What should the paramedic fap do. Job description of a paramedic fap

The FAP paramedic is obliged to:

1. Conduct outpatient reception and care of patients, including children, at home according to the established schedule.
2. Provide emergency and emergency pre-medical care in conditions that threaten human life and health.
3. To carry out timely and in full the appointment of a doctor when organizing dynamic monitoring and treatment of the patient at the place of residence.
4. To carry out dynamic monitoring, including control over the organization of timely treatment, of patients with socially significant diseases (tuberculosis, sexually transmitted diseases, mental and narcological diseases, oncological pathology, diabetes).
5. Carry out the simplest physiotherapeutic procedures: ultraviolet irradiation, paraffin therapy, solux (if you have the appropriate training).
6. To participate, under the guidance of doctors of medical and preventive institutions, in conducting preventive and dispensary examinations of decreed groups of the population and patients registered with dispensaries. Keep control cards (form No. 030 y) for dispensary patients in the prescribed manner and ensure their timely appearance to specialist doctors; to carry out preventive measures among dispensary patients according to the recommendations of doctors.
7. Carry out activities for the active early detection of patients and persons with risk factors for the development of diseases; organization of a fluorographic examination of the attached population; cytological examination of women, measurement of blood pressure from 7 years of age and older, measurement of intraocular pressure in persons over 40 years of age).
8. Carry out patronage of pregnant women (in the absence of a midwife) and children under 1 year old; carry out dynamic monitoring of children of the first year of life at risk, prevent rickets, anemia, promote rational feeding, participate in work with socially disadvantaged families, family planning.
9. Timely and efficiently carry out preventive vaccinations for the population in accordance with the vaccination schedule; know the permanent and temporary contraindications to them.
10. Carry out, under the guidance of doctors of medical and preventive institutions and the supervision of specialists of the Central State Sanitary and Epidemiological Service, a complex of sanitary and hygienic and anti-epidemic measures in the event of an unfavorable epidemiological situation in the service area. Know the clinic of especially dangerous infections and the tactics of the middle medical staff upon their discovery.
11. Regularly conduct house-to-house rounds in order to actively monitor the status of the attached population, early detection of diseases, including infectious ones.
12. To carry out under the guidance of the head of the FAP:
- preventive measures occupational injury and occupational diseases;
- work as part of mobile sanitary posts at field camps and in places of work of brigades of agricultural enterprises;
- control over the sanitary condition of the territory of attached settlements, reservoirs, hairdressers, dairy farms, grocery stores, canteens, hostels, schools, preschool educational institutions, water supply sources.
13. Participate under the guidance of the head of the FAP in providing medical care in the event of an emergency.
14. Follow the established normative documents sanitary and anti-epidemic regime.
15. Comply with the requirements of the current regulatory legal acts M3 of the Russian Federation and M3 of the Republic of Belarus for the receipt, storage, accounting, purpose, use and release medicines, honey products and ethyl alcohol.

16. Keep approved records - reporting forms of medical documentation and timely submit reports on the work done to the head of the FAP.
17. Comply with the rules of fire safety and labor safety at the workplace.
18. Regularly engage in health education, hygiene education and education of the population.
19. Carry out work in accordance with the principles and norms medical ethics and deontology.
20. Systematically level up vocational training: take an active part in the work of district seminars, meetings for health workers, periodically travel to advanced FAPs to exchange work experience, get acquainted with the relevant medical literature. Raise professional qualification at advanced training courses in postgraduate education institutions at least once every five years in accordance with the established procedure.
21. Annually pass an examination of the level of training in the technique of setting and reading the results of tuberculosis tests and revaccination against tuberculosis with obtaining a certificate - admission.

The FAP paramedic has the right:

1. Within its competence, conduct an examination, establish a diagnosis, prescribe treatment, perform medical manipulations and preventive measures.
2. Use all approved instructive and methodological materials issued by the health authorities of the Russian Federation and the Republic of Belarus regarding the activities of the FAP.
3. Make proposals for improving the work of the FAP, improving the system of medical care in the service area.
4. To improve professional qualifications at advanced training courses in postgraduate education institutions at least once every five years in accordance with the established procedure.
5. Enjoy the established benefits in accordance with applicable law.

The FAP paramedic is responsible for:

1. Fulfillment of assigned duties in accordance with this job description.
2. Compliance with the current legislation and other regulations of the Russian Federation and the Republic of Belarus, the implementation of orders, instructions and guidelines of the Ministry of Health of the Russian Federation and the Republic of Belarus, instructions and orders of the head of the municipal health institution to which the FAP is subordinate, the head of the FAP.
3. Compliance with the internal regulations of the FAP and labor discipline.

The responsibility of the FAP paramedic for violation of this job description is carried out in accordance with applicable law.

A person with a secondary medical education in the specialty "General Medicine" and an appropriate certificate of a specialist is appointed to the position of a FAP paramedic.

1. General Provisions

1. This job description defines the job duties, rights and responsibilities of the head of the feldsher-obstetric station (hereinafter - FAP).
2. A person with a secondary medical education in the specialty "Medicine" or "Obstetrics" is appointed to the position of head of the FAP.
3. The head of the FAP must know the basics of the legislation of the Russian Federation on health care; legal documents regulating the activities of healthcare institutions; the basics of organizing medical and preventive care in hospitals and outpatient clinics, emergency and emergency medical care, disaster medicine services, sanitary and epidemiological services, drug supply to the population and health care facilities; theoretical basis, principles and methods of clinical examination; organizational and economic foundations for the activities of health care institutions and medical workers in the conditions of budget-insurance medicine; fundamentals of social hygiene, organization and economics of healthcare, medical ethics and deontology; legal aspects of medical activity; general principles and basic methods of clinical, instrumental and laboratory diagnostics of the functional state of organs and systems of the human body; etiology, pathogenesis, clinical symptoms, course features, principles of complex treatment of major diseases; rules for the provision of emergency medical care; bases of examination of temporary incapacity for work and medico-social examination; fundamentals of health education; internal labor regulations; rules and norms of labor protection, safety measures, industrial sanitation and fire protection.
4. The head of the FAP is appointed to the position and dismissed by the order of the head of the healthcare institution in accordance with the current legislation of the Russian Federation.
5. The head of the FAP is directly subordinate to the head of the governing body or healthcare institution or his deputy.

2. Job responsibilities

The head of the FAP has the right to:
1. make proposals to the management of the institution to improve the work of the FAP, the treatment and diagnostic process, incl. on the organization and conditions of their labor activity;
2. control the work of middle and junior medical personnel, give them orders within the framework of their official duties and demand their precise execution, make proposals to the management of the institution for their encouragement or imposition of penalties;
3. request, receive and use information materials and legal documents necessary for the performance of their official duties;
4. to take part in scientific and practical conferences and meetings, which discuss issues related to his work;
5. pass certification in accordance with the established procedure with the right to obtain the appropriate qualification category;
6. to improve their qualifications at refresher courses at least once every 5 years.
The head of the FAP uses all labor rights in accordance with Labor Code RF.

4. Responsibility

The head of the FAP is responsible for:
1. timely and high-quality implementation of the duties assigned to him;
2. organization of their work, timely and qualified execution of orders, instructions and instructions of the management, regulatory legal acts on their activities;
3. compliance with internal regulations, fire safety and safety;
4. timely and high-quality execution of medical and other service documentation provided for by the current legal documents;
5. providing, in accordance with the established procedure, statistical and other information on their activities;
6. Ensuring compliance with executive discipline and performance of their duties by subordinate employees (if any);
7. prompt action, including timely informing the management, to eliminate violations of safety, fire and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors.
For violation of labor discipline, legislative and regulatory legal acts, the head of the FAP can be brought in accordance with the current legislation, depending on the severity of the misconduct, to disciplinary, material, administrative and criminal liability.

The feldsher-obstetric station (FAP) is the largest pre-medical outpatient and polyclinic institution providing primary health care to the rural population and plays big role in medical and preventive maintenance, carrying out a complex of preventive and health-improving measures, as well as in sanitary and anti-epidemic work. The creation of the FAP was caused by the peculiarities inherent in rural healthcare, the need to bring medical care closer to the population in the conditions of a large service radius of the district hospital (medical outpatient clinic) in relation to all available settlements.

FAP provides early detection of infectious patients, conducts primary anti-epidemic measures in outbreaks, current sanitary supervision over the territory of populated areas. An important place in the activities of the FAP is occupied by the active implementation of sanitary and educational work among the population. Paramedics and midwives are directly involved in organizing and conducting medical examinations, annual clinical examination of the rural population. The main tasks of the FAP are:

Provision of pre-medical medical care to the population;

Timely fulfillment of doctor's prescriptions in full;

Organization of patronage of children and pregnant women, systematic monitoring of the health status of disabled people and participants in the Great Patriotic War;

Carrying out, under the guidance of a doctor, a complex of preventive, anti-epidemic and sanitary-hygienic measures aimed at reducing morbidity, agricultural and domestic injuries;

Implementation of measures to reduce mortality, including child and maternal;

Participation in the current sanitary supervision of institutions for children and adolescents, communal, food, industrial and other facilities, water supply and cleaning of settlements;

Door-to-door rounds according to epidemic indications in order to identify infectious patients, persons in contact with them and suspicious of infectious diseases;

JOB DESCRIPTION

head of the feldsher-obstetric station (approximate)

1.
GENERAL PROVISIONS

1. A paramedic, midwife, nurse with a completed secondary medical education is appointed to the position of head of the feldsher-midwife station.

2. The head of the FAP is appointed and dismissed by the chief physician of the Central District Hospital (TMO).

3. In his work, the head of the FAP reports directly to the head physician of the Central District Hospital (TMO).

4. The head of the FAP for processing issued documents has a round seal, a stamp indicating the name of the FAP, as well as a triangular seal

5. The head of the FAP is at the same time the head of the FAP pharmacy and performs the duties stipulated by the "Regulations on Pharmacy Points of the 2nd Category".

6. The head of the FAP maintains documentation and reporting in accordance with approved forms. Folders of accounting and reporting documents are stored at the FAP.

7. The head of the FAP is subordinate to the middle and junior medical staff of the FAP.

2. RESPONSIBILITIES

The head of the FAP is obliged to:

1. Provide free medical care to the population of your site, and, if necessary, to sick and injured people who do not live in the area of ​​the service site.

2. Conduct an outpatient appointment at the FAP of all patients, pregnant women, puerperas, children and serve them at home.

3. Provide first aid for acute illnesses and accidents, followed by calling a doctor to such a patient or referral to a rural district hospital or other medical institution, depending on the state of health. If necessary, accompany the patient personally.

4. Identify all pregnant women among the population served and take them into account in the early stages of pregnancy. Record and identify long-term and frequently ill patients with an unexplained diagnosis, as well as those requiring medical intervention. Ensure their timely appearance at the appropriate health facility.

5. Carry out treatment of patients under the supervision of a doctor, identify the source of the disease, examine persons in contact with patients, and also ensure timely detection of tuberculosis and oncological patients and their treatment as prescribed by a doctor.

6. Actively participate in the medical examination of the population, select the contingent to be examined by a doctor. To carry out dynamic monitoring and control over the correct organization of work, to carry out health-improving measures prescribed by the doctor.

7. Take all measures to ensure that all pregnant women are under observation. At each inspection, turn Special attention for the presence of edema, measure blood pressure, enter all survey data into the pregnancy card (f.11). Send pregnant women for examination to the doctor and to the nearest laboratory for testing according to the established deadlines, as well as to collect material for cytological examination with subsequent referral to the cytological laboratory. Ensure that all pregnant women are admitted to the maternity ward for delivery.

8. Provide medical care to preschool institutions and schools if these institutions do not have full-time health workers.

9. Conduct preventive examinations of women and other contingents of the population (disabled people and participants in the Great Patriotic War, machine operators, livestock breeders, etc.) together with the doctor of a rural district hospital (rural medical outpatient clinic (SVA), central district hospital (CRH)) Persons who, during preventive examinations, have revealed changes in organs, tissues, mucous membranes and skin, should be referred for examination to specialist doctors.

10. Carry out patronage of all pregnant women, puerperas, children from birth to three years, according to the established deadlines, in order to identify previously prescribed appointments and regimens, teach women the rules of personal hygiene and child care, observe the feeding regimen, and also to familiarize themselves with housing - living conditions of women and children.

11. Carry out preventive vaccinations for children and adults under the supervision of a doctor at a rural district hospital (SVA, CRH) in accordance with current instructions.

12. To signal to the chief doctor of the CRH (TMO), as well as the raiTsHiE about each case of an infectious disease and at the same time send them an emergency notification, take measures to prevent the spread of the disease.

13. Monitor the sanitary cleaning of settlements, conduct door-to-door walks, monitor the sanitary and hygienic condition of schools, kindergartens, shops, food enterprises, water supply sources, etc. Signal to the district center of public health and safety with the provision of acts on the unsatisfactory condition of the objects being examined.

14. Carry out antihelminthic measures:

Amnestic examination of certain groups of the population for tenidosis;

Registration of identified patients and their deworming.

In accordance with the plan, conduct systematic health education among the population by holding lectures, talks, issuing health bulletins, etc., using clubs, schools and other public places for these purposes. Conduct individual sessions with pregnant women on psychoprophylaxis. Consider sanitary propaganda as a necessary part of the whole complex of medical and preventive work. Actively promote a healthy lifestyle among the population.


16. Carry out all medical and preventive, sanitary and epidemiological work according to the plan approved by the chief physician of the Central District Hospital (TMO).


17. Fulfill the obligations for labor protection provided for by the collective agreement, correctly use and take care of personal protective equipment, workwear. Timely undergo medical examinations and immunizations, knowledge testing, briefing and training in labor protection and safety. Assist the head of the structural unit in ensuring healthy and safe working conditions and immediately report accidents and situations that may lead to emergencies. Know and follow the safety rules.


18. Attend and participate in the work of seminars, conferences, meetings in the Central District Hospital (TMO). Pass advanced training courses in accordance with the Decree of the Ministry of Health of the Republic of Belarus No. 45 of 07/01/2002, but at least once every 5 years.


19. Observe work schedule, labor discipline, as well as the principles of ethics and deontology.


3. RIGHTS


The head of the FAP has the right to:


1. Have workplace protected from the impact of hazardous and harmful production factors. Be provided with collective and individual protective equipment. Receive payments due to harm to health as a result of an industrial injury.


2. Issue a death certificate at home if he treated and observed the patient during his lifetime, except for accidents.


3. Issue sick leave certificates for more than 3 days, in compliance with the current instructions, provided that this paramedic is included in the list of paramedics who are allowed to issue sick leave and certificates of illness, quarantine and other reasons for the absence of a child attending school, a preschool institution.


4. Has the right to start providing emergency medical care to persons in need, within its competence and to the extent determined by the instructions.


5. Give instructions and orders to the subordinate and junior medical staff of the FAP regarding direct work.


6. To make proposals for the appointment, promotion and imposition of administrative penalties on employees subordinate to him.


4. RESPONSIBILITY


The head of the FAP is responsible for:


1. Untimely and poor-quality provision of medical and preventive care to the population of the service area.


2. Preservation and proper use of medical equipment, medical instruments, soft and hard equipment at the FAP.


3. Organization and quality of work of all FAP personnel.


4. Proper storage and use of medicines.


5. Proper maintenance of medical records and timely reporting on the work done, issuance, accounting and storage of sick leaves, death certificates, etc.


6. Fulfillment and compliance with labor protection instructions, internal labor regulations.


7. Accident-free operation of equipment, safety of personal protective equipment, overalls and means of production received for use.


8. Concealment of the facts of an industrial injury, occupational disease, violation of labor protection, fire safety, sanitary and epidemiological regime, which can lead to an accident, fire, injury or death.


9. The quality of health education among the population of the site.


10. Failure to comply with the principles of ethics and deontology.


5. SERVICE RELATIONSHIPS


1.
The head of the FAP receives the necessary information to carry out his functional duties from the chief physician of the Central District Hospital (TMO), the deputy chief physician for medical care of the population, to whom the FAP is subordinate.


3. Provides information on the relevant sections of the work to district specialists, the organizational method of the Central District Hospital (TMO) in a timely manner.


4. Supervises the work of the FAP medical staff.


LIST OF REGULATORY DOCUMENTS REGULATING THE REQUIREMENTS FOR COMPLIANCE WITH SANITARY AND EPID REGIMEN AND ORGANIZATION OF THE WORK OF MEDICAL STAFF OF A Feldsher and Obstetric Station


1.
OST 42-21-2-85 “Sterilization and disinfection of medical devices. Methods, means and regimes”.


2. Decree of the Chief State Sanitary Doctor of the Republic of Belarus dated December 26, 2002 No. 143 "Sanitary rules for the implementation of disinfection activities."


3. Decree of the Ministry of Health of the Republic of Belarus dated 11.07.03 No. 71 “On approval and enforcement of the “Sanitary rules for the arrangement, equipment and operation of medical and preventive organizations”.


4 Order of the Ministry of Health of the Republic of Belarus dated November 25, 2002 No. 165 “On disinfection and sterilization by healthcare institutions”.


5. Order of the Ministry of Health of the Republic of Belarus dated December 16, 1998 No. 351 “On the revision of departmental regulations governing issues related to the problem of HIV / AIDS”.


6. Order of the Ministry of Health of the Republic of Belarus dated April 2, 1993 No. 66 “On measures to reduce the incidence of viral hepatitis in the Republic of Belarus”.


7. Order of the Ministry of Health of the Republic of Belarus dated October 21, 2003 No. 166 “On limiting the use of ethyl alcohol in healthcare organizations”.


8. Instruction of the Ministry of Health of the Republic of Belarus dated November 25, 2000 “Hygienic and surgical asepsis of the skin of the hands of medical personnel”.


9. Instruction of the Ministry of Health of the Republic of Belarus dated March 23, 1999, No. 40-9903 "Instructions for performing injections and intravenous infusions in health facilities and at home."


10. Guidelines of the Ministry of Health of the Republic of Belarus No. 90-9908 dated November 30, 1999 “Quality control of sterilization of medical devices”.


11. Guidelines of the Ministry of Health of the USSR of 24.06.87 "Disinfection measures during physiotherapy procedures."


12. Decree of the Ministry of Health of the Republic of Belarus dated 14.06.02. "On approval of the "Model internal rules of the organization of health care for patients".


13. Order of the Ministry of Health of the Republic of Belarus dated 17.02.04. No. 33 "On approval of the forms of medical records of healthcare organizations."


14. Order of the Ministry of Health of the Republic of Belarus dated 29.03.04. No. 75 "On approval of the forms of medical records of healthcare organizations."


15. Order of the Ministry of Health of the Republic of Belarus dated 10.01.94. No. 02 "On measures to improve the prevention of tetanus."


16. Order of the Ministry of Health of the Republic of Belarus dated 03.09.01 No. 225 “On improving the organization of detection, dynamic monitoring and treatment of patients with arterial hypertension”.


17. Order of the Ministry of Health of the BSSR dated 04.09.87 No. 179 "On the introduction of accounting, registration and analysis of nosocomial infections in medical institutions."


18. Order of the Ministry of Health of the USSR of May 30, 1986 “On the procedure for conducting a general medical examination of the population.”


LIST OF MAIN DOCUMENTS REQUIRED FOR THE WORK OF MEDICAL STAFF OF A Feldsher-Obstetric Station


1. Regulations on the feldsher-obstetric station.


2. Job descriptions: head of the FAP; FAP midwives; patronage nurse FAP; FAP nurses.


3. Work schedule of FAP medical staff.


4. The FAP equipment sheet, including the sheet for equipping the treatment room with solid equipment, means for providing emergency surgical care, resuscitation, emergency measures in case of poisoning.


5. Inventory of the paramedic's bag.


6. Description of the midwife's bag.


9. Rules for the provision of emergency care in life-threatening conditions in adults and children.


10. Calendar of preventive vaccinations.


11. Memo on checking the work of the FAP by the specialists of the district hospital.


HOURLY SCHEDULE


8.00-8.10 — Start of work:


Remove all jewelry from hands;


Prepare sterile materials and instruments necessary for work, checking their expiration date;


Prepare the dressing material necessary for work;


Check the availability of necessary medicines and their expiration dates.


9.30-13.00 – Outpatient work:


Fulfillment of medical appointments, provision of emergency care;


Preventive examination of the population;


Distribution of pharmaceutical medicines to the population;


Disinfection and preparation for sterilization of used instruments;


Disinfection and preparation for disposal of used dressings;


Carrying out sanitary work.


13.00-13.30 — Lunch break


13.30-15.30 - Work on the site:


Patient care at home;


Carrying out medical examinations at school, preschool institution;


Monitoring the sanitary condition of supervised facilities (shops, farms, water supply sources, etc.);


Visiting children under one year old;


Carrying out sanitary work.


15.30 - 16.00 - Disinfection of used medical instruments and materials


16.00 - End of work


Note. The first Wednesday of each month - attending a general hospital seminar, receiving bacterial preparations at the raytsgie and medicines from the head nurse of the health facility.


JOB DESCRIPTION


midwives of the feldsher-midwife station (approximate)


1. GENERAL PROVISIONS


1. A specialist who graduated from secondary medical educational institution with the qualification of a midwife, paramedic-midwife or paramedic.


2. The approval and dismissal of the FAP midwife is carried out by the chief physician of the Central District Hospital (TMO).


3. The midwife of the FAP in her work is guided by the "Regulations on the midwife of the FAP", "Regulations on the FAP", orders,


instructions, methodological and other instructions of the health authorities, as well as orders and instructions of the relevant officials.


4. The midwife reports directly to the head of the FAP. The methodical management of its work is carried out by a doctor of a medical institution, who is responsible for providing obstetric and gynecological care to the population in the territory of the FAP.


5. The head of the FAP - a paramedic has the right to involve a midwife within her competence and professional rights to perform the functions assigned to the paragraph, not provided for by the "Regulations on the midwife of the FAP".


2. RESPONSIBILITIES


The FAP midwife must:


1. Identify pregnant and gynecological patients and provide them with appropriate medical and preventive care. For these purposes, the FAP midwife:


Conducts an outpatient appointment at the FAP;


Carries out patronage of pregnant women and puerperas at home:


Provides emergency obstetric and gynecological care with the subsequent call of a doctor or referral of women to the appropriate health facilities, accompanying them personally if necessary;


Conducts gynecological patients at home.


2. Provide first emergency medical care in case of acute illnesses and accidents (wounds, bleeding, poisoning, etc.), followed by a doctor's call to such a patient or referral to the appropriate nearest medical facility, regardless of departmental subordination, accompanying the patient personally if necessary.


3. Timely refer pregnant women to doctors and appropriate hospitals of health care facilities.


4. Carry out preventive examinations of women within the time limits regulated by the documents of the Ministry of Health of the Republic of Belarus.


5. Follow medical appointments.


6. Prepare pregnant and gynecological patients for admission by a doctor for FAP.


7. Carry out health education work among the population on issues of maternal and child health, to promote breastfeeding and a healthy lifestyle.


8. Attend and participate in the work of seminars, conferences, meetings in the Central District Hospital (TMO). Pass advanced training courses in accordance with the Decree of the Ministry of Health of the Republic of Belarus No. 45 dated 01.07.02, but at least once every 5 years.


9. Maintain established documentation for your section of work.


10. In the absence of the post of patronage nurse in the staff of the FAP, in addition to their duties, monitor the health and development of children in the first year of life.


11. Comply with the work schedule, labor discipline, as well as the principles of ethics and deontology.


12. Fulfill the obligations for labor protection provided for by the collective agreement, correctly use and take care of personal protective equipment, workwear. Timely undergo medical examinations and immunizations, knowledge testing, briefing and training in labor protection and safety. Assist the head of the structural unit in ensuring healthy and safe working conditions and immediately report accidents that may lead to emergency situations. Know and follow safety regulations.


13. Comply with labor discipline, labor internal regulations, principles of ethics and deontology.


3. RIGHTS


The FAP midwife has the right to:


1. Within the limits of competence and professional rights, conduct examinations, establish a diagnosis, establish the terms of pregnancy, prescribe and carry out treatment, perform medical manipulations and carry out preventive work among the population.


2. Give instructions and orders to the junior medical staff of the FAP regarding direct work.


4. RESPONSIBILITY


The FAP midwife is responsible for:


1. Ensuring an appropriate level of medical care for pregnant women and gynecological patients, as well as for the quality of sanitary and educational work among the population.


2. Timely and correct reporting on the service.


3. Violation of labor discipline, non-observance of labor protection and safety regulations.


4. Failure to comply with the principles of ethics and deontology.


5.
SERVICE RELATIONSHIPS


1. The FAP midwife receives the necessary information to perform her functional duties from the head of the FAP.


2. Provides information on the relevant sections of the work to district specialists, the organizational method of the CRH (TMO) in a timely manner.


HOURLY SCHEDULE


8.00-8.10 - Start of work:


Put on changeable shoes in the wardrobe, a clean ironed robe or long-sleeved suit, a cap that completely covers the hair;


Remove all jewelry from hands;


Keep nails trimmed short and clean at all times.


8.10-9.30 – Preparing the office for work:


To control the quality of the wet cleaning of the office carried out by the nurse;


Prepare the necessary medical documentation for work;


1. Medical and obstetric station(FAP) - a medical institution that carries out the initial (pre-medical) stage of providing medical care in countryside. FAPs work as part of a rural medical district under the guidance of an outpatient clinic, district or district hospital.

Activity

The need for pre-medical health care in rural areas is determined by the low density of the population (in contrast to the compact urban population). FAPs are located in the most remote settlements from the hospital, making medical care more accessible for their residents.

The staff of the FAP consists of the head - a paramedic (midwife), a patronage nurse - a midwife and a nurse. FAP receives the population on an outpatient basis and at home, can prescribe treatment within the competence of a paramedic and midwife, provides patronage for children under 3 years old, provides consultations with specialists and fulfills medical prescriptions. Provides medical care to preschool institutions that do not have health workers. FAP provides emergency medical care at the pre-medical stage.

FAPs carry out sanitary and anti-epidemic work in the territory under their jurisdiction: they identify and isolate infectious patients, carry out routine disinfection of the premises where patients arrived, remove persons who have been in contact with the hospital from work in catering units, children's and medical institutions, and carry out preventive vaccinations. FAP carries out sanitary and epidemiological supervision of the territory and organizations located on it.

Device

The FAP room consists of at least 3 rooms. In addition, the FAP may have a room for women in labor with a separate examination room for their reception and sanitation. For temporary isolation of contagious patients, a separate isolated room may also be provided.

2. Job responsibilities.

Paramedic:

1. Carries out the reception of patients, acquaints them with the internal regulations and the appointed mode in the department and monitors their implementation.

2. Provides infectious safety (complies with the rules of the sanitary-hygienic and anti-epidemic regime, asepsis, properly stores, processes, sterilizes and uses medical products) for the patient and medical personnel.

3. Carries out all stages of the nursing process in patient care (initial assessment of the patient's condition, interpretation of the data obtained, care planning together with the patient, final assessment of what has been achieved).

4. Timely and efficiently performs preventive and medical-diagnostic manipulations and procedures independently or prescribed by a doctor.

5. Assists in the doctor's treatment and diagnostic manipulations and minor operations in outpatient and inpatient settings or performs them independently within his competence.

6. Provides emergency pre-medical care for acute illnesses, accidents and various types of disasters, followed by a doctor's call to the patient or referral to the nearest medical institution.

7. Informs the doctor or head, and in their absence, the doctor on duty about all detected serious complications and diseases of patients, complications that arose as a result of medical manipulations or in cases of violation of internal regulations that go beyond his competence.

8. Conducts simple laboratory studies (urine for protein, sugar, determination of hemoglobin and erythrocyte sedimentation rate - ESR) and evaluates their results.

9. Introduces drugs, anti-shock agents (in case of anaphylactic shock) to patients for health reasons (if a doctor cannot arrive in time to the patient) in accordance with the established procedure for certain conditions of the patient.

10. Performs blood transfusion and infusion therapy prescribed by the doctor in the presence of a doctor and under his control.

11. Applies conservative methods of treatment of patients, conducts medical procedures.

12. Determines the indications for hospitalization, organizes the transportation of sick and injured.

13. Conducts an examination of the temporary disability of the patient or the person caring for the patient.

14. Prescribes appropriate treatment, writes prescriptions for drugs using reference literature.

15. Organizes treatment and medical care at home.

16. Carries out the organization and conduct of dispensary observation of various groups of the population (children, adolescents, pregnant women, participants and invalids of wars, patients who have had acute illnesses, patients suffering from chronic diseases, etc.).

17. Organizes and conducts anti-epidemic measures in the focus of an infectious disease.

18. Organizes and produces preventive vaccinations for children and adults.

19. Ensure proper storage, accounting and write-off of medicines, compliance with the rules for taking medicines by patients.

20. Carries out the selection of material for bacteriological studies in accordance with the disease or doctor's prescriptions.

21. Trains family members to create a safe environment for the patient. Provides care and training for family members during the period of illness and rehabilitation of the patient.

22. Explains to the patient the methods and procedure for preparing for laboratory, instrumental and hardware studies.

23. Maintains approved medical records and reports.

24. Carries out sanitary and educational work to promote health and prevent diseases, promote a healthy lifestyle.

3. Rights.

The paramedic has the right:

1. Receive the information necessary for the accurate performance of their professional duties.

2. Make suggestions for improving the work and organization of nursing in the institution.

3. Require the head of the institution, the head nurse of the department to provide the post (workplace) with equipment, equipment, tools, care items, etc., necessary for the high-quality performance of their functional duties.

4. Improve qualifications, undergo certification (re-certification) in order to assign qualification categories.

5. Participate in the work of professional associations of nurses and other public organizations not prohibited by law Russian Federation.

4. Responsibility.

The paramedic is responsible for:

1. For improper performance or non-performance of their official duties provided for by this job description - to the extent determined by the current labor legislation of the Russian Federation.

2. For offenses committed in the course of carrying out their activities - within the limits determined by the current administrative, criminal and civil legislation of the Russian Federation.

3. For causing material damage - within the limits determined by the current labor and civil legislation of the Russian Federation.

5. Documentation on FAPs.

It is very important in the work of the FAP midwife to carry out careful documentation. For each pregnant woman who applied to the FAP, an “Individual card of a pregnant woman in childbirth” (f-111 / y) is filled out. If obstetric complications or extragenital diseases are detected, a duplicate of this card is filled in, which is transferred to the district obstetrician-gynecologist.

There are many options for storing individual cards. One of the most convenient options that can be recommended for work is as follows: a box for storing individual cards (the width and height of the box must correspond to the size of the card) is divided into 33 cells by transverse partitions. Each partition is marked with a number from 1 to 31. These numbers correspond to the days of the month. When appointing a pregnant woman for the next visit, the midwife places her card in a cell marked with the corresponding day of the month, that is, the day when she needs to come to the appointment. Before starting work, the midwife removes all individual cards from the cell corresponding to the day of admission and prepares them for reception - they will check the correctness of the records, the availability of the latest tests, etc. Finishing the reception of the pregnant woman, appoints her the day of the next appearance and places the card of this pregnant woman in the cell with a mark, corresponding to the day of the month for which she is scheduled to appear. At the end of the appointment, by the number of remaining cards, it is easy to judge pregnant women who did not appear at the appointment on the day appointed by them. The midwife places these cards in the 32nd cell of the box marked "Patronage". Then the midwife visits at home (patronizes) all women who did not appear at the reception. All cards of those who have given birth and are subject to dispensary observation until the end of the postpartum period are placed in the 33rd cell with the mark "Purrenders".

For each woman in labor, the "History of Childbirth" (f-099 / y) is filled out. All women who gave birth in the FAP are registered in the birth register (f-098 / y). In addition to these documents, the FAP maintains a diary for recording pregnant women (f-075/y) and a diary (f-039-l/y). When a pregnant woman (after 28 weeks of pregnancy) or a puerperal is sent to a medical obstetric hospital, she is given an “Exchange card” (account file No. 113) in her hands. If a pregnant woman is hospitalized before 28 weeks, an extract from the medical history is issued to her (account form No. 27). Discharging from the hospital, she receives an extract from the medical history in the same form, which is handed to her by the FAP midwife.

In accordance with the main tasks, the following functions are assigned to the feldsher-obstetric station:

2.1. Provision of pre-hospital medical care to the population, including emergency and urgent measures in conditions that threaten human life and health.

2.2. Timely fulfillment of the doctor's prescriptions in full when organizing dynamic monitoring and treatment of the patient at the place of residence.

2.3. Organization of systematic monitoring of the health status of decreed population groups: patronage of children and pregnant women, dispensary examinations of war invalids and equivalent contingents, agricultural workers (machine operators, livestock breeders) and production workers working in hazardous working conditions, work with women of childbearing age of a high group risk, etc.

2.4. Carrying out activities aimed at active early detection of patients and persons with risk factors for the development of diseases (targeted medical examination of the population, fluorographic examination, cytological examination of women, measurement of blood pressure in persons over 16 years old.).

2.5. Implementation of measures to reduce child and infant mortality (patronage of pregnant women and children under 1 year old, routine preventive vaccinations, dynamic monitoring of the risk group of children in the first year of life, prevention of rickets, anemia, promotion of rational feeding, work with socially disadvantaged families, family planning ).




2.7. Participation in the implementation of complex anti-epidemic and sanitary-hygienic measures in the event of an unfavorable epidemiological situation in the service area.

2.9. Participation in the provision of medical care in case of emergencies.

2.10. Drawing up current (monthly) and prospective (annual) work plans, providing operational and planned reports on their activities in the prescribed manner. Maintenance of approved medical and accounting records.

2.11. Organization of the work of the pharmacy point to provide the population with medicines in accordance with the approved "Regulations on the pharmacy point of group II under the FAP".

2.12. Carrying out sanitary and educational work among the population, including with the use of the media.

III. RIGHTS

To perform its functions, the FAP has the right to:

area, instructions and orders of the head of the municipal health institution to which the FAP is subject, "Regulations on the feldsher-obstetric station", this job description.

1.4. In his work, the FAP paramedic directly reports to the head of the FAP.




II. RESPONSIBILITIES

The FAP paramedic is obliged to:

2.1. Carry out outpatient reception and home care for the assigned population according to the established schedule.

2.2. Provide emergency and emergency pre-medical care in conditions that threaten human life and health.

2.3. To carry out timely and in full the appointment of a doctor when organizing dynamic monitoring and treatment of the patient at the place of residence.

2.4. To carry out dynamic monitoring, including control over the organization of timely treatment, of patients with socially significant diseases (tuberculosis, sexually transmitted diseases, mental and narcological diseases, oncological pathology, diabetes mellitus).

2.13. Participate in the provision of medical care in case of emergencies.

2.14. Comply with the sanitary and anti-epidemic regime established by regulatory documents, carry out the correct storage of medical immunobiological preparations and medicines.

2.15. Maintain approved accounting and reporting forms of medical documentation and submit reports on the work done in a timely manner (to the head of the municipal healthcare institution of the territory).

2.16. Comply with the rules of fire safety and labor safety at the workplace.

2.17. Regularly engage in health education, hygiene education and education of the population.

2.18. Carry out work in accordance with the principles and norms of medical ethics and deontology.

2.19. Systematically improve the level of professional training: take an active part in the work of district seminars, meetings for paramedical workers, periodically travel to advanced FAPs to exchange work experience, get acquainted with the relevant medical literature. To improve professional qualifications at courses (cycles) of improvement in institutions (departments of postgraduate education) at least once every five years in accordance with the established procedure.

III. RIGHTS

The FAP paramedic has the right:

3.1. Within the limits of its competence, conduct examinations, establish a diagnosis, prescribe treatment, perform medical manipulations and preventive measures.

3.2. Use all approved instructive and methodological materials issued by the health authorities of the Russian Federation and the Kaliningrad region regarding the activities of the FAP.

3.3..Make proposals for improving the work of the FAP, improving the system of medical care in the service area.

3.6. Inform in writing or orally the prosecutor's office, police, education, social protection about the observance of the rights of the child, situations that threaten his health and life.

IV. RESPONSIBILITY

The FAP paramedic is responsible for:

4.1. Fulfillment of assigned duties in accordance with this job description.

4.2. Compliance with the current legislation and other regulatory legal acts of the Russian Federation and the Kaliningrad region, the implementation of orders, instructions and guidelines of the Ministry of Health of the Russian Federation and the Health Committee of the Volgograd Region, instructions and orders of the head of the municipal health institution to which the FAP is subordinate, the head of the FAP.

4.3. Compliance with the internal regulations of the FAP and labor discipline.

The responsibility of the FAP paramedic for violation of this job description is carried out in accordance with applicable law.

V. QUALIFICATION REQUIREMENTS

A person with a secondary medical education in the specialty "General Medicine" and an appropriate certificate of a specialist is appointed to the position of a FAP paramedic.

JOB DESCRIPTION

Midwifes

I. GENERAL

1.1. The position of a FAP midwife is introduced to provide pre-hospital medical care to the female population attached for service.

1.2. Appointment and dismissal of the FAP midwife is carried out by the chief physician of the relevant municipal health care institution in accordance with subordination in agreement with the head of the FAP in the prescribed manner.

1.3. The midwife of the FAP is guided in her activities by the current legislation and other regulatory legal acts of the Russian Federation, the administration of the Kaliningrad region, the health department of the administration of the Kaliningrad region, the head of the municipal health institution to which the FAP is subordinate, the "Regulations on the feldsher-obstetric station", this job description .

1.4. In her work, the midwife of the FAP is directly subordinate to the head of the FAP.

II. RESPONSIBILITIES

The FAP midwife must:

2.1. Carry out outpatient appointments for pregnant women, gynecological patients according to the established schedule and serve them at home.

2.2. Keep records and patronage of pregnant women and puerperas: conduct psychoprophylactic preparation of women for childbirth, promote rational feeding and modern methods contraception, participate in work with socially disadvantaged families, family planning. In providing medical care to pregnant women, to carry out close interaction with the women's consultation of the municipal health institution, to which the FAP is subordinate.

2.3. Conduct an examination of all women (with taking smears for cytology) who applied for the first time during the year for FAP, regardless of age and nature of the disease. Refer women with identified pathology or suspected disease to an obstetrician-gynecologist for a subsequent stage of medical care.

2.4. To carry out in a timely manner and in full the appointment of medical specialists in the organization of dynamic monitoring and treatment at the place of residence of gynecological patients and pregnant women.

2.5. Provide emergency and emergency pre-medical care in conditions that threaten human life and health.

2.6. Carry out the simplest physiotherapeutic procedures: ultraviolet irradiation, paraffin therapy, solux.

2.7. Participate under the guidance of doctors of medical institutions in carrying out:

Periodic and targeted medical examinations of women for early detection of patients with gynecological, venereal and precancerous diseases;

Activities in the group of women of childbearing age of a high risk group;

Dynamic examinations of patients registered at the dispensary.

Keep control cards (form No. 000 / y) for dispensary patients in the prescribed manner and ensure their timely attendance at specialist doctors.

2.8. To carry out, under the guidance of doctors of medical institutions and specialists of the Central State Sanitary and Epidemiological Service, a set of sanitary-hygienic and anti-epidemic measures in the event of an unfavorable epidemiological situation in the service area. Know the clinic of especially dangerous infections and the tactics of nursing staff when they are detected.

2.9. To study the working and living conditions of women, to make timely proposals to the district obstetrician-gynecologist on their rational employment and social rehabilitation.

2.10. Participate under the guidance of the head of the FAP in the provision of medical care in case of emergencies.

2.11. Comply with the sanitary and anti-epidemic regime established by regulatory documents.

2.12. Draw up and submit current (monthly) and long-term (annual) action plans for the medical care of women and children to the head of the FAP in a timely manner.

2.13. Maintain approved accounting and reporting forms of medical documentation and submit reports on the work done to the head of the FAP in a timely manner.

2.14. Comply with the rules of fire safety and labor safety at the workplace.

2.15. Regularly engage in health education, hygienic education and education of the population, organize the work of a mother and child school.

2.16. Carry out work in accordance with the principles and norms of medical ethics and deontology.

2.17. Systematically improve the level of professional training: take an active part in the work of district seminars, meetings for paramedical workers. Days of the midwife; periodically travel to advanced FAPs to exchange work experience, get acquainted with the relevant medical literature. To improve professional qualifications in courses (cycles) of improvement in institutions (departments) of postgraduate education at least once every five years in accordance with the established procedure.

III. RIGHTS

The FAP midwife has the right to:

3.1. Within the limits of its competence, conduct an examination, establish a diagnosis, terms of pregnancy, prescribe treatment, perform medical manipulations and preventive measures.

3.2. Use all approved instructive and methodological materials issued by the health authorities of the Russian Federation and the health department of the Kaliningrad Region Administration regarding the activities of the FAP.

3.3. Make proposals to improve the work of the FAP, improve the system of medical care in the service area.

3.4. To improve professional qualifications in courses (cycles) of improvement in institutions (departments) of postgraduate education at least once every five years in accordance with the established procedure.

3.5. To use the established benefits in accordance with the current legislation.

ALGORITHM FOR PERFORMING THE MAIN SECTIONS

FAP STAFF WORKS

	List and sequence of working actions	Registration of medical documentation
	Reception of children up to1 year:
	2.1. Questioning the child's parents
	Weighing a child, measuring height, head, chest, fontanels, thermometry.
	General examination of the skin and visible mucous membranes, navel. Examination by systems (inspection, palpation, percussion, auscultation).
	Assessment of the physical and mental development of the child.
	In case of illness - diagnosis, first aid and referral to a pediatrician.
	Registration in the history of the development of the child. Filling out the register of outpatients.
	Compliance with the procedures and appointments of a pediatrician. Entry in the register of procedures
	Reception of pregnant women:
	At the first visit:
	Questioning and examination of a pregnant woman
	Measurement of pulse to blood pressure on both arms
	Vaginal examination and pap smear
	Referral of a pregnant woman to specialist doctors
	Recommendations for a pregnant woman on taking iodine, vitamin A, folic acid, iron supplements, multivitamins; training on the topic "Hygiene of the first half of pregnancy"
	Registration of records:
	in the notebook of records of pregnant women who were under the supervision of the FAP
	exchange card pregnant
	When reappearing, the management of a pregnant woman according to the assessment by risk groups:
	Analysis of information on primary patronage
	Questioning and examination of a pregnant woman
	Measurement of pulse and blood pressure on both arms
	Determining the position and presentation of the fetus
	Listening to the fetal heart
	Urine test for protein (sulfasalicylic acid test or boiling
	Assessment of the state of the pregnant woman, appointment of a second visit
	Preparing a pregnant woman on the topic: "Hygiene of the second half guilt of pregnancy", "The advantage of natural feeding"
	"Psychoprophylaxis of pain relief in childbirth"
	Registration form:
	in the pregnancy notebook
	individual card of a pregnant woman and a woman in labor
	exchange card pregnant
	outpatient register
	Organizationmedical appointment at FAP
	Notification of the population, parents of children, local governments about the hours of doctor's appointments for FAP
	Invitation of patients who need consultation of a specialist doctor. Check-in attendance
	Joint reception of the population. Fulfillment of medical appointments
	Filling out the register of outpatients with the mark "doctor's appointment"
	ChapterII. Serving the population at home
	Providing medical care to patients at home:
	Interrogation of the patient. Thermometry. General examination of the patient. Examination by systems (inspection, palpation, percussion, auscultation). Measurement of blood pressure.
	Diagnosis, treatment appointment; if necessary, referral for examination and consultation with specialists
	If necessary, the provision of emergency and urgent pre-medical care
	If necessary, the solution of the issue of hospitalization of the patient; accompanying seriously ill patients and children under 1 year old to the hospital. Sick children from asocial families are hospitalized in the children's departments of the MUSIC without fail
	Patronage of pregnant women
	Survey. General examination of the pregnant woman. Inspection and palpation of the mammary glands. Measurement of the circumference of the abdomen, the height of the fundus of the uterus. Measurement of pulse and blood pressure on both arms.
	Determining the position of the fetus. Listening to the fetal heartbeat.
	If necessary, refer the pregnant woman for examination and consultation with specialists.
	Registration of records:
	in the individual card of a pregnant woman and a woman in labor
	exchange card pregnant
	Filling out a notebook for recording work at home of a patronage nurse) midwife

	Patronage of puerperas in the first three days and for 7-8 days
	Survey. General inspection. Assessment of the general condition. Measurement of temperature and blood pressure. Inspection of the mammary glands and palpation of the abdomen, assessment of the condition of the uterus, control of lochia
	Making entries in the individual card of a pregnant woman and a woman in labor
	Patronage of newborns and children up to a year
	Questioning the child's parents
	Inspection of the skin, visible mucous membranes, navel. Inspection and palpation of the fontanel. Measurement of body temperature, height, head volume. Measurement of pulse and respiratory rate. Examination by systems (inspection, palpation, percussion, auscultation)
	Assessment of physical and mental development
	Checking the living conditions
	Filling out a work-at-home notebook for a visiting nurse (midwife)
	Working with children
	Patronage of newborns and children up to 1 year. Dynamic monitoring of the risk group of children of the first year of life
	Organization and control over the prevention of rickets, anemia. Promotion of rational feeding
	Organization and implementation of preventive vaccinations in a timely manner
	Working with socially disadvantaged families. Participation in family planning.
	Making records in the history of the development of the child
	Filling out a notebook for registering work at home of a patronage nurse (midwife) or an outpatient register

	Work with patients with socially significant diseases
	Organization of registration of persons with socially significant diseases (tuberculosis, sexually transmitted diseases, HIV infection, mental and narcological diseases, oncological pathology, diabetes mellitus)
	Conducting active dispensary examinations of patients in a timely manner: survey, assessment of the general condition, examination
	Control over the organization of treatment, implementation of medical and preventive measures prescribed by the doctor. If necessary, timely referral of the patient to the next stage of medical care
	Informing in writing the authorities of the prosecutor's office of education and social protection, the head of the MUSIC about the critical situation of children that threatens their life and health
	Registration of records in the medical record of an outpatient
	Filling out the book of records of calls to paramedics at home
	Work with women of childbearing age of a high risk group for obstetric and perinatal pathology
	Identification and registration of women of childbearing age with a high risk group	application
	Individual work on family planning, selection of optimal contraceptives
	Dispensary observation for the underlying disease
	ChapterV. Work on active early detection of patients and individuals with risk factors for disease
	Filling out the card of the primary examination of the population (I stage of targeted medical examination). Organization of additional examination of persons at risk identified during the survey
	Organization of a fluorographic examination of the attached population: notification of the population and local authorities about the date and time of the examination, invitation to the examination, control over attendance; keeping a log of fluorographic examination
	Sputum sampling for BC in non-transportable patients
	Measurement of intraocular pressure for persons over 40 years (once every three years). Entry in the medical record of an outpatient
	For women from the age of 18 who are sexually active, annual cytological screening, examination in the mirrors of the cervix and vagina, bimanual examination of the uterus and appendages
	For women from the age of 30, an annual examination of the skin and visible mucous membranes, examination and palpation of the mammary glands, thyroid gland, abdomen, peripheral lymph nodes, cytological screening, examination in the mirrors of the cervix and vagina, bimanual examination of the uterus and appendages, digital examination of the rectum in women over 40 years of age and in the presence of complaints
	For men from the age of 30, an annual examination of the skin and visible mucous membranes, examination and palpation of the vulva, mammary glands, thyroid gland, abdomen, peripheral lymph nodes,
	Registration of entries in the medical card of an outpatient, a journal of the payroll of the female population from the age of 18

Scroll

forms of primary medical documentation for FAP

	Form name
	Outpatient medical record
	Referral to counseling and support rooms
	Procedure Log
	Control card of dispensary observation
	Book of records of calls of doctors (paramedics) to the house
	Register of visits to the secondary medical health center staff, FAP
	Emergency notification of an infectious disease, food, acute occupational poisoning, unusual reaction to vaccination
	Journal of Infectious Diseases
	Work log of preventive vaccinations
	Journal of accounting and consumption of bacterial preparations
	Emergency tetanus prophylaxis log
	Outpatient Register
	Record book of pregnant women under supervision
	Medical certificate of death
	Individual card of the pregnant woman and the puerperal
	Child development history
	Exchange card of the maternity hospital, maternity ward hospitals, information from the antenatal clinic about the pregnant woman
	Notebook of work at home patronage medical sisters (midwives)
	Emergency register
	Log book of fluorographic examination
	The payroll of the female population from the age of 18 age and medical record
	List of high-risk women of childbearing age
	Passport of the serviced area
	Report on the work of the FAP for the year
	Journal of comments and suggestions made during inspections of the FAP for the year
	Logbook temperature regime refrigerator
	Journal of germicidal lamps operation
	Log book for air and steam sterilizers
	Journal of accounting and consumption of ethyl alcohol
	Journal of accounting for work on hygienic education and education of the population, promotion of a healthy lifestyle