What does the department of medical prevention of the polyclinic do. Department of Prevention

Carrying out preventive medical events and services to the population, coordination of preventive activities with district physicians medical organization, health centers and the territorial center of medical prevention. Participation in the formation of a system of information support for the population on the preservation and promotion of health, disease prevention, the formation of a healthy lifestyle that helps reduce the impact various factors health risk. Application of modern organizational technologies preventive work and medical care(individual and group preventive counseling) for the correction of risk factors for chronic noncommunicable diseases, which are the main cause of disability and premature mortality of the population of Moscow (hereinafter referred to as chronic non-communicable diseases).

Tasks of the department (office) of prevention:

For residents countryside who wish to visit the Health Center executive power municipal formation in the field of healthcare, at the established hours and days of the week, travel can be organized from the health facility to the territorial health center located in the area of ​​responsibility. Health Center for rural residents living in the area of ​​​​responsibility of the health center, in planned outreach campaigns aimed at promoting actions to promote a healthy lifestyle can be held. For a citizen, including a child, who applied (sent) to the Health Center (Scheme 2), a paramedical worker starts an accounting form No. on installed equipment.
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Attention

The nurse of the Department of Prevention and Medical and Social Work directly works under the guidance of a specialist doctor. 2. Responsibilities The nurse of the Department of Prevention and Medical and Social Work is obliged to: 2.1. Assist the doctor of the department in organizing and conducting sanitary-epidemiological, immunoprophylactic work, keeping records general medical examination, advisory work on the issues of immunoprophylaxis of patients.

Departments (rooms) of medical prevention

Annex No. 7 to the Regulations on the organization of the provision of primary health care adult population, approved by order of the Ministry of Health and social development Russian Federation dated May 15, 2012 No. 543n) RULES FOR ORGANIZING THE ACTIVITY OF THE DEPARTMENT (OFFICE) OF MEDICAL PREVENTION 1. These rules establish the procedure for organizing the activities of the department (office) of prevention (hereinafter - the Department). 2. The department is organized in a medical organization (its structural subdivision) providing primary health care.
3. Department of prevention includes the following structural units: anamnestic office; functional (instrumental) research room; office promoting a healthy lifestyle; an office for centralized accounting of annual medical examinations; smoking cessation clinic. four.

Prevention cabinet

The main tasks of the nurse of the prevention department

The main tasks of the department's nurses are: maintaining a register of patients of certain age groups (studying the database on the attached population); Assistance to polyclinic doctors in organizing preventive medical and social work with the population; analysis of the effectiveness of preventive and medical and social work; accounting for informing the population on targeted medical examination programs; Organization and implementation of immunoprophylaxis of the population within the framework of National calendar vaccination; Formation of individual plans for targeted medical examination programs; · development and implementation of a progressive targeted system of work with the population; Formation of reports on the results of the activities of the service for planning preventive work with the population.

Department (office) of medical prevention

The nurse is responsible for the fuzzy and untimely implementation of all points of this instruction. For violation labor discipline, legislative and regulatory legal acts, a nurse can be brought in accordance with applicable law, depending on the severity of the misconduct, to disciplinary, material, administrative and criminal liability. INVITATION! government agency The city polyclinic No. 000 of the Health Care Center of the North-Eastern Administrative Okrug is carrying out work on the implementation of the program “Targeted medical examination of the population of the city of

Important

Moscow". Targeted medical examination is a real way to improve your health. Within the framework of the program "Targeted medical examination of the population of Moscow" we offer you a number of free diagnostic examinations which will reveal the initial forms of various diseases.

Comply with the rules for the use of equipment, tools, and the norms for spending medicines. 2.16. Monitor the serviceability of electromechanical equipment, in the event of a malfunction, disconnect it from the network and notify the administration. 3. Rights The nurse of the Department of Prevention and Medical and Social Work has the right to: necessary conditions in the workplace, ensuring the quality performance of their official duties; - take part in meetings (meetings) when discussing the work of the department; - receive necessary information to fulfill their functional duties from the head of the department, head nurse; - require visitors to comply with internal regulations; - master a related specialty; - in in due course improve your qualifications.

Cabinet of prevention in the polyclinic of the function of a nurse

Women over 40 years of age undergo a mammography examination once every two years, the result is reported to the patient by the staff of the X-ray department, and if a pathology is detected, the patient is sent to an appointment with a mammologist. Targeted medical examination of the male population for the detection of diseases prostate. The nurse of the Department of Prevention and Medical and Social Work writes out a referral for a blood test to determine the level of PSA.

Result this study is sent to a urologist, if a pathology is detected, the nurse of the urology department calls the patient for an appointment with a urologist. Targeted clinical examination of the female population to identify diseases of the cervix. Women are examined in the examination room. The midwife conducting the examination sends the tests for examination to the cytology laboratory.

Get the full text 5) providing, in the prescribed manner, statistical and other information on their activities; 6) ensuring compliance with executive discipline and performance of their duties by employees subordinate to it (if any); 7) prompt action, including timely informing management, to eliminate violations of safety, fire and sanitary regulations that pose a threat to the activities of the healthcare institution, its employees, patients and visitors. The assessment of the work of the nurse of the department is carried out by the head nurse, in her absence - by the head nurse on the basis of taking into account the fulfillment of her functional duties, compliance with internal regulations, labor discipline, moral and ethical standards, and social activity.
Previously, the transfer of information about the results of the passage of targeted programs was entered weekly by nurses of the Department of Prevention and Medical and Social Work manually from the relevant documentation. Currently, to facilitate the work of the department's nurses, all results are transferred automatically over the local network. Get full text 5. Direct work with patients.

Patient visits city ​​polyclinic No. 000 as a result of receiving an invitation letter or as a result of a call. He is sent to the Department of Prevention and Medical and Social Work. Nurses Departments pick up the patient's outpatient card at the reception and accompany him to an appointment with a specialist out of turn.

II. Differences in work (depending on target program): Target medical examination of the population according to early detection cardiovascular diseases.

1. An office (department) of medical prevention (MP) is organized as part of territorial polyclinics, polyclinic departments central, district (city) hospitals, medical units.

2. Chief Physician polyclinic or his deputy for organizational and methodical work manages and is responsible for the activities of the office (department) and the preventive work of primary health care workers organized by it.

3. The staff of the cabinet (department) of medical prevention - a doctor and / or paramedic who has appropriate training in medical prevention and health promotion.

4. The doctor / paramedic of the medical prevention office is directly subordinate to the deputy. chief physician for organizational and methodological work of the polyclinic.

5. In accordance with the main tasks, the cabinet (department) of medical prevention interacts with the MCMP and the SSES center:

Sends employees of healthcare facilities to the MCMP for training in MP, improving knowledge and introducing methods of disease prevention;

Receives from the GCMP and SGES, acquires and distributes among the employees of the institution and the organized and unorganized population instructive and methodological documents on the preservation and promotion of health, visual aids of a sanitary educational nature;

With the help of the SCMP, it creates a bank of health education literature (on the prevention of infectious and non-infectious diseases), lectures, conversations, articles medical profile from the periodical press for use in daily work;

Receives new methods of preventive orientation of health care facilities from the SCMP and SGES;

Completes the video library with the support of GCMP;

Submits a consolidated statistical report to the OCMP and to the SSES center on time.

MP office methodically provides activities medical workers polyclinics to identify risk factors, correct lifestyle, promote medical and hygiene knowledge and healthy lifestyle among the attached population

by providing evidence-based data, training and updating the algorithms for mandatory preventive actions of the MPH. For what:

Organizes and conducts training seminars on MP among the staff of health facilities;

Coordinates individual plans the work of the MPH on issues of medical prevention - on conducting PE, daily preventive work, running Schools in the clinic and in the district institutions, conducting lectures and conversations at enterprises;

Provides organizational, methodological and advisory assistance in the preparation of lectures, talks, radio programs, round tables, conferences, seminars, meetings, etc.;

Controls and analyzes the activities of the MPH with the population according to the MP, makes an objective assessment of their activities on a quarterly basis and submits it to the head physician (deputy head physician for medical and preventive work) for subsequent decision and use when holding medical conferences and when resolving bonus issues;

Works in close contact with regional specialists in profiles (district oncologist, phthisiatrician, gynecologist, dermato-venereologist, psychiatrist, narcologist), who provide qualified methodological guide according to the section MP of the population in accordance with the profile of activity. Provides them with methodical and SP literature. Organizes speeches at polyclinics, speeches in print, on television, radio.

7. The cabinet (department) of the MP methodically and organizationally works with the pre-medical reception room and with the examination room for preventive examinations

8. The office of the MP draws up reports on the work done, draws up a summary statistical report on health facilities, brings the results to the attention of the chief physician;

9. The MP specialist of the cabinet studies and evaluates the knowledge of prevention and healthy lifestyle issues of the population (questionnaires, question and answer board).

4. Algorithm for medical prophylaxis in primary health care units.

A diagram of the types of activities for medical prevention of medical personnel in primary health care is presented in Fig.

Comments:

1. Primary health workers in the area of ​​responsibility identify individuals with risk factors and, preferably, the first stages of diseases, provide adequate care, including secondary and tertiary prevention. They refer patients with initial stages arterial hypertension, bronchial asthma, diabetes mellitus, etc. for training in specialized schools for patients. At preventive examinations and when patients apply for honey. with the help, dispensary groups of patients are formed with the definition of the frequency of observations and inform patients about this.

If the patient's visit is not the first one this year, then the health workers conduct a survey, conversation, examinations according to the age and risk factors noted in the insert. outpatient card"Prophylactic Inspection".

Risk factors are marked in the outpatient card. For example:

Smoking then label A. Black - smokes a lot (more than a pack a day and on an empty stomach after sleep) ______________________________________ comments and reminder for the patient

B. Blue - smokes 1-15 cigarettes per day ________________________ comments and reminder for the patient

B. Green - does not smoke

G. Red - quit smoking

Overweight

Alcohol

Hypodynamia

Grouped patients attend Schools of the Sick arterial hypertension, diabetes, asthma, who decide to quit smoking, lose weight, who need support with problems with alcohol and drugs.

Classes in the group are conducted by district doctors, their nurses and polyclinic specialists according to an agreed schedule and programs. Each school appoints a responsible person (curator) who is best trained on the problem and leads the analysis of the work of the School. Programs should be concise and the content of the material should be fully consistent with the wishes of patients in terms of the amount of information and skills development.

Primary health care workers are methodically and organizationally assisted by specialists in the prevention of the prevention room of the health facility.

The work of the medical staff is taken into account accordingly.

Work in the institutions of the microdistrict.

Patients themselves are not ready to go to doctors for information, realizing that "doctors do not have enough time for appointments even for patients, not to mention preventive examinations and consultations." In order to reach target groups with potentially possible factors risk, lectures and conversations are needed in institutions. It is necessary to establish patronage (partnership) relations with the institutions of your microdistrict in order to revive the “lecture halls” of health.

Preventive checkups

The proposed system of annual preventive examinations (AP) is based primarily on the identification of risk factors (RF) and diseases in early stages and training work healthy lifestyle of life (HLS) of the entire population. For each resident of the site, a basic set of examinations, questions and examinations is offered, which has proven its effectiveness in world practice. And in a set of surveys for those population groups (risk groups), in which, according to the data evidence-based medicine there is a high probability of the presence of risk factors and/or diseases; additional questions, surveys, research. Thus, the software becomes concise and targeted to target groups, resource-saving. But it is also proven to be effective. Also, the PO events include conversations, the topics of which are mandatory for the entire population and for individual groups risk.

We especially emphasize that screening programs not built according to the principle of "frequent comb" - i.e. not aimed at finding all possible deviations and diseases but only those that, on the basis of global evidence, are most statistically likely in these sex and age groups and risk groups.

Depending on the capacity and structure of health care facilities, PE can be carried out both by district (GP) independently, and with the help of pre-medical appointments and examination rooms for women. Previously, the main thing that was done for women in examination rooms was gynecological examination and an annual Papanicolaou test (smear for "cytology"). It has now been proven that the Papanicolaou test should be carried out no more than 1 time in 3 years, but most importantly, in addition to women who regularly visit the clinic, women who are at risk by the type of their sexual behavior need it. Below will be presented how much assistance is provided in the examination room.

On the left branch of the algorithm for the preventive work of district police officers (Fig. 6.2), the algorithm for preventive examinations is presented.

When a patient visits the clinic, an experienced receptionist assesses how urgent the care the patient needs is. If the situation is urgent and / or the patient's condition is serious, he is provided with adequate assistance and a decision is made on hospitalization.

If the condition is not urgent, and the patient's visit to the clinic is the first one this year, then he is invited to undergo a preventive examination, starting with a visit to the pre-medical examination rooms and the examination room for women (located nearby). The registrar gives the patient an insert in the outpatient card "Prophylactic examination", where the columns of the full name, number of the patient's outpatient card are already filled in, it is noted whether the patient needs a Papanicolaou test (if two years have passed after latest study) and other sex- and age-appropriate tests (blood in feces, mammography, chlamydia, blood cholesterol levels, rubella antibody titer - Table) and coupons are issued for the corresponding laboratory research. If the disease is acute, then the doctor invites the patient for a preventive examination at the end of the treatment of this episode of the disease.

In front of the register is located stand with information about annual preventive examinations, their purpose and procedure, and the benefits for residents. Offered enroll on the certain time to pass software. For a polyclinic with 30,000 assigned population, one can expect 100-150 visits per day for PO, i.e. active invitations to the software indicating the time of visit regulate the flow. Laboratories are invited to work throughout the day.

Table 1 presents a set of activities that should be carried out at annual LOs. Rosto - weight coefficient, blood pressure defined in pre-medical reception room (KDP), here the patient fills out questionnaires for assessing the level of alcoholism and assessing the patient's depressive status (see Appendix). In the examination room (SC) material is taken for Papanicolaou and chlamydia tests, breast palpation is performed - certain age groups.The evaluation of the questionnaires and the conducted research is carried out by the district police officer.

Table 1. A set of activities for annual preventive examinations of the entire population by age groups

*for who have begun and are sexually active

As can be seen from Table. 1, absolutely everyone who comes to the clinic does not need to undergo resource-intensive fluorography and gynecological examination every year.

In Table. 2 topics are given questions and conversations at the preventive examination of the patient, depending on age. These are mandatory topics for all patients. At the end of the conversation, patients are provided with booklets on relevant and / or problems of interest to the patient, for example, memo-diaries for patients with hypertension "If your blood pressure rises ...".

The form of the survey and who conducts it is determined by the situation in a particular health facility. From how much huge pressure doctors, how many nurses work in the brigade, who in the brigade was trained in conducting a conversation, the duties of district doctors and nurses are distributed.

For the age groups 25-64 years and 65 years and older, it has been proven ineffective to talk at the reception about the use of drugs and alcohol, but the dangers of combining their use with swimming, driving a car and a boat should always be said.

Table 2. Topics of questions and conversations during preventive examinations

(by age group)

* for beginners and those who are sexually active

Table 3 Scheme of activities for medical prevention of doctors and nurses in primary health care. If during the patient's answers and during the examination, it turned out that the patient belongs to one or more risk groups(see Table 4), then, if necessary, examinations and other interventions are scheduled (see Table 3) and the patient is invited to the School on the relevant problem, a convenient time for him is determined.

Table 3. Risk groups and related interventions - tests and vaccinations (by age group)

*RPR - test for rapidly forming atopic plasma antibodies

Table 4. Criteria for assignment to groups high risk

The main objection when developing a system of annual preventive examinations was: “In the past, “general medical examination” did not justify itself.” But the "general medical examination" was aimed at identifying diseases and diagnosing them as much and accurately as possible. The entire potential of primary care was spent on diagnostics, and neither algorithms nor medical time was enough for the treatment stage. In addition to notifying attached residents about their illnesses, there was no real outpatient care, especially preventive care.

• 1. Public health and healthcare as a science and area of ​​practice. Main goals. Object, subject of study. Methods.
• 2. History of healthcare development. Modern health care systems, their characteristics.
• 3. State policy in the field of public health protection (Law of the Republic of Belarus "on healthcare"). Organizational principles of the public health system.
• 4. Nomenclature of healthcare organizations
• 6. Insurance and private forms of healthcare.
• 7. Medical ethics and deontology. Concept definition. Modern problems of medical ethics and deontology, characteristics. Hippocratic oath, doctor's oath of the Republic of Belarus, Code of Medical Ethics.
• 10. Statistics. Concept definition. Types of statistics. Statistical data accounting system.
• 11. Groups of indicators for assessing the health status of the population.
• 15. Unit of observation. Definition, characteristics of accounting features
• 26. Dynamic series, their types.
• 27. Indicators of the dynamic series, calculation, application in medical practice.
• 28. Variation series, its elements, types, construction rules.
• 29. Average values, types, methods of calculation. Application in the work of a doctor.
• 30. Indicators characterizing the diversity of a trait in the studied population.
• 31. Representativeness of the trait. Assessment of the reliability of differences in relative and average values. The concept of Student's "t" criteria.
• 33. Graphic displays in statistics. Types of diagrams, rules for their construction and design.
• 34. Demography as a science, definition, content. The value of demographic data for health care.
• 35. Health of the population, factors affecting the health of the population. Health formula. Indicators characterizing public health. Scheme of analysis.
• 36. Leading medical and social problems of the population. Problems of the size and composition of the population, mortality, fertility. Take from 37,40,43
• 37. Population statics, research methodology. Population censuses. Types of age structures of the population. Population size and composition, health implications
• 38. Dynamics of the population, its types.
• 39. Mechanical movement of the population. Study methodology. Characteristics of migration processes, their impact on population health indicators.
• 40. Fertility as a medical and social problem. Methods of study, indicators. Birth rates according to WHO. Modern trends in the Republic of Belarus and in the world.
• 42. Reproduction of the population, types of reproduction. Indicators, methods of calculation.
• 43. Mortality as a medical and social problem. Methods of study, indicators. Levels of general mortality according to WHO. Modern tendencies. The main causes of death of the population.
• 44. Infant mortality as a medical and social problem. Factors determining its level. Methodology for calculating indicators, evaluation criteria for WHO.
• 45. Perinatal mortality. Methodology for calculating indicators. Causes of perinatal mortality.
• 46. ​​Maternal mortality. Methodology for calculating the indicator. The level and causes of maternal mortality in the Republic of Belarus and the world.
• 52. Medico-social aspects of the neuropsychic health of the population. Organization of psycho-neurological care.
• 60. Methods for studying morbidity. 61. Methods for studying the incidence of the population, their comparative characteristics.
• Methodology for studying general and primary morbidity
• Indicators of general and primary morbidity.
• 63. The study of the incidence of the population according to special records (infectious and major non-epidemic diseases, hospitalized morbidity). Indicators, accounting and reporting documents.
• The main indicators of "hospitalized" morbidity:
• The main indicators for the analysis of the incidence of wut.
• 65. The study of morbidity according to preventive examinations of the population, types of preventive examinations, the procedure for conducting. health groups. The concept of "pathological affection".
• 66. Morbidity according to causes of death. Methods of study, indicators. Medical certificate of death.
• The main indicators of morbidity according to the causes of death:
• 67. Prediction of morbidity rates.
• 68. Disability as a medical and social problem. Definition of the concept, indicators.
• Trends in disability in the Republic of Belarus.
• 69. Lethality. Method of calculation and analysis of lethality. Significance for the practice of the doctor and healthcare organizations.
• 70. Methods of standardization, their scientific and practical purpose. Methods for calculating and analyzing standardized indicators.
• 72. Criteria for determining disability. The degree of expression of persistent violations of body functions. Indicators characterizing disability.
• 73. Prevention, definition, principles, contemporary problems. Types, levels, directions of prevention.
• 76. Primary health care, definition of the concept, role and place in the system of medical care for the population. Main functions.
• 78. Organization of medical care provided to the population on an outpatient basis. The main organizations: a medical outpatient clinic, a city polyclinic. Structure, tasks, directions of activity.
• 79. Nomenclature of hospital organizations. Organization of medical care in a hospital setting of healthcare organizations. Indicators of provision with inpatient care.
• 80. Types, forms and conditions for the provision of medical care. Organization of specialized medical care, their tasks.
• 81. Main directions for improving inpatient and specialized care.
• 82. Women's and children's health. Control. Medical organizations.
• 83. Modern problems of women's health. Organization of obstetric and gynecological care.
• 84. Organization of medical and preventive care for the children's population. Leading child health issues.
• 85. Organization of health protection of the rural population, the basic principles of providing medical care to rural residents. stages of organization.
• Stage II - territorial medical association (TMO).
• Stage III - the regional hospital and medical institutions of the region.
• 86. City polyclinic, structure, tasks, management. Key performance indicators of the polyclinic.
• Key performance indicators of the polyclinic.
• 87. Precinct-territorial principle of organization of outpatient care to the population. Types of plots.
• 88. Territorial therapeutic area. Regulations. The content of the work of the local general practitioner.
• 89. Cabinet of infectious diseases of the polyclinic. Sections and methods of work of a doctor in the office of infectious diseases.
• 90. Preventive work of the clinic. Department of prevention of the polyclinic. Organization of preventive examinations.
• 91. Dispensary method in the work of the clinic, its elements. Control card of dispensary observation, information reflected in it.
• 1st stage. Accounting, examination of the population and selection of contingents for dispensary registration.
• 2nd stage. Dynamic monitoring of the state of health of those undergoing medical examinations and carrying out preventive and therapeutic measures.
• 3rd stage. Annual analysis of the state of dispensary work in the hospital, evaluation of its effectiveness and development of measures to improve it (see Question 51).
• 96.Department of medical rehabilitation of the polyclinic. Structure, tasks. The order of referral to the department of medical rehabilitation.
• 97. Children's polyclinic, structure, tasks, sections of work.
• 98. Peculiarities of providing medical care to children on an outpatient basis
• 99. The main sections of the work of the local pediatrician. The content of medical and preventive work. Communication in work with other medical and preventive organizations. Documentation.
• 100. The content of the preventive work of the local pediatrician. Organization of nursing care for newborns.
• 101. Comprehensive assessment of the health status of children. Medical examinations. health groups. Clinical examination of healthy and sick children
• Section 1. Information about the subdivisions, facilities of the medical and preventive organization.
• Section 2. States of the medical and preventive organization at the end of the reporting year.
• Section 3. The work of doctors in polyclinics (outpatient clinics), dispensaries, consultations.
• Section 4. Preventive medical examinations and the work of dental (dental) and surgical rooms of a medical organization.
• Section 5. Work of medical auxiliary departments (offices).
• Section 6. Work of diagnostic departments.
• Section I. Activity of women's consultation.
• Section II. Obstetrics in a hospital
• Section III. maternal mortality
• Section IV. Information about births
• 145. Medico-social expertise, definition, content, basic concepts.
• 146. Legislative documents regulating the procedure for conducting a medical and social examination.
• 147. Types of mrek. The composition of regional, district, inter-district, city and specialized MRECs. Organization of work, rights and obligations. The procedure for sending to the mrek and inspecting citizens.

• Prevention is not a narrow departmental function of the health authorities, but is provided by the entire system of socio-economic activities of society, is comprehensive in nature and is aimed at preventing diseases, protecting and strengthening the health of each person and society as a whole.

  A distinctive feature of medical care provided in polyclinics is the organic combination of medical and preventive work in the activities of all doctors of this institution.

  3 main directions in the preventive doctor:

  a) witheducational work- when communicating with each patient, he should be explained the principles of a healthy lifestyle and regimen for a specific disease, the basics of rational and therapeutic nutrition, the harm of smoking and alcohol abuse, and other sanitary and hygienic aspects; the doctor also conducts lectures in the clinic and at enterprises, issues health bulletins and other information materials, and so on.

  b) vaccination work- carried out under the guidance of immunologists by infectious disease specialists and district therapists of the polyclinic (in recent years, the need for general vaccination of the adult population against diphtheria has become acute)

  in) medical examination (dispensary method) is a method of active dynamic monitoring of the health status of the population, aimed at improving health and increasing working capacity, ensuring proper physical development and preventing diseases through a complex of therapeutic and preventive measures. In the dispensary method of work of the health care facility, the preventive orientation of the health care facility is most fully expressed.

  Identification of patients is carried out during preventive examinations of the population, when patients seek medical help in health facilities and at home, with active calls to the doctor, as well as during special examinations regarding contacts with an infectious patient.

  Distinguish3 types of preventive examinations .

  1) preliminary- is carried out by persons entering work or study in order to determine the suitability (suitability) of workers and employees for their chosen work and to identify diseases that may be contraindications for work in this profession.

  2) periodic- carried out by persons in a planned manner within the established time limits for certain groups of the population and with the current appeal for medical care to medical institutions.

  To contingents subject to mandatory periodic inspections, relate:

  Workers of industrial enterprises with harmful and dangerous working conditions;

  Workers of leading professions of agricultural production;

  Decree contingents;

  Children and adolescents, young men of pre-conscription age;

  Students of vocational schools, technical schools, university students;

  Pregnant women;

  Disabled people and participants of the Great Patriotic War and contingents equated to them;

  Persons affected by the Chernobyl disaster.

  In relation to the rest of the population, the doctor should use each visit of the patient to a medical institution for a preventive examination.

  3) target- carried out for the early detection of patients with certain diseases (tuberculosis, malignant neoplasms, etc.)

  The main forms of preventive examinations are

  a. individual- are carried out:

  According to the appeal of the population to health facilities (for a certificate, in order to issue a sanatorium card, in connection with a disease);

  With the active call of persons served by the polyclinic for a dispensary examination at the polyclinic;

  When doctors visit patients with chronic diseases at home;

  Among those who are being treated in a hospital;

  When examining persons who have been in contact with an infectious patient.

  This is the main form of medical examinations of the unorganized population.

  b. massive- are carried out, as a rule, among organized groups of the population: children of preschool and school institutions, young men of pre-conscription age, students of secondary specialized institutions and university students, workers and employees of enterprises and institutions. Mass preventive examinations, as a rule, are of a complex nature and combine periodic and targeted ones.

  Examinations of organized groups are carried out on the basis of agreed schedules and are regulated by the relevant orders of the Ministry of Health.

  The data of medical examinations and the results of the examinations carried out are entered in medical records(“Medical record of an outpatient”, “Individual card of a pregnant woman and a puerperal”, “History of the development of a child”).

  Based on the results of the examination, a conclusion is given on the state of health and is determined observation group:

  a) group "healthy" (D1)- these are persons who do not complain and who have no deviations in their state of health in their history and during examination.

  b) group "practically healthy" (D2) - persons with a history of chronic diseases without exacerbations for several years, persons with borderline conditions and risk factors, often and for a long time ill, convalescents after acute diseases.

  c) group "chronic patients" (D3):

  Persons with a compensated course of the disease with rare exacerbations, a short disability that does not interfere with the performance of normal work activities;

  Patients with a subcompensated course of the disease, who have frequent annual exacerbations, prolonged disability and its limitation;

  Patients with a decompensated course of the disease, with stable pathological changes, irreversible processes leading to permanent disability and disability.

  If a disease is detected in the examined, the doctor fills out a statistical coupon (f.025 / 2-y); makes records about the state of health in the medical record of an outpatient (f.025 / y). Persons assigned to the third health group are taken for dispensary registration by a district doctor or a specialist doctor

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ORDER of the Ministry of Health of the USSR dated 30-05-86 770 (as amended on 12-09-97) ON THE PROCEDURE FOR CARRYING OUT THE GENERAL CHECK-OUT OF THE POPULATION (2019) Relevant in 2018

REGULATIONS ON THE DEPARTMENT (OFFICE) OF PREVENTION OF OUTPATIENT POLYCLINIC INSTITUTIONS (SUBDIVISIONS)

1. The department (office) of prevention is organized in polyclinics (territorial, departmental, medical and sanitary units) and polyclinic departments of central district hospitals.

2. The department of prevention includes the following functional units:

anamnestic office;

Cabinet of functional (instrumental) studies;

Observation women's office;

Healthy Lifestyle Promotion Office;

Cabinet of centralized accounting of the annual medical examination of the entire population.

Taking blood and other biological materials for analysis, ECG studies and preventive fluorographic studies are carried out, respectively, by the clinical diagnostic laboratory, the department (office) of functional studies and the x-ray department (office) of the institution by specially designated workers, whose workplaces should, as a rule, be located in prevention department.

3. The department of prevention is headed by the head, who is directly subordinate to the head physician of the outpatient clinic (head of the outpatient department).

4. The main tasks of the prevention department are:

4.1. Organizational support of the annual medical examination of the entire population in accordance with the current instructive and methodological documents.

4.2. Organization and conduct of dispensary examinations.

4.3. Early detection of diseases and persons with risk factors.

4.4. Control and accounting of the annual medical examination of the entire population.

4.5. Preparation and transfer to doctors of medical documentation for identified patients and persons with an increased risk of disease for additional examination, dispensary observation and medical and recreational activities.

4.6. Sanitary and hygienic education and promotion of a healthy lifestyle (combating smoking, alcoholism, overnutrition, physical inactivity, etc.).

5. To carry out these tasks, the prevention department:

5.1. Together with other departments, offices draws up plans and schedules for dispensary examinations of the entire population and monitors their implementation.

5.2. Conducts an examination of the population and the necessary functional studies in accordance with the "Regulations".

5.3. Keeps a record of people who have passed the examination, sends out invitations with a request to visit a doctor at the appointed time, indicating the date and time of admission, controls the attendance for examination, as well as other activities for the annual medical examination of the entire population.

6. The prevention department is equipped with the necessary equipment and inventory in accordance with the equipment sheet for each cabinet.

Boss
Main Directorate
medical and preventive care
A.M.MOSKVICHEV

Appendix No. 3
to the order of the Ministry
health care of the USSR
May 30, 1986 No. 770

organization, coordination and evaluation of the effectiveness of the activities of medical facilities for the provision of preventive services to the population;

identification of behavioral risk factors for non-communicable diseases among the population and their correction;

hygienic education of the population;

organization and conduct, together with the territorial center of medical prevention, training of medical workers of the institution in the methods of providing medical preventive services to the population;

· participation in information support of specialists and various groups of the population on the issues of disease prevention and health promotion;

Conducting medical and social surveys of medical workers and attached population on the issues of disease prevention, satisfaction and need for preventive care;

Maintaining accounting and reporting documentation.

97 Sanitary and hygienic education of the population: forms and methods

Hygiene - honey. a science that studies the influence of the environment and industrial activities on human health and is developed. optimal, evidence-based requirements for the living and working conditions of the population. Gig work. training and education of the population, as a rule, fully assigned. to medical centers prevention, which, to the detriment of organizational and methodological. and coordination activities, replace the work of specialists and institutions. health care, sanitary epidemiol. services. In medical prof. Institutional rural areas completely or partially abolished the positions of doctors and secondary medical. staff, employment profile questions. forget, hygiene. training and education. The existing system of promotion of medical hygiene. knowledge does not correspond to modern. requirements, since it does not provide for the involvement of interested organizations and institutions for these purposes, primarily education, culture, environmental services, society. and religious organizations, mass media. The country has not resolved the issues of training and promotion. medical qualifications. workers on profile issues. forget, hygiene. training and education of the population. Scientific research. institutions have practically withdrawn from the development of scientific approaches and systems of hygiene. training and education of various groups of the population, criteria for evaluating its effectiveness, psychological, pedagogical. and other aspects of healthy lifestyle promotion. In order to radically restructure and improve. hygiene systems. education and upbringing, formation of healthy lifestyle habits among the population.

The most important tasks of health care institutions for hygienic education and upbringing of the population:

1) Formation of a healthy lifestyle among the population.

2) Promotion of hygiene and honey. knowledge

3) Popularization of medical achievements. science

4) Education of the conscious attitude of the population to the protection and promotion of health.

Work on hygienic education and upbringing and healthy lifestyle is mandatory in every health facility. This is an integral part of the professional duties of all medical workers, regardless of their specialty and position.

The work on hygienic education and upbringing is based on the following principles:

1. State character - the state finances the activities of institutions for hygienic education and upbringing of the population, ensures the development of the material and technical base, training of personnel, the legal basis for the activities of service institutions.

2. Scientific character - compliance of medical and hygienic knowledge with the current state of science and practice.

3. Mass character - the participation of all honey. employees, involvement of specialists from other departments and public organizations.

4. Accessibility - when presenting the material, incomprehensible medical terms should be avoided, speech should be understandable.

5. Purposefulness - work should be carried out in the chosen direction in a differentiated way, taking into account different groups of the population.

6. Optimism - to achieve the effect, it is important to emphasize the possibility of a successful fight against diseases.

7. Relevance - the choice of the direction of work should be relevant at a given time.

99 Dispensaries: functions and organization of work

D - active dynamic. observation for comp. health is defined. contingents of the population (healthy and sick), the registration of these population groups for the purpose of early detection. diseases, dynamic observation and complex. treatment of the sick, health promotion activities. their working and living conditions, warning. development and distribution. diseases, recovery labor and prolongation of the period of active life.

At present, there are various dispensaries (medical-sports, dermatovenerological, anti-tuberculosis, narcological, cardiological, oncological, neuropsychiatric). Dispensaries and dispensary departments (offices) carry out mass prevention activities aimed at preventing. diseases, keep records of care and mortality from pathology in their profile, and also carry out therapeutic measures, consultations of patients and organizational-methodical. management of the work of doctors of the general network to combat compliance. zab. The tasks of dispensaries include: conducting training of general practitioners in relevant specialties; introduction of modern methods of prevention, diagnosis and treatment into the practice of medical and preventive institutions; promotion of healthy lifestyles.

dispensary(English distribute, patronize) - this is the main specialized institution that provides medical and preventive care to patients of a certain profile and is an organizational and methodological center for combating certain diseases in a specific area; this is an independent institution of the ZO having the rights of a legal entity, seal, account, charter, internal regulations. The dispensary is managed by the chief physician, the states depend on the number of people served, the level of morbidity, and the epidemic situation. The work is based on the territorial principle.

Tasks of the dispensary and their role in improving the quality of specialized care:

Provision of qualified, specialized medical, advisory and diagnostic assistance

Implementation of medical examination of patients and organization of dispensary observation of them in medical institutions

Organizational and methodological management of the activities of territorial medical institutions of the general medical network

Registration of patients, analysis of morbidity, disability, mortality, registration of patients, development of preventive and organizational measures

Organization and holding of seminars, conferences in order to increase the level of knowledge on the relevant pathology

Carrying out mass preventive medical examinations

Introduction of new methods of diagnostics, treatment and prevention in healthcare facilities

Dissemination of knowledge among the population, hygienic training and education.

The dispensary also provides social assistance to patients (solving issues of employment, guardianship of incompetent patients, solving housing issues, etc.)

Dispensary structure:

1. Outpatient department (conducts a specialized outpatient appointment)

2. Diagnostic department (laboratories, radioisotope diagnostics room, radiation diagnostics room, etc.)

3. Hospital

4. Organizational and methodological department

Types of dispensaries by profile (the number in the Republic of Belarus is indicated for 1997):

Dermatovenerological dispensaries - 35

Tuberculosis dispensaries – 30

Psychoneurological dispensaries - 14

Oncological dispensaries - 11

Narcological dispensaries - 10

Endocrinological dispensaries - 5

Cardiovascular dispensaries - 5

Specialized dispensaries for victims of the Chernobyl nuclear power plant - 2

In total, in 1997 there were 113 dispensaries in the Republic of Belarus.

By localization dispensaries can be republican, regional, city, interdistrict.

The relationship between the work of the dispensary and the clinic: the polyclinic, according to indications, sends patients to dispensaries of the appropriate profile for the implementation of medical diagnostic and rehabilitation measures; the dispensary transfers to the polyclinic documentation about the examined and treated patients, provides organizational and methodological guidance for the work of polyclinics in its field, holds seminars, conferences, etc. to increase the general level of knowledge of doctors on a specific pathology, introduces new methods of diagnosis and treatment, etc.

New technologies

Increasing the availability of high-tech types of medical care
Satisfying the needs of the population in high-tech types of medical care, transferring federal specialized medical institutions to work under the conditions of the state order
Creation of new high-tech medical centers capable, taking into account the achievements of medical science, to make a breakthrough in domestic healthcare in the field of high technologies and ensure the availability of high-tech medical care

Providing the population with high-tech medical care:

increase in the volume of high-tech medical care;

· construction of new centers of high medical technologies, training of highly qualified doctors and paramedical personnel for these centers.

In 2008, the national project "Health" included new measures aimed at reducing the mortality of the population of the Russian Federation from manageable causes and maintaining the labor potential of the country:

· Improving the organization of medical care for victims of road traffic accidents, which will help to reduce the death rate as a result of road accidents every year.

· Improving medical care for patients with cardiovascular diseases will reduce mortality from cardiovascular diseases by 1.3 times. As part of this direction, it is planned to create regional vascular centers for minimally invasive surgery in healthcare institutions of the constituent entities of the Russian Federation and municipalities.

· Development of new high-tech medical technologies on the basis of federal medical institutions, as well as medical institutions under the jurisdiction of the subjects of the Russian Federation and municipalities, which will increase the level of provision of the population with high-tech types of medical care to 70% of the need.

In 2009, the following areas were additionally included in the national project "Health":

· Formation of a healthy lifestyle among Russians. Within the framework of this direction, the Ministry of Health and Social Development of Russia proposes to conduct a large-scale information campaign aimed both at combating alcoholism and smoking, and at promoting a healthy lifestyle.

· Reduced morbidity and mortality from tuberculosis. The program provides for the introduction of modern methods of diagnosis and prevention of tuberculosis, treatment and rehabilitation of patients.

100 Organization of ambulance and emergency care: definition of the principles of organization of service, the main tasks. Stages of first aid.

Emergency(SMP) - a system for organizing round-the-clock emergency medical care in life-threatening conditions and diseases at the address, at the scene of the incident and on the way to medical institutions.

The main feature of emergency medical care, which distinguishes it from other types of medical care, is the speed of action. A dangerous condition occurs suddenly, and the patient, as a rule, is far from people who can provide professional medical care, so doctors need to be brought to him as soon as possible. There are two main approaches to providing emergency medical care - the doctor is brought to the patient (In Russia and the former republics of the USSR) and the patient is taken to the doctor (USA, Europe). It is not yet possible to single out the best of these two approaches, each of them has its own advantages and disadvantages.

In accordance with the Federal Law of the Russian Federation of November 21, 2011 No. No. 323-FZ "On the basics of protecting the health of citizens in the Russian Federation", "Article 32. Medical care, paragraph 4:

4. Forms of medical care are:

1) emergency - medical care provided in case of sudden acute diseases, conditions, exacerbation of chronic diseases that pose a threat to the patient's life;

2) emergency - medical care provided in case of sudden acute diseases, conditions, exacerbation of chronic diseases, without obvious signs of a threat to the patient's life;