Organization of the work of the treatment room: regulatory documentation, responsibilities of medical staff, device and equipment

In the article, we will consider the organization of work of the treatment room.

A set of certain actions called the sanitary epidemiological regime allows creating the most favorable conditions for the complete recovery of patients, providing high-level hygiene and preventing the spread of infectious diseases within a medical organization. To ensure compliance with this regime, two basic conditions are required: the level of qualification of the procedural nurse and the availability of working equipment and facilities.

Organization of the work of the treatment room

Work in such an office requires nurses to have the ability not only to carry out medical manipulations, but also to ensure the sterility of the instruments and supplies used. Procedures in the form of blood sampling, along with intramuscular and intravenous injections, a throat swab for analysis, pressure measurement, autohemotherapy, cavity instillation, as well as dressings, can be performed in the treatment room according to the profile of the hospital.

As part of the storage of pharmaceutical drugs in the treatment room, they must all be labeled and placed on shelves in the refrigerator. The sterility of reusable instruments and dressings is ensured by placing them in special bix.

In the treatment room, there must also be containers with working solutions of disinfection substances. They are used for disinfecting instruments after their use (by soaking), as well as for all kinds of primary disinfection measures. The use of a quartz lamp provides cleaning of surfaces and the air.

What else involves the organization of the work of the treatment room?

Zoning

In order to ensure infectious safety within the framework of the treatment room, an instruction has been developed for dividing this room into functional zones, namely aseptic, economic and working. The current legislation does not regulate the requirement for zoning of such premises. Separation is carried out in accordance with the principle of epidemiology and infectious safety.

Responsibilities of the medical staff

The main function of medical personnel is to carry out measures to diagnose and treat the disease. The list of these activities for organizing the work of the nurse of the treatment room includes the implementation of medical manipulation and administration of prescribed pharmaceutical preparations to patients. These actions must strictly comply with all available standards that are set for specific activities. The procedural nurse, in turn, is obliged to assist the doctor in performing the following actions:

• During testing for an allergic reaction.
• Assist a patient who is in serious condition.
• Check the effect of a new pharmaceutical drug.
• Perform venosection.
• The procedure for determining the blood type and Rh factor of the patient.
• The implementation of a blood transfusion.

The organization of work of the nurse of the treatment room is subject to strict control.

In the event of complications due to medical and diagnostic measures, the nurse must report the incident to the doctor and stop the complication. The activities of the junior clinical staff should be organized and supervised by a medical nurse. She should also take care of preparing backup workers.

Normative acts

In organizing the work of the treatment room, documentation occupies an important place. To do this, use special magazines. The volume, along with the quality and terms of the clinical care provided, as well as the conditions for providing such, is controlled by the head of the medical institution. In addition, external regulatory agencies are also involved in oversight. Identification of defects in the provision of appropriate assistance entails disciplinary, and sometimes material liability.

In this regard, it is extremely important to fix everything that happens during the diagnosis and treatment of each patient in the documentation for organizing the work of the treatment room of the clinic, as this subsequently helps to prove the correctness of the personnel’s actions. Documentation is also considered equally important, because violation of the rules and incorrect entry of information is also considered a serious defect. The treatment room log is used to record the following actions:

• Blood transfusion or blood transfusion.
• The delivery of syringes (this information is usually taken into account in a separate journal).
• Taking a blood test to test for the presence of AIDS, to determine the Wasserman reaction, and to carry out biochemical studies. Each of the analyzes is recorded in a separate journal.
• Performing intravenous infusions (in the corresponding journal, the presence and use of droppers are also taken into account).
• The functioning of the dry oven.
• Implementation of general cleaning.
• Performing intramuscular injections.

What requirements for the organization of work of the treatment room exist, should every healthcare provider know.

In addition, in the framework of compliance with regulatory documentation, it is required to store logs taking into account the following criteria:

• Fixation of patients who have had hepatitis.
• Emergencies.
• The appearance of complications that arose in the process of medical activity.
• Fixing the air temperature in the refrigerator.
• Recording of cases of injuries by employees of medical facilities.
• Shelf life of pharmaceutical drugs.
• The quality of pre-sterilization cleansing.

Thus, clinical documents are a special form, which is kept by the staff of hospitals or clinics, noting in them the actions related to the provision of medical services. The institution is required to keep such documents for a specified period. In a special journal, appointments made by doctors are recorded. In addition, a general journal for recording the activities of the treatment room should be kept. Regulatory documentation that would specify uniform formats or templates does not yet exist. In this regard, in such organizations they choose the form of documents independently. It is important at the same time that all the entries made are understandable, and in addition, written in readable and distinct handwriting.

Shelf cards are used to organize the work of the treatment room of the clinic.

Shelf cards

They are used to identify pharmaceutical drugs that are stored in this room. This identification method is used along with the use of electronic special devices and codes, which fully complies with the rules approved in the Order of the Ministry of Health of the Russian Federation. They stipulate the necessary conditions for the storage and placement of medicines. But at the same time, the document does not stipulate any standards for maintaining a rack card. As a rule, they are placed in a cabinet, which is not a room, which explains the lack of regulatory requirements. Against this background, sometimes at the regional level, authorities introduce regulations on the design of rack cards.

Further, we will focus on the organization of work of the hospital treatment room.

Equipment and device

In a hospital there should be two treatment rooms. One of them should be intended for intravenous and intramuscular intervention, and the other for subcutaneous injection. The area of ​​such a premises should be from fifteen to twenty square meters. It must be equipped with sources of artificial and natural lighting, equipping with exhaust and supply ventilation. The temperature should be at least twenty degrees, relative humidity is sixty to sixty-five percent.

According to the organization of the treatment room, the room is ventilated at least four times a day. Bactericidal irradiators of reflected and direct action are turned on for thirty to sixty minutes. Walls along with floors and ceilings should be made of moisture-resistant materials that are resistant to disinfectants and detergents. The treatment room must be equipped with the following items of use:

• Hand and glove towel.
• Hangers for gowns of the patient and the nurse.
• Sink for washing hands (it is important that it is with an elbow valve).
• A sink for washing instruments after a disinfection and sterilization cleaning procedure.

As for the nurse's workplace in the treatment room, it is equipped with the following items:

• Sterile table.
• Desktop for injection preparation.
• One or two manipulation tables.
• A pair of couches and a set of venous tourniquets.
• The presence of a set of oilcloth pillows.
• The presence of a cabinet with injection solutions.
• First-aid kits for emergency patients (with anaphylactic shock, myocardial infarction, and so on).
• A sufficient number of syringes.
• Bixes with dressings.
• Disinfectant containers for syringes, needles, dressings, gloves, rags.

In order to organize the work of the treatment room and dressing room, at least once a week the premises are cleaned. When working in such a room, the nurse must follow all safety precautions. For example, it is forbidden to work with broken syringes or those that have cracks. Worn syringe piston gaskets and other defective tools must not be used.

The equipment standard, documentation and organization of work of the treatment room should be strictly observed.

All electrical appliances available in the cabinet must be earthed. It is forbidden in the presence of patients to turn on open lamps of bactericidal irradiators. Care should also be taken when working with potent drugs and disinfectants that can cause burns or poisoning. Next, we will talk in detail about the nurses and their duties and rights.

Nurses and their responsibilities

Consider the organization of work of the sister of the treatment room in more detail.

This job title should do the following:

• Provide a high level of professional medical communication.
• Prepare the workplace by rationally organizing your work in a medical preventive institution (MPI).
• Work planning and analysis of performance indicators.
• Providing a safe environment for the patient and staff.
• Ensuring the infectious safety of the patient and staff (we are talking about compliance with the sanitary, anti-epidemic and hygienic regimen).
• Implementation of standardized nursing technologies (preventive, curative and diagnostic manipulation).
• The implementation of all stages of the nursing process during periods of daily life, illness and rehabilitation of patients.
• Providing nursing counseling and training for the patient and his family. What else involves the organization of work of a nurse in the treatment room?
• Providing injured and sick patients with emergency first aid in case of injury, poisoning, acute condition and in the focus of disasters in accordance with existing state standards.
• Keeping records and analysis of demographic and social structures of the population on the site along with the implementation of medical social patronage.
• Implementation of propaganda of a healthy lifestyle and conducting sanitary and educational work.
• Registration and reporting medical documentation.
• Coordination of their professional and social activities with the work of other employees and teams in the interests of patients.
• Compliance with safety and health measures for all personnel.
• Independently obtaining additional knowledge and skills in the framework of professional activities.

The organization of work of the nurse of the treatment room provides for certain prerogatives.

Workers rights

Nurses are vested with the following rights:

• Making suggestions to management on how to increase productivity and organize labor.
• Taking part in the discussion of issues that correspond to the position, attending sessions of sections for procedural nurses.
• Taking part in a cross-audit as directed by management. Acquaintance of the employee with the acts of inspections.
• Making decisions that are in line with competency.
• Announcing reprimands or penalties orally to the junior staff due to malfunctions.
• Request for incentives for junior staff in treatment rooms.

Children's health facilities

Let us consider in more detail the features of the organization of work of the treatment room of children's health facilities.

Children's medical preventive institutions include hospitals (hospitals), polyclinics, dispensaries, departments of maternity hospitals and motels for babies. Preventive assistance is provided in educational and educational institutions (for example, in a children's home, a nursery school complex, school, rest camp, sanatorium type, among others, and so on).

A children's hospital is a preventive medical institution intended for children who are under the age of eighteen years old and who need constant (i.e. stationary) supervision. There are different types of children's hospitals. For example, according to the profile criterion, they are multidisciplinary and specialized, and according to the organization system they are distinguished not united and combined with the clinic, according to the volume of their activity they are divided into different categories depending on the number of beds. Children's hospitals can be district, city, clinical (when the department of a medical or scientific research center operates on the basis of the institution), regional, republican.

The main task of modern hospitals for children is rehabilitation assistance, which includes the following four stages: diagnosis, emergency treatment and surgery, basic therapy and rehabilitation. Children's hospitals have the following basic responsibilities:

• Providing highly qualified therapeutic assistance.
• The process of putting into practice modern methods of diagnosis, therapy and prevention of various diseases.
• Consulting and methodological work in the sponsored region.

Each hospital for children has the following departments:

• Emergency room.
• The medical department, that is, the hospital.
• Diagnostic sector (or appropriate laboratories and cabinets).
• Pathology department.

The auxiliary divisions of the medical and preventive institution are the pharmacy along with the catering department, the office of medical statistics, the archive, the administrative office, the library and so on. The following categories of staff are provided in the children's hospital:

• The position of the chief physician and his deputy for medical treatment.
• Deputy on economic part.
• Heads of departments, along with resident doctors, senior and junior nurses.

Employee Responsibilities

The duties of the medical staff of children's hospitals include the provision of highly qualified medical care for sick children. In large hospitals for small patients there is a position of a teacher who is engaged in educational work. There are also states in certain technical and economic specialties (we are talking about cooks, engineers, locksmiths, accountants, and so on).

We examined the organization of work of the treatment room.