Parents often have to deal with various diseases in their baby, which, alas, accompany him during the entire period of growing up, and therefore an inevitable and frequent event for them is a visit to the doctors of the children's clinic. The structure and organizational system of this institution, however, is not transparent and understandable for everyone, and therefore in today's article we will understand this issue. We will also find out what is the procedure for contacting local pediatricians, and what is their area of responsibility.
Definition of a medical institution
So, what is a children's clinic? The tasks, structure and features of this outpatient unit of the state health care system involve assisting children from birth until they reach adulthood.
In this case, the main work should not be aimed at treating the child in fact, but at the prevention of his diseases, his timely medical examination. The structure of the children's clinic does not allow for active manipulation of patients. Diagnostic and consultative assistance is provided to a greater extent there. In some cases, outpatient treatment in the clinic is also possible if the scheme prescribed by the doctor allows the provision of medical and other types of care in a day hospital and does not require round-the-clock monitoring of the patient.
Clinic functions
The main function of this institution is to serve patients who do not need urgent hospitalization. At the same time, the provision of services by medical personnel occurs not only in the conditions of a children's clinic. The structure of the institution guarantees the departure of pediatricians and patronage nurses at home.
The list of functions also includes the organization of preventive measures aimed at reducing the incidence rate among children. There are several ways to achieve this:
- establishing a system of periodic scheduled examinations of patients of all age groups. In this case, special attention is paid to babies up to a year;
- popularization of a healthy lifestyle among children, timely anti-epidemic measures;
- mandatory must be carried out mass immunization against infectious diseases in accordance with WHO standards and regulations.
The structure of the children's clinic implies the presence of specialized specialists in its staff who are able to provide initial consultative and diagnostic assistance to patients. Without fail, this is a surgeon, orthopedist, neurologist, ENT specialist and ophthalmologist. Large polyclinics of the 1-2 category are also assigned a cardiologist, infectious disease specialist, dentist, psychologist, speech therapist and other specialists.
In addition, the functional responsibilities of medical personnel employed in children's clinics suggest the establishment of a system of measures aimed at preparing children for admission to schools and kindergartens.
Objectives of the institution
In addition to the direct treatment of patients and the implementation of measures to prevent diseases among children, outpatient services do the work of providing clinical and expert opinions. It is in this institution that an examination of the disability of children and adolescents (temporary and persistent) is carried out.
An equally important task is the competent preparation of statistical, accounting and reporting documentation. At the moment, each clinic has a specific area. The pediatricians responsible for the territory entrusted to them are required to monitor the situation with the physical and mental development of children from their area, keep records of wards from the risk group.
What other services can a children's clinic provide to patients? The structure, tasks and operating principles of each institution directly depend on which category is assigned to it. We will discuss this in more detail later.
Categorization
Children's clinics are divided into only five categories. This division depends on the number of patients to whom a particular medical institution provides its services. In large cities, these are mainly clinics of the 1st and 2nd categories, which, respectively, can receive up to 800 or 700 patients per day. At the same time, the structure and organization of the children's clinic of the first category falls on the shoulders of 50-70 doctors, and the smaller institution in attendance in the state can contain up to 50 medical posts.
Such clinics are most often very well equipped and have additional services in their structure:
- physiotherapy room and exercise therapy;
- massage room;
- dental office;
- a clinical laboratory, including an X-ray room;
- unit working in the field of psychological rehabilitation of children.
Small clinics of the 4th and 3rd category per day can accept up to 500 patients, no more than forty doctors are involved in their staff. Institutions of the 5th category have the least load (up to 150 people come here). Most often these are clinics located in small settlements, such medical facilities have a small staff, which is mainly represented by general practitioners (pediatrician or family doctor).
Organizational structure of the children's clinic
Regardless of its category, a children's clinic must comply with generally accepted state standards. The structure of the described medical institution consists of the following departments:
- Clinic management (head physician). The administrative and economic part of the medical institution is also subordinate to this.
- Information office, which includes the registry and methodology office.
- Pediatric department involved in medical and preventive activities (district pediatricians, a healthy child’s office, vaccination room, treatment room).
- Department of counseling and diagnostics (offices of narrow-profile specialists, rooms where patients undergo diagnostic measures, physical procedures).
- Laboratory.
- Emergency room.
- Cabinet for work with school and preschool educational institutions.
- Day hospital.
If we consider an outpatient clinic for adults and a children's clinic, then there is a significant difference between them. What is the difference between the structure of the children's clinic? The layout of the room involves the creation of two separate entrances to the medical facility so that healthy and sick children do not come into contact with each other.
Medical staff
The basis of the staff of any children's clinic is pediatricians. According to the standards, there are about 800 patients per specialist. In practice, this number is much higher due to the insufficient number of qualified specialists (especially in small cities and towns).
Within one reception hour, the pediatrician needs to examine an average of 6 people; the time that a specialist can devote to each patient is no more than 15 minutes. And when leaving the house for one patient, he can spend a maximum of 30 minutes. During professional examinations, the doctor’s workload increases, so in one hour he needs to let seven children go.
According to the civilian schedule, there is 1.5 nursing rate per one pediatrician rate. Employees from the mid-level medical staff conduct an appointment with doctors, carry out procedures in handling rooms. Patronage nurses go to newborn children to provide advice to young mothers and to monitor babies.
The structure and tasks of the children's clinic have a serious focus on the provision of medical services to children in their first year of life. Before the baby is 24 days old, a pediatrician and a nurse come to him weekly (alternately). This measure helps reduce morbidity and mortality among newborns.
Providing specialized assistance
The number of specialists of narrow specialization directly depends on the category of the clinic. We will talk about their functional responsibilities in more detail now. At the age of one month, each child is subject to examination by such doctors as a neurologist, surgeon, orthopedist and ophthalmologist. These specialists help at an early age to identify possible health problems of the baby, including a lag in mental and physical development.
Also, the pediatrician can refer the child for examination to a cardiologist, ENT specialist, hematologist, dermatologist, infectious disease specialist, endocrinologist or gastroenterologist. Before conducting an examination with narrow specialists, the child will need to conduct a comprehensive examination, the direction for which the district pediatrician gives. It includes blood tests, urine, feces, x-rays, abdominal ultrasound and neurosonography.
Not always the structure and functions of the children's clinic allow you to do all these manipulations on the basis of one institution, so doctors can give a ticket to the district or city children's hospital.
Immunization of children
Mass vaccination of the population against certain infectious diseases is one of the main tasks of medical institutions. The vaccination procedure is simple and transparent. First of all, the pediatrician should examine his patient and make a conclusion about his state of health. A healthy child who has no reason for medical attention from vaccinations is given a vaccine. Manipulation is carried out in a special office.
The structure of the vaccination room in the children's clinic is a separate service in view of the fact that there is organized work on the supply, storage and use of accountable drugs. The required air temperature is maintained in this room, special equipment is provided.
Manipulations and day care
In the conditions of a children's clinic, children are provided with not only consultative and diagnostic assistance, but also therapeutic measures, rehabilitation procedures:
- balneotherapy;
- mud therapy;
- water treatments;
- Exercise therapy, therapeutic massage;
- UHF, tube, inhalation, paraffin warming, etc.
All these procedures are carried out only after the appointment of a doctor. Junior and mid-level medical personnel cannot manipulate the patient based on their own decisions.
Work at home
The structure and organization of the children's clinic allows visits to patients at home. Pediatricians make departures according to the schedule, each in its own area. Calling a doctor at home is done by telephone through the registry.
At the same time, at home, the doctor can examine the child not only at the initial stage of the disease. Repeated treatment is possible if the patient does not feel better or his condition worsened. Documentation (prescription, referral for tests, ultrasound or radiography, contacting a specialist) at home is also possible.
Age of children in the clinic
Patients can go to the children's clinic from birth until they are 18 years old. At the same time, help is also provided to pregnant women who have been diagnosed with a complication of fetal development. A visit to the local pediatrician is also planned for expectant mothers of completely healthy babies. A pediatrician should conduct an explanatory work with a future woman in labor on how to care for a newborn, and advise her on issues of natural feeding.
When the child reaches the age of majority, the district pediatrician transfers his patient to a family doctor or therapist, draws up all the medical documentation necessary for this process.