

Certificate of preventive vaccinations (f. 156/u-93) The data entered in the certificate is certified by the signature of the doctor and the seal of the medical institution.

After prophylactic vaccination, observation is provided for the period specified in the instructions for use of the corresponding vaccine preparation (at least 30 minutes). The medical record notes the nature and timing of general and local reactions, if they occur. Adverse reactions during routine vaccinations are currently quite rare.

There are general and local complications.

Local complications include reactions at the site of vaccine administration - redness, suppuration, lymphadenitis. General complications: allergic reactions, increased body temperature, the appearance of symptoms of an infectious disease. Complications associated with individual hypersensitivity to the vaccine. This group of complications poses the greatest danger, since in most cases it is impossible to predict their possible development in a particular patient. The most dangerous reaction is considered to be anaphylactic shock. More often they manifest themselves in the form of allergic and neurological reactions. Depending on the type of vaccine, complications of this kind may be due to:

Toxic effect of the drug itself (inactivated vaccines);

An infectious process that occurs after the administration of a vaccine (live vaccines);

Development of perverse sensitivity to the drug (sensitization).

If an unusual, strong reaction or complication develops after administering the vaccine, immediately notify the head of the clinic and send an emergency notification (f. 058/u) to the Federal State Institution "Center for Hygiene and Epidemiology" in the Chelyabinsk region. The fact of refusal of vaccination with a note that honey. the employee provided explanations about the consequences of such a refusal, it is documented in the outpatient card and signed by both the citizen and the medical professional. employee.

Immunization of citizens with a vaccine purchased in pharmacies. In pharmacies, medical immunobiological drugs must be dispensed with a doctor's prescription. Transportation of the vaccine to a medical institution is possible only in a thermal container or thermos. Immunization with the vaccine in the treatment room is carried out with a receipt for the vaccine, or a mark on the date and time of sale of the vaccine on the packaging, if no more than 48 hours have passed since the date of purchase.

Disposal of vaccine residues, used syringes and needles.

Remains of vaccines in ampoules or vials, used disposable needles, syringes, cotton swabs, napkins, gloves after injection are dumped into containers with a disinfectant solution prepared in accordance with the instructions for its use. The following medical immunobiological preparations are subject to destruction:

Expired.

Stored in violation of the “cold chain”.

With changed external properties not indicated in the instructions.

After disinfection treatment, I dispose of medical waste in accordance with sanitary rules and SanPiN standards.

SanPiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for the management of medical waste.”

SanPiN 2.1.7.728-99 "Rules for the collection, storage and disposal of waste from medical institutions."

10. Sanitary and epidemiological regime in the workplace

Disinfection of medical products.

Reusable (glass jars, trays, tweezers).

Pre-sterilization cleaning involves the final removal of protein, fat, mechanical contaminants and residual quantities of medications. All products to be sterilized must undergo pre-sterilization cleaning.

Disassembled products are subjected to pre-sterilization cleaning in disassembled form with complete immersion and filling of the channels. Pre-sterilization cleaning is carried out manually in containers made of plastic, glass or enamel-coated (without damage). Currently, there are a number of means that allow you to combine disinfection and pre-sterilization cleaning into one processing stage.

Disinfection steps are the same as for disposable syringes

Stages of pre-sterilization cleaning:

Stage 1: rinsing with running water after disinfection over the sink for 30 seconds until the smell of disinfectants is completely eliminated;

Stage 2: rinsing with distilled water for 30 seconds;

Stage 3: drying with hot air at a temperature of +75..+87 in drying cabinets.

To dispose of waste material and disposable medical devices, disinfectants containing chlorine are used - Clorendez, Javel - Sin, Deachlor, Javel - Solid, Javel, etc.

Control of the concentration of chlorine-containing solutions is determined by the express method, the indicator "Dezikont X-02" from the company "Vinar" with a mark in the logbook for monitoring the concentrations of working solutions of disinfectants and sterilants.

Every six months, disinfectants are changed according to the microflora.

Quality control of pre-sterilization cleaning

The results of pre-sterilization cleaning control are recorded in the Form -366/у journal. 1% of processed products of the same name, but not less than 3-5 units, are subject to control. The effectiveness of subsequent sterilization directly depends on the completeness and quality of pre-sterilization treatment; therefore, standards have introduced mandatory quality control of pre-sterilization cleaning carried out by the medical institution itself. Self-monitoring of the quality of PSO in departments of medical institutions is carried out daily. Organized and supervised by the head nurse at least once a week. When choosing disinfectants used in health care facilities, the effectiveness of disinfection and destruction of various types of microorganisms, including spore forms and viruses, is taken into account. Every six months, disinfectants are changed according to the microflora. If the blood test is positive, the entire group of controlled products from which the control was taken is subjected to repeated processing until negative results are obtained.

Sterilization.

Sterilization is a method that ensures the death of vegetative and spore forms of pathogenic and non-pathogenic microorganisms in the sterilized material.

Sterilization methods:

Thermal (steam, air, glassperlene);

Chemical (gas, solutions of chemical compounds);

Radiation;

Plasma and ozone (group of chemical agents).

In a clinical setting, the most common methods for sterilizing instruments and medical devices are:

Steam (autoclaving),

Air (dry-heat oven),

Chemical (gas, solutions of chemical compounds).

Steam sterilization is carried out by supplying saturated water steam under pressure in steam sterilizers (autoclaves). Steam sterilization is considered the most effective method due to the fact that the bactericidal power of hot air increases as it is humidified, and the higher the pressure, the higher the temperature of the steam. Products made from textiles (linen, cotton wool, bandages, suture material), rubber, glass, some polymeric materials, nutrient media, and medications are subjected to steam sterilization.

Steam sterilization modes.

132 °C -- 2 atmospheres (2 kgf/cm2) -- 20 minutes -- main mode. All products (glass, metal, textiles, except rubber) are sterilized.

120 °C -- 1.1 atmosphere (1.1 kgf/cm2) -- 45 minutes -- gentle mode (glass, metal, rubber products, polymer products - according to the passport, textiles).

110 °C -- 0.5 atmosphere (0.5 kgf/cm2) -- 180 min -- especially gentle regime (unstable drugs, nutritional media).

Packaging materials for steam sterilization:

The sterilization box (bix) is simple. Shelf life 3 days after sterilization.

Sterilization box (bix) with filter. Shelf life is 20 days after sterilization.

Infection safety in the workplace.

For medical personnel, every patient should be considered as a possible carrier of a viral infection. The danger of infection exists when generally accepted rules of asepsis and hygienic conditions are violated during treatment procedures. Regulatory document on infectious safety of medical personnel, order of the Ministry of Health of the Russian Federation No. 338 dated November 24, 1998 “On introducing amendments and additions to the order of the Ministry of Health of Russia dated November 26, 1997 No. 345 “On improving measures for the prevention of nosocomial infections in obstetric hospitals”, SaN PiN dated May 18, 2010 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities.”

11. Personal protective equipment

Disposable rubber gloves.

Safety glasses or shields.

Laminated robe, apron.

Shoes made of leather or leatherette.

The danger of contracting HIV infection can arise in emergency situations (cuts, injections with instruments contaminated with blood and other biological fluids or contact with the mucous membranes of the eyes, oropharynx and nose. An Anti-HIV first aid kit is available to provide assistance.

First aid kit "Anti HIV" - available, stored in a container that is processed. Any emergency situation is recorded in the Journal of Medical Personnel Injuries and Post-Traumatic Prevention.

In the MM health care establishment “CRH of Troitsk and the Troitsky district”, order No. 458 of October 20, 2009 was issued “On ensuring the prevention of nosocomial HIV infection among medical workers of the Troitsk urban district”, it developed an algorithm for carrying out measures for post-exposure prevention of HIV infection medical workers. In case of contact with blood or other biological fluid of an HIV-infected person, you should: start taking specific antiretroviral drugs as soon as possible (preferably for the first 2 hours after the accident): azidothymidine (zidovudine) orally 0.2 g 3 times a day (the drug is stored in the reception area Department No. 1, 2 - responsible senior nurse of the admission department).

Then: make an entry about what happened in the emergency log with a note about the date, time and place of the emergency, full name. and the position of the medical worker, full name, age and address of the patient, the circumstances of the emergency and the nature of the injury, the scope of first aid. Inform the head of the institution about it. Donate blood for the presence of antibodies to the HIV virus on the day of the accident to establish the fact of their absence or presence at the time of the emergency. If the patient's HIV status is unknown, perform a rapid diagnosis and record the results in the express testing journal (admission department No. 1, 2 - the responsible senior nurse of the admission department). If the rapid diagnostic result is positive or questionable, or if the result is negative, but there is an unfavorable epidemiological history and alarming clinical data in the patient, the healthcare worker should continue taking antiretroviral drugs.

Regardless of the results of express diagnostics, blood is collected from the patient for testing for HIV infection using ELISA. Within 24-48 hours, the injured medical worker must contact the infectious diseases department and then be referred for a consultation to the AIDS Center at the Clinic of the State Educational Institution of Higher Professional Education "ChSMA" of the Russian Health Ministry (Chelyabinsk, Cherkasskaya str. 2, tel. 83517218282). Take medications received at the AIDS center for 30 days. Register with the infectious diseases department and donate blood for the presence of antibodies to the HIV virus at the AIDS laboratory 3, 6, 9, 12 months after the emergency. In the absence of antibodies to the HIV virus, 12 months after the emergency, dispensary observation is terminated. The Central District Hospital received "RETROCHEK HIV" rapid tests, which make it possible to determine within a few minutes whether a patient is infected. Health care facilities have a stock of drugs for chemoprophylaxis of HIV infection.

All clinic employees are vaccinated against:

Hepatitis B.

Diphtheria and tetanus.

Rubella (according to indications).

Corey (according to indications).

Swine flu H 1 N 1.

Seasonal flu.

12. Disinfection of premises and furnishings of the vaccination room

The vaccination room has a bactericidal lamp corresponding to the area of ​​the room. Work tank. lamps are carried out according to schedule. Every day the bactericidal irradiator works for at least 2 hours a day, and on the day of general cleaning for one hour more. The operating time of the lamp is strictly recorded in the “Bactericidal lamp working time log”, because Having worked 1/3 of the set time, the quartzing time increases by 30 minutes. During general cleaning, the surface of the bacterial installation is treated with a sterile cloth moistened with 95° alcohol.

Routine and general cleaning.

During the working day and after finishing work, routine cleaning (disinfection) is carried out: with a rag moistened with disinfectant. with a solution, wipe the walls to the height of an outstretched arm, tables, a couch, all objects are moved away from the walls. Wet cleaning is carried out twice. After the current cleaning of the cabinet with quartz for 1 hour. General cleaning is carried out once a week. A rag moistened with disinfectant. solution, I wipe the walls (to their entire height), ceiling, furniture, windows, objects, as well as the surface of the tank. lamps. Currently, there are disinfectants with a cleaning effect that allow you to combine the first two stages into one.

General cleaning is carried out in three stages:

Stage - irrigation disinfection. agent (Aminaz 1%) - 200 ml per 1 sq. meter.

Stage - Ventilate (prevent poisoning from chlorine vapors), rinse, wipe dry with a rag.

Stage - Turn on the bactericidal lamp for 2 hours.

The date of general cleaning and the name of the disinfectant used is indicated in the “Log of General Cleaning Conducted.” Routine and general cleaning in the vaccination room is carried out according to:

Order No. 720 of July 31, 1978 “On improving medical care for patients with purulent surgical diseases and strengthening measures to combat nosocomial infections.”

Order No. 338 of November 24, 1998 “On introducing amendments and additions to Order No. 345 of November 26, 1997 “On improving measures for the prevention of nosocomial infections in obstetric hospitals.”

13. Bacteriological control

The vaccination room is regularly monitored by the sanitary group by a bacteriological laboratory, once every 6 months. The following are carried out: washings from the walls and furniture in the office, washings from the nurse’s gown and hands, air seeding (for the number of colonies and flora seedings), monitoring the operation of the tank. lamps, seeding of sterile material, as well as flushes after general cleaning (to control the quality of its implementation).

I carry out sanitary and preventive work on hygienic education of the population in the clinic in the form of conversations on various topics of interest.

Topics of sanitary and preventive work

In 2010, she prepared and held conferences for clinic staff on the topic: “Prevention of tick-borne encephalitis”

14. Analysis of work for 2010 in comparison with 2009

In 2010, the immunization plan included the following types of vaccination:

Against influenza (education, medicine, people over 60 years old) - 2943 people.

Against hepatitis of citizens from 18 to 55 years old - 5 people and RV 30 people - health workers.

Against measles - 3 people.

Against diphtheria -1190 people.

20 people against rubella.

Against polio - 6 people.

Against tick-borne encephalitis - 96 people.

The plan was carried out 100%.

24% of the adult population has been vaccinated against influenza.

Since 2006, 7,930 people have been vaccinated against hepatitis.

The result of immunization over 3 years was:

Reducing the incidence of influenza,

Reduced incidence of hepatitis B,

Absence of diphtheria, tetanus, and measles for several years.

New ways of working in 2010. Developed, approved by the chief physician (order dated March 15, 2010 No. 91) “On approval of emergency care algorithms” and implemented:

Algorithm of measures for anaphylactic shock;

Algorithm of measures for fainting;

Algorithm of measures for insect bites;

Composition of the “First aid kit for assistance with anaphylactic shock.”

The “Vaccine Prevention” program was introduced - a computer version in the vaccination room. The vaccination room has a “DI-1M” Destructor for destroying needles.

vaccination room vaccine medical immunobiological

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When monitoring the equipment and equipment of the vaccination room, it is necessary to pay attention to the presence of:

An ultraviolet irradiator switched on outside the room (except for those that can operate in the presence of people) with a power corresponding to the volume of the room;

- medical furniture resistant to detergents, disinfectants and medications;

A refrigerator for storing MIBP with marked shelves and two thermometers, cold elements (the number of cold elements must be no less than that specified in the instructions for use of the thermal container or cooler bag available in the vaccination room);

- medical cabinet for medicines and instruments;

- medical couch;

- changing table;

- medical tables marked by types of vaccinations (at least 3);

- a desktop for storing documentation, instructions for using all MIBP, a chair;

- sinks for washing hands;

- a thermal container or cooler bag with a set of cold elements;

- container - a puncture-proof container with a lid for disinfection of used syringes and needles;

- a container with a lid for disinfection of used swabs and used vaccines;

- disposable syringes (based on the number of vaccinated + 25%), with a capacity of 1, 2, 5, 10 ml with a set of needles;

- needle removers (cutters), needle destructors;

- reversible bags with soft material;

Biks with sterile material (cotton wool - 1.0 g per injection, bandages, napkins), tweezers - 5, scissors - 2, rubber band - 2, heating pads - 2, kidney-shaped trays - 4, adhesive plaster, towels, diapers, sheets;

- a supply of disposable rubber medical gloves;

- containers for storing disinfectant solution;

A syndromic list of medications for antishock therapy approved by health authorities with instructions for use (indicating age dosages, methods of administration);

- medical documents of the vaccination room and immunization room:

- log of examinations and vaccinations performed according to f. 064/у;

- forms of a certificate of preventive vaccinations (form 156/u-93);

- outpatient cards of patients (f. 112/u, f. 025/u);

- f. 058 - emergency notification of side effects of vaccines;

- instructions for use of all used MIBP in Russian (in a separate folder);

- f. 63 - record card of preventive vaccinations;

- a log of vaccinations performed (for each type of vaccine);

- journal of accounting and consumption of medical immunobiological preparations;

- refrigerator temperature log;

- logbook for recording the operation of the bactericidal lamp;

- journal for registering general cleaning;

- emergency plan to ensure the cold chain in emergency situations;

Sets of removable clothing for medical personnel of the vaccination room of the hospital: gowns, caps, masks, removable shoes (slippers);

- individual lockers for storing a change of clothes;

- conditions for washing clothes;

- schedule for changing clothes (should be carried out as they get dirty, but at least twice a week);

Conditions for washing and disinfecting the hands of doctors and nurses before examining each patient or performing vaccinations, as well as after performing “dirty procedures”

Question 4 Child development is normal

Ticket No. 13 (1)

Child mode at the age of 3 years. Preschool age 1-3 years

This is characterized by rapid maturation of the nervous system. Expanding motor capabilities. Improving speech. Development of mental reactions adequate to the situation. Expanding contacts with other children and adults.

Children of this age are sociable, inquisitive, and emotional. By the age of 3, communication with peers is needed. Children develop fine coordinated movements, develop drawing and modeling skills, and develop fine motor skills.

AFO skin: Skin folds are smoothed out. Self-hygiene training is important.

AFO Musculoskeletal system: Bones contain a lot of cartilage tissue. Large muscles develop. The spine grows evenly up to 1.5 years, then the growth of the thoracic and cervical vertebrae slows down.

AFO SSS. Pulse 105 ular per minute, arrhythmic in 60 seconds, blood pressure 90+2p, where p is age.

AFO of the digestive system. The stomach capacity is 300 ml, and by 3 years 500 ml. Stool 1-2 times a day.

AFO of the urinary system. Single volume of urine. Specific gravity 1010 mg/l. During this period, girls 1.5 - 2 years old, boys 3 years old, are potty trained.

Respiratory system. From 2 years to 3 years, the frontal sinuses are formed. The respiratory tract is still narrow, the mucous membranes are loose, often acute viral diseases, the type of breathing is diaphragmatic-thoracic. RR 28 puerile breathing loud sonorous breathing.

Calculation of height and weight:

M = 10kg + 2p (±10%) e = 75 + 5p (±5%) - error

Night sleep 12 hours. Daytime 3 hours.

Meals 4 times a day, by the age of 3 3 meals a day. Daily volume 1l – 300, 1l – 400g.

Protein – 55g, fat – 55g, carbohydrates – 200g in the daily diet. Calorie content 1600 kilocalories. Distributed throughout the day: breakfast 25%, lunch - 40%, afternoon snack - 10%, dinner - 25%

Drink 600 ml milk daily.

Preparing for kindergarten.

1. The home schedule corresponds to the kindergarten.

2. Stop using pacifiers and bottle feedings.

3. Personal hygiene and neatness.

4. Vaccination.

In accordance with Article 37 of the Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, No. 48, Art. 6724) I order:

Approve the Procedure for providing pediatric care in accordance with.

Application
to the Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Order
providing pediatric care

For information on the procedures for providing medical care to the population of the Russian Federation, see the certificate

1. This procedure establishes the rules for the provision of pediatric care by medical organizations, regardless of their organizational and legal form.

2. Medical pediatric care is provided in the form of:

primary health care;

emergency, including specialized, medical care;

specialized, including high-tech, medical care.

3. Medical pediatric care can be provided in the following conditions:

outside a medical organization (at the place where the emergency medical team is called, as well as in a vehicle during medical evacuation);

outpatient (in conditions that do not provide round-the-clock medical observation and treatment), including at home when a medical professional is called;

in a day hospital (in conditions that provide medical supervision and treatment during the day, but require round-the-clock medical supervision and treatment);

inpatient (in conditions that provide round-the-clock medical supervision and treatment).

4. Primary health care includes activities for the prevention, diagnosis, treatment of diseases and conditions, medical rehabilitation, promotion of a healthy lifestyle and sanitary and hygienic education of the child population.

5. Primary health care includes:

primary pre-hospital health care;

primary medical care;

primary specialized health care.

Primary health care is provided on an outpatient basis and in a day hospital.

6. Primary health care for children with childhood illnesses is provided on an outpatient basis by local pediatricians, general practitioners (family doctors), medical specialists, and relevant paramedical personnel.

7. If there are medical indications, local pediatricians, general practitioners (family doctors), and medical personnel of educational institutions refer children for consultations to medical specialists of medical organizations in the specialties provided for by the Nomenclature of Specialties of specialists with higher and postgraduate medical and pharmaceutical education in the field Health of the Russian Federation, approved by order of the Ministry of Health and Social Development of Russia dated April 23, 2009 No. 210n (registered by the Ministry of Justice of Russia on June 5, 2009, registration No. 14032), as amended by order of the Ministry of Health and Social Development of Russia dated February 9, 2011 No. 94n (registered by the Ministry of Justice of Russia March 16, 2011, registration No. 20144).

8. In order to provide primary health care to children in case of sudden acute diseases, conditions, exacerbation of chronic diseases that are not accompanied by a threat to the child’s life and do not require emergency medical care, medical care units may be created within the structure of medical organizations that provide the specified assistance in an emergency form .

9. Within the framework of emergency, including emergency specialized medical care, pediatric medical care for diseases, accidents, injuries, poisoning and other conditions requiring urgent medical intervention is provided to children by paramedic mobile ambulance teams, medical mobile emergency medical teams in accordance with the order of the Ministry of Health and Social Development of Russia dated November 1, 2004 No. 179 “On approval of the procedure for providing emergency medical care” (registered by the Ministry of Justice of Russia on November 23, 2004, registration No. 6136) as amended by orders of the Ministry of Health and Social Development of Russia dated August 2, 2010. No. 586n (registered by the Ministry of Justice of Russia on August 30, 2010, registration No. 18289) and dated March 15, 2011 No. 202n (registered by the Ministry of Justice of Russia on April 4, 2011, registration No. 20390).

10. When providing emergency medical care, if necessary, medical evacuation is carried out, which includes air ambulance and sanitary evacuation.

11. Ambulance, including specialized emergency medical care, is provided in emergency and emergency forms outside of a medical organization, as well as in outpatient and inpatient settings.

12. An emergency medical team delivers children with childhood illnesses complicated by life-threatening conditions to medical organizations that have an anesthesiology-reanimation department or a resuscitation and intensive care unit (ward) and provide round-the-clock medical observation and treatment of children.

13. If there are medical indications, after eliminating life-threatening conditions, the child is transferred to the pediatric department (beds), and in its absence, to the therapeutic department of the medical organization to provide medical care to the child.

14. Specialized, including high-tech, medical care for children is provided by pediatricians and medical specialists and includes prevention, diagnosis, treatment of diseases and conditions that require the use of special methods and complex medical technologies, as well as medical rehabilitation, provided in hospital conditions and conditions of a day hospital.

15. Routine pediatric medical care is provided when carrying out preventive measures, for diseases and conditions that are not accompanied by a threat to the child’s life, that do not require emergency and emergency care, and delaying the provision of which for a certain time will not entail a deterioration in the child’s condition or a threat to his life and health.

16. Children with childhood diseases for medical reasons are sent for rehabilitation treatment in accordance with the Procedure for organizing medical care in rehabilitation medicine, approved by order of the Ministry of Health and Social Development of Russia dated March 9, 2007 No. 156 (registered by the Ministry of Justice of Russia on March 30, 2007, registration No. 9195) .

17. Medical organizations providing pediatric care carry out their activities in accordance with this Procedure.

18. If medical procedures related to the provision of pediatric care may result in pain in the child, such manipulations are carried out with anesthesia.

Appendix No. 1
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Rules
organizing the activities of a local pediatrician’s office

1. These Rules establish the procedure for organizing the activities of the office of a local pediatrician, which is a structural unit of a medical organization.

2. The office of a pediatrician at a local medical organization (hereinafter referred to as the Office) is created to provide advisory, diagnostic and therapeutic assistance to children.

3. A specialist who meets the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by Order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n, is appointed to the position of pediatrician in the local office (registered by the Ministry of Justice of Russia on July 9, 2009). , registration No. 14292), in the specialty "pediatrics" without presenting requirements for work experience in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. 541n "On approval of the Unified Qualification Directory of positions of managers, specialists and employees, section "Qualification characteristics of employee positions in the field of healthcare" (registered by the Ministry of Justice of Russia on August 25, 2010, registration No. 18247).

4. The staffing level of the medical staff of the Office is established by the head of the medical organization based on the volume of diagnostic and treatment work carried out and the number of children served, taking into account the recommended staffing standards in accordance with the Procedure for the provision of pediatric care approved by this order.

The Cabinet is equipped in accordance with the equipment standard provided for in the Procedure for the provision of pediatric care, approved by this order.

5. The office performs the following functions:

dynamic monitoring of the physical and neuropsychic development of the assigned child population;

conducting primary patronage of newborns and young children, pregnant women;

preventive examinations of children;

carrying out immunoprophylaxis;

carrying out work to protect children's reproductive health;

referral of children for consultations to medical specialists in the specialties provided for by the Nomenclature of Specialties of Specialists with Higher and Postgraduate Medical and Pharmaceutical Education in the Healthcare Sphere of the Russian Federation, approved by Order of the Ministry of Health and Social Development of Russia dated April 23, 2009 No. 210n (registered by the Ministry of Justice of Russia on June 5, 2009 , registration No. 14032), as amended by order of the Ministry of Health and Social Development of Russia dated February 9, 2011 No. 94n (registered by the Ministry of Justice of Russia on March 16, 2011, registration No. 20144);

referral of children, if there are medical indications, to inpatient treatment;

Carrying out diagnostic and therapeutic work on an outpatient basis;

dynamic monitoring of children with chronic diseases registered at the dispensary and their improvement;

preventive examinations and health improvement of children before their admission to educational organizations;

ensuring the transfer of information about children and families at social risk to the medical and social assistance department of the children's clinic, guardianship and trusteeship authorities;

organization of hospital work at home;

registration of medical documentation of children for sanatorium-resort treatment;

carrying out activities for the prevention and early detection of hepatitis B and C, HIV infection and tuberculosis in children;

implementation of measures to prevent and reduce morbidity, disability and mortality of children, including the first year of life;

registration of medical documentation of children suffering from childhood diseases for referral to medical and social examination;

providing medical consultation and vocational guidance for children;

participation in the analysis of the main medical and statistical indicators of morbidity, disability and mortality among children in the service territory;

maintaining accounting and reporting documentation, submitting reports on the activities of the Cabinet in the prescribed manner;

organization and implementation of anti-epidemic and preventive measures in outbreaks of infectious diseases.

6. To ensure its activities, the office uses the capabilities of all treatment, diagnostic and auxiliary units of the medical organization within which it is organized.

Appendix No. 2
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

medical staff of the office of a local pediatrician

3. For organizations and territories subject to service by the Federal Medical and Biological Agency, in accordance with the order of the Government of the Russian Federation of August 21, 2006 No. 1156-r “On approval of lists of organizations and territories subject to service by FMBA of Russia” (Collection of Legislation of the Russian Federation 2006, No. 35, Art. 3774; No. 49, Art. 5267; No. 52, Art. 5614; 2008, No. 11, Art. 1060; 2009, No. 14, Art. 1727; 2010, No. 3, Art. 336; No. 18 , Article 2271) the number of staff positions for a local pediatrician is established regardless of the size of the assigned child population.

Appendix No. 3
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Standard
equipping the office of a local pediatrician

* the kit of a local pediatrician for the purpose of providing medical care at home includes a stethoscope or stethoscope, disposable syringes (2 ml), a medical thermometer, spatulas, dressings (bandage, cotton wool) and medicines

Appendix No. 4
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Rules
organizing the activities of a children's clinic (department)

1. These Rules establish the procedure for organizing the activities of a children's clinic (department) in medical organizations.

2. A children's clinic (department) (hereinafter referred to as the Clinic) is an independent medical organization or a structural unit of a medical organization for the provision of preventive, advisory, diagnostic and therapeutic care for children, which does not provide round-the-clock medical supervision and treatment.

3. The management of a Polyclinic, created as an independent medical organization, is carried out by the chief physician, and the management of a Polyclinic, created as a structural unit of a medical organization, is carried out by the deputy chief physician of a medical organization (head of department).

4. A specialist who meets the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n (registered by the Ministry of Justice of Russia on July 9, 2009, registration No. 14292), in the specialty “pediatrics”, “general medicine” or “health care organization and public health”, with work experience in this specialty of at least 5 years in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. 541n “On approval Unified qualification directory of positions for managers, specialists and employees, section “Qualification characteristics of positions of workers in the field of healthcare” (registered by the Ministry of Justice of Russia on August 25, 2010, registration No. 18247).

5. A specialist who meets the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n, is appointed to the position of head of the department of the Polyclinic (registered by the Ministry of Justice of Russia on July 9, 2009, registration No. 14292), in the specialty "pediatrics", with work experience in this specialty of at least 5 years in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. 541n "On approval of the Unified Qualification Directory of positions of managers, specialists and employees, section "Qualification characteristics of positions of workers in the healthcare sector" (registered by the Ministry of Justice of Russia on August 25, 2010, registration No. 18247).

6. The staffing level of medical and other personnel, the standard of equipment of the Polyclinic are determined taking into account the volume of medical and preventive work carried out, the number of children served and are established by the head of the medical organization.

treatment and preventive department (pediatric), including: offices of local pediatricians, an office of a healthy child, an immunization office, a treatment room;

a consultative and diagnostic department, including offices of medical specialists, a functional diagnostics office, a radiation diagnostics office, and a laboratory;

emergency department;

Department of Rehabilitation Medicine;

department of medical and social assistance;

department of organizing medical care for children in educational institutions;

vision protection office;

allergy diagnostic room;

inhalation room;

physiotherapy department (office);

physical therapy room;

massage room;

The clinic should also include a group of premises, including a wheelchair room, a room for receiving house calls, and a receiving and examination filter - a box with a separate entrance.

8. The clinic performs the following functions:

provision of preventive, consultative, diagnostic and therapeutic assistance to the assigned child population;

providing patronage to pregnant women by a local pediatrician;

implementation of primary patronage of newborns and children up to one year of age;

conducting audiological screening for newborns and children in the first year of life who have not been screened for hearing loss in a maternity facility;

ensuring the transfer of information about newborns and children of the first year of life with hearing impairments identified during audiological screening to the hearing rehabilitation center (office), referral of children with hearing impairments to the rehabilitation center (office) for diagnosis;

carrying out preventive examinations of children, including in educational institutions;

organization of rational nutrition for children under 3 years of age, as well as children raised and studying in educational institutions;

organization of sanitary and hygienic education and training of children and their parents (legal representatives);

carrying out sanitary and educational work with children and parents (legal representatives) on the issues of timely detection and treatment of childhood diseases and the formation of a healthy lifestyle;

conducting medical examinations of students of educational institutions before and during practical training in organizations whose employees are subject to preliminary and periodic medical examinations;

observation of children involved in physical education and sports;

organization and implementation of immunoprophylaxis of infectious diseases;

carrying out preventive measures to prevent and reduce morbidity, identify early and latent forms of diseases, socially significant diseases, including hepatitis B and C, HIV infection, tuberculosis, identify risk factors for diseases, disability, and child mortality;

organization and implementation of anti-epidemic and preventive measures in outbreaks of infectious diseases;

referral, if there are medical indications, for consultations with medical specialists in the specialties provided for by the Nomenclature of Specialties of Specialists with Higher and Postgraduate Medical and Pharmaceutical Education in the Healthcare Sphere of the Russian Federation, approved by Order of the Ministry of Health and Social Development of Russia dated April 23, 2009 No. 210n (registered by the Ministry of Justice of Russia 5 June 2009, registration No. 14032), as amended by order of the Ministry of Health and Social Development of Russia dated February 9, 2011 No. 94n (registered by the Ministry of Justice of Russia on March 16, 2011, registration No. 20144);

referral of children, if there are medical indications, for inpatient examination and treatment to medical organizations;

organization of diagnostic and therapeutic work at home;

organization of dispensary observation of children with chronic diseases and disabled children, their timely recovery;

organization of work to protect the reproductive health of the child population;

organizing the implementation of individual rehabilitation programs for disabled children;

conducting an examination of the temporary disability of parents (legal representatives) of sick children and working children;

ensuring, in the presence of medical indications, the referral of children for a medical and social examination to establish disability;

providing medical, social and psychological assistance to children and families with children;

organization of medical and social preparation of children for admission to educational institutions;

organization of medical care for children in recreation and recreation institutions;

introduction of new preventive, diagnostic and therapeutic technologies into pediatric practice;

preparation of medical documentation when transferring medical supervision of children to a city (district) clinic upon reaching adulthood;

conducting an analysis of the main medical and statistical indicators of morbidity, disability and mortality among children in the service territory;

ensuring the maintenance of accounting and reporting documentation, submission of reports on the activities of the Clinic in the prescribed manner.

9. To ensure its activities, the Polyclinic uses the capabilities of all treatment, diagnostic and auxiliary units of the medical organization within which it is organized.

Appendix No. 5
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Recommended staffing standards
medical and other personnel of the children's clinic (department)

2. For areas with low population density and limited transport accessibility of medical organizations, the number of medical personnel at a children's clinic is established based on the smaller child population.

3. In educational organizations with a student population of less than 500 people (but not less than 100), 1 full-time position of nurse or paramedic is provided.

4. The positions of a dentist for children's and nursing staff are established in accordance with the order of the Ministry of Health and Social Development of Russia dated December 3, 2009 No. 946n “On approval of the Procedure for providing medical care to children suffering from dental diseases” (registered by the Ministry of Justice of Russia on February 10, 2010, registration No. 16348).

5. For organizations and territories subject to service by the Federal Medical and Biological Agency, in accordance with the order of the Government of the Russian Federation dated August 21, 2006 No. 1156-r “On approval of lists of organizations and territories subject to service by FMBA of Russia” (Collection of Legislation of the Russian Federation 2006, No. 35, Art. 3774; No. 49, Art. 5267; No. 52, Art. 5614; 2008, No. 11, Art. 1060; 2009, No. 14, Art. 1727; 2010, No. 3, Art. 336; No. 18 , Article 2271) the number of staff positions of medical specialists is established regardless of the size of the attached child population.

Appendix No. 6
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Standard
equipping a children's clinic (department)

1. Healthy child’s office in a children’s clinic (department)

2. Vaccination room of the children's clinic (department)

3. Treatment room of the children's clinic (department)

4. Physiotherapeutic department (office) of the children's clinic (department)

5. Physical therapy room of the children's clinic (department)

6. Massage room of the children's clinic (department)

7. Day hospital of a children's clinic (department)

______________________________

* the anti-shock kit includes a 0.1% solution of adrenaline, mezaton, norepinephrine, a 5.0% solution of ephedrine, a 1.0% solution of tavegil, a 2.5% solution of suprastin, 2.4% - th solution of aminophylline, 0.9% solution of calcium chloride, glucocorticoid drugs - prednisolone, dexamethasone or hydrocortisone, cardiac glycosides: strophanthin, korglykon

** the styling includes: 70% ethyl alcohol - 50 ml (alcohol wipes in the package); 5% alcohol solution of iodine - 5 ml.; 50 mg weighed portions of dry potassium permanganate; 1% boric acid solution; distilled water in 100 ml containers; 1% solution of protargol; bactericidal patch; eye pipettes - 2 pcs.; sterile cotton balls, swabs, individual napkins; latex gloves; disposable robe.

Appendix No. 7
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Rules
organizing the activities of a consultative and diagnostic center for children

1. These Rules establish the procedure for organizing the activities of a consultative and diagnostic center for children in medical organizations, with the exception of issues of organizing the activities of a consultative and diagnostic center for children with various manifestations of tuberculosis infection.

2. The Consultative and Diagnostic Center for Children (hereinafter referred to as the CDC) of a medical organization is created to provide advisory and diagnostic assistance to children.

3. The CDC is an independent medical organization or a structural unit within a medical organization and carries out its activities in cooperation with medical organizations providing medical care to children.

4. The management of the CDC, created as an independent medical organization, is carried out by the chief physician, and the management of the CDC, created as a structural unit of a medical organization, is carried out by the deputy chief physician of the medical organization (head of the department).

5. A specialist who meets the requirements of the Qualification Requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by Order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n, is appointed to the position of head of the CDC (registered by the Ministry of Justice of Russia on July 9, 2009). , registration No. 14292), “pediatrics”, “general medicine” or “health care organization and public health”, with work experience in this specialty of at least 5 years in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. 541n “On approval Unified qualification directory of positions for managers, specialists and employees, section “Qualification characteristics of positions of workers in the field of healthcare” (registered by the Ministry of Justice of Russia on August 25, 2010, registration No. 18247).

6. The staffing level of the medical staff of the CDC is approved by its head (the head of the medical organization within which it is created) based on the volume of treatment and preventive work carried out, the structure of the morbidity of children and the number of children served, taking into account the recommended staffing standards in accordance with the Procedure for the provision of pediatric care, approved by this order.

The CDC is equipped in accordance with the equipment standard provided for in the Procedure for the provision of pediatric care, approved by this order.

administrative and economic department;

information and analytical department, including a registry, an organizational and methodological office (medical statistics office);

specialist doctors' offices;

department of organization of diagnostic studies;

department of functional diagnostics;

laboratory;

Department of Radiation Diagnostics;

department of radioisotope diagnostics;

Department of Ultrasound Diagnostics;

endoscopy department;

telemedicine office (or Skype connection);

a day hospital for conducting a diagnostic examination of a child, including a room for accommodating children with 5 beds, a room for medical staff, a toilet for children and parents, a toilet for medical staff;

allergy diagnostic room;

room for feeding children;

centralized sterilization department.

The CDC must provide wheelchair access.

8. CDC performs the following functions:

conducting a consultative and diagnostic examination of children;

Conducting hardware, instrumental and laboratory diagnostic tests for children;

consultations of children with medical specialists in accordance with the Nomenclature of specialties of specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare of the Russian Federation, approved by order of the Ministry of Health and Social Development of Russia dated April 23, 2009 No. 210n (registered by the Ministry of Justice of Russia on June 5, 2009, registration No. 14032 ), as amended by order of the Ministry of Health and Social Development of Russia dated February 9, 2011 No. 94n (registered by the Ministry of Justice of Russia on March 16, 2011, registration No. 20144);

preparation, after completion of advisory and diagnostic activities, of a conclusion on the prognosis of the development of the disease and recommendations for further treatment of the child;

carrying out activities to introduce modern methods of diagnosis and prevention of childhood diseases and pathological conditions of childhood;

conducting a clinical and epidemiological analysis of the level and structure of morbidity among children in the service area;

participation in the organization of seminars, conferences, exhibitions on pediatric issues;

maintaining accounting and reporting documentation, submitting reports on the activities of the CDC in the prescribed manner.

Appendix No. 8
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Recommended staffing standards
medical and other personnel of the consultative and diagnostic center for children

2. For areas with low population density and limited transport accessibility of medical organizations, the number of staff positions is established based on the smaller child population.

3. For organizations and territories subject to service by the Federal Medical and Biological Agency, in accordance with the order of the Government of the Russian Federation of August 21, 2006 No. 1156-r “On approval of lists of organizations and territories subject to service by FMBA of Russia” (Collection of Legislation of the Russian Federation 2006, No. 35, Art. 3774; No. 49, Art. 5267; No. 52, Art. 5614; 2008, No. 11, Art. 1060; 2009, No. 14, Art. 1727; 2010, No. 3, Art. 336; No. 18 , Article 2271) the number of staff positions of medical specialists is established regardless of the size of the attached child population.

Appendix No. 9
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Standard
equipping a consultation and diagnostic center for children

Appendix No. 10
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Rules
organizing the activities of the pediatric department

1. These Rules establish the procedure for organizing the activities of the pediatric department in medical organizations.

2. The pediatric department of a medical organization (hereinafter referred to as the Department) is created as a structural unit of a medical organization.

3. The Department is headed by a head, appointed and dismissed by the head of the medical organization within which the Department was created.

A specialist is appointed to the position of head of the Department who meets the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by Order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n (registered by the Ministry of Justice of Russia on July 9, 2009, registration No. 14292) , in the specialty "pediatrics", with work experience in this specialty of at least 5 years in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. 541n "On approval of the Unified Qualification Directory of positions of managers, specialists and employees, section "Qualification characteristics of employee positions in the field of healthcare" (registered by the Ministry of Justice of Russia on August 25, 2010, registration No. 18247).

4. A specialist who meets the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by Order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n (registered by the Ministry of Justice of Russia on July 9, 2009, registration No.) is appointed to the position of doctor of the Department. 14292), in the specialty "pediatrics" without presenting requirements for work experience in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. 541n "On approval of the Unified Qualification Directory of positions of managers, specialists and employees, section "Qualification characteristics of positions of workers in the field of healthcare "(registered by the Ministry of Justice of Russia on August 25, 2010, registration No. 18247).

5. The staffing level of the medical staff of the Department is determined based on the volume of diagnostic and treatment work carried out and bed capacity, taking into account the recommended staffing standards in accordance with the Procedure for the provision of pediatric care, approved by this order, and is approved by the head of the medical organization within which it was created.

The Department is equipped in accordance with the equipment standard provided for in the Procedure for the provision of pediatric care, approved by this order.

rooms for children, including single rooms;

manager's office;

premises for doctors;

head nurse's office;

room for nursing staff;

procedural;

the housekeeper's room;

pantry and distribution;

dining room;

game room;

class;

room for storing clean linen;

room for collecting dirty laundry;

shower and toilet for children;

shower and toilet for medical personnel;

sanitary room;

day hospital, including a room for receiving children, wards for accommodating children, a room for medical personnel, a sanitary room, a toilet for medical personnel, a toilet for children and their parents, a room for parents to relax;

a room for parents to relax;

training class of the clinical base.

7. The department carries out the following functions:

providing pediatric care;

diagnostics and treatment of childhood diseases;

implementation of preventive measures aimed at preventing relapses of diseases in children;

application of modern methods of diagnosis, treatment of diseases and pathological conditions in children;

participation in the process of improving the professional qualifications of medical personnel on diagnostics and pediatric care;

carrying out sanitary and educational work with children and parents (legal representatives) on the prevention of childhood diseases and the formation of a healthy lifestyle;

providing advice to doctors of departments of a medical organization on the prevention, diagnosis and treatment of childhood diseases;

participation in the analysis of the main medical and statistical indicators of morbidity, disability and mortality of children;

maintaining accounting and reporting documentation, submitting reports on the activities of the Department in the prescribed manner.

8. The department can be used as a clinical base for scientific, higher and secondary educational organizations and organizations of additional professional education.

9. To ensure its activities, the department uses the capabilities of all treatment, diagnostic and auxiliary units of the medical organization within which it is organized.

Appendix No. 11
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Recommended staffing standards
medical staff of the pediatric department (30 beds)

Appendix No. 12
to providing
pediatric care,
approved
Ministry of Health
and social development of the Russian Federation
dated April 16, 2012 No. 366n

Standard
equipping the pediatric department

Document overview

The Procedure for the provision of pediatric care has been approved. It applies to all medical organizations.

Assistance is provided in the form of primary health care, emergency and specialized medical care. In this case, different conditions are possible.

The first is outside the medical organization (at the place where the ambulance is called, as well as in a vehicle during medical evacuation).

The second is outpatient (in conditions that do not provide round-the-clock medical supervision and treatment).

The third is in a day hospital (in conditions that provide observation and treatment during the day, but not around the clock).

The fourth is inpatient (in conditions that provide round-the-clock observation and treatment).

The rules for organizing the activities of a local pediatrician's office, a children's clinic (department), a consultative and diagnostic center for children, and a pediatric department are given. For each of these structures, recommended staffing standards for medical personnel and equipment standards have been determined.