Official instruction doctor Obstetrician gynecologist of the maternity branch. Official instruction doctor of the obstetrician-gynecologist

In its specialty, an obstetrician gynecologist should know modern methods prevention, diagnosis, treatment and rehabilitation; content and sections of obstetrics and gynecology as independent clinical disciplines; tasks, organization, structure, states and equipment of the obstetric and gynecological service; existing regulatory and guidance and methodological documents in the specialty; rules for registration of medical records; The procedure for conducting examination of temporary disability and medical and Social Examination; Principles of planning activities and reporting of obstetric and gynecological service; Methods and procedure for monitoring its activities. 4. An obstetrician-gynecologist is appointed and dismissed by the order of the LPU chief physician in accordance with the current legislation of the Russian Federation. five.

Official instruction of the doctor of the obstetrician-gynecologist of the maternity hospital

Gives recommendations on the employment of pregnant women, which will exclude the influence of production intories. 2.11. Takes part in conducting preliminary medical examinations upon admission to work and periodic medical examinations.

It takes a timely taking on dispensary records and dynamic observation of gynecological patients, conducting a complex of medical and recreational activities using sanatorium-resort treatment, as well as other means and methods of examination and treatment, analysis of the effectiveness of the dispensarization. Reveals gynecological patients who need inpatient treatment.

Official instructions

Conducts the following operations and manipulations: - colposcopy; - diagnostic scraping of the uterine cavity; - scraping of the uterus in the interruption of pregnancy; - classic manual allowance; - Extraction of the fetus; - obstetric tongs; - Massage of the uterus in its atony; - cesarean section; - sewing cervical break, vagina, crotch; - manual separation and the selection of the last, manual control of the uterine cavity; - Lapotomy with ectopic pregnancy and twist the cyst of the ovary; - rear axle puncture; - hydrotubation; - amniotomy; - hysterosalpingography; - amputation of the uterus; - aiming biopsy; - removal of a polyp mucosa of the cervix; - Catheterism bladder; - probing the stomach; - siphon enema; - Veneziction, intravenous infusion, blood transfusion. 2.6. Experts temporary disability.
2.7.

A doctor who has made a specialization in obstetrics and gynecology, and has experience in the field of this specialty, is adopted for the position of doctor of the Acoucher-Gynecologist. 1.3. The doctor an obstetrician-gynecologist is hired and dismissed.
(Position) 1.4. An obstetrician-gynecologist must apply in practice the principles of the scientific organization of labor, actively use electronic computing and medical and diagnostic techniques in relation to the profile of its activities, be able to navigate in modern scientific and technical information, to effectively use it to solve practical problems, to show ini - cytiv, principle and conscientiousness in work, promote healthy image Life and himself follow its principles. 1.5.

Official instruction of an obstetrician-gynecologist

Important

Conducts an in-depth analysis of incidence with temporary disability due to gynecological diseases and complications. 2.16. Participates in conducting medical and labor expertise to determine the working capacity of the patient.

Info

Complies with the principles of medical ethics and deontology. 2.20. If necessary, has emergency obstetric and gynecological assistance, including emergency promptual help Newborn.

Attention

In a timely manner and qualified executes orders, orders and instructions of the management of the institution 2.22. Complies with the rules of the indoor routine. 2.23. Compliance with the rules of labor protection, industrial sanitation and safety III.

Functional responsibilities of the doctor of the obstetrician - hospital gynecologist:

An obstetrician-gynecologist is directly subordinated to the head of the department (women's advice), and with his absence to the head of the LPU or his deputy. 2. Official duties have a qualified medical care By its specialty, using modern methods of prevention, diagnosis, treatment and rehabilitation, allowed for use in medical practice. Determines the tactics of the patient in accordance with the established rules and standards. Develops a patient survey plan, clarifies the volume and rational methods of the patient's survey in order to obtain full and reliable diagnostic information in the lowest time.

Based on clinical observations and surveys, the collection of history, data of clinical and laboratory and tool Research Sets (or confirms) the diagnosis.
Operations and manipulation 2.1. An obstetrician-gynecologist performs the following operations and manipulations: - colposcopy; - diagnostic scraping of the uterine cavity; - scraping of the uterus in the interruption of pregnancy; - classic manual allowance; - Extraction of the fetus; - obstetric tongs; - Massage of the uterus in its atony; - cesarean section; - sewing cervical break, vagina, crotch; - manual separation and selection of last, manual control of the uterine cavity; - laparotomy with ectopic pregnancy and twist the cyst of the scrambled eggs; - rear axle puncture; - hydrotubation; - amniotomy; - hysterosalpingography; - amputation of the uterus; - aiming biopsy; - removal of a polyp mucosa of the cervix; - the catheterization of the bladder; - probing the stomach; - siphon enema; - Veneziction, intravenous infusion, blood transfusion. 3. Official duties 3.1.

Official instruction doctor of the obstetrician-gynecologist

To give instructions to the subordinate to him by Middle and younger medical professionals, make proposals to encourage these workers or imposing disciplinary penalties. 3.10. [Other rights stipulated by the labor legislation of the Russian Federation]. 4. Responsibility doctor obstetrician-gynecologist of the maternity hospital is responsible: 4.1. For non-fulfillment, improper execution of the duties stipulated by this Instruction, within the limits of the labor legislation of the Russian Federation. 4.2. For the offenses committed in the process of carrying out their activities - within the limits defined by the current administrative, criminal and civil law of the Russian Federation. 4.3. For causing material damage to the employer - within the limits defined by the current labor and civil law of the Russian Federation.

Official instruction of the doctor of an obstetrician-gynecologist of the hospital

Of the Russian Federation - the rules of the internal labor regulation; 1.6. During the absence of midwives (travel, vacation, illness, etc.), its obligations in the prescribed manner performs an appointed person carrying full responsibility for their proper performance.

II. Official duties doctor-obstetrician-gynecologist: 2.1. Has a permanent, emergency and urgent qualified medical care to the population in its specialty using modern methods and methods of prevention, diagnosis, treatment and rehabilitation, allowed for use in medical practice.
2.2. Daily examines the patient in the hospital. 2.3. Organizes and independently conducts special diagnostic studies and interprets their results. 2.4. Depending on the patient's condition, changes in the treatment plan and determines the need for additional examination methods. 2.5.

Official instruction of the doctor of the obstetrician-gynecologist of the day hospital

The doctor of the obstetrician gynecologist of the maternity hospital should be able to determine the diagnosis and carry out the necessary treatment when next diseases: - ectopic pregnancy; - Complete abortion; - genital tuberculosis; - inflammatory diseases female genital organs of septic etiology; - anomalies of the position of the genital organs; - Gonorrhea in women; - trichomoniasis of urinary organs; - Domor monomic diseases; - benign tumors uterus and appendages; - malignant tumors uterus and appendages. 2. Official duties doctor obstetrician-gynecologist of the maternity hospital: 2.1.

Provides qualified medical care in the specialty "Obstetrics and Gynecology", using modern methods of diagnosis, treatment, prevention and rehabilitation. 2.2. Determines the tactics of the patient in accordance with the established standards.

2.3. Sets (or confirms) the diagnosis. 2.4.

Provision of primary health obstetric and gynecological assistance to women during pregnancy, in the postpartum period, preparing for pregnancy and childbirth, breastfeeding;

Dispensary observation of pregnant women, incl. Allocation of women "risk groups" in order to prevent and early detecting complications of pregnancy, childbirth and postpartum period;

Rendering qualified medical care pregnant and women with gynecological diseases using modern medical technologies, including in a day hospital and house (hospital at home);

The examination of gynecological patients in accordance with the standards for medical care, including rehabilitation;

Conducting examination of temporary disability on pregnancy, childbirth, due to gynecological diseases, the definition of the need and timing of the temporary or continuous translation of the employee for other work, the direction in the prescribed manner to the medical and social examination of women with signs of the resistance of disability;

Sanitary and educational work;

Providing medical and social, legal and psychological assistance;

Interrupting pregnancy in early deadlines (when menstruation delay no more than 20 days), as well as the implementation of small gynecological operations using modern medical technologies (hysteroscopy, laser, cryotherapy, etc.);

Ensuring interaction in the examination and treatment of pregnant women, pupils, gynecological patients between women's consultation and other medical and prophylactic institutions (skin-venereological, oncological, psycho-neurological, drug treatment, anti-tuberculous dispensaries, etc.), territorial fund of compulsory medical insurance, insurance companies, Regional Office of the Social Insurance Fund of the Russian Federation.

Women's consultation carries out its work on the precinct principle. One obstetric and gynecological site geographically includes approximately 2 therapeutic sites (3300 women over 15 years old). A woman can be given the right to choose a doctor at her wishes. In order to optimize continuity, it is recommended to observe women during pregnancy and after delivery by the same doctor. Help at home pregnant, maternity hospitals and gynecological patients with the attending or duty doctor of female consultation. Help at home is carried out on the day of the call. After visiting the woman, the doctor makes an appropriate entry into the primary medical records. Therapeutic and diagnostic manipulations at home are carried out by middle medical personnel (as appointing a doctor). The load of the obstetrician-gynecologist on an outpatient reception is 5 women per hour, during a survey at a house of 1.2 people per hour. The duration of the working day is 6.5 hours at a 5-day work week. The function of the medical position of the obstetrician-gynecologist ranges from 7,000 to 8,000 visits per year.

The work of the female consultation is organized by ensuring the maximum availability of outpatient obstetric and gynecological assistance to the female population. In women's consultations, work time is recommended from 8 to 20 hours; On Saturday, pre-holiday and holidays - from 8 to 18 hours. Emergency obstetric and gynecological care is provided by specialized departments of hospitals or maternity homes. Information about the hours of work of women's consultation, the schedule of receptions of the doctors of all specialties, therapeutic and diagnostic cabinets, the work of the motherhood school is posted at the registry. It should be provided with the possibility of self-copying to the doctor or visiting a doctor with a coupon on hand. Recording to specialists and for examination may be preliminary. In accordance with these recordings, the midwives prepares the necessary documentation for receiving.

The main structural division of the medical and preventive part of the women's consultation are the cabinets of district doctors of obstetrician-gynecologists. The task of the doctor of the obstetrician-gynecologist of the female consultation is to provide qualified outpatient obstetric and gynecological assistance to the population of the site in women's consultation and at home.

Functional duties of the obstetrician-gynecologist of women's advice:

Conducting medical and preventive measures aimed at preventing pregnancy complications, postpartum period, gynecological diseases based on modern achievements science and practice;

Early registration of pregnant women (up to 12 weeks of pregnancy) and dispensary observation;

Identification of pregnant women who need hospitalization in the departments of the pathology of pregnancy maternity homes and other medical and preventive institutions for the disease profile (extragenitial, endocrine diseases, immunoconsflicts, etc.);

Conducting classes on psychoprophylactic and physical preparation of pregnant women and attracting them for training in the "School of Mothers";

Organization and conduct of preventive gynecological examinations of women using modern methods of examination (colposcopy, cytology, etc.) with the aim of early detection and treatment of gynecological diseases; Identification of gynecological patients in need of inpatient treatment and preparation for their hospitalization;

The examination of gynecological patients (timely taking into account the recovery of contingents, conducting therapeutic and health events);

Organization of abortion (the use of modern contraceptives in order to prevent undesirable pregnancy, etc.);

Timely provision of pregnancy and childbirth in accordance with the current legislation; hospital sheet in cases of temporary disability;

Conducting sanitary and educational work among the population and the organization of a sanitary asset on its site;

Systematic increase in their professional qualifications and the implementation of new treatments, advanced and organizational forms of work. Qualitative maintenance of accounting medical records;

Visiting patients on the day of receipt of the challenium with the provision of medical care at home and further medical supervision to recovery, hospitalization or permission to attend women's advice;

The implementation of successive connections with the maternity hospital, clinic and other medical preventive institutions (anti-tuberculosis, skin-venereological, oncological dispensaries, etc.).

An obstetrician-gynecologist has the right: to produce sick leave in accordance with the current instruction; give instructions to subordinate to him by middle and younger medical workers; control the correctness and timeliness of the implementation by the Middle Medical Healthcare Office for the Treatment of Pregnant and Gynecological Patients; To make proposals for the promotion of medium and younger health workers or imposing disciplinary penalties for individual omissions in the work or violation of the rules of the internal labor regulation.

When organizing medical care, pregnant women are important (up to 3 months) take them on accounting, dynamic observation of their health. The provision on the organization of the treatment of pregnant women and herds is approved by the Order of the Ministry of Health and Social Development of the Russian Federation on March 30, 2006 (No. 224). According to this provision, the dispensary observation of pregnant women and the maternity hospitals is carried out by obstetrician-gynecologists of women's consultations and obstetric and gynecological offices of medical and preventive institutions and includes:

Inspection with the required volume of clinical and laboratory and instrumental research;

Assessment of health status, the implementation of dynamic observation; timely identification of complications of pregnancy and postpartum period;

Identifying pregnant women and pupils in need of hospitalization in day hospitals, branches of pregnancy pathology of branching institutions and other units of medical and preventive institutions for the profile of obstetric and extragenital pathology;

Timely detection of malformations of the fetus using biochemical screening of serum markers of the mother's blood markers in the first or second trimesters of pregnancy and three-time ultrasound examination in the order of the Ministry of Health of the Russian Federation of December 28, 2000 No. 457 "On the improvement of prenatal diagnosis in the prevention of hereditary and congenital diseases children ";

Patronage of pregnant and herds;

Conducting physical and psychoprophylactic preparation of pregnant women to childbirth, the formation of motivation in a pregnant woman and family to the birth and education of a healthy child;

The implementation of the sanitary and hygienic education of pregnant women on breastfeeding issues, prevention of abortion and diseases of the reproductive system;

Conduct a complex of necessary medical and preventive, rehabilitation and social events to preserve and restore the health of pregnant women and herds;

Ensuring the interaction of women's consultation (obstetric-gynecological cabinets) with other medical and preventive institutions (outpatient polyclinical institutions, skin-venereological, drug treatment, anti-tuberculosis dispensaries, centers for the prevention and control of AIDS and infectious diseases, etc.) during survey and the treatment of pregnant women and herds.

In the physiological course of pregnancy, the inspections are conducted by an obstetrician-gynecologist - at least ten times, a physician-a-therapist - at least two times, a doctor-oculist, a doctor-otolaryngologist, a dental physician - with a primary circulation. The frequency of laboratory and other diagnostic studies is established in accordance with the following scheme: a clinical analysis of blood is 3 times (at the first visit, under a period of 18 and 30 weeks), urine analysis for each visit, microscopic separated from the vagina - twice, determination of blood type, RH factor (with rhesse-negative accessories - a husband's examination), blood test to the Vasserman reaction - 3 times, blood test for HIV - 2 times, ultrasound -3 times (under a period of 10-14 weeks, 20-24 weeks, 32- 34 weeks). The detection of markers of herpes-infections and toxoplasmosis is carried out.

With a complicated course of pregnancy, the number of inspections by the doctor obstetrician-gynecologist and other specialist physicians, as well as the volume of laboratory studies is determined taking into account the health of the pregnant woman and the fetus.

In hard-to-reach and remote areas, in rural areas, in the absence of a doctor-obstetrician-gynecologist, the dispensary observation, the patronage of pregnant women and their birthrods can be carried out by a general practitioner (family doctor). When observing a woman with a physiological course of pregnancy at a general practitioner (family doctor), a pregnant woman visiting an obstetrician-gynecologist is carried out 6-8 times during pregnancy.

With a complicated course of pregnancy and the postpartum period, a general practitioner (family doctor) directs pregnant women and herds to specialist physicians (doctor-accepher-gynecologist, doctor-cardiologist and others). Removal from the dispensary accounting of herds in the physiological course of the postpartum period is carried out by a general practitioner (family doctor). In the presence of obstetric or extragnenital pathology (or residual phenomena After her), the decision of the issue of removal from the dispensary accounting of herds is carried out by an obstetrician-gynecologist or an appropriate physician.

All data of the survey and clinical laboratory research, as well as recommendations and appointments, should be recorded by the doctor in the "individual map of the pregnant and the parental" with each visit and subscribe to them. "Individual maps of the pregnant and the parental" are stored in the office of each doctor of the obstetrician-gynecologist in the card file by date of the next visit. The maps of giving birth should also be highlighted in the card file; Women to be patronizing, and pregnant, hospitalized in the hospital. For patronage, women who did not appear on the designated term are selected. The patronage at home is made by midwife for the appointment of a doctor. For inspection at home, the midwife must have a tonometer, a phonenendoscope, a centimeter tape, an obstetric stethoscope or a portable ultrasonic apparatus. Records of the results of a patronage visit to the midwife are entered into the "individual map of the pregnant and the parental" and are recorded in the "notebook of accounting for work at the house of the district (patronage) medical sister (midwife). In the most difficult cases, the patronage at home is carried out by the doctor an obstetrician-gynecologist.

Psychophysical preparation of pregnant women and motherhood is carried out both individually and in groups. The most promising and effective form of classes is family preparation for the birth of a child, aimed at attracting family members to active participation in prenatal preparation. In women's consultation, it is recommended to use traditional methods for psychophysical preparation of pregnant women to childbirth, as well as training for personal hygiene rules, preparation for future childbirth and child care in "Maternity schools". At the same time, demonstration materials, visual benefits, technical means and objects of child care are used. Direct assistants of doctors when conducting classes in the "Maternity School" are midwives and medical sisters that have gained special training. To visit the "motherhood school" should attract all women with the I trimester of pregnancy, it is desirable together with future fathers or close relatives. When conducting classes for certain days of the week, it is advisable to form groups with no more than 10-15 people, it is desirable to unite women with the same pregnancy. To actively attract future fathers, as well as other family members in training for preparing for childbearing in women's consultations, it is necessary to provide accessible information about programs and time of classes.

Women's consultation Along with the Center for Family Planning and Reproduction is an important link in the prevention of abortion, ensuring advice on reproductive health and individual selection and methods of contraception. The work on family planning work is carried out by doctors of obstetrics-gynecologists and midwives, having special training. Reception is carried out on schedule. Time to receive the patient is not limited and is determined individually in each case. The specialized office (reception) on family planning is equipped with audio and video equipment, with demonstration of contraceptive means, visual benefits, printed information materials for the population on family planning and abortion prevention.

In order to inform the obstetric hospital about the state of the health status, the peculiarities of the course of pregnancy, a female consultation doctor issues each pregnant woman under a pregnancy time of 32 weeks "Maker's home exchange card". These subsequent inspections and research are recorded at each of its visits to the women's consultation.

Socio-legal assistance to women turns out to the legal advisory counseling. In accordance with the order of the Ministry of Health, one position of the legal adviser stands out for women's consultation with the number of medical posts 5 or more. An important sections of the work of the Legal Counsel include: work with parents, evading their duties, the provision of legal assistance in the search for parents, when collecting alimony, settlement of family conflicts, the establishment of paternity, assisting a woman when appointing benefits (lonely, large, low-income, etc. .), and etc.

In the States of women's consultation it is recommended to introduce social workers. The social worker participates in the work on the protection of reproductive health and family planning. Its main task is to work with teenagers, young people and women of a social risk group to prevent non-planned pregnancy, sexually transmitted infections.

The detection of gynecological diseases is carried out in women's consultation during preventive inspections and by treatment. For each woman who applied or aimed at female consultation, the "Medical Card of Ambulator Patient" will start. In women's consultations, both an outpatient treatment of gynecological patients and in a day hospital, as well as in specialized medical and preventive institutions. Day hospitals are organized with female consultations, maternity hospitals (branches), perinatal centers with an appropriate material and technical base and personnel. The recommended day of the day hospital is at least 5-10 beds. To ensure a full-fledged therapeutic and diagnostic process, the duration of the patient's stay in the day hospital should be at least 6-8 hours. On the patients of the day hospital, the map of the patient's day hospital polyclinic, hospital at home, day stay in the hospital ".

A number of small gynecological operations and manipulations are performed in the day hospital: aspiration of the contents of the uterine cavity for cytological research; hysterosalpingography, hysteroscopy; Knife biopsy cervix; Destructive methods of treating benign diseases of the cervical (diathermocoagulation, cryodestruction, laser coagulation) in the absence of a malignant process, etc. Control over the quality of medical care gynecological patients is carried out by the head physician (head) of women's consultation. For this purpose, there is a medical documentation for about 50% of patients accepted by the obstetrician-gynecologist during the month, examination of the management of "control cards of dispensary observation" and "medical cards of an outpatient patient" is carried out. It is estimated to comply with the regularity of inspections, the volume of preventive, diagnostic and medical measures carried out, the presence of epicrosis, as well as the effectiveness of the treatment.

Family stay hospitals in female consultations can also be used to hospitalize pregnant women whose condition does not require round-the-clock observation and treatment. Indications for the selection of pregnant women for hospitalization in the day stay hospital are the following diseases: Vegeth-vascular dystonia and hypertonic disease in I and II trimesters of pregnancy; aggravation of chronic gastritis; anemia (reduced hemoglobin not less than 90 g / l); Early toxicosis in the absence or presence of transient ketoneuria; The threat of interrupting pregnancy in I and II trimesters in the absence of a history habitual miscarriage and saved neck of the uterus. Pregnant women can be hospitalized in a day hospital for a medical and genetic survey, including invasive methods (amniocentesis, chorion biopsy, etc.).

Approximate routine of the day of the daily stay of pregnant women:

8.00 - 8.30 - Admission to the hospital

8.30 - 9.15 - Breakfast

9.15 - 12.00 - Medical traversal, appointment

12.00 - 12.30 - Second breakfast

12.30 - 14.00 - Implementation of appointments, leisure of pregnant women

14.00 - 14.45 - Lunch

14.45 - 17.00 - pregnant women

17.00 - 18.00 - extract from the hospital; Sanitary cleaning of rooms

With the deterioration of the course of the disease and the need for round-the-clock medical surveillance, pregnant is immediately translated into the appropriate department of the hospital.

Accounting documentation for women's advice:individual map of pregnant and parental, medical card outpatient patient, static coupon, disability sheet, exchange card, emergency infectious disease notification, control map of dispensary observations, doctor's diary Polyclinic.

Analyze the activities of women's consultation on the annual report. Along with general indicators, characteristic of any outpatient polyclinic institution, calculate special performance indicators of women's advice: early coverage of pregnant women (up to 12 weeks), the share of pregnant women who enrolled with late terms (after 28 weeks) pregnancy; The frequency of errors in determining the date of delivery, the average number of visits to pregnant consultations to childbirth, indicators of the gynecological morbidity of women, etc.

Methods for calculating and analyzing special indicators

women's Consultation Activities

Early coverage of pregnant women with dispensary observation

The number of pregnant women who are surveiled with a period of up to 12 weeks of pregnancy × 100

The number of all pregnant women who enrolled for women's advice

The indicator reaches 80-90% is considered good - more than 70%.

2. The proportion of pregnant women inspected by the therapist

Number of pregnant women inspected by therapist × 100

Normally, the indicator is 100%. The therapist pregnant woman is observed at least two times.

The share of pregnant women inspected by the therapist up to 12 weeks of pregnancy

Number of pregnant women inspected by therapist up to 12 weeks of pregnancy × 100

The number of completed pregnancy by childbirth + abortions in the reporting year

The therapist for women's consultation should examine all (100%) women in the first half of pregnancy and preferably up to 12 weeks of pregnancy.

The proportion of pregnant women surveyed on the Vasserman reaction

The number of pregnant women surveyed to the Vasserman reaction × 100

Number of completed pregnancy clan + abortions

Normally, the indicator is 100%. Blood on the reaction of Wasserman is analyzed - 3 times.

Added to the site:

Job description Doctor of the obstetrician gynecologist of the maternity hospital[name of company]

This job description was developed and approved in accordance with the provisions, the provisions on the doctor of the obstetrician-gynecologist of the hospital, approved. By order of the USSR Ministry of Health of April 8, 1980 N 360, the order of the USSR Ministry of Health of July 21, 1988 N 579 "On approval of the qualification characteristics of specialist doctors", qualifying reference book positions of managers, specialists and employees, section "Qualification characteristics of posts of workers in the field of health care", approved. Order of the Ministry of Health and Social Development of the Russian Federation of July 23, 2010 N 541n, a list of industries, shops, professions and positions with harmful working conditions, the work in which it gives the right to additional leave and a shorter working day, approved. Resolution of the State Protection of the USSR and the Presidium of the WCSPS of October 25, 1974, N 298 / P-22, and other regulatory and legal acts regulating labor relations.

1. General Provisions

1.1. The doctor of the obstetrician gynecologist of the maternity hospital belongs to the category of specialists and directly subordinate [the name of the post of direct supervisor].

1.2. At the position of doctor of the obstetrician gynecologist of the maternity hospital, a person with a higher professional education is made in the specialty "Therapeutic case", "Pediatrics", postgraduate vocational education (internship or byfend) and a specialist certificate of specialist "obstetrics and gynecology", without presentation of requirements for the experience Work.

1.3. The obstetrician-gynecologist of the maternity hospital is appointed and exempt from her by order [name of the head].

1.4. An obstetrician-gynecologist of the maternity hospital should know:

Constitution of the Russian Federation;

Laws and other regulatory legal acts of the Russian Federation in the field of health care, the protection of consumer rights and the sanitary and epidemiological well-being of the population;

Regulatory legal documents regulating the activities of health institutions;

Modern methods of prevention, diagnosis, treatment and rehabilitation of patients according to the profile "Obstetrics and Gynecology";

General principles and basic methods of clinical, instrumental and laboratory diagnostics functional state organs and systems human organism;

Organization of obstetric and gynecological service;

Indicators of maternal and perinatal mortality and decline measures;

The main issues of normal and pathological physiology, respectively, in healthy women and at obstetric and gynecological pathology;

The relationship of the functional systems of the body and the levels of their regulation;

Physiology and pathology of pregnancy, childbirth and postpartum period, risk groups;

The causes of the occurrence of pathological processes in the body of a woman, the mechanisms of their development and clinical manifestations;

Issues of asepsis and antiseptics in obstetrics and gynecology;

Fundamentals of pharmacotherapy, immunology and genetics in obstetrics and gynecology;

Principles, techniques and methods of pain relief in obstetrics and gynecology, the basics of intensive therapy and resuscitation in women and newborns;

Principles of preoperative preparation and postoperative management of patients, rehabilitation methods;

New modern methods for the prevention and treatment of obstetric and gynecological pathology, as well as non-planned pregnancy;

The basics of oncological alertness in order to prevent and early diagnosis malignant neoplasms among women;

Questions of temporary and disability, medical and labor examination in obstetrics and gynecology;

The organization, carrying out women's cliserization, analysis of its effectiveness;

Features of SanEpidrej in the branches of the obstetric and gynecological hospital;

Indications for hospitalization of pregnant women and gynecological patients;

Equipment and equipment of operational and chambers of intensive therapy, safety equipment when working with equipment, surgical instruments used in various obstetric and gynecological operations;

Rules for registration of medical records;

The rules of the internal labor regulation;

Rules for labor protection and fire safety;

- [Other general and special knowledge].

1.5. The obstetrician-gynecologist of the maternity hospital should be able to:

Establish the term of pregnancy, evaluate the health status of pregnant, to identify possible violations and carry out a complex of dispensary events;

Identify signs of early or late pathology of pregnancy (early and late toxicosis, dropsy, nephropathy, eclampsia) and conduct all the necessary measures to eliminate it;

Perform an outdoor and inner obstetric study, determining the phase of the flow of labor and the position of the fetus, the degree of maturity of the cervix;

Carry out dispensarization and evaluate its effectiveness;

Conduct physiological genera, childbirth during the occipital or head preservation of the fetus;

Timely recognize and conduct childbirth in case of extensible prelations of the fetus, pelvic presence, large fruit and multiple pregnancy;

Timely determination of the testimony for the cesarean section;

Justify the tactics with the transverse position of the fetus and perform it;

Justify the tactics of childbirth under the extragnenital diseases;

Identify abnormalities and regulate generic activities;

Establish the cause of obstetric bleeding (premature placenta, premature detachment, atonic bleeding) and assign required help at the same time;

Establish signs of intrauterine hypoxia of the fetus and provide the necessary assistance;

Perform resuscitation activities during asphyxia and generic injury of the newborn;

Evaluate the course of the postpartum period, identify postpartum complications and fight against them;

Define the complications of the newborn period, develop and carry out therapeutic measures;

- [Other general and special skills].

1.6. An obstetrician-gynecologist of the maternity hospital should be able to make a diagnosis and carry out the necessary treatment in the following diseases:

Ectopic pregnancy;

Complete abortion;

Genital tuberculosis;

Inflammatory diseases of the female genital organs of septic etiology;

Anomalies of the position of the genital organs;

Gonorrhea in women;

Trichomonias of urinary organs;

Domor monomic diseases;

Benign tumors of uterus and appendages;

Malignant tumors of uterus and appendages.

2. Official duties

Doctor obstetrician-gynecologist of the maternity hospital:

2.1. Provides qualified medical care in the specialty "Obstetrics and Gynecology", using modern methods of diagnosis, treatment, prevention and rehabilitation.

2.2. Determines the tactics of the patient in accordance with the established standards.

2.3. Sets (or confirms) the diagnosis.

2.4. Independently conducts or organizes the necessary diagnostic, therapeutic, rehabilitation and preventive procedures and events.

2.5. Conducts the following operations and manipulations:

Colposcopy;

Diagnostic scraping of the uterus of the uterus;

Scraping of the uterus in the interruption of pregnancy;

Classical manual manual;

Extraction of the fetus;

Obstetric nippers;

Massage of the uterus in its atony;

Cesarean section;

Sewing cervical break, vagina, crotch;

Manual separation and selection of the last, manual control of the uterine cavity;

Laparotomy with ectopic pregnancy and twist the ovarian cyst;

Rear axle puncture;

Hydrotubation;

Amniotomy;

Hysterosalpingography;

Uterus amputation;

Aim biopsy;

Removal of the uterine mucosa polyp;

Bladder catheterisation;

Protecting the stomach;

Siphonic enema;

Veneziction, intravenous infusion, blood transfusion.

2.6. Experts temporary disability.

2.7. Every day bypass in the wards together with the midwife ( medical sister) And participates in the collaboration of the department.

2.8. Provides sanitary and hygienic content chambers, compliance with the established mode, carrying out anti-epidemic activities.

2.9. Participates in the reception of pregnant women, harvesting, psivilians and patients entering the department at his work hours, conducts their inspection, appoints the necessary medical and diagnostic measures.

2.10. Carries duty in accordance with the approved schedule.

2.11. With the personal treatment of relatives, there is a certificate of the state of health of the feminine, the birthroles and patients, taking into account the principles of preserving the medical mystery.

2.12. It reports the head of the department, and in his absence directly to the deputy chief physician at the medical unit (or the chief doctor) on the health of the patients and all cases of death, as well as the gross violations of the internal regulations on the part medical personnel and patients.

2.13. Systematically improves their qualifications.

2.14. He has medical records in the prescribed manner.

2.15. Manages work and conducts measures to improve the qualifications of subordinate medium and junior medical personnel.

2.16. [Other job duties].

3. Rights

The doctor of the obstetrician gynecologist of the maternity hospital has the right to:

3.1. Assign and cancel (previously appointed by them) any medical and diagnostic measures arising from the changing state of the patient and the availability of opportunities in the field of diagnosis and treatment.

3.2. Conduct an extract and translation of a woman to another branch of the maternity hospital or other medical and prophylactic institution in coordination with the head of the department.

3.3. Machine sick leave.

3.4. For all social guarantees provided for by the legislation of the Russian Federation.

3.5. For extra leave.

3.6. Require the creation of conditions for the fulfillment of professional duties, including the provision of the necessary equipment, inventory, a workplace that meets sanitary and hygienic rules and norms, etc.

3.7. Require from the management of the organization to assist in the performance of their professional duties and the implementation of rights.

3.8. Get acquainted with the draft decisions of the management of the Organization regarding its activities.

3.9. To give instructions to the subordinate to him by Middle and younger medical professionals, make proposals to encourage these workers or imposing disciplinary penalties.

3.10. [Other rights provided labor legislation Russian Federation].

4. Responsibility

The doctor of the obstetrician-gynecologist of the maternity hospital is responsible:

4.1. For non-fulfillment, improper execution of the duties stipulated by this Instruction, within the limits of the labor legislation of the Russian Federation.

4.2. For the offenses committed in the process of carrying out their activities - within the limits defined by the current administrative, criminal and civil law of the Russian Federation.

4.3. For causing material damage to the employer - within the limits defined by the current labor and civil law of the Russian Federation.

The job instruction is designed in accordance with [Name, number and document date].

Head of Personnel Service

[initials, surname]

[signature]

[day month Year]

Agreed:

[initials, surname]

[signature]

[day month Year]

The instructions are familiar with:

[initials, surname]

[signature]

[day month Year]

Perhaps the most important doctor for a woman is a gynecologist. Everyone knows about the importance of regular visits to this specialist. It helps maintain health, can identify any deviations in a timely manner. To control the state of the pregnant, there is an obstetrician-gynecologist. Its competences are all questions relating to pregnancy and the recovery process.

In any profession it is important to know what is required from a specialist, what skills and knowledge are needed. This article presents the characteristic of the doctor of the obstetrician-gynecologist. For a doctor, this can be a reference book, and for a patient - an assistant in choosing.

You will be interested:

Job description

Official instruction of an obstetrician-gynecologist regulates the activities of the employee. There is prescribed which responsibility is provided for the (or unfulfilled) actions. This document is drawn up by the employer on the basis of the Labor Code of the Russian Federation, signed with the conclusion of an employment contract.

Range of duties

Based on the job instruction, the obstetrician-gynecologist must have a number of skills that will apply in the performance of work. Main duty - providing professional medical care when using modern diagnostic methods.

Other main responsibilities include:

• carrying out the necessary procedures for the purpose of treatment or prevention;
• conducting a survey and design of a document defining temporary disability;
• records management.

Luggage knowledge

Executed great responsibility, the doctor obstetrician-gynecologist has a huge luggage of knowledge. And in the list of what you need to know, not only information on its specialty. This direction is closely intertwined with others, and therefore it is important to apply the main knowledge from different areas of medicine, such as pharmacology, oncology, etc. Only all together will show the correct picture of reality.

Considering the influence of various vital factors on reproductive feature You can help prevent or eliminate most Diseases.

Studying duties prescribed in the official instruction, it becomes clear that you need to know a specialist. Below is a list of what a doctor who works in the direction of obstetrics and gynecology should be known:

• the structure and functioning of the sexual system;
• major and small prompt factors that can affect health;
• features of pregnancy, childbirth and postpartum period;
• criteria that determine the likelihood of the mother or child, the measures to reduce them;
• the main signs of the presence of pathologies in a woman during pregnancy;
• the relationship of organ systems;
• information about medicinal substances and their actions on the body during and outside pregnancy;
• the physiology of the menstrual function of women, as well as criteria that determine the presence of deviations affecting health;
• the influence of production factors (the presence of harmful funds at work, as well as hazardous working conditions, severe fatigue, large loads and a number of others) to the body;
• the structure and operation of the excretory system;
• normal level of components of blood components, indications and prohibitions to blood transfusion;
• basics of immunology and genetics;
• methods of anesthetics;
• organization and criteria for the purpose of intensive therapy;
• resuscitation standards;
• criteria defining availability oncological diseases, formations of tumors, as well as methods of their warning;

Important paper

There are a number of documents, provisions and regulatory acts, which are included in the list of mandatory obstetrician-gynecologist. They will make clarity to work, indicate the framework of the permitted.

The basis is the constitution, which is recommended to study everything without exception. It is based on all other documents regulating the activities of the obstetric and gynecological service and the device of relevant organizations. There are certain standards for assistance to know.

The work of the obstetrician-gynecologist is primarily interaction with people. And any work of this kind, its norms are enshrined by law. For example, many laws on the protection of consumer rights are known.

After 30 weeks, until childbirth, the reception to the doctor should come 1 time per week. At this time, special attention is paid to the fetus and mother, the date of delivery is planned, there is all sorts of preparation for them.

Ultrasound

Ultrasound examination (ultrasound) during pregnancy is required. For many women, this is an important event. At the reception of the doctor of the obstetrician-gynecologist in the office of the ultrasound, a picture is taken, Mom first sees his child. Some clinics are invited to conduct an ultrasound based on three-dimensional echography (3D) and real-time (4D).

In the absence of complaints and well-being of the mother, the procedure is carried out 1 time in three months. If there are suspicions for the presence of pathologies, the doctor obstetrician-gynecologist in the hospital himself will appoint an ultrasound. This allows you to control the situation and react to changes in time.

Ultrasound at different terms

The earliest ultrasound is carried out already on 5-6 weeks through a vaginal sensor. His goal: detection in the mat of the fetal egg. The procedure at such a term is not all women, but doctors obstetrician-gynecologists ultrasound recommend. It can determine the term of pregnancy with an accuracy of 1 week, and still helps to establish the fact of the presence or absence of pathologies.

• 1 trimester (11-14 weeks). Confirmation of the fact of pregnancy, estimation of the position of the embryo.
• 2 trimester (18-24 weeks). Analysis of the anatomy of the fetus, diagnosis.
• 3 trimester (30-34 weeks). This ultrasound is mandatory for all future mothers. It displays the development of the fetus at this stage, shows the location of the placenta, the position of the fetus in the womb. Such a study helps to determine what way the woman will give birth.

There is no unambiguous answer to the question, is it harmful to ultrasound. Some believe that there is nothing bad in it, others prove a negative impact ultrasonic research. But nevertheless, most doctors agree that with normal pregnancy flows, it is absolutely not necessary to undergo this procedure at each reception.

The best

The Government has established an annual prize "calling", which defines the best employee of the medicine sphere. But besides her, regional contests are held in individual cities that allow you to identify the "best of the best." Not only victory, but also participation in such an event shows high level skill.

Of course, for each person there is a "best doctor", his name causes a sense of deep respect. In any area it is important to find your doctor who will understand the patient well. Pregnancy lasts 9 months - it would seem not long, but during this time there are so many changes that only with a good doctor located nearby, you can enjoy this process. Such a specialist will become the best doctor obstetrician gynecologist.

Afterword

The presence and observance of the above mentioned does a doctor with a real professional. Patients are built to it, work is assessed highly, in dignity. "Doctor from God", "Guardian Angel" ... This is exactly what I see and describes a doctor who has facilitated a difficult period.

Women who have to give birth should be explored reviews about clinics and people, working in them. Careful selection, preliminary preparation - pledge of easy pregnancy.

1. This Officer instruction determines the duties, rights and responsibility of the obstetrician-gynecologist.

2. The person who has a higher professional education in the specialty "Medical Case", "Pediatrics", Postgraduate Professional Education (Internship or Residue) and the certificate of a specialist in the specialist "Obstetrics and Gynecology" are appointed to the position of doctor-acuse-gynecologist, without presentation of requirements for I'll face work.

3. An obstetrician-gynecologist should know: the foundations of the legislation of the Russian Federation on health care; Constitution of the Russian Federation; Laws and other regulatory legal acts of the Russian Federation in the field of health care, the protection of consumer rights and the sanitary and epidemiological well-being of the population; regulatory legal documents regulating the activities of medical organizations; Modern methods of prevention, diagnosis, treatment and rehabilitation of patients according to the profile "Obstetrics and Gynecology"; theoretical aspects all nosologies both by profile "Obstetrics and Gynecology" and other independent clinical disciplines, their etiology, pathogenesis, clinical symptoms, features of the flow; general principles and the main methods of clinical, instrumental and laboratory diagnostics of the functional state of organs and systems of the human body; Principles comprehensive treatment major diseases; the rules for the provision of emergency medical care; the basics of examination of temporary disability and medical and social expertise and the procedure for their implementation; Fundamentals of sanitary enlightenment; organization of obstetric-gynecological service, structure, states and equipment of medical organizations of the obstetric and gynecological profile; rules for registration of medical records; Principles of planning activities and reporting of obstetric and gynecological service; methods and procedure for monitoring its activities, theoretical foundations, principles and methods of dispensarization; population medicine; Basics of organizing medical and preventive care in hospitals and outpatient polyclinic institutions, emergency and emergency medical care, disaster medicine service, sanitary-epidemiological services, organizational and economic basis for the activities of medical organizations and medical workers in the conditions of fiscal medicine; Basics of social hygiene, organization and economics of health care, medical ethics and deontology; legal aspects of medical activities; The rules of the internal labor regulation; Rules for labor protection and fire safety.

4. An obstetrician-gynecologist is appointed and exempt from office by order of the head of the medical organization in accordance with the current legislation of the Russian Federation.

5. The obstetrician-gynecologist is directly subordinated to the head of the department (female consultation), and with his absence to the head of the medical organization or his deputy.

2. Official duties

Provides qualified medical care in the specialty "Obstetrics and Gynecology", using modern methods of diagnosis, treatment, prevention and rehabilitation. Determines the tactics of the patient in accordance with the established standards. Based on the collection of anamnesis, clinical observation and the results of clinical and laboratory and instrumental research, it establishes (or confirms) the diagnosis. Independently conducts or organizes the necessary diagnostic, therapeutic, rehabilitation and preventive procedures and events. Experts temporary disability. He has medical records in the prescribed manner. Manages the work of the subordinate to him of the middle and junior medical personnel.

3. Rights

An obstetrician-gynecologist has the right:

1. independently identify the diagnosis of the specialty on the basis of clinical observations and surveys, the collection of history, data of clinical and laboratory and instrumental research; determine the tactics of the patient in accordance with the established rules and standards; Assign the necessary for comprehensive examination patient methods of instrumental, functional and laboratory diagnostics; conduct diagnostic, healing, rehabilitation and preventive procedures using the allowed diagnostic and treatment methods; If necessary, to attract doctors in the prescribed manner of other specialties for consultations, surveys and treatment of patients;
2. to make suggestions to the improvement of the medical and diagnostic process, improving the work of administrative and paraclinical services, organization and conditions of its labor activity;
3. to control the work of secondary and junior medical personnel as part of its competence, give them orders and require their clear execution, to make suggestions to the guide to promote or imposition of recovery;
4. request, receive and use informational materials and regulatory documents necessary to execute their official duties;
5. take part in scientific and practical conferences and meetings on which issues related to its work are considered;
6. to undergo in the prescribed manner certification with the right to obtain the relevant qualification category;
7. improve your qualifications on improvement courses at least once every 5 years.

An obstetrician-gynecologist enjoys all employment rights in accordance with Labor Code RF.

4. Responsibility

An obstetrician-gynecologist is responsible for:

1. timely and qualitative exercise of official duties assigned to him;
2. timely and qualified fulfillment of orders, orders and instructions of the leadership, regulatory and legal acts on their activities;
3. compliance with the rules of the internal schedule, fire safety and safety;
4. timely and qualitative design of medical and other service documentation provided for by the current regulatory documents;
5. provision in the prescribed manner statistical and other information on its activities;
6. compliance with the performing discipline and the fulfillment of official duties subordinate to him by employees (if available);
7. operational adoption of measures, including timely informing the leadership, to eliminate violations of safety, firefire and sanitary rules that make a threat to the activities of a medical organization, its employees, patients and visitors.

For violation of labor discipline, legislative and regulatory acts, an obstetrician-gynecologist can be attracted in accordance with the current legislation, depending on the severity of the offense to disciplinary, material, administrative and criminal liability.