Report on the category of neurologist doctor nurse. Certification work self-report of the nurse of the neurological department

03.09.2020

Qualification documentation for attestation

Nurse ward department No. 1

OKU "Lipetsk Regional Psychoneurological Hospital"

Drepina Svetlana Borisovna

lipetsk 2012

I approve

Chief physician of OKU "LOPNB"

__________________ Galtsov B.I. "_______" ______________ 2012

REPORT

about work for 2012

Drepina Svetlana Borisovna

nurse of ward department No. 1

OKU "Lipetsk Regional Psychoneurological Hospital No. 1"

to confirm the qualification category for

specialties nursing

I, Drepina Svetlana Borisovna, graduated from the Lipetsk Medical School in 1989 with a degree in Nursing

In 1989, she was hired as a ward nurse at the Lipetsk Regional Psychoneurological Hospital, where I still work in department No. 1.

During her work, she completed specialization in 1993 and advanced training courses for nurses in psychiatric hospitals at the Lipetsk CPC SMR in 1998, 2002, 2006, 2011, where a specialist certificate was issued.

In August 2003, she passed the qualifying examination for the first category. In 2008, she passed certification at the Lipetsk Region Health Administration, where she was awarded the highest qualification category in the specialty "nursing". Work experience 25 years.

CHARACTERISTICS OF THE DEPARTMENT

MAIN INDICATORS OF THE DEPARTMENT

PROFESSIONAL CHARACTERISTICS OF THE ATTESTED In my work, I am guided by regulatory orders

Orders regulating the activities of the attested	Specific measures to fulfill the order
Order of the Ministry of Health of the Russian Federation No. 245article 29 "Law on psychiatric care and guarantees of citizens' rights in its provision" Article 5 "Rights of persons with mental disorders" Article 39 "Duties of the administration and medical staff in a mental hospital"	I provide the patients in the mental hospital with the necessary medical care: I provide an opportunity to get acquainted with the text of the law, the internal regulations of this psychiatric hospital; I ensure the safety of patients in the hospital, control the content of parcels and transfers.
SanPin 213 26 3010 dated May 18, 2010 Sanitary and epidemiological requirements for organizations carrying out medical activities.	I carry out and control the sanitary-epidemiological regime in the department. All premises, equipment, medical and other equipment must be kept clean. Cleaning equipment is clearly marked with an indication of the premises and types of cleaning work, is used strictly for its intended purpose and is stored in a dedicated room. Wet cleaning of premises is carried out at least 2 times a day using detergents and disinfectants. General cleaning of chambers and other functional rooms, offices is carried out according to the schedule once a week with the treatment of walls, floors, equipment, lamps, inventory. For disinfection of air and surfaces, bactericidal lamps are used. Pre-sterilization cleaning and sterilization of reusable medical devices is carried out in the centralized inspection center. In the meeting room in the department, there is a list of products allowed for transfer with an indication of their limit. Every day I check compliance with the rules and terms of storage of food products stored in the refrigerator of the department and the bedside tables of patients.
SanPin 3.2.1333-03 Upon admission to the department of patients, I carefully examine the skin, check for head lice, followed by a record in the journal that the patient has been examined. If head lice is detected, I inform the head nurse, the head of the department. The department keeps a registration journal F-20. I spend bathing days once every 7 days and, if necessary, with a change of underwear and bed linen. The department has anti-pediculosis packing, with the help of which disinsection and disinfection of clothes are carried out. When a patient is discharged or transferred to another department, I control that the underwear and bed linen are processed in the desiccamera and I register them in the chamber treatment log. I examine for helminthiases and protozoses.
SanPin 3.1.1.1.17-02 "Prevention of acute intestinal infections"	When the patient is admitted to the department, I take the analysis for the disgroup. I control the observance of personal hygiene by patients: washing hands before eating, after using the toilet. I talk with patients about the prevention of intestinal diseases. I attend a meeting of patients with relatives. I make sure that relatives bring only food products that are allowed by the hospital administration and are stored in the refrigerator. I control the work of the barmaids, the availability of all disinfectants, compliance with sanitary and hygienic rules. I monitor the timely conduct of current and general cleaning of all premises with the use of disinfectants.
Order No. 706 "n" 08/23/2010 Ministry of Health of the Russian Federation“On measures to improve the accounting, storage, prescription, use of narcotic and psychotropic drugs.	I receive medicines from the head nurse, taking into account the daily need, keep records of them, monitor the expiration date and storage. List A medicines are stored separately in a metal cabinet under lock and key. On the inside of the cabinet door there is a list of toxic substances with an indication of the highest single and daily doses. List B drugs are stored separately in a wooden cabinet under lock and key. In places of storage of narcotic, psychotropic, potent and poisonous medicines at the posts of duty nurses and doctors there is a table of the highest single and daily doses and a table of antidotes. Medicines for internal and external use are stored separately. Stocks of narcotic drugs do not exceed 3 days' need, poisonous substances 5 days' needs, potent 10 days' needs.
Order No. 785 of 12/14/2005. Ministry of Health of the Russian FederationOn the registration of medicines, dressings and medical products in health care facilities "	According to this order, I keep a substantive quantitative accounting of medicinal products, dressings and medical products in an approved form, in a numbered journal, sealed and signed by the head of the institution. Medicines are stored in cabinets, on racks in their original packaging separately, strictly according to groups: toxicological, pharmacological, depending on the physical and chemical state and the influence of environmental factors, taking into account the shelf life, depending on the method of application: external, internal , injection.
Order of the Ministry of Health of the Russian Federation No. 36 of 07/05/1997. "On improving measures for the prevention of diphtheria."	When patients are admitted to the department, I take a smear separately from the pharynx and nose for the carrier of diphtheria bacillus. I send it to the laboratory no later than 2 hours after the collection.
SanPin 31.1.2341-08 "Prevention of viral hepatitis" B "	When a patient is admitted to the department, I take blood samples for HBsAg and antibodies to hepatitis "C". When carrying out manipulations, I follow the principles of development, individuality, sterility. I carry out injections in special clothes: a gown marked "for injections", I wear gloves, a protective screen, a cap. I make sure that directions for analysis are sent separately from tubes with laboratory material. Anything that has been contaminated with blood and body fluids is classified as Class B hazardous waste. Syringes, cotton balls, gloves are disinfected in specially prepared containers. Disinfection time 1 hour. After processing, I hand over the syringes to the head nurse for subsequent disposal. After processing, I collect cotton balls, gloves in a bag (yellow), pack them, indicate the date, the name of the institution, the department number and the nurse's signature on the tag. As a person in contact with blood, I annually take a blood test for HBsAg and antibodies to hepatitis "C"
Order of the Ministry of Health of the Russian Federation No. 338 dated November 24, 1998 Prevention of HIV infection in emergency situations. " SanPin 3.1.5.2836-10 of 11.01.2011	I notify the head nurse and the head of the department about all cases of dangerous contacts and accidents with blood, registering them in the Emergency Situations F-50 journal. In case of contamination with biological fluids or the blood of patients in the department, I use the preparations included in the first-aid kit F-50: 70% ethyl alcohol, 6% hydrogen peroxide solution, gauze napkins, bandages, 1% boric acid solution (it is possible to replace with a 0.05% solution of manganese acid potassium), 5% solution of alcoholic iodine, bactericidal adhesive plaster, adhesive plaster, eye pipettes (2-3 pieces), scissors, medical gloves -2 pairs or fingertips.
SanPin 2.1.7.2790-10 dated 09.12.2010, No. 163	Every day I undergo instructions on the safety rules for waste management. Class A waste collection is carried out in white bags and sent to garbage containers. Wastes contaminated with biological fluids are disinfected beforehand, then collected in yellow bags, marked, indicating the department number, full name. nurses and hand over for recycling.

SCOPE OF WORK DURING THE WORKING DAY

At work, I am directly subordinate to the head of the department and the head nurse.

I carry out shift shifts according to the schedule. I start my working day by taking on duty and end it by handing it over. Taking the watch, I check the number of patients, the appearance, the presence of bruises or abrasions, as well as fever, weakened and seriously ill patients. I check the sanitary condition of the department, as well as the availability of medical instruments, patient care items, inventory. After that, I make out the reception of duty in a complex journal with my signature. Also in it I record all changes in the state of patients. I assign junior staff to posts. I acquaint them with the mental and somatic state, the types of supervision of the admitted patients.

During the entire shift, I am in the department, I ensure order, according to the separation mode.

When receiving a patient in the department, I get acquainted with his medical history, examine the skin, head lice. I check the quality of the sanitation in the emergency room. I distribute the applicants to the wards, according to supervision. Immediately I take blood for BL and disgroup, with subsequent sending to the laboratory. Also, while on duty, I write out requirements for the necessary drugs, and then I receive them from the head nurse. I check the expiration dates of medicines.

In our department, drugs are kept in a locked cabinet, while poisonous and potent drugs are kept in a safe. General medicines are stored according to pharmacological groups, on shelves labeled: external, internal, injectable. I lay out and distribute tableted drugs and control their intake. The distribution of medicines is carried out in accordance with the prescription sheet. In the morning and in the evening, I take a body temperature measurement with fixing the data in temperature sheets.

In case of a change in the patient's condition, I notify the attending physician, and in his absence, the hospital doctor on duty. In our department, patients suffer not only from mental disorders, but also from somatic diseases. Therefore, I accompany patients on consultations with doctors of narrow specialists, as well as for additional examination methods: ECG, EEG, ultrasound, FGDS. During feeding of patients, I am in the canteen, distributing food and controlling dietary tables prescribed by the doctor. I feed the weakened and seriously ill independently. I exercise control over the sanitary and epidemiological regime, which is strictly observed in the department. I monitor the appearance of patients, control the washing of hands before meals and after using the toilet. I attend visits of patients with relatives, control the quality and shelf life of the transferred products. I strictly control that during the meeting with the patient, cutting and stabbing objects are not transferred.

LIST OF MANIPULATIONS THAT I HAVE

DIAGNOSTIC

Measurement of blood pressure and body temperature, collection of urine, sputum, feces for laboratory biochemical and bacteriological studies, blood sampling from a vein for biological analysis, HBs Ag, AIDS, RW, preparation of the patient for instrumental examinations (ultrasound, FGS, X-ray).

THERAPEUTIC

I am fluent in the technique of subcutaneous, intramuscular, intravenous injections. Intravenous drip infusion. Statement of cleansing and therapeutic enemas. Instillation of drops in the ears, eyes, nose, bladder catheterization. The setting of mustard plasters, compresses, washing of the epicestomy.

REHABILITATION

Of particular importance for the rehabilitation of patients is related to them by medical personnel and others. I make sure that patients do not be rude to each other, the rude attitude of the medical staff towards patients is not acceptable. The appearance of the nurse, the comfort in the department, the kindness and attention of the staff are of great importance. I try to give patients as much attention as possible, talk to them, explain the importance of treatment and orient them towards the need for treatment. I show a professional understanding of the morbid nature, wrong behavior, ridiculous statements. Gradually, to improve the mental state of the patient, I conduct psychological training to overcome lethargy, indifference, physical weakness and return it to a normal rhythm of life. To distract patients from painful experiences, I organize entertainment events: I bring newspapers, magazines, books, patients play checkers, chess, watch TV. In the warm season, I take patients for a walk.

FOR EMERGENCY ASSISTANCE

I know the technique of applying a hemostatic tourniquet and bandages. The technique of artificial ventilation and chest compressions. Methods of assisting with fainting, collapse, shock, hypertensive crisis, injuries, burns.

ANALYSIS OF PROFESSIONAL ACTIVITIES FOR 2012

During the reporting period, I performed manipulations:

Taking tests				Injections
Blood on RW				Intravenous
Blood for Austrian antigen				Intramuscular
Blood for bilirubin				Subcutaneous
Urine collection				Installation of systems for infusion
Feces sampling for disgroup
Feces sampling on I / ch.
Collecting smears for diphtheria
Urine according to Nechiporenko

PREVENTIVE AND HEALTH PROTECTION ACTIVITIES

Kind of activity	Workload
Testing for the presence of HBs Ag and antibodies to hepatitis "C"	Annually
Examination by a therapist	Annually
Clinical examination within the framework of the National Project "Health"	Once every 3 years
Promotion of healthy lifestyles	2 times per year
Conversation with junior staff	2 times per year
Conversation with patients and their relatives	10 times a year

In the department I conduct conversations with nursing staff on the topics: "Prevention of acute intestinal infections", "Care of seriously ill patients", "Prevention of bedsores". I also conduct conversations with junior staff on the topics: "Types of supervision", "Fixation rules".

PROFESSIONAL IMPROVEMENT

Mentoring

Young specialists come to work in our department. She trained a young nurse who came to our department E.V. Shabanova. , within one month she taught the technique of intravenous, subcutaneous, and intramuscular injections, about the rules for fixing patients with excitement and possible complications, about the features of disinfection, about personal precautions when working with patients.

NEW TECHNOLOGY, DEVELOPMENT AND SPECIALTIES USED BY PROFILE; PARTICIPATION IN INNOVATIVE NURSING TECHNOLOGIES; IMPROVING THE QUALITY OF NURSING CARE

She mastered the method of taking blood using VACUTEST vacuum systems.

This ensures the greatest safety for healthcare providers who draw blood. I also mastered the technique of determining blood sugar on a glucometer. She mastered the device Sol-1 "Mobile shower-bath", for bathing seriously ill patients directly at the patient's bedside.

Findings:

In my report, I reflected the main functions of my work and came to the conclusion that in communicating with patients, a health worker should find a warm, encouraging word, since sympathy and reassurance with a word is one of the most important psychotherapeutic tools. No wonder the ancient formula says: "The word heals a person"

Proposals for improving the quality of medical care.

Work regularly to improve professional skills and meet moral criteria.

To provide highly qualified assistance to the patient not only with the help of medical manipulations, but with a sensitive attitude and a kind word.

In our department there are elderly people, many of them within the bed, so we would like the department to be provided with functional beds.

Monitor the timely receipt of research results and paste them into the medical records of outpatients. 5. To regulate the flow of visitors by recording the appropriate time in the coupons of repeated patients. 6. Inform the card storage about all cases of transfer of medical records of outpatients to other offices in order to make a corresponding entry in the replacement card. 7. If necessary, help patients prepare for the examination of the Doctor. 8. Keep records of dispensary patients and promptly call them to see a doctor. 9. Explain to patients the methods and procedures for preparing for laboratory, apparatus research. 10. Participate in carrying out sanitary and educational work among patients. 11. Systematically improve your qualifications by studying the relevant literature, participating in conferences, seminars. 12.

I. General Part The main tasks of a nurse of a cardiology office are to fulfill medical and diagnostic prescriptions of a cardiologist in a polyclinic and to help him organize cardiological care for the population living in the area of \u200b\u200boperation of the polyclinic, as well as workers and employees of attached enterprises. The appointment and dismissal of the nurse of the cardiology office is carried out by the chief physician of the polyclinic in accordance with the current legislation.

The nurse of the cardiology office reports directly to the cardiologist and works under his direction. In her work, a nurse of a cardiology office is guided by this job description, as well as methodological recommendations for improving the activities of nursing staff in outpatient clinics.

II.

Features of the work of the cardiology department of the hospital

The department has 60 beds, of which 45 are 24-hour and 15 are day-care beds. Bed profile:

Therapeutic - 20 beds (including 5 day beds).
Cardiological - 20 beds (including 5 day beds).
Neurological - 15 beds (including 5 day beds).
ONMK - 5 beds.

There are 3 round-the-clock posts in our department, one of them is an intensive care unit.
The department has 17 wards, 2 treatment rooms, an enema room, an ECG and ECHO - encephalodiagnostics room, an internship, a senior nurse's office, a hostess sister's office, two sanitary rooms, two rooms for nurses.

Certification work for the highest category of a nurse in a neurological office

The technique of sputum collection for general analysis, VC, bacterial culture.

Indicators of the amount of work performed to prepare patients for examinations. No. Examination (preparation) 2009 2008 1 Sigmoidoscopy Irrigoscopy Colonoscopy (cleansing enemas, dieting) 30 28 12 28 24 10 2 Fibrobronchoscopy (performed on an empty stomach) 12 8 3 Fibrogastroscopy (performed on an empty stomach) 48 40 4 Ultrasound of the abdominal cavity 60 48 5 Fluoroscopy of the stomach (performed on an empty stomach) 34 36 6 Fluoroscopy of the chest organs 64 60 7 Examination of the function of external respiration (weighing the patient, measuring growth) 32 19 8 Gastroduodenoscopy (cleaning the stomach and duodenum from the contents) 5 3 9 Duodenal intubation (performed on an empty stomach) 7 5 Conclusion: During the reporting year, the indicators of the amount of work performed increased, because

Nursing job in cardiology

Attention

The main task of LLC "MPC" is to provide medical care at a high professional level and in sufficient volume. Thanks to the health center, which is located on the territory of the city-forming enterprise OJSC Uralskaya Kuznitsa, medical care is as close as possible to the workers of the plant, which makes it possible to provide timely emergency assistance in case of injuries and acute conditions.

Polyclinic LLC "MPTs" is a two-storey building with rooms equipped by profiles. The dental department, the department of functional diagnostics and ultrasound, which includes rhythmocardiography, ECG, bicycle ergometry, echocardiography, ultrasound, REG, EchoEG, RVG, as well as the offices of a professional pathologist and a senior paramedic are equipped with modern equipment and computers.

The neurologist's office has two rooms and is equipped with furniture (tables, chairs, couch, wardrobe, bookshelf, bookcase).

Work of a ward nurse of the highest category

Important

On the procedure for conducting general medical examination. " Order No. 90, 1996 and No. 83, 2004. ... "On the conduct of periodic medical examinations of workers employed in harmful and (or) hazardous production factors". Order No. 330 dated 12.11.97. "On measures to eliminate serious shortcomings and further strengthen the fight against drug addiction, improve the accounting, storage, prescription and use of narcotic drugs."

Order No. 328 of 23.08.99. "On the rational prescription of medicines, the rules for prescribing them and the procedure for their dispensing by pharmacies." Order No. 171 dated 19.06.00. "On the organization of registration of medicines and medical products in the medical institution of the Chelyabinsk region."
Order No. 141 dated 09.04.1990. "On further improvement of measures for the prevention of tick-borne encephalitis." Order No. 338 dated November 24, 1998.

Certification work of the nurse of the cardiology office of the polyclinic

In her work, the nurse of the cardiology office is guided by this job description, as well as guidelines for improving the activities of nurses in outpatient clinics. 2. FUNCTIONAL RESPONSIBILITIES To perform her functions, a nurse of a cardiology office is obliged to: 2.1. Prepare workplaces before an outpatient visit to a cardiologist, controlling the availability of the necessary medical documentation, inventory, checking the serviceability of equipment and office equipment. 2.2. Prepare and send to the registry vouchers for an appointment with a doctor for the current week. 2.3.
Before the start of the reception, bring outpatient medical records, selected by the registrars in accordance with the self-registration sheets, from the storehouse. 2.4.
Indicators of the performed volume of manipulations. No. Name of manipulations 2009 2008 1 Intravenous injections 330 320 2 Intravenous drip infusions 480 420 3 Intramuscular and subcutaneous injections 3500 3400 4 Bladder catheterization 30 24 5 Compress application 28 20 6 Microclysters 26 24 7 Assisting with blood transfusion 20 15 8 Registration of electrocardiogram 60 50 9 Measurement of blood pressure 750 600 10 Thermometry 3800 3700 11 Weighing of patients 170 100 12 Pleural puncture (assistance) 10 8 13 Lumbar puncture (assistance) 15 10 14 Blood sampling for biochemical analysis 120 80 15 Preparation for research (cleansing enemas) 70 60 Conclusion: as compared to the previous year, the number of manipulations and prescriptions increased, only doctors began to prescribe microclysters less often. Organization of meals in the department.
To continue the sanitary and educational work with the patients of the neurological office. Bibliography. Literature, worked out during the reporting period: 1. "Manual for special patient care."

MV Milich, VI Pozdnyakov, SN Lapchenko 2. "A textbook on patient care for training nurses." VV Murashko 3. "Fundamentals of the organization of polyclinic care for the population."

AF Serenko 4. "Sanitary statistics". AM Merkov 5. Magazines: "Nurse" "Your health" "Nursing" 6. "Care of neurological patients." LG Perov The report was compiled on the basis of the following registration forms: Statistical coupon Control card of a dispensary patient: F-30 Form-16 Journal of dispensary patients Annual report of a medical institution Final acts of preventive examinations.
The report consists of 11 pages, 4 tables, 2 diagrams.

Certification work of a nurse of the cardiology department

During the last two years, patients with the following nosological forms were under dispensary observation: Nosological forms / Years 2007 2008 Chronic vascular diseases of the brain (DEP II) 41 26 Traumatic brain injuries 7 5 Diseases of the musculoskeletal system 48 61 Diseases of the peripheral nervous system 4 4 Vegeto-vascular dystonia 16 10 Occupational diseases 3 1 Epilepsy 8 3 Inflammatory diseases - - Acute cerebrovascular accident 16 9 Total: 143 119 Simultaneously with the clinical examination of chronic patients, short-term clinical examination of patients undergoing acute conditions according to the following nosologies: Nosologies / Years 2007 2008 Neuropathy of the facial nerve 12 10 Neuropathy of the trigeminal nerve 15 17 Polyneuropathy 9 11 Acute lumbago 59 39 Dyscirculatory encephalopathy I stage.

The nurse of the neurological department is obliged:

Ø feeding the patient through a gastrostomy tube; body temperature measurement; plotting the temperature curve;

Ø taking an ECG;

Ø collection of sputum;

Ø collection of urine for research.

Methods and means of disinfection of medical instruments and equipment.

Disinfection facilities	Disinfection means	Disinfection modes	Disinfection methods
Solution concentration,%	Holding time, min
Metal spatulas	Hydrogen peroxide
Septodor Forte	0,1
Virkon
Kornzang	Deoxone-1	0,5		Immersion in solution followed by rinsing with water
Septodor Forte	0,1
Pressure cuff	Hydrogen peroxide			Immersion in solution, rinsing with running water, or wiping twice with an interval of 15 minutes
Phonendoscope	70 ° alcohol			Wiping
Medical thermometer	Chloramine			Full immersion in solution followed by rinsing
Chloramine
Hydrogen peroxide
Lysoformin-3000	0,75
Chlorhexidine gluconate	0,5
Anolyte	0,05
Precept	0,1
Gibitan (chlorhexidine 20%), aqueous solution	0,5
Deoxone	0,1
Sulfochlorantin	0,1
Septodor Forte	0,1
Virkon	0,1
Enameled plastic patch	Lysoformin-3000			Immersion in solution, rinsing with running water
Virkon
Chloramine with 0.5 detergent
Sodium hypochlorite	0,25
DP-2	0,1
Infusion stand	Virkon			Wiping twice
Amocid
Wooden spatulas, used dressings	Chloramine			Full immersion in solution
Precept	0,2
Lysoformin-3000	0,25
Lysoformin-special	0,75	12 hours
Amocid		12 hours
Deochlor	7tab. for 10L
Containers for used dressings	Chloramine			Single wipe
Precept	0,2
Lysoformin-special	0,75
Deochlor	7tab for 10l
Floor scales (footrest)	Chloramine			Wipe after each patient
Virkon

Functional duties of the nurse of the gastroenterology department.

The nurse of the gastroenterology department is obliged to:

1. Rationally organize your work in the department.

2. Ensure infectious safety (observe the rules of sanitary-hygienic and anti-epidemic regime, asepsis, properly store, process, sterilize and use medical products).

3. To carry out all stages of nursing care of the patient.

4. Timely and efficiently fulfill all the doctor's prescriptions.

5. Provide emergency first aid to a patient with a subsequent call to him a doctor.

6. Introduce medications, anti-shock drugs to patients for health reasons in accordance with the established procedure for this condition.

7. Inform the attending physician or the head of the department, and in their absence, the doctor on duty, about all discovered serious complications and illnesses of patients, complications arising from medical manipulations or about cases of violation of the internal order of the department.

8. Ensure correct storage, accounting and write-off of medicinal products, compliance with the rules for taking medications by patients.

9. Interact with colleagues and staff from other services for the benefit of the patient.

10. Maintain approved medical records.

11. To carry out, sanitary and educational work on health promotion and disease prevention, promotion of a healthy lifestyle.

12. To systematically improve their professional qualifications.

13. To carry out the reception of newly admitted patients, to acquaint them with the internal regulations and the prescribed regime in the department and to monitor their implementation.

14. Provide a safe environment for patients in the department.

15. To take a direct part in bypassing the patients by the attending physician or the doctor on duty, to inform them about changes in the state of health of the patients.

16. Carry out high-quality and timely preparation of patients for various kinds of research, procedures, operations.

17. Perform the following manipulations qualitatively:

Ø sanitary treatment of the patient;

Ø preparation of disinfectant solutions

Ø disinfection of patient care items;

Ø transportation and transfer of the patient;

Ø use of a functional bed;

Ø making the bed;

Ø change of underwear and bed linen;

Ø patient toilet;

Ø hygiene measures in bed;

Ø washing;

Ø feeding the patient in bed;

Ø prevention of bedsores;

Ø introduction of a nutrient mixture through a tube;

Ø feeding the patient through a gastrostomy tube;

Ø measurement of body temperature;

Ø plotting the temperature curve;

Ø pulse measurement;

Ø determination of the number of respiratory movements;

Ø measurement of blood pressure;

Ø determination of daily urine output;

Ø application of a heating pad and an ice pack;

Ø oxygen supply;

Ø supply of the vessel and urine bag;

Ø installation of a gas outlet pipe;

Ø setting all types of enemas;

Ø bladder catheterization;

Ø taking an ECG;

Ø taking feces for research;

Ø collection of sputum;

Ø collection of urine for research.

Sanitary and hygienic regime in the reception area.

1. The doctor examines all those entering the admission department for the timely detection and isolation of patients with purulent-septic diseases. In patients, the skin, pharynx are examined and the temperature is measured. Wooden spatulas are destroyed after use, and metal spatulas are disinfected. The whole thermometers are placed in a vessel with a disinfectant solution.

2. Examination of the patient is carried out on a couch covered with oilcloth. After taking each patient, the oilcloth must be wiped with a rag moistened with a disinfectant solution.

3. Examination of the patient, examination of wounds and change of dressings are carried out in a dressing room in dressing gowns, hats, completely covering the hair, masks, gloves. When treating patients with purulent wounds, an oilcloth apron is additionally worn, which is disinfected after work.

4. Liquid soap (Sterizol, Vaza-soft, Klindzin-soft) is used to wash the hands of the personnel.

5. The following are used as antiseptics for hygienic treatment of the hands of personnel: AHD 2000-special, Sterizol-antiseptic, Klindzin-elite, Hospisept-spray, Hospisept-tukh.

6. An individual towel is allocated for each member of the duty team. The towel is changed at least once a day.

7. A patient in the emergency department undergoes complete sanitization: takes a shower or a bath (as directed by a doctor), cuts his nails. The patient receives a clean washcloth for washing.

8. After sanitization, the patient puts on clean hospital linen, a dressing gown (pajamas), slippers.

9. After a single use, washcloths for washing patients, hair clippers, razors and razors, nail clippers and scissors, tips for enemas and baths - all these items are disinfected.

10. The premises of the reception area are cleaned at least 2 times a day using a wet method using disinfectants.

11. Cleaning material (buckets, basins, etc.) is marked and used strictly as intended. The rags are isolated and stored strictly according to the objects of processing. After use, the cleaning material is disinfected.

Responsibilities of the nurse of the therapeutic department.

The nurse of the internal medicine department is obliged to:

1. Rationally organize your work in the department.

2. Ensure infectious safety (observe the rules of sanitary-hygienic and anti-epidemic regime, asepsis, properly store, process, sterilize and use medical products).

3. To carry out all stages of nursing care of the patient.

4. Timely and efficiently fulfill all the doctor's prescriptions.

5. Provide emergency first aid to a patient with a subsequent call to him a doctor.

6. Introduce medications, anti-shock drugs to patients for health reasons in accordance with the established procedure for this condition.

8. Ensure correct storage, accounting and write-off of medicinal products, compliance with the rules for taking medications by patients.

9. Interact with colleagues and staff from other services for the benefit of the patient.

10. Maintain approved medical records.

11. To carry out, sanitary and educational work on health promotion and disease prevention, promotion of a healthy lifestyle.

12. To systematically improve their professional qualifications.

13. To carry out the reception of newly admitted patients, to acquaint them with the internal regulations and the prescribed regime in the department and to monitor their implementation.

14. Provide a safe environment for patients in the department.

15. To take a direct part in bypassing the patients by the attending physician or the doctor on duty, to inform them about changes in the state of health of the patients.

16. Carry out high-quality and timely preparation of patients for various kinds of research, procedures, operations.

17. Perform the following manipulations qualitatively:

Ø sanitary treatment of the patient;

Ø preparation of disinfectant solutions

Ø disinfection of patient care items; transportation and transfer of the patient;

Ø use of a functional bed; making the bed; change of underwear and bed linen;

Ø patient toilet; hygiene measures in bed; washing away;

Ø feeding the patient in bed; prevention of pressure sores; the introduction of a nutrient mixture through a tube;

Ø feeding the patient through a gastrostomy tube; body temperature measurement; plotting the tempo of the curve;

Ø pulse measurement; determination of the number of respiratory movements; blood pressure measurement;

Ø determination of daily urine output; using a heating pad and an ice pack; oxygen supply;

Ø supply of the vessel and urine bag; installation of a gas outlet pipe; setting all types of enemas;

Ø bladder catheterization; taking an ECG; taking feces for research; collection of sputum; collection of urine for research.

Sterilization by air method, optimal sterilization mode, shelf life of sterility in packaging, types of packaging for air sterilization.

In the air sterilization method, the sterilizing agent is dry hot air at a temperature of 160 ° C and 180 ° C. Sterilization is carried out in air sterilizers.

The air method sterilizes surgical, gynecological, dental instruments, parts of devices and apparatus, including those made of corrosion-resistant materials, syringes marked at 200 ° C. injection needles, silicone rubber products.

Before sterilization by the air method, the products after pre-sterilization processing must be dried in a drying cabinet at a temperature of 85 ° C until the visible moisture disappears.

The quality of air sterilization depends on the uniform distribution of hot air in the sterilization chamber, which is achieved by correct loading of the sterilizer. The products are loaded in such an amount that allows free air supply to the product to be sterilized.

Types of packaging material:

Ø non-impregnated sack paper;

Ø high-strength packaging paper;

Ø crepe paper for medical purposes (Lithuania);

Ø CRAFT paper.

Table # 1. Air sterilization (dry hot air)

Notes to Table # 1:

Ø dry products are sterilized;

Ø products sterilized in packaging made of untreated sack paper, high-strength packaging paper, CRAFT paper can be stored for 3 days, in a two-layer packaging made of crepe paper for medical purposes (Lithuania) - up to 20 days.

Ø Products sterilized without packaging should be used immediately after sterilization during a work shift (6 hours) under aseptic conditions.

The effectiveness of air sterilization depends on an even distribution of hot air in the sterilization chamber, which is achieved by correctly loading the device. Products to be sterilized are loaded in an amount that allows free air supply to the item to be sterilized.

During air sterilization, metal instruments without packaging are positioned so that they do not touch each other. Reusable syringes are sterilized disassembled.

Loading and unloading from air sterilizers should preferably be carried out at a temperature in the chamber of 40-50 ° C. The sterilization time should be counted from the moment the sterilization temperature is reached (180 or 160 ° C), depending on the selected mode.

Reuse of packages:

Ø Sterilization boxes without filters and coarse calico are used for packaging many times while maintaining integrity and without deformation and breakages.

Ø Sterilization boxes with bacterial filters are used repeatedly, filter life: 1 month with 1-2 sterilizations per day. When replacing the filter, use the following materials: 1-layer filter diagonal; madapolam, calico, voluminous coarse calico in 2 layers.

Ø Frequency of use of packaging papers: parchment - 2 times, high-strength packaging paper (CRAFT) - 3 times; double-layer crepe paper - 2 times. Combined packages of the "Sterking" type are used, as a rule, once.

All-metal dental instruments are sterilized by the Glasperlen method by immersing them in a medium of glass beads heated to 190-250 ° C. The processing times are indicated in the instructions for use of the particular sterilizer.

Functional responsibilities of a nurse in a polyclinic.

The clinic's nurse is obliged to:

1. Prepare an outpatient doctor's appointment: preparation of the workplace, devices, instruments, individual outpatient cards, prescription forms and other statistical medical forms, timely receive the results of laboratory and other studies and paste them on outpatient cards.

2. Prepare the patient for an outpatient appointment with a doctor: measure blood pressure, conduct thermometry and other medical research and manipulations within their competence or on behalf of a doctor.

3. Fill out emergency notification cards, referral forms for medical and diagnostic examinations, help in filling out letters to MSEC, health resort cards, extracts from individual cards of an outpatient. Enter the data of fluorographic and other studies into the individual card of an outpatient patient.

4. Explain to the patient the methods and procedures for preparing for laboratory, instrumental and instrumental studies.

5. Carry out the selection of material for bacteriological research in accordance with the doctor's prescription.

6. Carry out preventive vaccinations under the guidance and supervision of a physician.

7. Train family members to create a safe environment for the patient.

8. Provide care and training for the care of family members during the period of illness and rehabilitation of the patient.

9. Provide training on safe environment and patient care at home.

Protective measures for a nurse when working with blood to prevent HIV and hepatitis.

Goal:prevention of nosocomial infection with hepatitis B and C, transmission of HIV and pathogens of other infections carried by blood from patients to staff, from staff to patients and from patient to patient.

Sequence	Justification
1. All manipulations, which may lead to contamination of hands with blood or serum, should be carried out in rubber gloves, and in order to avoid splashing blood - in face masks and goggles.	Protective barriers reduce the risk of spreading infection.
2. Cover all injuries on the hands with adhesive plaster, waterproof bandages.	Prevention of contact with open wounds and mucous membranes.
3. Breathing bags should be available in all healthcare settings where resuscitation may be required.	Prevention of contact with mucous membranes.
4. Mechanical and electrical devices should be used instead of mouth-to-mouth resuscitation in newborns.	Infection barrier for staff and patients.
5. Disassembly, washing and rinsing of instruments, devices, laboratory glassware and everything in contact with biological fluids should be carried out only after disinfection and wearing thick rubber gloves.	Prevention of transmission of infection through contaminated instruments.
6. Used needles should not be bent, broken by hand and re-capped.	Prevention of damage when working with piercing tools.
7. Disposable instruments are immediately placed with the syringe in a strong, leak-proof container for disposal.	Prevention of environmental contamination.
8.Store sharps to be reused in a sturdy container for processing.	Prevention of damage when working with piercing and cutting tools.
9. In working areas where there is a risk of occupational infection, it is forbidden to eat, drink, smoke, apply cosmetics, and take contact lenses.	Personnel health protection.
10. Nurses who have constant contact with blood are subject to preventive examination for hepatitis B antigen and HIV infection upon admission to work and then 1-2 times a year.	Contact of hands with nose, eyes, and mouth may increase the risk of indirect infection through common contaminated surrounding surfaces.
11. In case of skin contamination with blood, it is necessary to quickly treat it using an emergency first aid kit: - remove gloves; - treat the skin with a tampon abundantly moistened with an alcohol-containing skin antiseptic; - wash with soap and water; - wipe with a napkin; - re-treat with an antiseptic (70% ethyl alcohol).
12. If blood gets on the mucous membranes, treat them with 0.05% solution of manganese-sour potassium.	Prevention of nosocomial infection, personnel health protection.
13. In case of injury by the tools used: - squeeze out the blood; - treat with iodine; - inform the administration; - undergo a timely confidential laboratory examination; - contact an infectious disease specialist.
14. In case of surface contamination with blood or other biological fluids, treat them with disinfectants.	Prevention of nosocomial infection.

Functional responsibilities of a nurse in a children's clinic.

The nurse of the children's polyclinic is obliged:

1. Conduct sanitary and educational work among children, their relatives and the population, advise on healthy lifestyles, nutrition, breastfeeding, observe the rules of medical ethics and deontology when communicating with staff, parents and children.

2. To teach parents to care for a healthy and sick child, to fulfill the sanitary and epidemiological requirements of childcare, to carry out patronage work in the family, to collect information about the conditions for raising a child, his personality traits, and habits for the successful implementation of caring for him.

3. Provide first-aid medical care to children in case of emergency, organize proper transportation.

4. Provide the pre-medical stage of preventive examinations of children of different ages based on screening programs.

5. Plan and monitor vaccine prophylaxis.

6. Monitor the implementation by the child and parents of the recommendations and prescriptions of the doctor.

7. Carry out the program of medical and preventive care for the child prescribed by the doctor. Plan and deliver nursing care for patients according to need priorities.

8. Carry out:

Reception of patients in a medical facility (department).

Inspection for head lice. Providing the patient with individual care items.

Collection of material from patients for laboratory examination.

A selection of medical records (development) of doctor's prescriptions

Preparing patients for instrumental research methods.

Compliance with the sanitary and epidemiological regime in relation to the child, relatives and himself.

Monitoring the child's nutrition in health care facilities and at home, the quality and consistency of the programs brought by the parents to the permitted range.

Drawing up portioned requirements for diet tables.

Monitoring the patient's condition with the registration of any changes, making decisions in accordance with the level of his competence.

9. Provide medical personnel with timely information about the deterioration of the patient's condition, complications. Arising as a result of medical procedures.

10. Regularly improve your qualifications.

Types and methods of disinfection, their characteristics.

Disinfection(disinfection) is the destruction of pathogenic and opportunistic microorganisms in the human environment, at the facilities of equipment and medical instruments in a medical institution.

Scheme No. 1. Types of disinfection.

Scheme No. 2. Disinfection methods.

Responsibilities of a nurse in a healthy child's room of a polyclinic.

The nurse of the healthy child's room of the polyclinic must:

1. Conduct sanitary and educational work among parents, advise on the hygiene of raising children. Healthy lifestyle, nutrition, breastfeeding, prevention of diseases and deviations in the development of the child, as well as preparation for admission to preschool and school institutions.

2. Comply with the rules of medical ethics and deontology when dealing with staff, parents and children.

3. To teach parents how to care for a healthy and sick child, how to comply with the sanitary and epidemiological requirements for caring for children.

4. Control the neuropsychic development of children.

5. To carry out a complex of massage and age complexes of gymnastics.

6. Maintain the medical documentation approved by the regulation.

7. Exercise:

Ø reception of patients in the room of a healthy child;

Ø compliance with the sanitary and epidemiological regime in relation to the child, relatives and himself;

Ø monitoring the child's condition with registration of any changes;

Ø making decisions in accordance with the level of their competence.

8. Provide medical personnel with timely information about the deterioration of the patient's condition, complications arising from medical procedures.

9. Regularly improve your qualifications.

Treatment of the patient upon detection of head lice.

By order of the Ministry of Health No. 320 dated 03/05/1982. head lice is equated with infectious diseases.

Each detected case of head lice, wardrobe and mixed lice is registered in the "Journal of Infectious Diseases" (f. 060u) and an emergency notification is sent about it. Individuals who, upon examination, have lice at any stage of development (egg-nit, larva, adult insect) are subject to registration.

When pubic lice is detected, the affected person is sent to a dermatovenerologic dispensary, where registration and registration of pubic lice is carried out, and appropriate treatment is prescribed.

Technique for the treatment of persons affected by head lice:

1. A preparation (pediculicide) is applied to the scalp, then the head is tightly tied with a scarf and the exposure is maintained according to the guidelines for this preparation.

2. The preparation is washed off with warm water and detergent.

3. Hair is rinsed with 5-10% warm solution of acetic acid, which helps to remove nits, which must be carefully combed out with a fine comb.

As pediculicides are used:

Ø lotions - Lontsid, Nittifor, Chubchik, Perfolon-1, Stagifor, Nytilon, Valiten, Sana, Florocid;

Ø tablets - Opofos, Aviron;

Ø creams - Insecto-cream;

Ø gels - Gelemid, Pedizol;

Ø emulsion - Pedilin;

Ø solid soaps - Vitar, Insecticidal soap F and Pj;

Ø dusts - Bifitrin R;

Ø shampoos - Amber, BIN, Biosim A and Z, Elko-insect, Grintsid-U;

Ø detergents - Tala. Vekurin, Sanam;

Ø liquid soap - Kadima;

Ø aerosol - Para-key

Lotions and emulsions are mainly ovocidal.

Note:

Pediculicide treatment of pregnant, lactating women, people with damaged skin and children under 5 years of age is prohibited, only mechanical methods of destruction of lice and nits are used by combing out with a frequent comb, cutting or shaving hair (with the consent of the patient!).

For the destruction of all types of lice on underwear and bedding, it is recommended to boil in a 1-2% soda solution for 15-20 minutes after boiling.

Items that cannot be boiled are ironed with a hot iron through a damp cloth, and insecticidal soap is also used.

For disinfection of premises with wardrobe and mixed pediculosis, use: 0.15% solution of karbofos, 0.5% water solution of chlorophos, Medifox, aerosol cans such as Prima, Dichlorvos, Carbozol, Neophos-2 ".

Disinfection is carried out with open windows and vents. At the end of the exposure, wet cleaning is carried out.

The nurse carries out the treatment, wearing an additional gown, scarf, gloves. At the end of the work, the patient's linen, his gown is sent to the disinfection chamber, the gloves are immersed in the disinfectant, the hands are washed, ensuring infectious safety.

The bed fund of the therapeutic department. Compliance with the sanitary and epidemiological regime in the department, wards, department premises. Record keeping at the nursing post. Distribution of medicines. Caring for and monitoring patients.

Medical unit of the Central Internal Affairs Directorate for the Chelyabinsk region

CERTIFICATION WORK

for 2009 ward nurse1sthospital therapy department Hospital No. 1 Makeeva Maria Feodorovnathe confirmation the highest qualification category in the specialty "Nursing"

chelyabinsk 2010

1. Professional route

2. Characteristics of the institution

3. Characteristics of the department, workplace

bed fund

b the structure of patients

b staff

4. Main sections of work

l functional responsibilities

b list of manipulations

sampling of material for analysis

participation in research

5. Related professions

6. Emergencies

7. Sanitary and epidemiological regime at the workplace

b regulatory orders

b used disinfectants

l infectious safety of health workers

l tool processing

b quality control of pre-sterilization treatment

8. Hygienic education of the population

9. Analysis of work for the reporting period

10. Conclusions

11. Tasks

Professional routet

I, Maria Fedorovna Makeeva, graduated from the Zlatoust Medical School of the Ministry of Railways with a degree in Nursing in 1973 - diploma No. 778717 dated June 29, 1973, registration No. 736. On assignment, he was sent to the Second Road Clinical Hospital of the city of Chelyabinsk, South Ural Railways. Accepted as a nurse in the 3rd surgical department (oncology). By the principle of interchangeability, she mastered the work of a nurse in a treatment and dressing room. In 1977, she was dismissed of her own free will.

In 1977, she was enrolled as a nurse of the therapeutic department in the Hospital with a polyclinic of the Medical Department of the Internal Affairs Directorate of the Chelyabinsk Regional Executive Committee.

In 1984 she was drafted into military service in military unit No. 7438 as a medical officer of a company. At the end of the contract in 1988, she was dismissed from the ranks of the Soviet Army.

In 1988 she was accepted as a nurse of the neurological department of the Hospital with a polyclinic of the Medical Department of the Chelyabinsk Regional Executive Committee. In 1990, she passed certification at the medical department of the Internal Affairs Directorate of the Chelyabinsk Oblast Executive Committee and by order of the medical department of the Internal Affairs Directorate of the Chelyabinsk Oblast Executive Committee, the first qualification category was awarded, certificate No. 53 dated 21.06.1990.

In August 1993, she was appointed senior nurse of the internal medicine department. On June 20, 1995, the attestation commission at the medical sub-department of the Internal Affairs Directorate of the Chelyabinsk region and by order of the medical sub-department of June 22, 1995 No. 34 awarded the highest qualification category of a hospital nurse. In 2000, at the Chelyabinsk regional basic school for advanced training of workers with secondary medical and pharmaceutical education, she listened to a series of lectures on the program "Modern aspects of management and economics of health care" - certificate No. 4876 dated November 24, 2000, protocol No. 49 - awarded the highest qualification category in the specialty "Nursing business". In February 2003. at her own request, she was transferred to the position of a ward nurse of the therapeutic department. In 2005. improved her qualifications at the State Educational Institution of Continuing Professional Education "Chelyabinsk Regional Center for Continuing Professional Education of Healthcare Professionals" in the cycle of improvement "Nursing in therapy" - certificate No. 2690/05 dated 18.10.2005. No. 373l.

In 2010. improved her qualifications at the GOUVPO "Chelyabinsk State Medical Academy of Roszdrav" in the cycle of improvement "Nursing in therapy" - certificate registration number 1946/122 dated 20.02.2010.

Work experience in a healthcare institution for 33 years.

Work experience in the specialty nursing is 37 years.

Characteristics of the institution

The medical and sanitary unit of the Central Internal Affairs Directorate for the Chelyabinsk region was organized to provide medical, preventive and diagnostic assistance to employees working in the Ministry of Internal Affairs, in accordance with order No. 895 of November 8, 2006. "On the approval of the regulation on the organization of medical care and sanitary and resort treatment in medical institutions of the Ministry of Internal Affairs of Russia." The medical and sanitary part is located in a typical five-storey building, three floors of which are occupied by a polyclinic and two floors by a hospital. The polyclinic is designed for 650 visits per day, where district therapists and narrow specialists provide medical assistance: an ophthalmologist, dermatologist, urologist, gynecologist, gynecologist, ENT, cardiologist, psychiatrist, surgeon, neurologist.

To conduct a diagnostic examination, the following services have been created in the polyclinic:

1. X-ray - conducts X-ray and fluoroscopic examinations of the chest, gastrointestinal tract, musculoskeletal system, skull, intravenous urography, irrigoscopy, fluorographic examinations.

2. Department of functional diagnostics - performs the following scope of examinations: ECG, HM-BP, HM-ECG, ECHO-cardiography, veloergometry, transesophageal electrical stimulation, neurophysiology: EEG, REG; Ultrasound diagnostics of the abdominal organs, pelvic organs, thyroid gland, mammary glands, lumbar spine, ultrasound of the vessels; the endoscopic office conducts FGDS of the stomach.

3. Laboratory department - conducts a full range of clinical, biochemical and bacteriological studies of blood, urine, feces, sputum and other biological media. All laboratories are equipped with appropriate equipment, including modern analyzers and reagents.

4. Physiotherapy department - conducts treatment with high-frequency currents, inductotherapy, magnetotherapy, UHF, laser therapy, UFO. The department has a massage room, a physiotherapy room, an inhaler, a massage shower.

5. Dental service.

Unit characteristics

The hospital of the Medical and Sanitary Unit is located on the 4th and 5th floors of the building and is designed for 100 beds: 40 beds in the neurological department and 60 beds in the therapeutic department.

Bedfund of the therapeutic department:

Table No. 1

Therapeutic department staff

In the therapeutic department of the hospital there is the office of the head of the department, the office of the head nurse of the Medical and sanitary unit, a treatment room, an internship, a manipulation room where patients are prepared for diagnostic examinations, showers for patients and medical staff, men's and women's toilets, and a toilet for staff. For patients' relaxation there is a lounge with upholstered furniture and TV. The department has two medical posts with the necessary equipment: work tables with a set of documentation: job descriptions of a ward nurse, an algorithm for performing medical appointments, work logs; a medical cabinet for storing medicines in accordance with the standard requirements, a cabinet for storing medical supplies, a cabinet for storing disinfectants and disinfection containers. The treatment room consists of two blocks: the first - for subcutaneous, intramuscular, intradermal and intravenous injections and blood sampling for biochemical and bacteriological analysis; the second is for infusion therapy. There are also cabinets for medicines, a refrigerator for storing thermolabile drugs (vitamins, hormones, chondroprotectors, insulins), a cabinet for storing sterile solutions, a bactericidal irradiator, containers for disinfection of disposable medical items that must be disposed of (syringes, systems for infusion of infusion solutions ), couches, cleaning equipment. In the treatment room, there are syndromic kits for treating emergency conditions and an Anti-AIDS first aid kit.

Main sections of work

In my work, as a ward nurse, I rely on regulatory documents, orders of the Ministry of Health of the Russian Federation, decrees of the Ministry of Health of the Russian Federation, San PiNy. I try to fulfill my job descriptions conscientiously and efficiently, which include:

· Caring for and monitoring patients.

· Timely and high-quality fulfillment of medical appointments.

· Thermometry of patients with subsequent mark in the medical history.

· Monitoring of hemodynamics: blood pressure, heart rate, NPV.

· Compliance with the sanitary and epidemiological regime in the department, wards, department premises.

· Carrying out the collection of material for laboratory research (preparation of directions, dishes, conversation with patients about the objectives of the study, the correct preparation and technique of collecting tests).

· Compliance with the medical and protective regime in the department.

· Familiarization of newly admitted patients with the internal regulations.

· Preparing patients for X-ray, endoscopic and ultrasound examinations.

· Record keeping at the nursing post:

Patient movement log in the department,

Journal of one-time medical appointments,

Specialist consultation journal,

Diagnostic examinations appointment log,

Shift change log,

· Drawing up the portion requirement, according to the diet prescribed by the doctor, in accordance with the order of the Ministry of Health of the RSFSR No. 330 dated 5.08.2003. "On measures to improve medical nutrition in medical institutions of the Russian Federation."

· Obtaining the required amount of medicines from the head nurse of the department. All medicines are arranged in groups in lockers. All medicinal products must be in their original industrial packaging, label outside and have instructions for using this drug, according to the orders:

Order No. 377 of 13.11.1996 "On approval of requirements for the organization of storage of various groups of medicines and medical devices."

Order of the Ministry of Health of the RSFSR dated 09/17/1976. No. 471 "Memo to a medical worker on the storage of medicines in the departments of medical and preventive institutions."

According to the order of the Ministry of Health of the USSR No. 747 dated 2.06.1987. "On the approval of the instructions for the registration of medicines, dressings and medical products in the medical facility" and the Ministry of Health of the Chelyabinsk region letter dated 4.06.2008. No. 01/4183 "On the organization of registration of medicines and medical supplies", strict accounting of medicines subject to quantitative accounting is kept.

· Distribution of medicines. It is carried out in accordance with the patient's prescription sheet, which indicates the name of the drug, its dosage, frequency and mode of administration. All appointments are signed by a physician indicating the appointment and cancellation dates. At the end of the treatment, the prescription sheet is pasted into the patient's medical history. I dispense medications in strict accordance with the time of appointment and adherence to the regimen (with meals, before or after meals, at night). The patient should only take medicine in my presence. I distribute medicines to bedridden patients in the ward. I definitely warn patients about possible side effects of the drug, the body's reactions to taking the drug (discoloration of urine, feces) containing iron, carbolene, bismuth. Narcotic drugs, psychotropic and potent drugs of the "A" list are given to the patient separately from other drugs in the presence of a nurse. To avoid mistakes, before opening the package and ampoule, it is necessary to read aloud the name of the drug, its dosage and check it with the doctor's prescription.

· Inspection for head lice. Order of the Ministry of Health of the Russian Federation No. 342 dated 26.11.1998. "On strengthening measures for the prevention of epidemic typhus and the fight against head lice."

· If a patient detects the first signs of an infectious disease, I immediately inform the attending physician, isolate the patient and carry out the current disinfection in accordance with San PiN 2.1.3.263010 of 08/09/2010. "Sanitary and Epidemiological Requirements for Organizations Performing Medical Activities"

· Transfer of the shift according to the instructions of the ward nurse: the number of patients on the list with the indication of the ward, number of the medical history, diet; medical supplies: thermometers, heating pads, beakers; devices: nebulizer, glucometer, tonometer; medical preparations. In the presence of critically ill patients in the department, the change is carried out at the patient's bedside.

Related professions

During her work, she mastered such related professions as a nurse in a therapeutic, neurological department, an emergency room and a treatment room. I know the technique of sampling material for research:

Clinical (blood, urine, sputum, feces),

Biochemical (blood),

Bacteriological (blood, sputum, urine, feces, swabs from the nose and throat).

I am proficient in the technique of applying aseptic dressings, warming compresses, using an ice bladder, catheterizing the bladder with a soft catheter, staging cleansing, hypertonic, oil and therapeutic enemas. I know the technique of taking an electrocardiogram on a portable electrocardiograph EK1T - 07. I also know the technique of chest compressions and artificial lung ventilation. She mastered the technique of blood transfusion and blood substitutes, infusion therapy and injections: subcutaneous, intradermal, intramuscular and intravenous.

Emergencies

Diseases of the cardiovascular system, respiratory organs can be complicated by acute severe conditions:

Anaphylactic shock,

Acute myocardial infarction,

Hypertensive crisis,

Asthmatic status,

Pulmonary edema.

For the provision of emergency medical care in the treatment room there are syndromic sets of medicines and a nurse's action algorithm. All kits are timely checked and replenished with the necessary drugs.

The technology of providing first aid in case of emergency is as follows:

Anaphylactic shock

1. Information allowing to suspect anaphylactic shock:

Against the background or immediately after the administration of the drug, serum, insect bite, weakness, dizziness, shortness of breath, feeling of lack of air, anxiety, feeling of heat throughout the body appeared,

The skin is pale, cold, moist, breathing is rapid, superficial, systolic pressure is 90 mm Hg. and below. In severe cases, depression of consciousness and respiration.

2. Nurse tactics:

Daction	justification
1. Provide a doctor's call	To determine further tactics of providing medical care
2. If anaphylactic shock has developed with intravenous administration of a drug, then: 2.2 give a stable lateral position, remove the dentures 2.3 raise the foot end of the bed 2.4 give 100% humidified oxygen 2.5 measure blood pressure and heart rate	Reducing the dose of the allergen Prevention of asphyxia Improving blood circulation in the brain Decrease in hypoxia Condition monitoring
3. With intramuscular injection: Stop drug administration Place an ice pack at the injection site Provides venous access Repeat steps of the standard from 2.2 to 2.4 for intravenous administration	Slowdown of drug absorption

3. Prepare equipment and tools:

System for intravenous infusion, syringes, needles for intramuscular and subcutaneous injections, ventilator, set for intubation, Ambu bag.

Standard set of drugs "Anaphylactic shock".

4. Evaluation of the achieved: restoration of consciousness, stabilization of blood pressure, heart rate.

Myocardial infarction(typical painful form)

1.Information to suspect a medical emergency:

Severe chest pain, often radiating to the left (right) shoulder, forearm, shoulder blades or neck, lower jaw, epigastric region.

Possibly choking, shortness of breath, heart rhythm disturbances.

Taking nitroglycerin does not relieve pain.

2. Nurse tactics:

Actions	Justification
1. Call a doctor
2. Observe strict bed rest, calm the patient	Reducing physical and emotional stress
3. Measure blood pressure, pulse	Control condition
4. Give nitroglycerin 0.5 mg sublingually (up to 3 tablets)	Reduction of spasm of coronary arteries
5. Give 100% humidified oxygen	Reducing hypoxia
6. Take an ECG	To confirm the diagnosis
7. Connect to heart rate monitor	To monitor the dynamics of the development of myocardial infarction

3. Prepare equipment and tools:

As prescribed by a doctor: fentanyl, droperidol, promedol.

Intravenous system, tourniquet.

Electrocardiograph, defibrillator, cardiac monitor, Ambu bag.

4. Evaluation of progress: the patient's condition did not deteriorate.

Bronchial asthma

1.Information: the patient suffers from bronchial asthma

Choking, shortness of breath, difficulty exhaling, dry wheezing, audible at a distance, participation in the breathing of auxiliary muscles.

Forced position - sitting or standing with support on hands.

2. Nurse tactics:

Actions	Justification
1. Call a doctor
2. Reassure the patient	Reducing emotional stress
3. Sit with an emphasis on your hands to unbutton the embarrassing clothing	Reduce hypoxia
	Patient monitoring
5. Take 1-2 breaths from the inhaler, which is usually the patient uses.	Eliminate bronchospasm
6. Give 30-40% humidified oxygen	Reduce hypoxia
7. Give hot drink, take hot foot and hand baths	Reduce bronchospasm

3. Prepare equipment and instruments: system for intravenous administration, syringes, tourniquet, Ambu bag.

4. Evaluation of the achieved: reduction of shortness of breath, cumulative sputum discharge, reduction of wheezing in the lungs.

Sanitary and epidemic regime

In my work on the implementation of the sanitary and epidemiological regime in the department, I am guided by the following orders:

· Order No. 288 of the USSR Ministry of Health dated 03.23.1976. "On the approval of instructions on the sanitary and anti-epidemic regime of hospitals and on the procedure for the implementation by the bodies and institutions of the sanitary and epidemiological service of state supervision over the sanitary state of medical facilities."

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

· Law of the Russian Federation No. 52 of 30.03.1997. "On the sanitary and epidemiological well-being of the population."

· OST 42-21-2-85 "Sterilization and disinfection of medical devices."

· Order No. 342 of 26.11.1998. Ministry of Health of the Russian Federation "On strengthening measures for the prevention of epidemic typhus and the fight against head lice."

CaN PiN 2.1.7.728-99 from 22.01.1992. "Rules for the collection, storage and disposal of waste from medical institutions."

· SaN PiN 1.1.1058-01 "Organization and implementation of industrial control over the observance of sanitary rules and the implementation of sanitary and anti-epidemic (preventive) measures."

· SaN PiN 3.5.1378-03 "Sanitary and epidemic requirements for the organization and implementation of disinfection activities."

· Order No. 408 of 12.07.1983. Ministry of Health of the USSR "On measures to reduce the incidence of viral hepatitis in the country."

· SaN PiN 2.1.3.2630-10 "Sanitary and epidemiological requirements for organizations carrying out medical activities."

After performing the manipulations, all tools are subject to processing. Medical items for single use are subject to disinfection and disposal, reusable - processing in 3 stages: disinfection, pre-sterilization cleaning and sterilization in accordance with OST 42.21.2.85. to use disinfectants in the department, you must have the following document:

1. License,

2. Certificate of state registration,

3. Certificate,

4. Methodical instructions.

When disinfecting instruments and processing working surfaces, we use an oxygen-containing 30% solution of Peroxymed, which is also used for pre-sterilization cleaning, certificate of state registration No. 002704 dated 01.18.1996. after repeated bacteriological examination of the treatment room (tank, sowing air and flushing from work surfaces), a negative result was obtained, therefore, the work on disinfection is based on the use of this disinfectant. Since the microflora has become more stable in the external environment, it is recommended to replace the disinfectant every 6 months. For this purpose, disinfectants such as Clorsept and Javelin are used.

Table No. 2

Disinfection modes

At the workplace, for the disinfection of medical devices (thermometers, beakers, spatulas, tips), we use a 3% solution of Peroximed. All containers are clearly labeled with disinfectant, concentration and date of preparation. I prepare solutions, guided by the methodological instructions, using personal protective equipment. To treat hands when performing various manipulations in the department, antiseptics are used - Kutasept and Lizhen.

Infectious safety of healthcare workers

Infectious safety is a system of measures that ensures the protection of health workers from infectious diseases, which includes immunization, the use of protective clothing, compliance with instructions and rules when performing procedures, compliance with the rules of personal prevention, annual medical examination in accordance with Order No. 90 of the Ministry of Health of the Russian Federation of 03/14/1996. "On the procedure for conducting preliminary and periodic examinations of medical workers and medical regulations and admission to work." In the context of the increasing spread of HIV infection among the population, all patients must be considered as potentially infected with HIV and other infections transmitted by blood contact, therefore, when working with blood and other biological fluids, it is necessary to observe 7 safety rules:

1. Wash hands before and after patient contact.

2. Treat the patient's blood and other body fluids as potentially infectious, therefore it is necessary to wear gloves.

3. Immediately after use and disinfection, place the used instrument in special yellow bags - class B waste. SaN PiN 2.1.7.728-99 "Rules for the collection, storage and disposal of waste in health care facilities."

4. Use eye protection (goggles, protective screen) and masks to avoid contact of blood and other biological fluids with the skin and mucous membranes of the medical staff.

5. Treat all blood-contaminated laundry as potentially infectious.

6. Use special moisture-proof clothing to protect the body from blood drops and other biological fluids.

7. Treat all laboratory specimens as potentially infectious material.

In order to prevent infection with HIV and viral hepatitis, I follow the rules of infectious safety recommended in the orders:

· Order of the Ministry of Health of the Russian Federation No. 170 of 08.16.1994. "On measures to improve the prevention and treatment of HIV infection in the Russian Federation."

· Order of the Ministry of Health of the Russian Federation No. 408 of 12.07.1989. "On measures to reduce the incidence of viral hepatitis in the country."

· Order of the Ministry of Health of the Russian Federation No. 254 of 3.09.1991. "On the development of disinfection business in the country"

· Order of the Ministry of Health of the Russian Federation No. 295 of 30.10.1995 "On the introduction of the rules for mandatory medical examination for HIV and the list of employees of certain professions, industries, enterprises, institutions and organizations that undergo mandatory medical examination for HIV."

· Instructional and methodological instructions of the Ministry of Health of the Russian Federation "Organization of measures for the prevention and control of AIDS in the RSFSR" dated 22.08.1990.

· CaN PiN 3.1.958-00 “Prevention of viral hepatitis. General requirements for epidemiological surveillance of viral hepatitis ".

If a biological fluid gets on open skin areas, it is necessary:

Treat with 70% alcohol

Wash your hands with soap and water

Re-treat with 70% alcohol

In case of contact with the mucous membrane of the eyes, it should:

process (rinse abundantly) with a 0.01% solution of potassium permanganate.

On contact with the nasal mucosa:

wash with 0.05% potassium permanganate solution or 70% alcohol.

For cuts and injections, you must:

Wash gloved hands with soap and running water

Take off gloves

Wear a clean glove on your intact hand

Squeeze blood out of the wound

Wash your hands with soap

Treat the wound with 5% iodine solution. Do not rub!

Table No. 3

Composition of the first-aid kit "Anti-AIDS"

P / p No.	Name	amount	Type of packaging	Storage period	Appointments
	Alcohol 70% -100 ml.		Bottle with tight stopper	Not limited	For rinsing the mouth, throat, skin treatment
	Manganese-sour potassium (2 weighed portions of 0.05 mg.)		Pharmacy, penicillin bottle	Indicated on the package	To prepare a solution of potassium permanganate to the norm for the purpose of washing the eyes, nose, throat
	Purified water (distilled)				For dilution of potassium permanganate for rinsing eyes, nose
	Capacity 2 pcs. (100ml and 500ml.)				For dilution of potassium permanganate
	Glass stick				To stir the solution
	5% iodine alcohol solution 10 ml.		Factory packaging	Indicated on the package	Damaged skin treatment
					For opening the bottle and other purposes
	Bactericidal adhesive plaster		Factory packaging	Indicated on the package	Sealing the injection site of the cut
	Sterile gauze swabs or sterile gauze wipes 14 * 16		Laminated packaging	Indicated on the package	For processing leather, dressing gown, gloves, surfaces
	Eye pipettes				For washing eyes (2pcs), nose (2pcs)
	Medical beakers 30 ml.				For 0.05% solution of potassium permanganate for washing eyes, nose
					For rinsing the mouth, throat
	Sterile gloves (pair)		Factory packaging	Indicated on the package	Instead of damaged
	Sterile bandage		Factory packaging	Indicated on the package	For aseptic dressing

The first aid kit "Anti AIDS" is located in the treatment room, always available. Expired medicines are replaced in a timely manner. The algorithm for the action of a medical worker in emergency situations during procedures is also in the treatment room. Emergency situations, as well as preventive measures taken, are subject to registration in the journal "Emergencies due to contamination with biological fluids". In cases of contamination, the head of the department should be notified and immediately contact the center for the prevention and control of AIDS at Cherkasskaya, 2. There were no emergencies during the reporting period.

Processing of medical instruments

The processing of medical instruments is carried out in 3 stages:

Processing stages

disinfectionpre-sterilizationsterilization

treatment

Disinfection- a set of measures aimed at destroying pathogenic and opportunistic microorganisms in the external environment in order to interrupt the transmission routes of pathogens of infectious diseases.

Disinfection methods

physicalchemical

drying, airpresence of highapplicationdisinfectants

temperatures, exposure to steamfunds

With the chemical method of disinfection, the disassembled spent instruments are completely immersed in a disinfectant using a drowner for 60 minutes.

Pre-sterilizationcleaning - it is the removal of protein, fatty, medicinal contaminants and residues of disinfectants from medical devices.

Manual pre-sterilization treatment:

Stage 1 - rinsing the instrument under running water for 30 seconds.

Stage 2 - complete immersion of the items in a 0.5% washing solution for 15 minutes. at a temperature of 50 *

detergent solution components:

Hydrogen peroxide

Synthetic detergent (Progress, Lotus, Aina, Astra)

Table No. 4

The ratio of the components in the washing solution

The detergent solution can be used up to 6 times during the day if the solution has not changed color.

Stage 3 - washing each instrument in the same solution for 30 seconds.

Stage 4 - rinsing with running water for 5 minutes.

Stage 5 - rinsing each instrument in distilled water for 30 seconds.

Quality control of pre-sterilization treatment is carried out in accordance with the order of the Ministry of Health of the Russian Federation No. 254 dated 03.09.1991. "On the development of disinfection business in the country." Inspection is performed on 1% of the total number of instruments, but not less than 3-5 products of the same name.

Azopyram test -identifies the remains of blood and chlorine-containing oxidants. A working solution consisting of equal proportions of azopyram and 3% hydrogen peroxide solution is applied to the instrument and the result is assessed after a minute. The appearance of a purple color indicates the presence of blood residues on the instrument.

Phenolphthalicsample -allows you to identify residual detergent. 1% alcoholic solution of phenolphthalein is evenly applied to the product. If a pink color appears, then there are residues of detergent on the product. In this case, the entire tool is reprocessed. If the sample is negative, the processed material must be sterilized. Pre-sterilization processing of medical instruments is not carried out in our department, because we work with disposable medical items, which are disinfected and disposed of in accordance with CaN PiN 3.1.2313-08 of 15.01.2008. "Requirements for the disinfection, destruction and disposal of single-use injection syringes."

Sterilization -this is a method that ensures the death of all vegetative and spore forms of pathogenic and non-pathogenic microorganisms.

All instruments that come into contact with the wound surface, that come into contact with blood or injectables, as well as diagnostic equipment that come into contact with the patient's mucous membrane are sterilized.

Table No. 5

Sterilization methods

Sterilization methods	Sterilization mode	Sterilization material	t* mode	Type of packaging	Sterilization time
	Autoclave	Textiles, glass, corrosion-resistant material
	Autoclave	Rubber, polymer products		Bix, craft package
Air	Tendon cabinet	Medical instruments		Open container
Air	Tendon cabinet	Medical instruments		Open container, craft bag

Sterilization control:

1. Visual - at the work of the equipment;

2. Thermal indicators of sterility.

3. Temperature control with technical thermometers.

4. Biological - using biotests.

The chemical method of sterilization is the use of chemicals for the prevention of infectious diseases during endoscopic manipulations. For sterilization of endoscopes, Lysopharmine 3000 8% solution is used at a temperature of 40 *, exposure is 60 min, then it is washed twice with sterile water, dried with a sterile napkin, and the channels are purged. Store endoscopes in a sterile wipe. For sterilization of metal products (burs) and plastics (enema tips), hydrogen peroxide 6% is used

At a temperature of 18 * - 360 min.,

At a temperature of 50 * - 180 min.

Then it is washed twice with sterile water and stored in a sterile box lined with a sterile sheet.

Guyhyenic education of the population

Hygienic education of the population is one of the forms of disease prevention. A healthy lifestyle: giving up bad habits, playing sports strengthens health, which allows you to avoid diseases of the respiratory system, cardiovascular system, and musculoskeletal system. Compliance with the regime of work, rest and nutrition reduces the risk of exacerbation of diseases of the gastrointestinal tract. Observance and implementation of the rules of personal hygiene prevents infection with infections such as HIV, hepatitis B, C. I carry out work on hygienic education among patients while on duty in the form of conversations.

Table 6

Topics of conversation

P / p No.	Subject	Reporting 2010	Previous 2009
	Personal hygiene of patients
	Hospital stay
	GHF and its implications for the prevention of tuberculosis
	Healthy lifestyle. Fighting bad habits
	Prevention of acute intestinal infections
	Prevention of HIV infection and viral hepatitis
	Risk factors for cardiovascular disease

Appendix N ___
to the employment contract

APPROVED
__________________________
(FULL NAME.)

General director
__________________________
(name of company)

JOB DESCRIPTION
neurological nurse

1. GENERAL PROVISIONS

The main tasks of a nurse in a neurological office are to carry out medical and diagnostic prescriptions of a neuropathologist in a polyclinic and to help him organize specialized care for the population living in the area of \u200b\u200boperation of the polyclinic, as well as workers and employees of attached enterprises. The appointment and dismissal of the nurse of the neurological office is carried out by the chief physician of the polyclinic in accordance with the current legislation. The nurse of the neurological office reports directly to the neurologist and works under his direction. In her work, a nurse of a neurological office is guided by this job description, as well as guidelines for improving the activities of nurses in outpatient clinics.

2. FUNCTIONAL RESPONSIBILITIES

To perform her functions, a nurse of a neurological office must:
2.1. Prepare workplaces before an outpatient visit to a neuropathologist, controlling the availability of the necessary medical documentation, equipment, inventory, checking the serviceability of equipment and office equipment.
2.2. Prepare and submit to the registry self-registration sheets of patients, coupons for an appointment with a doctor for the current week.
2.3. Before the start of the reception, bring the medical records of outpatients, selected by the registrars in accordance with the self-recording sheets, from the storehouse.
2.4. Monitor the timely receipt of research results and paste them into the medical records of outpatients.
2.5. Regulate the flow of visitors by recording the appropriate time in self-registration sheets for repeat patients and issuing coupons to them.
2.6. To help patients, as directed by a doctor, prepare for examination and examination during an outpatient appointment.
2.7. Inform the card store about all cases of transfer of medical records of outpatients to other offices in order to make a corresponding entry in the substitute card.
2.8. Keep records of dispensary patients, participate in dispensary and other preventive examinations.
2.9. To systematically improve their qualifications by studying the relevant literature, participating in conferences, seminars.
2.10. Participate in carrying out sanitary and educational work among patients.
2.11. Explain to patients the methods and procedures for preparing for laboratory, instrumental and instrumental studies.
2.12. Prepare medical documentation under the supervision of a doctor: referrals for consultation and auxiliary offices, statistical coupons, health resort cards, extracts from medical records of outpatients, temporary disability certificates, certificates of temporary disability, referrals to MSEC, control cards of dispensary observation, work diary nurses, etc.

3. RIGHTS

The nurse of the neurological office has the right to:
3.1 Submit the requirements of the polyclinic administration to create the necessary conditions at the workplace, ensuring the high-quality performance of their duties;
3.2 take part in meetings (meetings) when discussing the work of the neurological office;
3.3 to receive the necessary information to fulfill their functional duties from a neuropathologist, the head nurse of the department (responsible for the office), the head nurse;
3.4 require visitors to comply with the internal rules of the clinic;
3.5 master a related specialty;
3.6 give instructions and supervise the work of the junior medical personnel of the neurological office;
3.7 improve their qualifications at workplaces, refresher courses, etc. in the prescribed manner.

4. LIABILITY

Evaluation of the work of a nurse in a neurological office is carried out by a neuropathologist, the head (senior) nurse on the basis of taking into account her fulfillment of her functional duties, compliance with internal regulations, labor discipline, moral and ethical standards, and social activity. The nurse of the neurological office is responsible for the unclear and untimely fulfillment of all points of this instruction. The types of personal liability are determined in accordance with applicable law.

This job description was developed in accordance with
Regulation on ______________ (number, date of the document).

Head of structural unit
___________________________
"__" _______ 200 _ g.

AGREED:
Head of the legal department ___________________________
"__" _______ 200 _ g.

Read the instructions: ___________________________
"__" _______ 200 _ g.

The material is posted on the website HRM.RU

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