Vaccination room equipment. Immunization room Equipment standard for the treatment room of a children's clinic

In accordance with Article 37 of the Federal Law of November 21, 2011 No. 323-FZ "On the Basics of Protecting the Health of Citizens in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, No. 48, Article 6724), I order:

Approve the Procedure for the provision of pediatric care in accordance with.

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

Order
providing pediatric care

On the procedures for providing medical care to the population of the Russian Federation, see the certificate

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

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

primary health care;

ambulance, including specialized, medical care;

specialized, including high-tech, medical care.

3. Medical pediatric care may be provided under the following conditions:

outside the medical organization (at the place where the ambulance brigade was called, as well as in the vehicle during medical evacuation);

on an outpatient basis (in conditions that do not provide for round-the-clock medical supervision and treatment), including at home when a medical worker is called;

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

stationary (in conditions providing round-the-clock medical supervision and treatment).

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

5. Primary health care includes:

primary pre-medical health care;

primary health care;

primary specialized health care.

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

6. Primary health care for the children's population in case of childhood illnesses on an outpatient basis is provided by district pediatricians, general practitioners (family doctors), medical specialists, relevant paramedical personnel.

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

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

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

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

11. Ambulance, including specialized ambulance, medical care is provided in emergency and emergency forms outside a medical organization, as well as on an outpatient and inpatient basis.

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

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

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

15. Planned pediatric medical care is provided during preventive measures, in diseases and conditions that are not accompanied by a threat to the child's life, that do not require emergency and emergency care, the delay in the provision of which for a certain time will not entail a deterioration in the child's condition, a threat to his life and health.

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

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

18. If medical manipulations related to the provision of pediatric care may cause pain in the child, such manipulations are performed with anesthesia.

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

Rules
organizing the activities of the district pediatrician's office

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

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

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

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

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

5. The Cabinet performs the following functions:

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

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

preventive examinations of children;

conducting immunoprophylaxis;

carrying out work to protect the reproductive health of children;

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

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

carrying out diagnostic and therapeutic work on an outpatient basis;

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

preventive examinations and rehabilitation of children before they enter educational organizations;

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

organization of work of a hospital at home;

registration of medical documentation of children for sanatorium treatment;

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

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

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

conducting medical consultations and vocational guidance for children;

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

maintenance of accounting and reporting documentation, submission of reports on the activities of the Cabinet in the prescribed manner;

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

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

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

medical staff of the district pediatrician's office

3. For organizations and territories to be serviced by the Federal Medical and Biological Agency, in accordance with the Decree of the Government of the Russian Federation dated August 21, 2006 No. 1156-r "On approval of the lists of organizations and territories to be serviced by the FMBA of Russia" (Collected Legislation of the Russian Federation, 2006, No. 35, item 3774; No. 49, item 5267; No. 52, item 5614; 2008, No. 11, item 1060; 2009, No. 14, item 1727; 2010, No. 3, item 336; No. 18 , article 2271), the number of staff units of a district pediatrician is established regardless of the size of the attached child population.

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

Standard
equipping the office of a local pediatrician

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

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

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

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

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

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

4. A specialist who meets the Qualification Requirements for Specialists with Higher and Postgraduate Medical and Pharmaceutical Education in the Healthcare Sphere, approved by the Order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n (registered by the Ministry of Justice of Russia on July 9, 2009, registration No. 14292), in the specialty "pediatrics", "general medicine" or "organization of healthcare and public health", having at least 5 years of work experience in this specialty in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. 541n "On Approval Unified qualification directory of positions of managers, specialists and employees, section "Qualification characteristics of positions of workers in the field of healthcare" (registered by the Ministry of Justice of Russia on August 25, 2010, registration No. 18247).

5. A specialist who meets the Qualification Requirements for Specialists with Higher and Postgraduate Medical and Pharmaceutical Education in the Healthcare Sphere, approved by the Order of the Ministry of Health and Social Development of Russia dated July 7, 2009 No. 415n (registered by the Ministry of Justice of Russia on July 9, 2009, registration No. 14292), specializing in pediatrics, having at least 5 years of work experience in this specialty in accordance with the order of the Ministry of Health and Social Development of Russia dated July 23, 2010 No. characteristics of positions of employees in the healthcare sector" (registered by the Ministry of Justice of Russia on August 25, 2010, registration number 18247).

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

treatment-and-prophylactic department (pediatric), including: offices of district pediatricians, office of a healthy child, vaccination room, treatment room;

consultative and diagnostic department, including offices of medical specialists, a functional diagnostics office, an X-ray diagnostics office, a laboratory;

emergency department;

department of restorative medicine;

department of medical and social assistance;

department of organization of medical care for children in educational institutions;

eye protection room;

allergy diagnostic room;

inhalation room;

physiotherapy department (office);

physiotherapy room;

massage room;

The polyclinic should also provide for a group of rooms, including a wheelchair room, a room for receiving calls to the house, a reception and viewing filter - a box with a separate entrance.

8. The polyclinic performs the following functions:

provision of preventive, consultative, diagnostic and therapeutic assistance to the attached children's population;

implementation of patronage of pregnant women by a local pediatrician;

implementation of primary patronage of newborns and children up to a year of life;

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

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

conducting preventive examinations of children, including in educational institutions;

organization of rational nutrition for children under 3 years old, as well as children brought up and studying in educational institutions;

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

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

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

observation of children involved in physical culture and sports;

organization and implementation of immunoprophylaxis of infectious diseases;

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

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

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

referral of children in the presence of medical indications for inpatient examination and treatment in medical organizations;

organization of diagnostic and medical work at home;

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

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

organizing the implementation of individual programs for the rehabilitation of disabled children;

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

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

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

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

organization of medical support for children in recreation and rehabilitation institutions;

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

preparation of medical documentation when transferring medical supervision of children to a city (district) polyclinic upon reaching the age of majority;

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

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

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

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

Recommended Staffing Rates
medical and other personnel of the children's polyclinic (department)

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

3. In educational organizations with the number of students less than 500 people (but not less than 100), 1 staff unit of a nurse or paramedic is provided.

4. The positions of a dentist for children and paramedical personnel are established in accordance with the order of the Ministry of Health and Social Development of Russia dated December 3, 2009 No. 946n "On Approval of the Procedure for Providing Medical Care to Children Suffering from Dental Diseases" (registered by the Ministry of Justice of Russia on February 10, 2010, registration No. 16348).

5. For organizations and territories to be serviced by the Federal Medical and Biological Agency, in accordance with the Decree of the Government of the Russian Federation dated August 21, 2006 No. 1156-r "On approval of the lists of organizations and territories to be serviced by the FMBA of Russia" (Collected Legislation of the Russian Federation, 2006, No. 35, item 3774; No. 49, item 5267; No. 52, item 5614; 2008, No. 11, item 1060; 2009, No. 14, item 1727; 2010, No. 3, item 336; No. 18 , article 2271), the number of staff units of medical specialists is established regardless of the size of the attached child population.

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

Standard
equipping a children's clinic (department)

1. Office of a healthy child of a children's clinic (department)

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

3. Procedure room of the children's polyclinic (department)

4. Physiotherapy department (office) of the children's polyclinic (department)

5. Physiotherapy room of a children's polyclinic (department)

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

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

______________________________

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

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

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

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

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

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

3. CDC is an independent medical organization or a structural unit within a medical organization and operates in cooperation with medical organizations providing medical care to children.

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

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

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

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

administrative and economic department;

information and analytical department, including the registry, organizational and methodological office (office of medical statistics);

offices of medical specialists;

department of organization of diagnostic studies;

department of functional diagnostics;

laboratory;

department of radiation diagnostics;

department of radioisotope diagnostics;

department of ultrasound diagnostics;

endoscopic department;

telemedicine office (or skype connection);

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

allergy diagnostic room;

room for feeding children;

centralized sterilization department.

CDC should provide wheelchair access.

8. CDC performs the following functions:

conducting a consultative and diagnostic examination of children;

conducting hardware, instrumental and laboratory diagnostic tests for children;

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

preparation after the end of the consultative and diagnostic measures of the conclusion on the prognosis of the development of the disease and recommendations for the further treatment of the child;

carrying out activities to introduce modern methods of diagnosing and preventing childhood diseases and pathological conditions of childhood;

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

participation in the organization of seminars, conferences, exhibitions on the problems of pediatrics;

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

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

Recommended Staffing Rates
medical and other personnel of the consultative and diagnostic center for children

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

3. For organizations and territories to be serviced by the Federal Medical and Biological Agency, in accordance with the Decree of the Government of the Russian Federation dated August 21, 2006 No. 1156-r "On approval of the lists of organizations and territories to be serviced by the FMBA of Russia" (Collected Legislation of the Russian Federation, 2006, No. 35, item 3774; No. 49, item 5267; No. 52, item 5614; 2008, No. 11, item 1060; 2009, No. 14, item 1727; 2010, No. 3, item 336; No. 18 , article 2271), the number of staff units of medical specialists is established regardless of the size of the attached child population.

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

Standard
equipping a consultative and diagnostic center for children

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

Rules
organization of activities of the pediatric department

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

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

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

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

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

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

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

wards for children, including single rooms;

manager's office;

room for doctors;

office of the head nurse;

a room for paramedical personnel;

procedural;

housewife's room;

buffet and distributing;

dining room

game room;

class;

a room for storing clean linen;

a room for collecting dirty linen;

shower room and toilet for children;

shower room and toilet for medical personnel;

sanitary room;

day hospital, including a room for receiving children, wards for placing children, a room for medical personnel, a sanitary room, a toilet for medical personnel, a toilet for children and their parents, a rest room for parents;

a room for rest of parents;

classroom of the clinical base.

7. The department performs the following functions:

providing pediatric care;

diagnostics and treatment of childhood diseases;

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

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

participation in the process of professional development of medical personnel on the issues of diagnostics and provision of pediatric care;

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

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

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

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

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

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

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

Recommended Staffing Rates
medical staff of the pediatric department (for 30 beds)

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

Standard
equipment of the pediatric department

Document overview

The procedure for rendering pediatric care has been approved. It applies to all healthcare organizations.

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

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

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

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

The fourth - stationary (in conditions that provide round-the-clock monitoring and treatment).

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

All work on the immunoprophylaxis of the population, as a rule, is assigned to the vaccination office.

Such a unit can be called differently: an immunization room, a vaccination room for a children's clinic, a vaccination room for an adult population, etc.

But in any case, in such offices, a set of measures aimed at the implementation of immunoprophylactic work is being fully implemented.

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In the article, we will consider the organization of the work of the vaccination room, the nuances, duties of the medical staff and other issues, and we will also give a sample magazine and regulations on the vaccination room for download.

Vaccination work and activities of an immunologist

The main task of the vaccination room is the organization and implementation of vaccination measures in the medical facility.

In addition, the cabinet actively cooperates with the health authorities, as well as with the authorities that carry out sanitary and epidemiological supervision in the territory of the settlement.

☆ How to organize vaccination, templates, formulas and equipment standards in the Chief Physician System.

The immunologist of the immunoprophylaxis office ensures the implementation of several sections of vaccination work in a medical facility. Let's take a look at these sections.

Refrigerator for storing vaccines

Cabinet for instruments (tonometer, electric pump, disposable syringes, etc.) and medicines

Bixes with sterile material

Changing table and/or medical couch

Tables for preparing preparations for use

Document storage table

Disinfectant solution container

Instructions for use of all drugs

Medicines for emergency care, anti-shock therapy:

• solutions of adrenaline 0.1%, mezaton 1% or norepinephrine 0.2%;
• prednisolone, dexamethasone or hydrocortisone in ampoules;
• 2.5% pipolfen or 2% suprastin, 2.4% eufillin, 0.9% sodium chloride;
• cardiac glycosides (strophanthin, corglicon), cordiamine;
• β-agonist metered-dose aerosol packaging;

Before entering the room there should be chairs for persons under observation after vaccination

Vaccinations against tuberculosis and tuberculin diagnostics should be carried out in separate rooms, and in their absence, on a specially designated table. A separate cabinet is used to accommodate syringes and needles used for BCG vaccine and tuberculin. The use for other purposes of instruments intended for vaccination against tuberculosis is prohibited. All items necessary for vaccination (revaccination) of BCG (tables, bixes, trays, cabinets, etc.) must be marked. On the day of BCG vaccination, all other manipulations to the child are not carried out.

The room in which vaccinations are carried out, before starting work, must be subjected to wet cleaning with the use of disinfectants. It should be ventilated regularly.

For preventive vaccinations in our country, domestic and imported vaccines are used that are registered in the Russian Federation and have a certificate from the National Control Authority for Medical Immunobiological Preparations - GISK named after L.A. Tarasevich. In the case of using an imported drug, it must have the original name in Russian.

Transportation and storage of vaccines must be carried out under a special cold chain system.

"Cold chain" - this is a continuously functioning system that provides optimal temperature conditions for storage and transportation of vaccines and other immunobiological preparations at all stages of their journey from the manufacturer to the vaccinated.

Vaccines and solvent should be stored in a refrigerator at a temperature of +2+8°C.

The freezer compartment must have a stock of frozen ice packs.

The refrigerator should only be used for storing vaccines and other immunobiological preparations.

Each drug must be in a separate box with a clear label. Cooled air must be provided to each package. It is not recommended to store vaccines on the refrigerator door.

The person responsible for the "cold chain" keeps a strict record of the receipt and consumption of vaccines, records the temperature regime for storing drugs (it is recommended to place the thermometer in the center of the middle shelf of the refrigerator).

The facility where vaccines are stored should have a contingency plan in place in case of problems with the cold chain, approved by the facility manager.

Vaccinations should be carried out by medical personnel trained in the rules of organization and technique of vaccination, as well as emergency procedures.

Immunizations should be carried out by healthy medical personnel.

Preventive vaccinations are carried out with the consent of citizens, parents or other legal representatives of minors and citizens recognized as incompetent.

The district pediatrician is responsible for the timeliness of vaccination of unorganized children; and for children attending educational institutions - the pediatrician of this institution.

When preparing a child for admission to a kindergarten, it is advisable to vaccinate no later than a month before the start of a visit to an organized group.

The nurse, orally or in writing, invites children to be vaccinated, parents or persons replacing them to a medical institution on the day determined for vaccination; in an educational institution - informs in advance the parents of children subject to preventive vaccination.

The fact of refusal of vaccinations with a note that the medical worker has given explanations about the consequences of such a refusal (the threat of developing a severe form of the disease, death, the patient's danger to others, etc.) is documented in medical documents (f.112 / y, f. 026 / y, f.063 / y, f.156 / y-93) and signed by the parents (guardians) of the child or the adult citizen himself, as well as a medical worker. Refusals must be renewed at least once a year.

Before vaccination, a pediatrician examines the child and takes thermometry. In the medical documents, a corresponding record of the pediatrician about the permission to carry out the vaccination is made.

If necessary, laboratory tests are carried out before vaccination.

Preventive vaccinations are carried out for children who do not have medical contraindications, in strict accordance with the indications for the use of a particular vaccine according to the instructions attached to the drug.

Responsibility for the correct selection for vaccination lies with the pediatrician (feldsher FAP).

It is advisable to vaccinate children in the morning

The healthcare worker must:

Check the name of the drug on the ampoule (bottle) with the doctor's prescription;

Make sure the expiration date of the drug, as well as disposable syringes and needles;

Check the physical properties of the vaccine (color, transparency, consistency) and the integrity of the ampoule (vial).

Then the nurse prepares the drug (shaking the sorbed vaccine, processing and opening the ampoules in compliance with the rules of antiseptics, dissolving the lyophilized drug, etc.).

It is necessary to properly treat the injection site (for subcutaneous and intramuscular injections - 70% alcohol, for the scarification method of immunization - with a mixture of alcohol and ether), as well as compliance with the dose of the drug, the method and place of its administration.

Vaccination equipment must be single use.

The vaccination should be carried out in the position of the child lying down or sitting.

The nurse makes a record of the vaccination in the work journal of the vaccination room, the history of the child's development (f.112 / y), the vaccination card (f. 063 / y), if necessary - in the certificate of preventive vaccinations (f. 156 / y-93 ), for organized children - in the child's medical record for educational institutions (f. 026 / y). In this case, the date of administration, type of drug, dose, series, control number, manufacturer, expiration date are indicated.

In the case of using an imported drug, its original name in Russian is entered.

The data entered in the certificate is certified by the signature of a doctor and the seal of a medical institution or a person engaged in private practice.

After vaccination, children are monitored for the first 30 minutes directly by a doctor (paramedic)

It is necessary to inform the vaccinated person (his parents) about possible reactions to the vaccine, adherence to the regimen in the post-vaccination period, the need to seek medical help if a strong or unusual reaction occurs, and also, if necessary, about first aid measures before the doctor arrives.

At the end of vaccination, ampoules and other containers containing unused remains of inactivated bacterial and viral vaccines, toxoids, as well as live measles, mumps and rubella vaccines and disposable instruments that were used for their administration are not subject to any special processing.

Ampoules and other containers containing unused remains of other live bacterial and viral vaccines, as well as the tools used for their administration, must be boiled for 60 minutes (anthrax vaccine for at least 2 hours), or treated with a 3-5% solution of chloramine for 1 hours, or 6% hydrogen peroxide solution (shelf life no more than 7 days) for 1 hour, or autoclaved. After BCG or BCG-M vaccination, a syringe with a needle and cotton swabs, ampoules with unused vaccine residues are soaked in a 5% chloramine solution for 60 minutes.

Car - if necessary;

Disinfectants with instructions for their use approved in the prescribed manner;

Forms of accounting (form 112 / y; f. 026 / y; f. 025 / y, etc.).

8. Medical immunobiological preparations used

in a children's clinic, the conditions for their storage

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

8.2. Medical immunobiological preparations are delivered to the children's polyclinic from the warehouse where the preparations are stored.

8.3. In the children's polyclinic, a monthly stock of all declared medical immunobiological preparations is created with a carry-over balance of not more than 30% of the need for the next month. Keep records of receipts, expenditures and write-offs in the journals of the established form. A report on the movement of vaccines is submitted quarterly to the warehouse from where they were received, as well as to the territorial health authorities, bodies and institutions exercising state sanitary and epidemiological supervision.

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

Annual order-application for MIBP;

Explanatory note (justification) on the preparation of the annual application;

Copies of requirements for obtaining MIBP from the warehouse;

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

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

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

MIBP write-off acts;

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

Instructions for the use of preparations.

8.5. When using foreign-made vaccines, additionally:

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

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

Instructions for use in Russian.

8.6. The cold chain system includes:

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

Refrigeration equipment designed for storage and transportation of vaccines under optimal temperature conditions;

The mechanism for monitoring compliance with the required temperature conditions.

8.7. Cold chain equipment.

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

8.7.2. Health organizations performing a large volume of vaccinations provide sufficient refrigeration equipment according to needs.

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

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

8.7.4. Cold cells filled with water are stored in the freezer of the refrigerator in case of emergency use, for example, when the power goes out. When loading cold cells into the freezer, free air circulation between them is ensured.

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

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

8.7.7. Thermal indicators for objective temperature control.

8.8. Documents: journal of receipt, issue of medical immunobiological preparations.

9. Accounting and reporting documents on the conducted

preventive vaccinations

9.1. To record and report on preventive vaccinations carried out in a children's clinic, medical documents are drawn up to ensure the completeness, reliability and timeliness of accounting for contingents subject to vaccination and vaccinations performed.

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METHODOLOGICAL INSTRUCTIONS ORGANIZATION OF THE WORK OF THE IMMUNATION ROOM OF THE CHILDREN'S POLYCLINIC OF THE ROOM OF IMMUNOPROPHYLAXIS AND VACCINATION ... Relevant in 2018

6. Logistics and equipment of the vaccination room and the immunization room

6.1. A set of premises for preventive vaccinations, areas, location, sanitary and technical condition must comply with sanitary and hygienic requirements.

6.2. In the vaccination room, the mode of cleaning, ventilation, disinfection with UV radiation is observed.

6.3. Medical documents of the vaccination room and the immunization room: a register of examinations and vaccinations performed (f. 064 / y); forms "Certificate of preventive vaccinations" (f. 156 / y-93) or certificates of vaccinations performed; outpatient cards of patients (f. 112 / y, f. 025 / y); emergency notice of side effects of vaccines (f. 058); instructions for use of all used medical immunobiological preparations in Russian (in a separate folder); a register of vaccinations performed (for each type of vaccine); journal of accounting and expenditure of medical immunobiological preparations; refrigerator temperature log; bactericidal lamp operation log; general cleaning register; emergency cold chain contingency plan.

6.4. Vaccination room equipment.

6.4.1. Equipment: refrigerator for storing vaccines with labeled shelves with two thermometers; ice packs (the number of ice packs must be at least as specified in the instructions for use of the thermal container or cooler bag available in the vaccination room, which are constantly in the freezer compartment of the refrigerator); medical cabinet for medicines and instruments - 1; medical couch - 1; changing table - 1; medical tables marked by types of vaccinations (at least three); desk of a nurse and storage of documents, instructions for the use of all medical immunobiological preparations (MIBP) - 1; chair - 1; bactericidal lamp; sink for washing hands; cleaning equipment; a thermal container or a cooler bag with a set of ice packs.

6.4.2. Capacity - a non-piercing container with a lid for disinfection of used syringes, swabs, used vaccines. Disposable syringes (based on the number of vaccinated + 25%), with a capacity of 1, 2, 5, 10 ml with a set of needles. Bixes with sterile material (cotton wool - 1.0 g per injection, bandages, wipes). Tweezers - 5, scissors - 2, rubber band - 2, heating pads - 2, kidney-shaped trays - 4, adhesive plaster, towels, diapers, sheets, disposable gloves, a container with a disinfectant solution.

6.4.3. Medicines: anti-shock kit with instructions for use (0.1% solution of adrenaline, mezaton, norepinephrine, 5.0% ephedrine solution, 1.0% tavegil, 2.5% suprastin, 2.4 % eufillin, 0.9% calcium chloride solution, glucocorticoid drugs - prednisolone, dexamethasone or hydrocortisone, cardiac glycosides - strophanthin, corglicon), ammonia, ethyl alcohol (at the rate of 0.5 ml per injection), a mixture of ether with alcohol, oxygen.

6.5. Vaccinations against tuberculosis and tuberculin diagnostics are carried out in separate rooms, and in their absence - on a specially allocated table, with separate tools that are used only for these purposes. A certain day is allocated for BCG vaccination and tuberculin tests.

6.6. Equipping the cabinet of immunoprophylaxis.

6.6.1. Office of a doctor and a nurse for children.

Equipment: tables - 2 (for a doctor and nurse), chairs - 4, couch - 1, changing table - 1, pressure measuring device - 1, thermometers - 5, containers for storing thermometers marked "clean" and "dirty" , sterile disposable spatulas.

6.6.2. Room for preventive vaccinations for children (equipment see paragraph 6.4.).

6.6.3. MIBP stock room (see 8.6 and 8.7).

6.6.4. Vaccination file cabinet.

6.6.4.1. Card file with manual work technology.

Equipment: racks with shelves and boxes for molds 063/u; forms 063 / y - for children registered in the immunization room, distributed in accordance with the timing and type of immunization; vaccination work plan logs for the current month; monthly reports of departments of healthcare facilities on vaccinations performed for the current month; a journal for analyzing the implementation of the vaccination plan for each division of the polyclinic (by sites and organizations served by the polyclinic), desktops for card readers, chairs, microcalculators.

6.6.4.2. Card file with an automated accounting system.

Equipment:

Computer equipment (personal computers) on which software and information bases are placed (automated workstations - workstations);

Software.

6.7. Vaccination room nurse (vaccinator).

6.7.1. Preventive vaccinations are carried out by a vaccination nurse trained in the technique of administering vaccinations, emergency procedures in case of development of post-vaccination complications, as well as methods of observing the "cold chain".

6.7.2. Before vaccination, the vaccinator:

Checks the availability of a doctor's opinion on admission to vaccination;

Checks the name of the drug on the ampoule with the doctor's prescription, checks the labeling, expiration date of MIBP, the integrity of the ampoule;

Visually evaluates the quality of the preparation (by shaking the adsorbed vaccines and after dissolving the lyophilized vaccines).

6.7.3. Conducts immunization with all the rules of asepsis and antisepsis, only with disposable syringes and needles, using the appropriate dose, method and site of administration provided for in the manual for MIBP.

6.7.4. After vaccination:

Removes an ampoule or vial from the refrigerator for multi-dose packaging of the drug;

Disinfects used syringes, cotton wool, ampoules or vials;

Makes a record of the vaccination in all forms of accounting (f. 112 / y, f. 026 / y, f. 025 / y, f. 156 / y-93, magazines) indicating the necessary information (date of immunization, place of administration, name drug, dose, series, control number, expiration date, for foreign vaccines - the original name in Russian);

If there is a local computer network, he enters into his computer information about the vaccinations carried out during the day;

Informs patients or parents (guardians) about the vaccination, possible reactions to the vaccine, the need to seek medical help in case of strong and unusual reactions, warns of the need to stay near the vaccination room for 30 minutes. and observes at this time the vaccinated.

6.7.5. Provides primary care in the event of an immediate reaction to a vaccine and calls a doctor.

6.7.6. Complies with the MIBP storage mode, keeps records of the movement of each MIBP used in the vaccination room (receipt, expenditure, balance, write-off), and the number of vaccinations performed by it (daily, monthly, annual reports).

6.7.7. Carries out measures to comply with the sanitary and anti-epidemic regime (wet cleaning twice a day, UV disinfection and ventilation, general cleaning once a week).