Doe Nurse Report. Certification work of a paramedic

The winner of the competition "Children's Nurse of the Year - 2010" in the nomination "Nurse educational institution"became Elena Anatolyevna Lomakova, senior nurse of the State Educational Institution "Kindergarten No. 824", Moscow. We are publishing her report on professional activities, submitted for the competition.

I. Organizational arrangements

1. Reconciliation of the lists of children enrolled in a preschool educational institution (hereinafter - preschool educational institution), and verification of the availability of the following medical documents:

  • Card of preventive vaccinations (form No. 063 / y);
  • The history of the development of the child (form No. 112 / y);
  • Medical record of the child (form No. 026 / y-2000).

2. Registration of the following reporting medical documents, journals that meet established requirements:

  • cyclogram of work for a week;
  • list and frequency medical examinations, research and professional hygiene training;
  • journal for monitoring the sanitary condition of the preschool educational institution;
  • passing log medical examinations;
  • journal of general cleaning of the treatment room (isolation room);
  • register of biological accidents;
  • journal of registration and control of the operation of the bactericidal lamp;
  • log of registration of the temperature regime of refrigeration equipment;
  • dispensary journal;
  • journal of examinations for pediculosis;
  • record book of contacts with carriers of acute infectious diseases;
  • register of infectious diseases;
  • child observation log;
  • journal of anthropometric measurements;
  • register of movement of children;
  • vaccination waiver log;
  • deworming journal;
  • immunization planning journal;
  • register of preventive vaccinations;
  • register of children referred to a tuberculosis dispensary.

3. Analysis of the health of newly admitted children. compilation of child health sheets based on the results of examinations.

4. Preparation for preventive examinations of children:

  • preliminary screening examination;
  • survey of parents;
  • measurement of blood pressure;
  • carrying out anthropometry;
  • dynamometry;
  • plantography;
  • Kern-Jerasica test.

Data on acute morbidity and exacerbations of chronic diseases and functional disorders in children attending the State Educational Institution "Kindergarten No. 824" are given in appendices 1, 2.

5. Planning and drafting the following documents:

  • a comprehensive work plan for the year;
  • monthly work plan;
  • annual plan for preventive vaccinations;
  • vaccination planning table (when vaccinating, it is necessary to have written consent parents).

6. Sending the reporting documentation of the established form to the Children's city ​​polyclinic No. 130 (hereinafter - DGP No. 130).

7. Extract of funds necessary for the work of the medical office:

  • medicines;
  • dressing material;
  • drugs for emergency care.

II. Therapeutic and preventive work

1. Implementation of outpatient reception of pupils. 23 appeals were registered regarding the provision of primary medical care, including:

  • with symptoms of acute respiratory diseases;
  • nosebleeds.

2. Injury prevention:

  • educating children to recognize traumatic situations and avoid them;
  • elimination of unfavorable environmental conditions in which the child lives.

3. Carrying out examinations of children for pediculosis, entering the results of examinations in a special journal.

4. Implementation of anthropometry, including:

  • carrying out anthropometric measurements of pupils;
  • entering data into the log of anthropometric measurements;
  • preparation of recommendations for seating children according to height indicators in order to prevent posture disorders;
  • control over the correspondence of the sizes of tables and chairs to the growth of children.

5. Prevention of visual impairment in children:

  • conducting an annual eye examination of pupils;
  • entering data into medical records;
  • conversations with parents, referral to a specialist;
  • preparation of recommendations for seating children in a group.

Engagement of specialists from DGP No. 130:

  • neurologist;
  • ophthalmologist;
  • orthopedist;
  • otolaryngologist;
  • dentist
  • surgeon
  • dermatologist;
  • allergist;

Laboratory tests of blood and urine;

Conducting electrocardiography.

7. Recording the results of examinations in the medical documents of pupils, drawing up a report. As a result of the examination of 120 people (present at the time of medical examination), children with chronic diseases were identified. Referrals were given for additional examinations of children at the place of residence, recommendations for their further improvement. Pupils with chronic diseases and frequently ill children (hereinafter - FIC) are taken to the dispensary.

Schemes of a complex of hardening procedures for CBD in summer and autumn-winter periods are given in appendices 3, 4.

Procedures

Duration, min

Air temperature, °C

Temperature
water, °C

Air baths

From 30 (limited by daily routine)

From +18-17 to +24-22

Solar air baths

From 2-3 to 20-35

Rubdown

From +20-18 to +34-32

Pouring from the shower

Not lower than +23

From +20-18 to +35-34

Pouring feet

From +18-16 to +32-30

Walking barefoot

Not lower than +18

Procedures

 (from +18-16 to +28-26) ed.

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Introduction

5. Quarantine measures

Conclusion

Literature

Introduction

Children's preschool institutions are intended for the public education of children aged 1.5 to 7 years. They contribute to the harmonious physical and neuropsychic development of children, the preservation and strengthening of their health, the inculcation of elementary practical skills and preparation for school. Children at the age of 1.5 to 3 years old are admitted to the nursery-garden; in kindergarten - from 3 to 7 years. The direct executors of all medical work in a preschool institution are a nurse.

According to the doctor's prescription, she organizes hardening of children and other recreational activities (daily routine, physical education, walks), carries out the prevention of injuries and poisoning. The nurse keeps records of children who are absent due to illness, isolates the sick, and fulfills the doctor's prescriptions. The duties of a nurse include morning reception, thermometry and other activities for children who came after an illness and were in contact with infectious patients, organizing ongoing disinfection, monitoring the daily intake of children by group educators.

In addition, she constantly monitors the quality of products, the correctness of their storage and compliance with the deadlines for implementation, catering and the quality of cooking, calculates the chemical composition and calorie content of the diet, and participates in the preparation of the menu layout.

1. Responsibilities of a nurse in a kindergarten

In accordance with Appendix No. 2 of Order No. 186/272, the list of functional duties of a paramedical worker of a preschool institution includes:

1. Organization of medical support for children

2. Primary prevention

2.1. Control over sanitary and hygienic conditions in educational institutions;

2.2. Control and provision of methodological assistance in the organization of the educational process.

3. Nutrition

3.1. Control over the state of actual nutrition and analysis of nutrition quality;

3.2. Control over the sanitary and hygienic condition of the catering unit;

3.3. Menu preparation;

3.4. Finished product scrapping;

3.5. Monitoring the implementation of natural norms.

4. Physical education 4.1. Implementation of control over the organization of physical education, tempering activities.

5. Hygienic education in the children's team 5.1. Formation of healthy lifestyle skills;

5.2. Control over hygiene education.

6. Immunoprophylaxis

6.1. Vaccination planning;

6.2. Vaccination;

6.3. Monitoring the state of health after vaccination, registration of local and general reactions to vaccination.

7. Measures to ensure adaptation in an educational institution

7.2. Control over the course of the adaptation period.

8. Record keeping

9. Medical examination

9.1. Conducting screening tests, assessing physical fitness;

The issuance of ready-made food is allowed only after taking a sample with a mandatory mark of taste, readiness of dishes and a corresponding entry in the finished dishes rejection log.

In the layout menu, the date, the total number of eating children and separately children in the institution at a given time, as well as the number of eating employees are put down. Children receiving individual meals are highlighted in a separate column. A special column lists dishes for each meal and indicates the consumption of products for their preparation.

For each dish, the output (mass of a portion of the finished dish) is indicated in grams - per child. It is better to indicate the mass of products only in grams or only in kilograms.

The layout menu accurately indicates the full name of the product and its variety, category, type technological processing(meat or poultry of the 1st or 2nd category, fish with heads or fillets, dairy products with an indication of fat content, etc.). The consumption of products of the same name is determined for each dish separately, and not for all meals.

The layout for the preparation of a particular dish should be constant. If the required quality of the dish is not achieved according to the accepted recipe, for example, with the indicated amount of cereal, the porridge turns out to be too thick or vice versa, then test cooking is carried out in the presence of a health worker.

When compiling a menu layout, you need to take into account the daily volume of food and the mass of each dish. The amount of food should be appropriate for the age of the child

The output of each dish is noted in the menu-layout and in the menu, which is posted for parents. Moreover, in the second courses, the output of meat or fish products, garnish, sauce and other products that complement it are separately indicated. Separately record the output of dishes for children of early and preschool age.

4. Calendar of preventive vaccinations

If earlier it was strictly forbidden to admit an unvaccinated child to a kindergarten, now there is no such provision in the law "On Immunoprophylaxis of Infectious Diseases".

The nurse should be aware that when vaccinating children, it is very important to: inform parents about the vaccination and obtain their written consent to conduct it; have a permit-permission for vaccination; comply with sanitary and hygienic requirements for the receipt, transportation, storage of the vaccine and vaccination (the latter only in the presence of a doctor); track the child's well-being and his reaction to the vaccine.

Paragraph 2 of Art. 11 of Law No. 157FZ "On Immunization of Infectious Diseases" states: "Prophylactic vaccinations are carried out with the consent of citizens, parents or other legal representatives of minors ...". It becomes clear that the doctor and nurse can only advise parents to vaccinate their child and give information about it. At the same time, the kindergarten nurse is obliged to inform the parents (legal representatives) about the vaccinations recommended by the "National Immunization Calendar", corresponding to the age of the child.

In addition, according to the Law "On the Protection of the Health of Citizens", parents of pupils have the right: to receive complete and objective information about the need for preventive vaccinations, the consequences of refusing them, post-vaccination complications; choice of institution where to get vaccinated (kindergarten or children's clinic); refusal of vaccinations, which must be in writing.

National calendar of preventive vaccinations

Child's age

Name of vaccination

Second vaccination against viral hepatitis B, first vaccination against diphtheria, whooping cough, tetanus, polio

4.5 months

Second vaccination against diphtheria, whooping cough, tetanus, polio

6 months

Third vaccination of viral hepatitis B, against diphtheria, whooping cough, tetanus, poliomyelitis

12 months

Fourth vaccination against viral hepatitis B (children at risk), vaccination against measles, rubella, mumps

18 months

First revaccination against diphtheria, whooping cough, tetanus, poliomyelitis

20 months

Second revaccination against polio

Revaccination against measles, rubella, mumps

Second revaccination against diphtheria, tetanus

Revaccination against tuberculosis (BCG)

From 1 year old, not sick, not vaccinated, vaccinated once against rubella

Rubella Immunization

All children attending preschool

Influenza vaccination

5. Quarantine measures

Quarantine is a system of measures that ensures the prevention of the spread of infectious diseases (by isolating patients, prohibiting entry and exit from the zone affected by the infection). Quarantine terms are established on the basis of data on the longest duration of the incubation period of the disease

At the morning reception, during quarantine for any disease of the child, a survey of parents is conducted about the general condition of the child, the nature of the stool. If there are complaints and clinical symptoms characteristic of this disease, the child is isolated. The results of medical observation are reflected in outpatient cards, in the histories of the development of the child (in special observation sheets for contacts in the outbreak), in hospitals - in the case histories of contacts. A medical worker who monitors contacts systematically conducts hygienic training with them.

The staff of the children's institution, as well as parents, should be instructed in detail about the first symptoms of the disease and the need to immediately report to medical workers about all deviations in the child's condition.

During the observation period, the quarantine group of the children's institution should not take part in activities held in common premises with other groups; groups are separated during walks. For the quarantine group, the self-service system and cultural events are canceled.

According to epidemic indications, the contingent of the examined can be expanded, including the personnel of the groups and the catering unit.

The nurse of the children's institution instructs and trains nannies, educators, kitchen workers, laundry workers, etc. on the implementation of disinfection during the quarantine period, controls the completeness and proper quality of its implementation.

Conclusion

The nurse of the kindergarten carries out: control over compliance with the sanitary and anti-epidemic regime, the sanitary condition of the premises and the site of the kindergarten, prepares children for a medical examination and participates in it, conducts anthropometric measurements, preventive vaccinations.

The nurse makes requests for medicines, disinfectants, medical instruments and equipment. She conducts sanitation work among employees of the institution and parents, monitors the timely passage of medical examinations by employees of a preschool institution; maintains relevant medical records.

The nurse monitors the cooking technology, the compliance of the weight of portions with the menu layout, and also controls the correct selection and storage time of the daily sample.

Every day, the nurse draws up a menu-layout, which is a document for receiving products from the pantry and a work sheet for the cook on the consumption of food for dishes in separate meals.

The Nurse of the Nursery School is obliged to inform the parents about the vaccinations recommended by the "National Immunization Schedule" corresponding to the child's age.

Literature

1. Belyakov V.D., Degtyarev A.A., Quality and effectiveness of anti-epidemic measures. L., Medicine, 1991 - 72 p.

2. Kasatkin V.N. Handbook of a kindergarten nurse. Publisher: Linka-Press, 2004 - 42 p.

4. Organization medical control for the development and health of preschoolers and schoolchildren on the basis of mass screening tests and their recovery in a kindergarten, school. Method. manual edited by G.N. Serdyukovskaya "Medicine", 1996 - 32 p.

5. Practical skills of a pediatrician: a practical guide. Chichko M.V. etc. "Medicine", 2005 - 348 p.

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Annual report on the activities of the head nurse of kindergarten No. 22 "Eaglet"
January 14, 2012
I. Organizational events
II. Therapeutic and preventive work
III. Control of physical education of children
IV. Anti-epidemic work
V. Sanitary and educational work
VI. Training
I. Organizational arrangements
1. Reconciliation of the lists of children enrolled in a preschool educational institution (hereinafter - preschool educational institution), and verification of the availability of the following medical documents:
Card of preventive vaccinations (form No. 063 / y);
The history of the development of the child (form No. 112 / y);
Medical record of the child (form No. 026 / y-2000).
2. Registration of the following reporting medical documents, journals that meet the established requirements:

Cyclogram of work for a week;
the list and frequency of medical examinations, research and professional hygienic training;
journal for monitoring the sanitary condition of the preschool educational institution;
register of medical examinations;
journal of general cleaning of the treatment room (isolation room);
register of biological accidents;
journal of registration and control of the operation of the bactericidal lamp;
register of the temperature regime of refrigeration equipment;
dispensary journal;
journal of examinations for pediculosis;
book of records of contacts with carriers of acute infectious diseases;
register of infectious diseases;
child observation log;
journal of anthropometric measurements;
register of movement of children;
vaccination waiver log;
deworming journal;
immunization planning journal;
register of prophylactic vaccinations;
register of children referred to a tuberculosis dispensary.
3. Analysis of the health of newly admitted children. compilation of child health sheets based on the results of examinations.
4. Preparation for preventive examinations of children:
survey of parents;
measurement of blood pressure;
carrying out anthropometry;
plantography;
Kern-Jerasica test.
Data on acute morbidity and exacerbations of chronic diseases and functional disorders in children attending MBDOU -Kindergarten No. 22 "Eaglet", are given in appendices 1, 2.
5. Planning and drafting the following documents:
a comprehensive work plan for the year;
monthly work plan;
annual plan for preventive vaccinations;
vaccination planning table (when vaccinating, a written consent of the parents is required).
6. Sending the reporting documentation of the established form to the Children's City Polyclinic No. 1 (hereinafter - DGP No. 1).
7. Extract of funds necessary for the work of the medical office:
medicines;
dressing material;
drugs for emergency care.
up

II. Therapeutic and preventive work
1. Implementation of outpatient reception of pupils. 45 applications were registered regarding the provision of primary medical care, including:
with symptoms of acute respiratory diseases;
nosebleeds.
2. Injury prevention:
educating children to recognize traumatic situations and avoid them;
elimination of adverse environmental conditions in which the child lives.
3. Carrying out examinations of children for pediculosis, entering the results of examinations in a special journal.
4. Implementation of anthropometry, including:
carrying out anthropometric measurements of pupils;
entering data into the log of anthropometric measurements;
preparation of recommendations for seating children according to height indicators in order to prevent posture disorders;
control over the correspondence of the sizes of tables and chairs to the growth of children.
5. Prevention of visual impairment in children:
conducting an annual eye examination of pupils;
entering data into medical records;
conversations with parents, referral to a specialist;
preparation of recommendations for seating children in a group.

6. Conducting scheduled preventive examinations of pupils:
– involvement of specialists from the SPD No. 1:
neurologist;
ophthalmologist;
orthopedist;
otolaryngologist;
dentist;...

Annual activity report

senior nurse of kindergarten No. 40.

1. Organizational measures

2.Treatment and preventive work

3. Control of physical education of children

4. Anti-epidemic work

5. Sanitary and educational work

6. Professional development

1. Organizational measures

*Reconciliation of the lists of children enrolled in a preschool educational institution

d / s No. 40, and checking the availability of the following medical documents:

Card of preventive vaccinations (form No. 63 / y);

dispensary journal;

examination log for pediculosis;

register of infectious diseases;

child observation log;

journal of anthropometric measurements;

immunization planning journal;

register of preventive vaccinations;

register of children referred to a tuberculosis dispensary.

*Analysis of the health of newly admitted children. Compilation of child health sheets

based on inspection results.

*Preparation for preventive examinations of children:


carrying out anthropometry.

*Planning and drafting the following documents:

comprehensive work plan for the year;

annual plan for preventive vaccinations;

vaccination planning table (the presence of written parental consent).

*Sending reporting documentation of the established form to the Children's City

polyclinic no.

* Statement of funds necessary for the work of the medical office:

medicines;

dressing material;

drugs for emergency care.

2.Treatment and preventive work

*Injury prevention:

educating children of the ability to recognize traumatic situations and avoid them;

elimination of unfavorable environmental conditions in which the child lives.

* Carrying out examinations of children for pediculosis, entering the results of examinations in

special magazine.

*Prevention of visual impairment in children:

conducting an annual eye examination of pupils;

entering data into medical records;

conversations with parents, referral to a specialist;

*conducting scheduled preventive examinations of pupils:

- involvement of specialists from Republic of Belarus No. 1.

neurologist

Laboratory tests of blood and urine.

* entering the results of examinations in the medical documents of pupils,

compilation of a report.

As a result of examination of 35 people, children with chronic

diseases. Referrals for additional examinations of children were given. Recommendations for their further improvement. Pupils with chronic diseases and frequently ill children are taken to the dispensary.

*Organization of examination for helminths .

35 children were examined. The disease has not been identified.

* Vaccination of pupils of MBDOU-Kindergarten No. 40 in 2012

*Organization of tuberculino-diagnosis of pupils with the identification of children

risk groups for tuberculosis, referral for examination to

Results of work:

3 people were sent for examination;

3 people were examined;

*Monitoring compliance with regime moments :

study load;

duration of walks;

catering.

3. Control of physical education of children .

*Implementation of control of physical education in the preschool educational institution.

* Control of the sanitary and hygienic state of the sports and physical culture

equipment and inventory, the condition of clothing and footwear.

*Organization and holding of health days in the preschool educational institution.

4.Anti-epidemic work .

*Prevention of infectious diseases:

disinfection of preschool educational institutions;

catering control;

organization of immunization;

*Prevention of tuberculosis:

tuberculin diagnostics of pupils;

Conversations with parents.

* Prevention of intestinal infections:

monitoring compliance with the sanitary and epidemiological regime in preschool educational institutions;

control of personal hygiene of pupils, staff, workers;

*Prevention of pediculosis:

conducting a weekly examination of pupils in accordance with the sanitary

epidemiological rules and regulations.

5. Sanitary and educational work.

Organization of lectures, conversations with staff in preschool educational institutions, parents.

Lecture topics for children:

1. "We are for a healthy lifestyle."

2. "Learn to eat right."

3.”Personal hygiene of a preschooler”.

Topics of lectures for the teaching staff:

1. Injury prevention.

2. Air-thermal regime.

3. Prevention of SARS and influenza.

Lecture topics for parents:

1.How to detect pediculosis.

2. What is a "button".

3. Hygiene of a preschooler.

6. Professional development.

1. Attending lectures, seminars.

2.Study normative documents.

(Organization of food in the preschool educational institution. We raise children healthy.)

Annual report on the activities of the head nurse of kindergarten No. 22 "Eaglet"
January 14, 2012
I. Organizational events
II. Therapeutic and preventive work
III. Control of physical education of children
IV. Anti-epidemic work
V. Sanitary and educational work
VI. Training
I. Organizational arrangements
1. Reconciliation of the lists of children enrolled in a preschool educational institution (hereinafter - preschool educational institution), and verification of the availability of the following medical documents:
Card of preventive vaccinations (form No. 063 / y);
The history of the development of the child (form No. 112 / y);
Medical record of the child (form No. 026 / y-2000).
2. Registration of the following reporting medical documents, journals that meet the established requirements:

cyclogram of work for a week;
the list and frequency of medical examinations, research and professional hygienic training;
journal for monitoring the sanitary condition of the preschool educational institution;
register of medical examinations;
journal of general cleaning of the treatment room (isolation room);
register of biological accidents;
journal of registration and control of the operation of the bactericidal lamp;
register of the temperature regime of refrigeration equipment;
dispensary journal;
journal of examinations for pediculosis;
book of records of contacts with carriers of acute infectious diseases;
register of infectious diseases;
child observation log;
journal of anthropometric measurements;
register of movement of children;
vaccination waiver log;
deworming journal;
immunization planning journal;
register of prophylactic vaccinations;
register of children referred to a tuberculosis dispensary.
3. Analysis of the health of newly admitted children. compilation of child health sheets based on the results of examinations.
4. Preparation for preventive examinations of children:
survey of parents;
measurement of blood pressure;
carrying out anthropometry;
plantography;
Kern-Jerasica test.
Data on acute morbidity and exacerbations of chronic diseases and functional disorders in children attending MBDOU - kindergarten No. 22 "Orlyonok" are given in appendices 1, 2.
5. Planning and drafting the following documents:
a comprehensive work plan for the year;
monthly work plan;
annual plan for preventive vaccinations;
vaccination planning table (when vaccinating, a written consent of the parents is required).
6. Sending the reporting documentation of the established form to the Children's City Polyclinic No. 1 (hereinafter - DGP No. 1).
7. Extract of funds necessary for the work of the medical office:
medicines;
dressing material;
drugs for emergency care.
up

II. Therapeutic and preventive work
1. Implementation of outpatient reception of pupils. 45 applications were registered regarding the provision of primary medical care, including:
with symptoms of acute respiratory diseases;
nosebleeds.
2. Injury prevention:
educating children to recognize traumatic situations and avoid them;
elimination of adverse environmental conditions in which the child lives.
3. Carrying out examinations of children for pediculosis, entering the results of examinations in a special journal.
4. Implementation of anthropometry, including:
carrying out anthropometric measurements of pupils;
entering data into the log of anthropometric measurements;
preparation of recommendations for seating children according to height indicators in order to prevent posture disorders;
control over the correspondence of the sizes of tables and chairs to the growth of children.
5. Prevention of visual impairment in children:
conducting an annual eye examination of pupils;
entering data into medical records;
conversations with parents, referral to a specialist;
preparation of recommendations for seating children in a group.

6. Conducting scheduled preventive examinations of pupils:
– involvement of specialists from the SPD No. 1:
neurologist;
ophthalmologist;
orthopedist;
otolaryngologist;
dentist;...

Content.
1. a brief description of institutions;
2. a brief description of the department, office in which the specialist works;
3. equipment and equipment of the workplace;
4. a list of accounting and reporting documents used by a specialist in the workplace;
5. measures to comply with personal security measures in the workplace;
6. the amount of work performed, quantitative indicators;
7. qualitative analysis of performance indicators for 1 year;
8. mastering new methods and applying them in practice;
9. implementation of mentoring activities;
10. ongoing anti-epidemic measures at the workplace;
11. a list of regulatory documents that guide the specialist in his activities;
12. assistance in emergency conditions, typical of the profile of work;
13. sanitary and educational work;
14. participation in the work of the Council of Sisters and public life institutions;
15. conclusion outlining the problems facing a specialist in labor activity and proposals for solving these problems;
16. suggestions for improving work, plans for the future.

characteristics of the institution.
Health care facility N is located at: N edge, N, st. H, 77. The polyclinic includes therapeutic, surgical departments of outpatient reception and a day hospital for 15 beds (10 therapeutic, 5 surgical, 2 of them gynecological).
The polyclinic is legally registered and licensed in 11 specialties: therapy, surgery, obstetrics and gynecology, dentistry, dermatovenereology, ophthalmology, otolaryngology, neurology, narcology and psychiatry, physiotherapy; carrying out preliminary and periodic medical examinations.
There are offices: pre-medical, ultrasound diagnostics, functional diagnostics, where they are carried out; ECG, computed spirography, Holter monitoring, EEG, EM-ECHO, ultrasound of the abdominal organs, parenchymal organs, heart, blood vessels, gynecological examination, there is an endoscopic room where EGD, colonoscopy, RRS and bronchoscopy are performed.
At the end of 2012, the served population of the N polyclinic was 8074 people.
Of them:
- employed - 3415 people.
- territorial population - 2071 people.
- pensioners - 1599 people.

The number of visits in 2013 in the polyclinic was 74261 visits.
The structure of the clinic includes:
1. Medical sites.
2. Doctors of narrow specialties.
3. Auxiliary - diagnostic services.
4. Day hospital.
5. Health centers.

Consultative and diagnostic reception is conducted by doctors of narrow specialties: ophthalmologist, surgeon, otolaryngologist, gynecologist, neurologist, psychiatrist - narcologist, cardiologist, dermatovenereologist, dentist.
In health centers with pre-trip medical examinations (PRMO), paramedics examine a professional group of drivers every time they enter a flight. The main task of the PRMO is to identify medical contraindications for admission to the flight, as well as operational dynamic monitoring.
Staffing with doctors 91.3%
The ratio of doctors and nurses is 1: 4.5
Staffing with paramedical staff 100%
Characteristics of the workplace.

The health center is a pre-medical stage of medical care, provides medical and preventive and sanitary and anti-epidemic support, as well as pre-trip and post-trip medical examinations for 330 people railway transport workers. There are 2 paramedics working in the health center.
The health center consists of three rooms:
? waiting rooms
? reception room PRMO
? treatment room
The health center is located at station H, on the first floor and close to the depot duty officer's office. Good access roads lead to the building, asphalt is everywhere.
In the reception office there is a stand where the monthly new issue of dignity is placed. newsletter, as well as various information on medical topics. Equipped telephone connection with the duty officer of the depot and the worker of the locomotive crews. The health center is equipped in accordance with Appendix No. 1 of the Instruction of the Ministry of Railways of the Russian Federation dated May 1, 1998 N TsUVS-552 "On the procedure for organizing and conducting pre-trip medical examinations of employees of locomotive crews." The health center is equipped with furniture and medical equipment according to the list:
- medical couch
-Desk
- table lamp
- hanger for outerwear
- paramedic's wardrobe
- fridge
- stethophonendoscopes
- thermometers, medical spatulas
- devices for indicating alcohol vapors in exhaled air Lion alkometer SD-400 and Lion alkometer SD2
- express drug test Immuno Chrome - 5 multi-express - 14 sets
- stowage suitcase with a set of medicines and medical supplies for emergency medical care
- tonometer - 1 pc.
- stopwatch - 1 pc.
There are also instructions for providing emergency care for myocardial infarction, hypertensive crisis. In the suitcase "emergency" there are stacks with the necessary medicines.
Treatment room.

If necessary, I provide medical assistance, which I spend in the treatment room, equipped with everything necessary equipment for procedures. The walls in the office are tiled to the ceiling, the ceiling is painted with light oil paint. The floor is covered with linoleum.
Office lighting natural and artificial (fluorescent lamps). Also, the office is equipped with a bactericidal lamp for quartzization.
For washing hands and rinsing tools, there is a sink with cold and hot water, soap, 2 individual hand towels, 2 individual towels for gloves for each paramedic).
The office has a refrigerator and a cabinet for medicines, where injectable drugs, emergency medicine kits are stored. Couch for patients. Desk for documentation.

In the treatment room there is a manipulation table for intravenous, intramuscular and subcutaneous injections, there are also bixes for sterilization and maintaining the sterility of napkins and tweezers, cotton balls. Rags that are sterilized in double-layer cloth bags made of dense fabric.
The treatment room has trays, tweezers, forceps, scissors, a mouth expander, a hemostatic tourniquet, test tube racks.
Bedside table with three sections, in the first section are stored disposable syringes for emergency care, in the second section - towels and sheets, in the third section in labeled containers of disinfectant, soda, soap, powder.
The manipulation table has two planes: on one there are trays with sterile wipes, a tray for empty ampoules, a tray for a container with a disinfectant and a clip for removing a needle from a disposable syringe for its subsequent disinfection, a bottle with antiseptic liquid, a hemostatic tourniquet and nail files for filing ampoules. On the second plane there are containers (marked) for used rags, surface treatment, treatment of working surfaces associated with blood, containers for disinfecting needles and containers for disinfecting cotton balls, a container for used gloves, a container for disinfecting used material when servicing a patient whose direction has a label.
The equipment of the treatment room should include a bactericidal lamp, in our office it is of a ceiling type. Cleaning equipment is available for cleaning the treatment room, it is also marked and stored in the places designated for it: two mops (for walls and floors), two buckets (for garbage of category A and B), a bucket for washing the floor, a bucket for preparing the hypochlorite stock solution , two basins for general cleaning (washing walls and panels and disinfection).

Accounting and reporting documentation of the health center.
The health center is equipped with a job description, other regulations Ministry of Railways of Russia, Ministry of Health of Russia, orders of the chief physician, forms of accounting documentation.
Forms of accounting medical records health center.

No. TsUVS - 552 FROM May 1, 1998. Ministry of Railways of Russia 1. Instruction on the procedure for organizing and conducting pre-trip medical examinations of locomotive crews.
Form NU-3 of the Ministry of Railways of Russia 2. Individual card of pre-trip medical examinations of an employee of a locomotive crew.
Form NU-4 of the Ministry of Railways of Russia 3. Record of pre-trip inspections of employees of locomotive crews.
Form NU-5 of the Ministry of Railways of Russia 4. Journal of registration of cases of removal from the flight of workers of locomotive crews.
Form NU-6 of the Ministry of Railways of Russia 5. Registration card for signs of the use of alcohol, narcotic drugs and psychotropic substances (state of intoxication).

In his work, the paramedic is guided by the following regulatory documents:
- Order No. 408 of 1989 Ministry of Health of the USSR "On measures to reduce the incidence of viral hepatitis and AIDS"
- SanPiN 2.1.3.2630-10 Sanitary and epidemiological requirements for organizations engaged in medical activities.
- Order No. 720 of 1978 Ministry of Health of the USSR "On the improvement of medical care for patients with purulent surgical diseases and the strengthening of measures for nosocomial infections"
- Order of the Ministry of Health of the Russian Federation No. 4 of 2003. "Recommendations for the prevention and diagnosis of arterial hypertension, features of the work of paramedics at pre-trip examinations"
- Order No. 8tsz dated 18.09.1990. Ministry of Railways of the USSR "On Approval of the Regulations on the Peculiarities of Working Time and Rest Time, Working Conditions certain categories employees of railway transport directly related to the movement of trains"
- sanitary rules 1.2.011-4 Rules for the collection, storage and disposal of waste from healthcare facilities
- Regulation No. 154 of 26.01.2011 On approval of the Procedure for conducting mandatory pre-trip or pre-shift medical examinations for railway transport common use"
- Letter No. 2510/9468-03-32 dated 21.08.2003 Ministry of Health of the Russian Federation "On pre-trip medical examinations of drivers Vehicle»,
- guidelines"Medical security traffic" and etc.
- Rules for the collection, storage of waste in health facilities. San-PiN 21.7.728-99.
- SanPiN 2.1.7.2790-10 "Sanitary and epidemiological requirements for the treatment of medical waste."
- Order No. 706 of 23.08.2010 "On approval of the rules for the storage of medicines".
- Guidelines 3.1.2313-08 "Requirements for the disinfection, destruction and disposal of single-use injection syringes."
- Resolution of the Chief State Sanitary Doctor Russian Federation dated January 11, 2011 N 1, Moscow "On approval of SP 3.1.5.2826-10 "Prevention of HIV infection" actions of a medical worker in an emergency.
- job description paramedic at the health center.

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