Quartz mode log. Maintaining medical documentation Journal of quartzing according to Sanpin

Methodological material for the treatment room nurse.(MY CHEET SHEET)

The role of the nurse in the process of treating a patient, especially in a hospital, is difficult to overestimate. Carrying out doctor's orders, caring for seriously ill patients, carrying out many, sometimes quite complex, manipulations - all this is the direct responsibility of nursing staff. The nurse also participates in examining the patient, preparing him for various surgical interventions, working in the operating room as an anesthetist or operating nurse, and monitoring the patient in the intensive care unit. All this places high demands not only on the knowledge and practical skills of the nurse, but also on her moral character, ability to behave in a team, when communicating with patients and their relatives.

The nurse must strictly follow the doctor’s instructions and strictly follow not only the dosage of the medication and the duration of the procedures, but also their sequence. When prescribing the time or frequency of drug administration, the doctor takes into account the duration of their action and the possibility of combination with other medications. Therefore, negligence or error can be extremely dangerous for the patient and lead to irreversible consequences.

Modern medical institutions are equipped with new diagnostic and treatment equipment. Nurses must not only know what a particular device is for, but also be able to use it, especially if it is installed in the ward. When performing complex manipulations, a nurse, if she does not feel sufficiently prepared for this or doubts something, should not hesitate to ask for help and advice from more experienced colleagues. In the same way, a nurse who is proficient in a technique or a particular manipulation is obliged to help her less experienced comrades master this technique. Self-confidence, arrogance and arrogance are unacceptable when it comes to human health and life. A mandatory quality of a nurse should be the desire to constantly improve their qualifications, deepen their knowledge, and acquire new skills. This should be facilitated by the general atmosphere of the medical institution, which plays an important role in the formation of a highly qualified and responsible employee, the development in him of high moral qualities, humanism and the ability with all his behavior to contribute to the return of health and ability to work for a sick person.

Infection control is a system of effective preventive and anti-epidemic measures aimed at preventing the occurrence and spread of hospital infections, based on the results of epidemic diagnostics.

The goals of infection control are to reduce morbidity, mortality, and economic losses from hospital-acquired infections. Hospital infection is any infectious disease that manifests itself in a hospital setting. Hospital-acquired infections also include cases of infection of medical workers in healthcare facilities that arose as a result of their professional activities.

To prevent nosocomial infection, the nurse must:

· store outerwear and workwear separately,

· do not go outside the hospital premises in special clothing,

· do not wear protective clothing during off-duty hours.

Work in the treatment room begins with routine cleaning.

The procedural nurse removes jewelry (watches, bracelets and rings) from hands. He tucks his hair under his cap and puts on a mask.

Routine cleaning of the treatment room carried out at least 2 times a day, if necessary more often: in the morning before the start of the working day and at the end of the working shift. Wet cleaning must always be combined with disinfection and bactericidal irradiation of the room. For disinfection, any disinfectants approved for use and available can be used, according to the methodological instructions for the solution.

The nurse or orderly puts on a gown and gloves for cleaning. A disinfectant solution is poured into a special container and a clean rag is placed for surface treatment. All surfaces are wiped in strict order - a table for sterile material, cabinets for sterile solutions, equipment, manipulation tables, chairs, couches for patients, walls at arm's length (1.5 m) from window to door.

For cleaning, specially designated cleaning equipment is used, which is clearly marked indicating the room, type of cleaning work and a specially designated storage location.

Hand hygiene with skin antiseptic should be carried out in the following cases: before direct contact with the patient

Before putting on sterile gloves and after removing gloves when placing a central intravascular catheter or intravenous injections and other procedures related to the integrity of the skin.

Hygienic treatment of hands with a skin antiseptic (without prior washing) is carried out by rubbing it into the skin of the hands in the amount recommended in the instructions for use, paying special attention to the treatment of the fingertips, the skin around the nails, between the fingers. An indispensable condition for effective hand disinfection is keeping them moist for the recommended treatment time.

Pay attention to what you wash your hands with:

Before using the product in the dispenser, pay attention if the instructions contain an active substance with a washing effect, this means that you do not need to wash your hands with soap before using the solution, after drying your hands with a disposable towel, put on a st. gloves;

If the bottle says that liquid soap has an antiseptic effect, then after washing your hands, dry with a disposable towel and put on a glass. gloves;

If it is written that it is a skin antiseptic, then wash your hands with soap for the time specified in the instructions for using soap

M/s washes hands under running water and soap for at least 2 minutes. (the time for soaping hands is indicated in the instructions for the specific name of the product used). Dry your hands with a sterile napkin or disposable towel and with the same towel or napkin that you used to dry your hands, turn off the water tap, and if there is no sterile napkin, then 10 grams 70 grams are provided to cover a large sterile table. alcohol, and mini table 3.0 alcohol pour onto your hands and dry your hands, rubbing the alcohol firmly into your palms, put on sterile gloves.

Covering the sterile table: There must be a tag on the bix that says what is in the bix and in what quantity, since after sterilization the letters of what is written are often erased, you need to constantly update them, and the date and time of sterilization and the date and time of opening the bix must also be indicated. If the set is sterilized in kraft paper, then the date and time of opening is written on the paper; kraft paper is used for sterilization once.

Before removing sterilized instrument materials (before opening the bins):

Visually assess the tightness of the lid of the sterilization box or the integrity of the single-use sterilization package;

Check the color of indicator marks of chemical indicators, including on sterilization packaging materials;

Check the date of sterilization;

The date, time of opening and the signature of the person opening it are placed on the package tag and packaging bag.

In the sterilization log book, the number of the package, the presence of medical products, the time of opening the package (package) must be written, and an indicator of the quality of sterilization taken from the inside of the opened package (package) is glued.

Before preparing sterile mini tables, the nurse cleans (hygienic treatment) hands with an alcohol-containing skin antiseptic using technology

puts on sterile gloves. Covering a large instrument table (after treating the hands, the m/s puts on a sterile gown and sterile gloves) takes out two sterile sheets from the bix with tweezers, each of which is folded in half, laid out on the left and right halves of the table, with the folds facing the wall. The sheets are overlapped so that in the center of the table the edges of one sheet overlap the other sheet by at least 10 cm, and the edges of the sheets on all sides of the table hang down by about 15 cm. A third unfolded sheet is laid on top of these sheets so that its edges hang down by at least 25 cm. The table with the instruments laid out on it is covered with a sterile sheet, folded in half along the length of the sheet, or two unfolded sheets. A large sterile table is set for 6 hours.

In treatment rooms, a mini sterile table is set for 2 hours.

The first tray (ministol) with sterile material

Second tray (mini-table) for temporary storage of syringes

On sterile table or mini trays be marked with the date and time of covering the sterile table.

After studying the prescription sheet, the m/s prepares ampoules with the medicine, a package with gloves, and syringes in the package. He washes his hands, shakes the syringe out of the bag onto a tray for temporary storage of sterile material, treats his hands with an antiseptic, puts on sterile gloves, pours alcohol onto a sterile cotton swab, wipes the neck of the ampoule, and files the bottles with the drug, ampoules, and with a dry sterile cotton swab, breaks off the sawn tip of the ampoule.

We treat our hands with antiseptic

With your right hand, take the needle by the plastic cap and rotate the needle sleeve onto the syringe and rub it in well. If necessary, place the assembled syringe on a sterile diaper;

Take the ampoule/bottle in your left hand, insert the needle on the syringe with your right hand, draw out the required amount of the drug, tilting them as necessary;

Remove air bubbles from the syringe by turning the syringe vertically with the needle up, pressing on the piston, and gradually squeeze out the air from the syringe;

It is unacceptable to press sterile cotton balls to the neck of a bottle with alcohol or squeeze a ball moistened with alcohol into a common container with alcohol with your hands, moisten a large batch of cotton balls with alcohol in advance and store them for a long time;

When working with patients, professional safety rules are strictly followed.

Injections are performed using sterile rubber gloves, changing them after each patient;

Before opening, bottle caps and ampoules are treated with a sterile swab moistened with 70g. ethyl alcohol;

The skin at the injection site is sequentially treated with two sterile cotton swabs with 70 g. ethyl alcohol: first a large area, then directly

injection site;

After the injection, a new sterile swab is applied to the wound surface;

For each injection, 2 needles are used (for diluting and collecting the injection solution and for injection);

When carrying out parenteral manipulations in the ward, including setting up systems, a mobile instrument table is used, on the top shelf of which a sterile mini tray is assembled, on which there is a syringe with drawn-up medicine between two layers of sterile diaper, as well as sterile gauze napkins and cotton balls, for injections on a specific patient. sick. A bottle of 70g is also placed there. alcohol and a bag of sterile gloves. On the bottom shelf there is a container for used material.

The nurse takes the charged system into the room along with the instrument table, then washes his hands in the treatment room. In the ward, a tourniquet is tied on the patient’s arm, and the hands are treated with an antiseptic (at this time the patient works with his fist to better see the vein for injection). Puts on sterile gloves, moistens a sterile cotton swab with an antiseptic, wipes the injection site according to the scheme twice, makes an intravenous injection, secures the system, covers the needle with a sterile gauze pad.

After the end of the drip, the needle is removed and a cotton swab with alcohol is applied to the injection site. The system is removed from the bottle and carefully placed in the waste tray without disconnecting the needle from the system. All used material on the instrument table is returned to the treatment room. Where the m/s, wearing gloves, takes a clamp and carefully disconnects the needle from the system and places it in a puncture-proof container for disinfecting needles, the remaining medications from the system are drained into a container for biological fluid. Then the system is placed in a container for disinfecting systems, the syringe is washed in the 1st container for washing syringes and placed in the 2nd container for disinfecting syringes.

It is unacceptable to return unused sterile material to the general packaging;

9. Wipe the washed refrigerator dry with a cloth.

Treatment of bactericidal lamps during general cleaning

1. The body of the bactericidal lamp is treated with the same disinfectant. the product I use to treat the surfaces, and the glass part is treated with 95g. alcohol at the rate of 5g. for one large lamp, for small ones 2.5g.

2. Once a month, the lamp frame is treated with a 3% solution of hydrogen peroxide per 1 liter 5g. detergent.

3. During current cleaning The lamp frame is wiped clean. means used to treat surfaces, and the glass part of the lamp is wiped with a dry sterile cloth.

When carrying out general cleaning, 3 rags are used (1st for soap and soda solution, 2nd for applying disinfectant, 3rd (sterile) for washing off disinfectant after exposure). General cleaning is carried out according to a schedule approved by the manager. department. The person responsible for carrying out general cleaning is the head nurse of the department. In the notebook of the gene. cleaning, the first sheet must include the footage of the surface to be treated, the required amount of disinfectant, also for current cleaning, and the approximate time for the start of general cleaning, so that there is no overlap with the register of quartzing the cabinet after the general cleaning has been carried out. cleaning

Now the calculation of disinfectants in the general cleaning log.

The senior m/s must have budgets for disinfectants to clean all the premises of the department or clinic rooms. Since the cleaning of all premises except office offices (staff rooms, senior m/s office, etc.) is carried out using disinfectants. Therefore, you need to make a folder in which manuals and certificates for disinfectants used in the department will be stored, as well as calculations for all premises. At the station m/s there must be data on the need for disinfectants for 1,3,6 months.

So that at any time she can present them to the main m/s for purchases for the future, knowing her balance. Also, do not forget about the disinfection of waste materials and medical products, etc., and the pre-sterilization treatment of instruments

To calculate disinfectants, you must know the area of ​​​​all premises.

1. S - area

2. L – cabinet length

3. H – cabinet height

4. D – cabinet width

For example

S – floor 6x4=24m. x 2 (if the ceiling is washed)

L – 6 meters x 2 (2 walls)

D – 4 meters x 2 (2 walls)

H – 2.5 meters for gen. For current cleaning, a height of 1.5 m is taken.

Find out the area of ​​all surfaces of the walls and floors

1) Walls length 6 x 2.5 x 2= 30m2

2) Wall width taking into account windows and doors (window area can be subtracted at the end) 4 x 2.5 x2 = 20m2

3) Floor 6x4 + ceiling 6x4 = 48m2

S=30+20+48 =98m2

Don't forget that during the gen. Cleaning: Refrigerators, cabinets, tables, chairs, couches and other furniture are washed.

All disinfectant solutions for wiping are taken in 100 ml. per 1 sq. m.

There are many magazines related to medical topics. They are determined for each type of institution in which they are conducted. For example, for a restaurant, one of such documents is the “Frying Fats Use Log.” Of course, for a pool that does not have its own kitchen, such a magazine is not needed.

This article will discuss four main types magazines:

1. Accounting for premises inspections.
2. Keeping records of employee medical records.
3. Accounting for sanitary days.
4. Instruction on the sanitary and epidemiological regime.

Premises inspection records

Such a sanitary journal (form 308/U) is called “ Book for recording the sanitary condition of the premises».

Journal of sanitary condition of premises on the title page indicates the name of the organization and its specific division in which the journal is kept.

For example, some firm"Aquagroup" built a swimming pool. To reflect the sanitary condition of the room where the pool bowl is located, this form of pool sanitary log is kept. In him dates of sanitary inspections are reflected specialists, comments, if any. Also, a sample of the sanitary log of the pool must be drawn up in form 308/U.

Also, in the third column, the SES officer writes recommendations for troubleshooting, and in the fourth date, to which all shortcomings should be eliminated.

After this, in the next column the doctor signs. The last column remains blank. In it, the doctor puts the date when he came again, and result of the second check.

So sanitary magazine(you can see a sample form below) must be maintained for each room: swimming pools, locker rooms, showers, children's pools and others. There must also be a form for the medical worker's log of the sanitary condition of the pool.

When if Aquagroup built a whole complex, which includes not only a swimming pool, but also a restaurant and office space, then they should also have a log of the sanitary condition of the catering unit.

Moreover, as far as a restaurant is concerned, there should be several types of such magazines:

• accounting for disinfection according to form No. 6;
• accounting for receipt and consumption of disinfectants and carrying out disinfection work at the facility;
• carrying out gene cleaning;
• visual inspection of the sanitary and technical condition of the premises (form C);
• and several more magazines related directly to the food premises.

Accounting for medical records

The sanitary record book (sample available) reflects information about all employee medical records at the enterprise where they are needed. In addition, information about the certification of these employees is reflected here.

Main section magazine It has the following contents from 8th count:

A medical record is document in the form established by the state, which is required when applying for a job in a number of industries.

When if the employee does not have such books(and due to the type of activity it is necessary), then he faces punishment, provided for in Article 327 of the Criminal Code of the Russian Federation.

The Moscow Government Decree dated December 28, 1999 provides a complete list of professions where such a book is required. You can view and download it.

If we take a generalized list, it looks something like this:

• employees of the food industry and other industries related to the circulation of food products;
• employees of educational institutions;
• public service workers (hairdressers, hotels, laundries, etc.);
• employees of commercial enterprises engaged in the sale of industrial goods;
• transport network workers.

Accounting for sanitary days

As such, a magazine with this name does not exist.

There are several other documents that keep a log of the sanitization of the premises and other measures that include the concept of “ Sanitary day».

Log of sanitary days indicates the following information:

1. On the title page Name of the organization and/or the specific room or workshop in which cleaning is carried out.
2. Date of cleaning, set according to schedule.
3. Actual date carrying out.
4. Name of solution, with whom the cleaning was carried out, and its concentration.
5. Full name of the persons who carried out the cleaning and the full name of the person who controlled the process.

If you need a sanitary inspection log, a sample can be found at the end of the section in *.PDF format.

In addition to such a document, it must be drawn up general cleaning schedule premises or premises and a schedule of sanitary days.

Most often during sanitization, the enterprise is closed to visitors. Such sanitary days are arranged once a month(recommended) on days established by the company management.

Instructions on the sanitary and epidemiological regime

Such magazines are an indispensable attribute of any medical institution. All employees are required to undergo training according to the rules of work in sanitary and epidemiological conditions.

All intelligence about the completion of such training by employees entered into the journal instructions on the sanitary and epidemiological regime. It reflects information about the date of the event, the full name of the employee who received the instruction, the full name of the employee who conducted the instruction and their signatures.

Important! Violation of sanitary-hygienic and sanitary-anti-epidemic rules is evidenced by the log of the sanitary condition of the institution ().

Filling rules

Filling out a health log looks something like this:

• enterprise sanitary log must be kept by the manager organizations or his deputy;
• must be flashed, pages are numbered. On the last sheet the number of pages is indicated, the organization's seal and the signature of the manager are affixed. The ends of the thread with which the sanitary condition control register was stitched are glued with square or rectangular pieces of paper to its cover from the inside;
• All records must be written with ballpoint pens with dark ink (black, blue);
• corrections in logs extremely undesirable. If an error is made, Absolutely forbidden use correction fluids, tear out sheets, or correct by writing over incorrect information.

  If a mistake was made, you must carefully cross out the entire line and write a new one. In this case, in the margins you need to put the inscription “ Corrected to believe» and put the organization’s seal.

  In some companies, when certifying corrections, the head of the organization or department puts his signature.

Reference! Maintaining a log of equipment sanitization and others is a must for some industries. Proper management of these documents will avoid many problems with sanitary and epidemiological services and work calmly in your field.

Now there are many companies on the market offering to draw up and fill out any sanitary logs for money. For companies that conduct their business honestly, such services are unnecessary and even dangerous. Therefore, it is better to know how to correctly fill out the sanitary log yourself.

If facts of document falsification are discovered, the organization faces large fines, and their managers may face real deadlines.

In all cases It is best to comply with all sanitary standards, defined for specific areas of activity. Both businesses and consumers will benefit from this.

The quartz mode for the treatment room depends on the type of installation used in the medical institution.

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The article will allow you to find out

Calculation of need

The quartz regime for the treatment room must be observed in every medical institution. This reduces the risk of the spread of pathogens.

First of all, a technical design is created; during its development, the need for special irradiators in the room should be calculated. These can be either classic ultraviolet bactericidal installations or supply and exhaust ventilation, which will provide the required level of bactericidal efficiency.

Read more about air disinfection here:

• How Rospotrebnadzor checks the quality of air disinfection in medical organizations
• How to choose where to place and how to operate UV irradiators

What does the quartzing schedule depend on?

The log contains basic information about the room and the bactericidal installations used in it (see table):

Read more about air disinfection here:

• Application of continuous spectrum pulsed ultraviolet radiation installations in medical organizations
• Calculation of the number of closed UV irradiators for continuous operation in premises of category I
• Is there an approved log form for a recirculator and how necessary is its maintenance if the display on the device displays the hours worked by bactericidal lamps?

Features when drawing up a schedule

Before quartzing, the treatment room is cleaned, general cleaning is done once a month and routine cleaning is done once a week.

The article is available for reading not only by subscription, but also by demo access. Read it and discuss it with your colleagues!

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A nurse, in addition to performing medical work and caring for patients, maintains medical documentation.

1. Journal, or notebook of appointments.

2. Log of reception and transfer of duties.

3. Sheet for recording the movement of patients and hospital beds.

4. Portion holder.

5. Register of medicines of list A and B.

6. Summary of the status of patients at the help desk.

7. Logbook of expensive and acutely scarce drugs.

8. Dressing journal.

9. Magazine for writing off materials and alcohol.

10. Journal of disinfection of instruments.

I. Journal of pre-sterilization of instruments.

12. Journal of general cleaning.

13. Journal of quartzing.

14. Journal of post-injection complications. In addition, she must be able to fill out a statistical form (form No. 30).

15. Journal of emergency prevention of tetanus.

Journal or appointment book. The nurse prescribes prescribed medications, as well as tests that need to be performed for the patient, in a prescription notebook, where the full name is indicated. patient, room number, manipulations, injections, laboratory and instrumental studies. It duplicates the entry data in the appointment sheet. The date and signature of the nurse must be included.

Log of reception and transfer of duties. Most often, the transfer of duty is carried out in the morning, but it can also be done during the day if one nurse works the first half of the day, and the second - the second half of the day and at night. The nurses receiving and handing over duty go around the wards, check the sanitary and hygienic regime, examine seriously ill patients and sign in the register of reception and transfer of duty, which reflects the total number of patients in the department, the number of seriously ill and feverish patients, movements of patients, urgent appointments, the condition of medical equipment, items care, emergencies. The log must contain clear, legible signatures of the nurses who accepted and passed duty.

The nurse who is on duty in the morning fills out the “Patient Movement Record Sheet” (form No. 007u).

The ward nurse, checking the appointment sheet, draws up a “portion plan” daily (if the dietetic nurse is absent). The portion planner must contain information about the number of different dietary tables and the types of fasting and individual diets. For patients admitted in the evening or at night, the nurse on duty prepares a portion plan. The ward nurses' information on the number of diets is summarized by the department's senior nurse, signed by the head of the department, and then transferred to the catering department.

Register of medicines of list A and B. Medicines included in list A and B are stored separately in a special cabinet (safe). There should be a list of these medications on the inside of the safe. Drugs are usually stored in the same safe, but in a special compartment. Hard-to-find and expensive items are also stored in the safe. The transfer of the keys to the safe is recorded in a special journal. To record the consumption of medicines stored in the safe, special journals are created. All sheets in these magazines should be numbered, laced, and the free ends of the cord should be sealed on the last sheet of the magazine with a sheet of paper indicating the number of pages. This sheet is stamped and signed by the head of the medical department. To record the consumption of each drug from list A and list B, a separate sheet is allocated. This magazine is also kept in a safe. Annual records of medication consumption are kept by the department's senior nurse. The nurse has the right to administer a narcotic analgesic only after the doctor has recorded this prescription in the medical history and in his presence. A note about the injection is made in the medical history and on the prescription sheet. Empty ampoules of narcotic analgesics are not thrown away, but are handed over, along with unused ampoules, to the nurse starting her next duty. When transferring duty, check the correspondence of the entries in the accounting log (the number of ampoules used and the balance) with the actual number of filled used ampoules. When the entire supply of narcotic analgesics is used, empty ampoules are handed over to the head nurse of the department and new ones are issued in return. Empty ampoules of narcotic analgesics are destroyed only by a special commission approved by the head of the medical department.

A journal of acutely scarce and expensive funds is compiled and maintained according to a similar scheme.

Summary of patients' conditions for the information desk. This summary is compiled daily by the night nurse, most often early in the morning, before the shift begins. It contains the names of the patients, their room numbers, as well as their state of health.

The dressing log indicates the date, types of dressings, the number of patients who received dressings, and also includes a daily signature.

The register for writing off alcohol and dressings is located in the surgical room or in the dressing room. This magazine is numbered and laced, signed by the head nurse and the head of the department. For the information of the nurse - alcohol consumption according to order No. 245 of August 30, 1991.

Surgical office - 1200 g per 1 thousand people (1 person - 1.2 g of alcohol).

Oncology room - 1000 g per 1 thousand people (1 person - 1 g of alcohol).

Urologist's office - 1200 g per 1 thousand people (1 person - 1.2 g of alcohol). To apply a compress, 20-30 g of alcohol is required. Treatment of burns - 20-40 g of alcohol.

The consumption of cotton wool, bandages, and furatsilin is taken into account in the same way. Logs of disinfection treatment of instruments and pre-sterilization treatment of instruments are compiled and maintained to monitor relevant activities (Table).

Example of a disinfection log entry

For instruments undergoing sterilization treatment at the CSC, the nurse must keep a log of instruments (see table).

An example of a journal entry for pre-sterilization cleaning of instruments

Logs of general cleaning and quartzing are compiled and maintained to monitor the implementation of relevant procedures in the department (Table).

An example of filling out a tool log

Quartz mode - 8.00-8.30; 13.00-13.30; 17.00-17.30, after general cleaning, quartzing is carried out for 2 hours. The title page must contain the inventory number, year of manufacture, and commissioning of the quartz lamp. After 3 thousand hours of operation of the quartz lamp, it is replaced.

Quartz journal

A log of post-injection and post-surgical complications is also kept in the surgical office, where the date and full name are indicated. the patient, home address, as well as who, when and under what circumstances gave the injection, what drug was administered, where the patient was sent, whether he was given a sick leave certificate, the name of the doctor who examined the patient; After filling out all these columns, the nurse reports this case to the sanitary and epidemiological station, and this patient is assigned an epidemiological number, which the nurse registers in the same journal.

In the trauma room, as well as in the surgical room, a log of emergency tetanus prophylaxis is kept, which indicates information about vaccinations, the amount of tetanus toxoid administered, its series and number, the amount of tetanus toxoid administered, the method of administration, the series and number of the serum, as well as information about to whom information about vaccinations is transmitted.

Each nurse must be able to fill out a statistical form to register updated diagnoses (form No. 025-27). The code of the disease according to the international classification of ciphers is placed in the upper left corner.

The nurse must be able to fill out a sanatorium-resort certificate and a sanatorium-resort card, form No. 30 (dispensary observation card). When maintaining documentation, the nurse's handwriting must be legible and neat; corrections and erasures are prohibited.