See and every single dental aid. Organization of the dental service and help the population
Ministry of Health Protection of the Russian Federation
State Budgetary Educational Institution of Higher Professional Education Saint-Petersburg State
FOUNDATIONS OF ORGANIZATION
Dental help for the population
St. Petersburg
Fundamentals of organizing dental assistance to the population(An initial-methodical guide for students of the dental faculty). ,. - SPb: GPMU, 2016 .-- 67p.
Honors of the Russian Federation for Science Children,
Doctor of Medical Sciences, Professor
Ph.D., associate professor
Ph.D., professor
Ph.D., associate professor
Ph.D., associate professor
Ph.D., assistant
reviewer:
Head of the Department of Social Pediatrics and Organizational Health Protection of the FP and DPO of the St. Petersburg State Pediatric Medical University, Honors of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor ,
Head of the Department of Humanitarian Disciplines and Bioetics of the St. Petersburg State Pediatric Medical University, Doctor of Medical Sciences, Professor
Entry…………………………………………………………………..5
Chapter 1. Organization of outpatient polyclinic stomatological
logical additional help
1.1.General principle organization of stomatological outpatient and polyclinic assistance .................................... ........ .................. 6
1.2. Organization of outpatient and polyclinic assistance to
scrap population ................................................ ..................... nine
1.2.1 Ordering medical aid mature population
in case of dental problems ............................................. .. . nine
1.2.2. Organization of the robot dental clinic for
mature population ................................................ .................. ..eleven
1.2.3. Organization of robotic education (rooms, laboratories)
dental professional in medical organizations, rendered
outpatient medical assistance .................................. 16
1.3. Organization of outpatient polyclinic assistance for children
to whom will the population ................................................ .................. ..eighteen
1.3.1. The procedure for providing medical assistance to children with stomatology -
logical illnesses ................................................ ... ......... eighteen
1.3.2. Organizational robots in the children's dental clinic ........ 19
1.3.3. Organization of robotics for a child's dental office .......... 23
1.4. Organizational activity of the dental office in
lighting installations ................................................ ..24
1.4.1. Organizational activity of the dental office in
educational establishments of the middle, food and pislyavuziv
and in organizations ............................................... ......................... .24
1.4.2. Organizational robotics of the dental office in children
lighting installations ................................................ ....... 25
Chapter 2. Organization of stationary dental aid
2.1. General principles of organization of stationary assistance ..................... 27
2.2. Organization of inpatient dental care ... .................... 32
2.3. Organization of stationary dental assistance for children .......... 35
Chapter 3. Organization of dental assistance to residents
SILICIAN MISSION
3.1. General principle of organizing medical aid to residents
Silk Mitzsevost. .................................................. ................ ... 38
3.2. Organization of dental assistance to the villagers ....... 39
3.3. Organization of stomatological aid at the FAP, vra
3.4. Organization of stomatological assistance at the time of delivery,
offices of the central district hospital (CRL), district stomatological and logical polyclinics ..................................... .......................... .42
3.5. Organization of dental aid in the region
(Kraiova, okrug, republican) stomatologic polyclinics ... 43
3.6. Staff standards for medical personnel to ensure
dental assistance to residents of the Silk city ..................... 45
3.7. Organization of the activity of the mobile dental office
no (brigade) .............................................. ............................. .46
3.8. Lykar-dentist (lykar-dentist home practice)…………………..49
Chapter 4. Oblikova medical documentation in dentistry and
rules of the law
4.1. Medical card of a dental patient ......................... 53
4.2. A leaflet of a doctor-dentist ......................................... 57
lіkarya) stomatologicheskoy polіklіnіki, vіddіlennya, kabinetu ................ 57
4.4. Journal of the field of professional examinations of the empty company .................. 58
4.5. A leaflet of an orthopedic dentist's robotics robot .......... 58
4.6. Schodennik obliku robotic doctor of a dentist-orthopedist ........................ 59
4.7. Medical card of an orthodontic patient ........................ .... 59
4.8. Schodennik obliku robotic doctor of the dentist-orthodontist ...................... 59
Chapter 5.Statistical analysis of the performance of dentistry -
most organizations
5.1. Dental illness .......................................... ..60
5.2. Analysis of the performance of dental organizations .................. 63
Entry
Dental assistance in our country is organized, coaxed, monitored and planned by the Ministry of Health Protection of the Russian Federation, the Ministry of Health Protection of the Oblast (Territory), local and regional health protection services. At all administrative levels of health protection management, the most qualifications and good knowledge of the organization of dental assistance, the population of Fakhivets is recognized as the head specialist in dentistry.
In this day, dental assistance, which includes therapeutic, orthopedic and surgical dentistry, is considered to be the most common types of medical assistance. The population of the region of the dental disease in the middle of the zealous disease of the population beyond the atrocities reaches 20-25%, the rate of incidence is 345-550 per 1000 inhabitants; Dentistry supplementary loans to other people were sent to medical doctors. In the system of health protection, dental specialists and dentists visit other places of therapists for a number of times.
By the staff of the dental organizations є carrying out a complex of dispensary visits from prevention, early detection, treatment and rehabilitation of ailments due to the incapacitation of the empty company, sluggish vines and slit-face dilyanka.
Before the dental units, in which ailments they can find a room and special dental assistance, they should be provided with:
· State and municipal dental policlinics for older adults and children (republics, krai, okrugs, oblasts, miski, rayon).
· Dentistry offices in dispensaries, women’s consultations, centers for out-of-town medical (family) practice, at first-aid posts of industrial enterprises, in educational establishments and іn.
· Dental examination and examination of slit-facial surgery for older adults and children in the warehouses of high-profile medicines, medical and sanitary units, household installations and in.
· Clinical pedagogues of scientific, scientific pre-installation.
· Private stomatological organizations (polyclinics, offices, etc.).
Chapter 1
Organization of outpatient polyclinic
dental assistance.
1.1. General principle of organization of stomatology
outpatient polyclinic assistance.
Outpatient-polyclinic help to treat close to 80% of all ailments that are killed in the organization of health protection. The main types of outpatient polyclinic establishments (APU) are referred to: polyclinics, including Dentistry for older children and children, dispensaries, centers for out-patient (family) practice, female consultations.
Dental clinics and services are provided for the level of service, according to the order, according to the categories.
1) For service staff:
Republics, regions, regions, regions;
miski;
District.
2) For the order:
territory;
Vidomchі.
The main principles of providing outpatient and polyclinic assistance є:
· Divisional character;
· Availability;
· Prophylactic straightness;
· The onset and stage of treatment.
Distinction. There is a large part of outpatient polyclinics who have established their practice according to the principle , that is, behind the installations of the fixed territories, which are distributed in their own room on the territory of the territories. Dilyanki are formed in the fallow area according to the population size. There is a medical doctor (therapist, pediatrician) and a medical nurse for the skin disease. When formulated for the protection of the living minds of robots and long-distance cars, it is not only the size of the population, but the length of the village, the type of forgetting, the visibility of the polyclinics, transport and accessibility. In stomatologic practice, the principle of long-term stagnation in the region is rare.
The organization of dental assistance according to a different principle, allowing the doctor-dentist to develop the basic indicators of illness (breadth, intensity and intensity of development of the disease)
availability . The implementation of this principle is ensured by a wide hemisphere of the APU, which is going on in the territory of the Russian Federation of outpatient and polyclinic establishments. Whether a resident of the country is not guilty of the mother, the transition for the operation to the APU, as for the place of residence, so on the territory, it is in this hour to be found. The availability of outpatient and polyclinic assistance is provided for and is provided without a medical assistance within the framework of the State Guarantee Programs for the community of citizens without a medical assistance.
The nutrition of the organization of dental assistance was always located in the center of respect for the protection of health.
In addition, the last decade is characterized by technical progress, in the introduction of modern possession and new technologies into the practice of dentists.
The main structure, as and earlier, was left out of the state of the municipal medical establishments, as it is unimportant for everything to go to the private dental sector, to see the most common dental care.
In the system of state and municipal services of the local health protection, there are three levels of provision of dental assistance.
First rіven. Before install Perche rіvnya vіdnosyatsya: stomatologіchnі vіddіlennya in bagatoprofіlnih polіklіnіkah, medikosanіtarna Chastain in skladі CRL (Center District lіkaren) that іnshih medichnih establish stomatologіchnі kabіneti on pіdpriєmstvah in The Teaching mortgages Kindergarten gardens, sіlskogospodarskih pіdpriєmstvah in zhіnochih konsultatsіyah that іnshih Set ... At the first stage, the main round of visits for individual preventive and treatment of the most widespread types of dental pathology is carried out, and the sanitation of the emptying of the company is completed and, if necessary, incapacitated teeth are required.
other rіven representations by the state and municipal dental policlinics of the administrative districts of the city, so that you will not be provided with high-quality special assistance for the main profiles of dental specialty: therapeutic dentistry and dentistry dentistry. As a rule, such dentistry clinics define the functions of modern methodical and practical centers for organizing dental assistance, implementation of municipal dental programs in the service area.
At the third level nadaєtsya visokokvalіfіkovana that spetsіalіzovana Consultative dіagnostichna that lіkuvalna dopomoga on such vuzkim rozdіlah stomatologії, yak parodontologіya, endodontіya, zahvoryuvannya slizovoї Ilya Obolonkov porozhnini company, stomatonevrologіya folding Tooth protezuvannya, ortodontіya, schelepno-litsova ortopedіya, dental іmplantatsіya, plastic hіrurgіya, onkostomatologіya i t. e. Before the establishment of the whole level, before the end of the history of the dental clinic of the federal sub-units, scientific and primary medical institutes, special centers. The main reason for the patients at the third level is guilty of being guilty as a result of direct failures in front of them (first and other). For this reason, it is necessary to organize the organization-methodically critical dental service of the Federation sub-committee.
STOMATOLOGICHNA POLIKLINIKA
A special place in the structures of the local dental service is occupied by dental clinics.
Provisions on stomatological policlinics approved by the order of the Ministry of Health Protection of the CPCP dated 10.12.76 r? +1166.
Provisions on stomatological polyclinics
1. Dentistry policlinics is a prophylactic prophylaxis dental patients, The occasional appearance and treatment of the ailments from the incapacitation of the cracked-face region.
2. Dental polyclinics are organized in the established order and their activity among the population, at industrial enterprises, among other and mid-level mortgages, and in the number of events, including
3. Between the district of the polyclinics' activity, the change of the organization, which is the service provider, is established by the health protection body for the order of the polyclinic.
4. The main staff of the polyclinic є:
a) Carrying out visits to the prevention of illnesses in the slit-face regions of the middle of the population and in organized groups;
b) organizing and carrying out visits that were direct at the early detection of ailments due to the incapacitation of the slit-facial picture and the time of the day;
c) the provision of qualified outpatient dental assistance to the population.
5. For the health of the main buildings of the polyclinic organization and conduct:
I will restore the sanitation of the empty company to all persons who are going to the clinic for nutritional support of stomatological assistance;
I will reorganize the empty company at the pre-prize and prize-winning contingents;
Emergency medical help we get sick with gostrich zvoryuvannyahі injuries of the slit-facial dilyanka;
Dispensary to watch over the singing contingents of ailments of the stomatological profile;
Qualified outpatient stomatological assistance with free hospitalization, which requires stationary treatment;
Examination of the team's non-compliance with ailments, vidach licensed leavesі recommendations for rational developmental education, directed at the lykarsko-work of the expert committee of specialties with the signs of a stable process of education;
The whole complex of rehabilitation treatment of pathologies of slit-facial disease and first for everything - dentures and orthodontic treatment;
Come in as soon as you advise the qualifications of doctors and middle medical personnel.
6. The warehouse of the dental clinic may include:
Introduction of therapeutic and surgical dentistry (including children in the general population);
Peresuvnі stomatologіchnі installations;
Renovation of dental prosthetics;
orgmethodcabinet;
Additional pidrozdili (roentgenologic, physiotherapeutic room);
restoration;
Administrative-gospodarska chastina;
Accounting.
The specific structure of the polyclinic is established by the health protection body for the order.
7. The staff of the dental clinic is set up for the state standards and typical states.
traditionally the structure of the dental clinic including onset pidrozdili (div. scheme below):
1) the structure;
2) dental education: therapeutic, surgical, orthopedic from dental laboratory, child dentistry;
3) the office of the first person to look around;
4) the office of non-adherent dental assistance;
5) office of physiotherapy;
6) X-ray diagnostics cabinet.
In addition, in the polyclinic there can be organized services and offices according to the provision of high school dentistry assistance. They are referred to a periodontology room, a room for receiving ailments with pathological changes in the mucous membrane of the empty company, anesthesiology, orthodontics, prophylaxis, holographic therapy, physiotherapy, and functional medicine. Great stomatological clinics (oblast, local) develop such medicine, sterility, anesthesia and reanimation, restoration therapy, endodontics, central laboratory diagnostics
At the structures of stomatological polyclinics є the structure is home, child, orthopedic.
At the head of the re- stratury it is necessary to include: the collection of outpatient cards, the regulation of the flow of patients, the information of the patients, the completion of the robot, the collection and registration of the personal lists, the recording of victories in the home.
The dentist's professional is referred to the group of people who have been affected by the disease on infectious diseases. With surgical dental procedures, it is possible to transfer infection from a patient to a patient, dentist and navpak.
Asepsis is a system of prophylaxis against infection in the wound before the hour of operations, to improve the development of internal infection. Asepsis includes a complex of entrances, providing sterilization of instruments, materials
SCHEME
and fixing the rules for operations and invasive surgical procedures.
Clinical and surgical rooms, dressings, procedural rooms for the operation of the flow, post-operative and general tidy up of chemical problems for the disinfection of bactericidal and physiological factors: mechanical injections... Drills and іnshі mechanical working tools are easily guilty of aseptic processing. pislya prompt engagement Transfer the okremium zbir to the jorstki containers of the vicious materials: gauze servetka, sack and metal tools - golok, climb, scalpel.
Likars, who work in the surgical polyclinic visualization and stationary, are guilty of short haircuts, quilts, and there were no tremors or bullying. Before the operation, a sterile brush and a nice brush before the operation, wash it with a sterile servet from finger tips to licks, doused with a swab, soaked alcohol, rosemary. In the last few years, the treatment of hands with 20% chlorhexidine was widened, as well as the accelerated methods of cleaning with antibacterial drugs (cerigel, 96% ethyl alcohol), the range of ND-410.
Before the operation, the patient is exposed to alcohol and the empty company with 0.12% solution of chlorhexidine, whether they are old or sterile, and to isolate the operation field.
Reinvent the barriers for exogenous infections, and in 90% of the cases, use them from the new middle when sterility is broken during the first hour of operations: in the morning, during the last hour of the operation:
Information can be seen by endogenous paths - from shkirny curves, from empty companies, ENT organs. Great importance in the activation of endogenous infection may be the factor of a non-specific patient and immunity.
In the minds of both the polyclinic and the stationary, especially in case of fiery illnesses, the infestation is perehraln, as it is often the reason for the operation of the disease.
Taking asepsis is of great importance for the protection of the drug and medical personnel, patients with viral hepatitis.
titami C and group B, syphilis, tuberculosis, pravets, siberku, VIL-infectious.
An important technique of asepsis is the sterilization of instruments. It is stored for pre-sterilization cleaning, packaging, sterilization, control of efficiency and delivery of tools to the operation.
Mechanical cleaning of instruments, syringes, or vasniks of carpool, systems of apparatus is carried out with the help of sterile brushes and sterile disinfectants, antiseptics. Particularly blamelessly guilty bori, cutters, disk files, gustry curettage spoons, rasps, tools for osteotomy. Mechanical and antiseptic cleansing and instruments are supplemented with ultrasonic processing. It is especially necessary to clean it and soak it in antiseptic solutions beforehand.
Sterilization of instruments should be carried out for additional physical factors, or chemical words. Steam, hot-air (dry-air), filtration, methods of infrared and radioactive infusion are introduced to physical methods of sterilization. In this hour, sterilization has been expanded in SUKHOPAROV sterilizers with packets of skin instruments. When sterilizing it, use kraft bags, and when it is steam sterilized, use a spherical parchment. Naybіlsh nadіyna bagatosharova packing.
Okremi devices (endoscopy, blocks of attachments for hemosorption, lymphosorption) are cleaned and sterilized in a gas sterilizer.
The tips of dental drills are sterilized in vaseline oleoresin and centrifuged units.
Chemically sterilization is most useful in the case of a low-temperature infusion with formaldehyde and ethylene oxide gases. The tsey method is duzhe zruchny, so the yak borrowed less than 20 min.
Perevyazuvalny material - servetki, tampons, bags, bandages packed in a towel or laid out and put in bixies, sterilized at a vice of 2 atm and temperatures 132.9 ° C for a stretch of 20 minutes. You should also sterilize your dressing gowns and stretch them out. Shavny material is sprinkled with a sprinkle in a small amount, rinsed with running water, dried and sterilized in distilled water
water with a stretch of 20 min. It is also effective to clean the packaging of disposable heads with suture material.
Bits, discs, caps, teeth splints for rinsing in running water for 1 hour disinfecting in 0.5% solution chlorhexidine, with MD-520 (50% glutaric aldehyde and 50% chlorhexidine chloride) solution of water peroxide, as well as stagnation of plasma disinfection. For cleaning with a disinfectant, rinse orthopedic splints, dripping in running water.
To control the sterilization of the ampoule with benzoic acid, resorcinol, antipyrine, ascorbic acid powder, hydrochloride pylocarpine, thiourea, put together with a material and a packing instrument. A high melting point (110-200 ° C) and melting point indicate the optimal sterilization temperature.
The sterility of the preoperative rooms, surgical blocks, materials and instruments is tested by the bacteriological method - inoculation in aerobic and anaerobic minds, as well as in biological samples of healthy spore-bearing culture. The growth rate of microorganisms indicates the sterility of instruments and materials. Continuous control of the sterilization process can be done by placing it in the biological indicator boxes. Slid mothers on uvaz, scho endospore pravtsya, Siberian virazki, tuberculosis microbacteria, viruses, including the virus CHIDu, fungi, cholera virus, are sickly in the middle and most effective against them.
In dental clinics, it is necessary for staff to be provided with foreign infections... The personnel are guilty of routinely undergoing medical examination with pre-existing blood tests for the presence of viruses in hepatitis A, B, C, D, VIL-infection, as well as in case of vaccination against hepatitis B, diphtheria.
I will look at the growth of the number of patients, those who are infected with the same infection, and those who are ill on the SNID when the urgent patients need to take care of the children who have the same sleeves and who are the wrong ones.
Infectious disease, which can be transferred to the dental clinic
The main vimogas, which are presented to the robotics of the dental office
Before the start of the robot and the end of the working process, the manipulative glass, the glass for the selection of sterile instruments, dental crystals, sinks, sinks of the sinks, disinfect the two-way bacteriological worms, 1% change Sterile steel can be rolled for 6 hours. Sterile instruments can also be taken in sterile packaging, or in a bactericidal chamber of the type "MicrocidMed" with the help of prevention of secondary contamination of dental instruments.
Pre-sterilization of dental instruments
Conducted by a medical nurse. step:
1. Soak (pink vyrobi will help you in rosebone viglyad) in 3% solution of chloramine, or 6% solution of peroxide water, or in 5 - 8% solution of alaminol with a stretch of 60 minutes.
2. Washing with a stretch of 15 with running water.
3. Zamochuvannya (outside zanurennya) in the range of Bіolot, pіdіgrіtom up to 40 ° C with a stretch of 15 minutes.
4. Promivannya in a wide range of yorzhyami or cotton-gauze tampons of the skin instrument with a stretch of 15 s.
5. Production lastly: with tap water and distilled water (with 200 ml of tap water per skin) for 1 or 0.5 minutes each.
6. Drying on an open basis.
Items 2, 3, 4 are indications for vicious changes in chloramine and peroxide.
Soaking the windsurfing, endodontic tools is carried out in a stretch of 30 minutes per des. roschinі (3% peroxide water, 10% ammonia and 70% alcohol, mixed in small quantities), then in the range Bіolot (at a temperature of 40 ° C) with a stretch of 15 minutes.
Soaking wet cotton-gauze tampons, mittens, masks, etc. Vyroblyaєtsya in 3% range of chloramine or 5 - 8% range of alaminol with a stretch of 120 minutes.
Control of the purity of the pre-sterilization treatment assess the setting of azopiramova (azopiram, 3% solution of peroxide water in spіvіdnoshennі 1: 1 apply with a pen on the instrument or wipe with a swab) or amidopyrin (95 g alcohol + 5 g amidopyrine. 2 drops each: amidopyrine, 3% water peroxide, 30% probic acid) The blue-violet booked to indicate the presence of blood. Controlling 1% of virobes of one name at a time (no less than three virobes).
Disinfection of dental instruments
Dental handpieces are wiped with 70% alcohol or 3% chloramine, then carry them through half of the pallet until they are finished. Disinfection of handpieces can also be carried out in disinfection systems "Terminator", "Assistina", special "kishenyah", etc.
Dental mirrors zanureyuyut 60 minutes in close range of 3% chloramine or 6% peroxide water. Then rinse with distilled water, wipe with sterile servetka. The mirror is stored in a sterile tray or in a closed sterile compartment.
Spreads, nozzles for pistoles for cleaning an empty tooth, knives for cutting crowns, a Kopa crown maker, etc. disinfecting two-way wipes 1 - 3% by chloramine (or by special disinfecting) with an interval of 10 min.
Mittens on the therapeutic wear with running water with sweet, wipe with alcohol or a special wipe. For surgical treatment, the gloves are disposable, sterile.
sterilization
Sterilization - outside the reduction of microorganisms and disputes on (in) sterilization of objects.
Vimogi, should you be presented before sterilization
Sterilization must be carried out directly at the workmanship, otherwise the sterilization must be placed in an impenetrable package (before sterilization).
The process of sterilization is not guilty of the vengeance of living microorganisms. The process of sterilization of the object cannot be given to us. After sterilization, the object is guilty of becoming sterile for the last hour.
Classification of methods in sterilization
1. Behind the obligate camp of the sterilizing agent:
a) different methods;
b) with vikorystannyam gas-like streams;
c) sterilization by plasma;
d) vikorystannyam vipromynyuvan.
2. By the factor of infusion into sterilization of the object:
a) penetrating abo about 'mnі (knocking down the blocks of microorganisms);
b) nadayut surface inlet.
3. The method is used to sterilize the object:
a) chemistry;
b) physical;
c) combined.
See sterilization, as a vikorist in dentistry
old
Chemistry. Prior to this type of sterilization, it is easy to use the vicious method of soaking, cleaning of instruments in retail (for example, peroxide 3%, 6%; chlorine acid salts; chloramine 1 - 3% and in.). Rozchini can also be used for processing grain, with ultrasonic processing. The overwhelming method is used in the possibility of processing internal channels of small diameter, low temperature of processing. The shortcomings of method є: surface injection, adherence to the technology of safety, the triviality of processing (at least 10 years), the necessity of carrying out decile washings, heavy injection to the personnel, the problem of disposing of inputs.
Thermal. Kip'yatinnya. Sterilization of suction-metal dental instruments (bori, heads, stopper, tackle, bagatoraz syringes, etc.) Method є is penetrating. Environmentally friendly. However, the triviality of the procedure, the unkindness of the operating state of the working tools, is intermingled with the victorious method.
Sterilization of dental handpieces can be carried out for 1 year in vaseline oil with a 2% oxychinol dosage supplied in centrifuges. The method is overwhelming, є penetrating, ale trivial and visible in the presence of special apparatus.
gas
Chemistry. Gas sterilization. Sterilizable object is vitrified in the middle of the gas for 1 year, for which it is necessary to provoke 10 hours. Reliability of the arch method (100% sterilization). Method є is penetrating. There is a high productivity, the tests are carried out in a centralized manner, with great parties sterilizing the object. Obmezhen for materials, which can be used for given method, Nemaє. Sterilization can be carried out in packaging. All one-time tools must be processed. The shortcomings of the method є: a high-toxicity gas, which can
sic debris on the surfaces of the crumbs, the triviality of the procedure.
Ozone sterilization. Ob'kt to showcase in the ozone atmosphere for 1.5 years (for example, in the SS-5 apparatus). Obmezhen for materials sterilization of the object is not possible. However, there is a great amount of toxic ozone, and the same triviality of the process does not give a plus to the sterilization method.
Thermal. Dry heat method. Є we will broaden the best in dentistry, some of the things in stasis, ecologically clean, admitting the processing of the object in the packaging. However, not all instruments can be sterilized by the method. Ob'єkt to be vitrified at temperatures of 180 ° С for 1 year. Dry heat can be stuffed (low reliability). Visoka temperature is equal to the temperature of the bezpeka technology.
Steam (autoclaving) method. Sterilizing with an agent in this vaping є steam, rose to 120 ° C under a vise of 1.1 atm. with a stretch of 12 min, up to 134 ° C - with a stretch of 4 min. The method is penetrating, ecologically clean, visoka flexibility. At the same time, the temperature and the ability to meet the requirements for working tools and the use of safety technology are also adequate. The method will remain for an hour, with a wide extension.
Glasperlen method. It is also penetrating, it is only used for sterilization of other instruments. The working part of the tools zanuruyutsya in the middle, rose to 240 - 270 ° C for a few seconds.
plasma sterilization
Plasma is a quarter camp of the speech. For this type of sterilization, argon must be stored, passed through a winter stream. Method є is penetrating. Vikoristovuatsya efect of kulovoy bliskavki. The bombardment with atoms and molecules of plasma speech is sterilized by the process of opening the sound of microorganisms, as a result of which there is a bend. Sterilization is carried out at temperatures of 60 - 80 ° C for a stretch of 10 - 12 minutes. Apparatus "Plasmodin-2".
Methods of sterilization in vikorystannyam vipromynyuvan
Exchange sterilization. Vikoristannya penetrating ionizuyuyu viprominuvannya, dzherel yakogo є From 60, can only be in the industrial minds through the risk of optimizing the staff.
Method maє ti z positive characteristics, Шо і gas (ethylene oxide) method.
UV sterilization. Ultraviolet treatment can only be used to cleansecritical surfaces. The method is simple, even with trivial robots, the apparatus sees a large amount of ozone.
IV sterilization. Infrachervone viprominuvannya also vikoristovuyutsya for sterilization of the surface (surface infusion) sterilization of the object. The ale method gives the surface heating.
Microwave sterilization. Above high frequency strumi (electromagnetne vipromynuvannya) can be sterilized. The method is not effective, it is shkidliviy for the personnel, it is not infused into the sterilization facility for a short time.
sterilization control
Sterilization control is carried out in one of the following ways:
Vibrating microbiological control (zmiv hangs on the livestock center);
Victory of chemical indicators (indicator pigs, changes in color at high temperatures);
Victory of biological indicators (a man with test microbial cultures, as for sterilization, is promoted in a living community, with the obviousness of growth, the whole party is rejected).
Sterilization of the instrument in case of a threat of VIL-infection
Virus guine at a temperature of 46 ° C with a stretch of 30 min.
Disinfectants (BOOZ, 1986): ethyl alcohol 70 ° - 10 min, 50 ° - 12 min; propilovy alcohol 75 ° - 1 xv, ethylovium with acetone 1: 1 - 10 xv; chlorhexidine 4% - 5 min, 3% - 10 min; sodium hypochloride 0.5% - 1 xv, 0.1% - 10 xv; water peroxide 3% - 1 xv, 0.3% - 10 xv; formaldehyde 0.2% - 5 xv, 2% - 1 xv; phenol 5% - 1 xv; lisol 0.5% - 10 min; paraformaldehyde 0.6% - 25 minutes; polyvinylpyralidone 10% - 1 xv; chloramine 2%, formaldehyde 40% 1: 1 - 10 years for mirrors.
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The special features of the organization of dental assistance to the child population begin, first for everything, a high level of dental illness in a child and adult life: more than 80% of children are guarding their teeth, 95% are couples.
Outpatient-polyclinic stomatologic support for children is provided by the following stomatologic establishments:
... children stomatologic polyclinics;
... children stomatologicheskie vіddіlennya (cabinets) installed zagalnolіkuvalnogo fencing;
... dental office
Children of dentistry polyclinics as self-contained hospitals are organized in great places the number of children in the population is not less than 60-70 thousand. cholovik. In places with the number of children, the population is up to 20 thousand. Dentistry assistance is available in the children's rooms (offices) of dental clinics for older adults.
Prior to the main establishments of the children's dental clinic, the following are referred to:
... provision of medical support for children who suffer from dental problems;
... organizing and carrying out in a planned order of preventive examinations and sanitation of emptying a company of children in the pledges of preschool, cob, main, middle (general) foreign, special education, special education;
Providing extraordinary stomatological (surgical) assistance to children who are ill with health problems and injuries of the slit-facial delyanka;
... conducting dispensary care for children with pathological tooth-tooth system and assessment of the level of dental health of children;
... straightening in the established order of sick children at the stationary treatment in special dentistry services;
Carrying out complex orthodontic treatment of children with tooth-tooth and facial anomalies;
... analysis of dental health problems of children and distribution of visits to reduce and determine the reasons for receiving the diagnosis of disease and delay;
... vprovazhennya modern methods prophylaxis, diagnostics and treatment of stomatological illnesses of slit-facial dylyanka in children;
Carrying out sanitary and educational robots for the population, including those for the average medical staff, educational and professional mortgages, pedagogical staff of schools and preschool institutions, fathers,
equipping structural podrozdiliv polyclinics of medical equipment, instrumentation, as well as medicines and vitratic materials, depending on the extent of possession and instrumentation;
... Providing the oblast and the folding of medical vitality in the established order.
Examine singing vimogs to the structure of a child's dental clinic; the presence of a minimum of 2-3 rooms for an orthodontist, a doctor-psychologist, and a game room. At the same time, if there is a dentist's help for children, they need to be at the entrance, if they are part of the structure of a dental clinic for the elderly, then it is up to the needy minds to see the presence of a certain entrance for children, who are not very smart.
One of the peculiarities of the organization of the robotics of child dental clinics is the widespread use of the method of planned sanitation.
The head figure in a child's dental clinic is a child's doctor-dentist who has taught me a professional education for the specialty of "stomatology" after completing the internship at the "doctor-dentist" clinic for dental practice.
Spetsіalіzovanu Relief nadayut lіkarі dental speschshlіsti (therapist hіrurg, orthopedist, orthodontist), SSMSC proyshli profesіynu perepіdgotovku of dityachoї stomatologії vіdpovіdno to vimog osvіtnogo standard tipovoї prog i The Teaching plan zatverdzhenі in the prescribed manner i otrimali sertifіkat fahіvtsya of vіdpovіdnoї spetsіalnostі. In addition, the dentist will help the children to pressure the teeth of the doctor.
Basically, the work of a child's doctor-dentist is a prophylactic, diagnostic, diagnostic, sanitary and sanitary-sanitary robotics, which is aimed at the optimal development of the tooth-tooth system of children. For the most part, there is a planned sanitation of the emptying company of children, dispensary examination, and the need for continuous dynamical care.
In necessary cases, I will give unadvisable dental assistance to children in outpatient clinics, in the prescribed manner, directing children to pathological slit-facial areas at the stationary treatment in special dental medicine.
O.P. Shchepin, V.A. medic
Organization of dental aid in the Russian Federation.
Therapeutic stomatological assistance is an unrecognizable structural component of complex dental assistance to the population.
Dental assistance in our country is organized, coherent, monitored and planned by the Ministry of Health and Social Development of the Russian Federation. In republics, regions, towns and villages, the dental service is provided by the ministries, committees, and the department of health protection under the administration of the new territory. At all administrative levels of health protection management head specialist on dentistry. In some cases, there are recognized fahivtsi in the high schools of dentistry (therapeutic dentistry, slit-lice surgery, etc.). The main specialty is recognized from the number of the most qualified doctors-dentists, professors, associate professors, scientific specialists, who practice in the field of dentistry and know well the organization of dental supplementary aid in the population. Most often plant
borrow the heads of the regional (republican, regional) or the great city dental clinics.
I will provide the following therapeutic and preventive dental care for the population:
republican (region, region) stomatological policlinics;
stomatologic policlinics, viddіlennya and kabinetti,
lays with the key bases of the
middle stomatological (stomatological) primary mortgages and pre-scientific institutes;
misc, district and interdistrict stomatological policlinics;
stomatologicheskie іddіlennya and rooms
policlinik, women's consultations, regional and local
lykaren, central regional dispensaries, medical dispensaries, paramedics and obstetric points, industrial establishments and primary mortgages;
stomatologic services and offices of household medical and preventive installations.
Organization and structure of dental clinic, therapeutic education, dental office.
In the dental clinic
date:
restoration;
introduction of therapeutic dentistry;
revision of surgical dentistry;
introduction of orthopedic dentistry from dental
laboratory;
periodontology cabinet or viddilennya;
physiotherapy room;
roentgen cabinet;
child dentistry (in great places, if there are
the line of the child population in the service zone becomes
Prote 60-70 yew. cholovik, self-organizing
children stomatologic polyclinics);
administrative-state department and accounting.
Dentistry clinic is stored in the re-stratum and medical facilities: therapeutic, surgical, orthopedic cabinets; roentgenologist., physiotherapist., oglyadogo, sterilization and dental laboratory. In a given hour, in the structure of the dental clinic, there will be organized the information (office) of anesthesia, the information (office) for the treatment of the periodontal disease and mucous membrane of the patient, as well as restoration, professional Great stomas. polyclinics can open up a cabinet of functional diagnostics, clinical laboratory, centralized sterilization, pharmacy kiosk.
The dental office for one doctor is responsible for occupying an area of at least 14 m². On the skin dodatkovo the crystal is introduced 7 m². The height of the office is not less than 3 m. The walls of the dental office are smooth, without cracks. The floor of the cabinet is guilty of being covered with linoleum, which is guilty of moving to the wall at the height of 10 cm. Walls and pidlogs are required for light colors: light-gray colors. The office is guilty of the mother of natural and piece lighting (luminescent lamps or lamps of ignition). When robotic with amalgam in the office, a knight's head will be installed.
The cabinet is to blame for the supply and ventilation, in the case of a quartz lamp.
The office has a working mission for a doctor, nurse and sanitary woman. A robust mice of a car transferring an installation, a crystal, a table for liquids and materials, a gwint style.
The work of a nurse can turn on a style for sorting tools, a dry-air shafa, a sterile style and a gwint style.
The cabinets are responsible for the shafa for the collection of materials and tools, the shaf (A) for the off-duty and the shaf (B) for the strong lykarsk words and writing styles.
4. Staff requirements therapeutic advice (office) Lykar - dentist - therapist Lykar-dentist of goiter
- systematically improve their professional skills, use new methods and diagnostics, treatment and prevention of dental problems;
- to ensure that there is no effective dentistry assistance and gradually reduce the number of illnesses;
- correctly and accurately store all forms of regional documentation;
- If you are sick with ailments, students and other persons will be respectful, follow the rules of deontology;
- being familiar with the robot, labor discipline for the middle and young medical personnel;
- carry out a sanitary and educational robot in the middle of the population for the update plan;
- after adjusting the rules of safety technology and anti-fire access to the work machine;
- take part in the planned sanitation of the empty company of organized contingents of grown-ups and children.
A lykar-dentist does not have a certainty:
- for vidmova in nadannі help the sick man, first for everything, we treat the sick man with a toothache;
- for a vinyinennya accelerated writing;
- for inaccurate and unreasonable maintenance of official medical documentation;
- for violation of labor discipline and deontology rules. Ordering of the dentist obovasovye for the middle
young medical staff of the therapeutic cabinet.
Medicna sister
The nurse sees to all my office, asks for her care and for the correctness of the registration, for the timely updating of the office with a new inventory, tools and business.
Vona zobov'yasya stitches for the correct work of illumination, water supply, canalization of the cabinet, as well as the technical quality of equipment, dental units and crystals.
The nurse of the therapeutic office for goiters is tied in front of the ear of the robot and prepares the medicine from the warehouse. pidgotuvati roboche misce lykarya. It’s an hour for the doctor to take care of the ailments in the office, give the doctor a sterile instrument, ready filling material, to the doctor for cleaning the doctor, and on the disinfecting tables.
The nurse did not care for the cleanliness and sanitary status of the office. Vona goiter is bound by the stitches for keeping up with the rules of asepsis, increasing the opinion for taking all medications, keeping up with the economical vitrachny materials, for keeping up with the technology of safety.
Nurses take care of themselves in a laborious way every hour to receive ailments.
sanitary woman
The sanitary woman is in the order of the head of the department, the nurse and the sister-master of the polyclinic.
Before the ear of the robot, the sanitary of the crop is tied to check the cabinet, to clean up the statuses, window frames, podvikon, panels and possession with disinfectants. Vona viroblyaє vologue tidying up pіdlogs not earlier than 3-4 times for a change. And also quilting for the purity of the spout.
5.Oblikovo-zvitna medical documentation.
honey documentation- a system of regional documents of the established form, which are intended for the restoration and analysis of the data, characterizing the country of health and the population, the society, the change and the quality of medical aid, as well as the activity of the medical aid.
To become victorious for the management and planning of the organization of honey. help the population. We will be based on the principles of single indicators, methods and methods of rejection, taking into account the terms of the development of the visibility and making it possible for the institution to stand.
Primary regional documentation:
Honey card stomat ill (f 043u),
One coupon of an outpatient patient (f. 025-8),
A leaflet of a robotic vr-stomat (037),
The office of the VR-stomat robot (039),
Dispatching control card (030),
Outpatient operations journal (069).
Dіyalnіst stomat. polyclinics according to f 039: I. Licuvalna robot:
1. the average number of visits in 1 day per 1 car = the number of all visits / number of working days in rots (rotated by users).
2.the average number of lykuvalnoy metoyu in 1 day for 1 liter = the number of visits for every single day / for a number of working days at roci.
3. Average number of seals in 1 day for 1 lykary = all seals were applied / to-t work days at rotsi.
4. the number of vivid teeth = the number of young teeth / to-t slave days at rotsi.
5.Putting of seals until visible = all seals are applied / number of visible teeth
6. number of seals for 1 primary ailment = all seals are applied / a set of primary ailments.
7.Number of insertions per 1 seal = the number of all insertions with a single seal / all seals were applied.
8.Installation of an unrelenting career before the last delay = completed in one report + continued and completed (on the basis of a decision) / distributed and completed in one report + continued and completed
9.% of pulps, fortified in one session = distributed and finished in one instance (test for pulp) * 100% / for fortified pulps (distributed and finished + continued and finished).
10.% of periodontitis is the same.
11. number of sanctions in 1 day per 1 lykary = the number of sanuvati ailments / to-t work days at rotsi.
12.number of visits for 1 sanitation = number of visits per month = number of visits per month / number of people with illnesses
13.% of sanuvati ailments = the number of sanuvati ailments * 100% / number of the first ones.
Healthy empty company є with the important mind of the normal physical body of the people. Seemingly, there is a strong ringing even more of all non-infectious ailments with damaged teeth and an empty company. Diagnosis in people of different types of pathology of the heart-vascular system, rheumatism, nephropathy, infectious-allergic diseases, ailments shlunkovo-intestinal tract and the ovens are looked at by clinicians in conjunction with dentists who are ill.
In the presence of chronic infections in the empty company, the frequency of somatic ailments increases by 2-4 times, and in the event of an unsuccessful indicator of the emptying of the company, the frequency of somatic ailments increases by 5 times. Therefore, the zavdannya to protect the health of the population can not be violated without the assumption of dental pathology.
Dentistry assistance has long been established to the number of the most common types of medical assistance. With a total of 99% of patients with illnesses, they must be serviced in outpatient polyclinic mortgages. In the structures of stomatological illnesses, who are diagnosed with hospitals (close to 1% of the ills), every day they take odontogenic ignition illnesses, new problems and injuries of the slit-facial picture.
The current Ministry of Health Protection of Russia, organizes the protection of the health of the regions of the country and municipal councils in the interim of their competence. At all administrative levels of health protection management, the head specialist in dentistry is appointed.
Preparatory education for dental doctors in health care at the dental faculties of medical universities. Order z tsim, in Russia to tsikh feast the release of dentists from the middle is going on medical education... The annual indicator of sickness of the population with cadres of all patients, the dental profession to become in the middle 4.7 (in the ranks of great places - more than 5) for 10 thousand inhabitants.
It is common in Russia that the nomenclature of doctors and dentists can practice in health protection systems for the main phase of "dentistry" "," Orthopedic dentistry "," surgical dentistry ".
Outpatient stomatologic help the local population to appear in different types of specialized medical and prophylactic establishments. To them are admitted:
1) state and municipal dental policlinics (for older and children);
2) dentists' nurses (delivery and offices) in the warehouses of the sovereign institutions protect health (territorial polyclinics, medical and sanitary units, medical centers, dispensaries, women's consultations, etc.);
3) dentistry offices in non-medical organizations (schools and preschool establishments, middle and special primary mortgages);
4) private dental clinics.
In the midst of the sovereign dentists, the country has not been established for the last ten years of any serious changes. A large number of dental clinics in the world have practically become invisible and become close to 950 units this year. At the same time, the number of dental infants (such as rooms) at the warehouses of other organizations has rapidly increased.
The transition to rinky changes in the sphere of health protection, liberalization of prices, development of new civil legislation - all the rest of the ten years of private dental clinics were welcome to the boorish growth. The annual private sector of dental assistance of representations as developed for their organizational and legal forms by commercial structures (all-round cooperatives, state-owned partnerships and partnerships),
Most of the private dental services are stocked in small outpatient clinics (in the average for 2-3 weeks) and in offices. There are more clinics and building blocks, which can be developed practically only in the great places.
In the minds of a strong market medical services the population has a real opportunity to choose a dental installation and a doctor. Moreover, the current paid dental assistance has already become the most important factor. financial camp not only private, but th state-owned dental installations. In the minds of the world, there is also competition among the clients for the patient’s award, which, by the singing world, improves the quality of dental assistance as a whole.
As of November 26, 1999, No. 1194 "About the program of state guarantors of protection of the citizens of the Russian Federation with no medical assistance" Krіm order for rakhunok koshtіv byudzhetіv usіh rіvnіv zdіysnyuєtsya pіlgove protezuvannya zubіv Pevnyi kategorіyam gromadyan, vklyuchayuchi dіtey 18 rokіv, pensіonerіv by starostі, іnvalіdіv voєn, іnvalіdіv h of Childhood, іnvalіdіv pratsі I i II group, geroїv Radyans'ka Union geroїv RF Povny kavalerіv Orders of Glory, residents of the besieged Leningrad, veterans of the boyovies in the territory of the first lands, etc.
In case of the carelessness of the big people with no cattle-free assistance, it is necessary to obtain the principle of centralization and decentralization in the organization of dental services. With a centralized form, the population is carried out without a median in the dental clinic, or in the dental clinic (office), in the leading medical and prophylactic mortgage.
Decentralized form of service for the transfer of permanently active dental offices at enterprises and in organizations. Perevaga tsієї forma polyagaє in that, in a way, in the first place, the servants of the population are seen on the mission and permanently; in a different way, є the possibility of a general medical service of working abnormalities; in the third place, the possibility of greater contact between the doctor and the patient is increased. In good dental care for children, the form of organization on the basis of education has been decentralized.
Organizational robotic dental clinic
Sered usіkh medical institutions, I will give dental help, especially when I loan a dental clinic. Dental clinic - the goal of a preventive and prophylactic mortgage, the activity of which is focused on the prevention of stomatological ailments, often detecting and eliminating ailments in the region of cracked-face Dentistry polyclinics are developed:
1. For equal service: republican, krai, oblast, miski, rayon.
2. According to the order: territorial,
3. For dzherela financing, budgetary, state projects.
Dentistry policy is established in accordance with the established procedure and its activity on the basis of the rights of an independent establishment of health protection. Between the district of health protection, the change of organization, such as servants, is established by the health protection management body in accordance with the order of the polyclinics. The main departments of the dental clinic є:
a) Carrying out visits to the prevention of illnesses in the slit-face regions of the middle of the population and in organized groups;
b) organizing and carrying out visits that were direct at the early detection of ailments due to the incapacitation of the slit-facial picture and the time of the day;
c) the provision of qualified outpatient dental assistance to the population. For the health of the main buildings, the polyclinic organizes and carry out:
We routinely for grafіkami, pogodzhenimi kerіvnikami of companies i organіzatsіy, profіlaktichnі Glancing pratsіvnikіv Promyslova of companies, budіvelnih organіzatsіy, uchnіv vischih i serednіh The Teaching zakladіv, pratsіvnikіv i uchnіv іnshih organіzovanih kolektivіv of odnochasnim zdіysnennyam lіkuvannya viyavlenih ailments;
Improvement of new sanitation of the empty company to all persons who go to the clinic for nutritional support of stomatological assistance;
I will reorganize the empty company at the pre-prize and prize-winning contingents;
We need extra medical help when we are sick with health problems and injuries of the slit-facial picture;
Dispensary to watch over the singing contingents of ailments of the stomatological profile;
Providing qualified outpatient dental assistance from the health of the hospital, which require stationary treatment;
Examination of the team's non-standardized ailments, the issuance of certificates of praise and recommendations for rational praticulation, directed by the experts of the com- munity with signs of praise of praise;
The whole complex of rehabilitation treatment of pathologies of slit-facial disease that, first of all, denture and orthodontic treatment;
Analіz zahvoryuvanostі population stomatologіchnimi hvorobami, in addition chislі zahvoryuvanostі of timchasovoyu vtratoyu pratsezdatnostі robіtnikіv i sluzhbovtsіv, SSMSC pratsyuyut on Promyslova pіdpriєmstvah, roztashovanih on teritorії area scho obslugovuєtsya and takozh rozrobku zahodіv schodo znizhennya i usunennya reasons scho spriyayut viniknennyu zahvoryuvan i їh uskladnen;
Widbir ailments, which require a spa resort;
In the provision of modern methods of diagnostics and treatment, new medical technology and equipment, lykarsky zasobiv;
Sanitary and illumination of the work in the middle of the population from the community of the community, the Association of the Chervony Khrest and the Chervony Pivmyatsya and to all the news of all the mass information (press, television, radio news, etc.);
Come in as soon as you advise the qualifications of doctors and middle medical personnel.
The warehouse of the dental clinic may include the following children (Scheme 1):
restoration;
Introduction of therapeutic and surgical dentistry (including children in the general population);
Introduction of orthopedic dentistry from dental laboratory;
Additional podrozdili (rooms for X-ray diagnostics, physiotherapy);
Peresuvn_ stomatolog_ichn_ cabinets;
Cabinet of non-ad hoc stomatological assistance;
Administrative-gospodarska chastina;
Accounting.
The structures of dental clinics are transferred to the stem of oglyadnyh clinics. Proceeding in them, they will not be able to get rims straight from the ailments to the polyclinics, as they will give special dental assistance. Medical dentists of medical clinics can and themselves pressure to help ailments at any time of the ability to direct them to a general view.
In addition, in the polyclinics there can be organized services and rooms according to the provision of higher education institutions for dental patients. They are referred to the cabinets of prophylaxis, periodontology, orthodontics, a cabinet for receiving ailments with pathological changes in the mucous membrane of an empty company, a cabinet of functional diagnostics, an allergological cabinet.
Organizational-methodical offices are established at the structures of republican, regional, local dental clinics, additional organizational and methodical offices, specialists of those who are mentally responsible for organizing-methodical work in dentistry,
Dental clinic of the republican, regional, regional order:
Organizationally-methodically critical dental clinics, visits and offices, roztasovany on the current territory;
Analysis of ailments at the time of the territory, the need for dental assistance and development, come straight to the point of view;
Zabezpechuє in the necessary problems of visiting fahivtsіv in the population points of the Silskoy mіstsevstі for carrying out in them the whole complex of prophylactic visits.
Without a pre-requisite dental clinic health care head license, the rights and regulations of which are based on the applicable provisions. Administrative department of polyclinics, social large organizations I will establish the rules of the internal labor order. The mode of robotic polyclinics is initiated by the health protection body for ordering the urahuvannya of the population and specific minds.
Dental clinic, equipped with modern possessions, staffed with qualified personnel, such as modern methods of diagnostics and treatment of stomatological ailments, without providing the most additional medical conditions.
An important part of the robotic dental care is the prophylactic activity. W metoyu aktivnoї Borotba of karієsom zubіv i іnshimi naybіlsh poshirenimi stomatologіchnimi zahvoryuvannyami stomatologіchnі polіklіnіki conductive planned sanatsіyu zubіv i porozhnini company dіtyam at school I doshkіlnih establish students vuzіv i uchnyam tehnіkumіv, vocational, robochem-pіdlіtkam, robochem, pov'yazanih of profesіynimi shkіdlivostyami, for recruits, women in attendance and the population
The registry plays a great role in organizing the reception and regulation of the flow of ailments, as well as seeing the tickets or before the registration on the reception. The first coupons are seen at the reception before the surgeon, or for the planned reception before the therapist, before the high school profile (periodontologist, specialist in the case of mucous membrane of the empty company). Orthopedic and child are seen, as a rule, their own registry.
Krim regulation vidviduvan 's restoration important functions: Registration and collection of outpatient histories of ailments, їkh pіdbіr, delivery to the office and distribution of letters to the reception, issued sheets of team-hour non-standard and їkh restratsіyu; ma dovidkovo-information service; zdіysnyu financial services with patients for payment of paid medical services.
In the organization of the reception of ailments in the dental clinic, a great role is played by the dentist. If necessary, I would like to provide a non-emergency dental assistance, looking at the patient and the appointment of the necessary dental assistance, directing the ailments to the other faculty members of the clinic.
Repeated identification of ailments by polyclinics is recognized and regulated by drugs. With the correct organization of robots, ailments are spared to use one likar to reorganize. Dentists of dental clinics carry out the robot according to a different principle, so that it adjusts the visibility of the skin doctor, allowing the assessment of the effectiveness of the robot and the control of the amount of assistance.
In ryadі polіklіnіk pіdvischennya yakostі stomatologіchnoї Relief zabezpechuєtsya Shlyakhov Introduction garantіynoї sistemi obslugovuvannya: pіslya zakіnchennya lіkuvannya i povnoї sanatsії porozhnini company ailing vidaєtsya so the title of "sanatsіyny" card, yaky daє ailing right razі viyavlennya defektіv zvernutisya to lіkarya into whether yaky hour pozachergovo protyagom rock from the day of issuing the coupon.
The main parts of the robotics of the dentist, who are practicing in the clinic, are:
Providing medical-prophylactic, surgical or orthopedic assistance for the animals;
Conducting consultations for licensed specialties;
Dispensary to watch over the singing groups of stomatologic ailments;
Conducting planned sanitation of the empty company among the singing contingents of the population;
Robot sanitation and education.
The child of stomatology is given pratsyu care for the method of planned sanitation. The whole method is implemented in two stages:
1st stage - looking at the empty company, making the consumption in different types of stomatological aid and obsyagu;
2nd stage - providing the necessary preventive and preventive assistance in a very short term before the next sanitation. In a number of patients there is a planned sanitation of the transfer and the third stage - further away, systematically and actively guarding for ailments, ie. Dispensary guarding.
The planned sanitation of organized child groups is carried out behind a special graph. For the vikonannya of the graph there is no evidence not only of a dental clinic, but of the administration of schools, children's cages.
Planned sanitation is needed for the children of the elderly population: people of the Great Victory Day, women in hospitals, pre-admission students, somatic ailments, as well as students at the dispensary, professional students
In particular, the merit of the organization of the robotics of orthopedic education. Denture assistance is reliant on the final stage of the treatment of dental ailments, in order to carry out a new sanitation.
Orthopedic education has its own re-structure, an oglyadny office, a clinic for orthopedic doctors, a dental laboratory, and maybe an orthodontist's office. An ailment that will require a denture should be transferred to the orthopedic hospital registry. If there is evidence of a new sanation, a special outpatient card will be started up and a coupon for the reception to the doctor's office will be seen. In the oglyadny office, a plan of prosthetics is stored, for whom ailments go to the reception to the doctor-dentist-orthopedist, who looks around the sick person, know the plan of prosthetics and draw up an outfit for preparing prostheses. In order to pay for dentures in the laboratory, the preparation of prostheses should be repaired.
In addition to the preparation of new prostheses in the orthopedic examination, repairs and replacement of old prostheses are carried out, advice is given on the nutrition of prosthetic teeth and orthopedic treatment of dental patients. The children of the great polyclinics rely on special orthodontic assistance.
Free dental prosthetics will take care of the invalids of the Great Victory Day, the Invalid Practice of the I and II Groups, personal pensions, children and deeds of the population.
Dentistry clinics are given in times of need for additional help we are ill at home for a wiklik of medical clinics. For better dental care at home in the clinic є portable equipment. At home, all the necessary types of assistance are available, including dentures. Apartment wikis will be serviced either by special visions for all doctors, or by all polyclinics in the order of the schedule.
An unadvisable dental aid in the year of robotic polyclinics appears as Chergov's dentists, at the svyatkov_ days And also at night - in special points of non-emergency dental aid, which are organized in the decile polyclinics of the city.
It is a great time in the robotics of the dental clinic of the loan of the dispensary examination of dental ailments. During the dispensary's visualization, ailments are actively treated with caries of teeth, due to cracks in the periodontal and mucous membranes of an empty mouth, chronic osteomyelitis cracks, malignant new malformations of anomalies and malformations The treatment of such ailments is carried out both in the course of prophylactic examinations and planned sanitation, as well as during the treatment to dentists for providing medical assistance.
Poliklіnіka pratsyuє for the plans, in which specific organizativnі and lіkuvіl-proіlaktychnі come in. The scope of the polyclinics' activity will be in the order established by the governing bodies for the protection of health for regional and audible documents, approved by the Ministry of Health Protection of the Russian Federation.
Oblik and assessment of the performance of the dental service
The decision of the tasks of organizing stomatological assistance to the population is unfortunate without the analysis of statistical data about the work of the dispensary and prophylactic establishments (LPU), and how to get away from the sound and regional documentation. The quality of the medical profession, the establishment of the dental service in general, is assessed for additional statistical indicators. It is important not only to use the methodology for the development of cich indicators, albeit and estimate them in the dynamism, according to the standards, average indicators for the region, indicators of the lowest single-profile installations. It means that the order of the expert assessment and medical standards are indicators of robots, as well as the most important way to control the quality of dental assistance. The analysis of the performance of the dental service is useful for:
1) detailed organization of the robotics of dental installations, flow and long-term planning of the efficiency and resource safety;
2) the value of the effectiveness of new methods of treatment and diagnostics, new medical technologies and new forms of organizing work for staff;
3) assessments of all components (structures, technologies and results) of the quality of providing dental assistance to the population.
The main role in organizing the primary statistical area in the medical and preventive settings and in the establishment of sound documentation is in the office of medical statistics. Functions of the Cabinet of Medical Statistics є:
1) establish the organization of the statistical information in the departments;
2) instruction of practical workers, how to store all the necessary documentation and control over the correct maintenance of documents and reliable information;
3) the folding of production (daily, business, quarterly, etc.) regional documents and calculation of indicators, necessary for operational management;
4) the folding of periodical (quarterly, quarterly, personal) calls and calls and submissions to the address and terms, transferred by the report card of state statistical vitality;
5) Conducting special statistical projects for the establishment of the server;
6) the preparation of statistical materials and the role in the robot from the analysis of performance should be established when the business plans are put together;
7) preparation of statistical materials for licensing and accreditation of the mortgage;
8) rational organization of the collection of regional documents and control over the uninterrupted supply of all documents by the necessary regional statistical documents.
The main document of a medical mortgage, whether to a professional є (form No. 30)
- "Vidomostі about medical kadri" (form No. 17);
- "Vidomostі about the activity of the drug-prophylactic mortgage in the compulsory health insurance system for__year" (form No. 52, form No. 14).
It means that only the elements themselves are taking place in everyday life, the foreign views do not reveal all the specific aspects and characteristics of the performance of the dental service. For a number of reasons in the skin specific dental pledges, make sure to memorize the deposits to the richest sound, to characterize in more detail the peculiarities of the robot for providing dental assistance to the population.
Sound documents are stored in the office of medical statistics at the presentation of these regional statistical documents, which will be memorized by the authors of the previous studies.
In a given hour, the system is based on the work of robots in clever labor units (UT).
By the order of the Ministry of Health of the SRSR No. 50 dated 01/25/1988 r "About the transition to a new system of work in such cases for the dental professional and in the thorough formation of the organization of the dental clinic" s nadannya stomatologicheskoy help. For example, the application of a seal in case of a superficial or middling position is yak 1 УТ, a foldable tooth is seen at 1.5 УТ, and splinting in case of fracture slits is 4 УЄТ.
Oblik robots likariv according to the odds of labor, labor, will be safe:
1. Organization of robots based on rejection of a specific result, which is rotated in UT.
2. Stimulation of the robot to provide maximum assistance in one view.
3. The ability to develop an adequate system of material stimulation of the robotics to improve the final result.
4. Otrimannya vartisnoy assessment of the skin vipad sanatsii one sick person.
5. Development of the planned assessment of labor vitrats for the implementation of one sanitation.
6. Differentiation of high-labor-intensive types of robots according to UT.
7. Possibility of rejecting the economic assessment of labor and labor.
8. Reading criteria for the transition to the differentiated payment of the rates for the fallowing in the amount of money and quality.
Change of types of robots, turning in UT, distributions on two groups:
1. Dorosly priyom.
2. Childish priyom.
You see the robot in a grown-up reception, in his own heart, distributed on the back and connected with therapeutic, periodontological, surgical and prophylactic methods.
It is necessary to make some respect for the assessment of the skin close to mind Robit with child dentistry established a larger number of UTs. For example, such a kind of robotics for a child dentist, like the treatment of pulp from filling 2 root canals of a post-tooth tooth with cement, should be assessed for a grown-up priyom at 4.5 UT, and for a child - at 5 UT. Indications of opinion in the assessment of labor for a child explain specific factors When children are given additional help: mental characteristics, labile behavior, etc.
As of current regulations A dentist's license with a six-day working day is guilty of a viconuvati robot equivalent to 21 UT, with a five-day one - 25 UT on a working day.
The main regional statistical documents, vikoristovuvanim in a given hour in dental mortgages, є:
Medical card of a dental patient (f. №043 / y);
A leaflet for the robotics of a dentist, a dental doctor of a dental clinic, a report, a cabinet (f. No. 37 / u-88);
a leaflet for the robotics of the doctor-dentist-orthopedist (f. No. 037-1 / o);
schodennik of the robotics of the doctor-dentist-orthodontist (f. 039 - 3 / y -88);
Schodennik for the robotics of the doctor of the dentist-orthopedist (f. 039, 4 / u);
Control card of the dispensary guarding 030 / y;
Direction to consultations in additional offices (form No. 028 / y);
The journal will record outpatient operations;
Journal for recording visnovkiv KEK (035 / y);
Book of restoration of non-standardized leaflets (0366 / y);
A coupon for the conclusion of vipadoks of a team-hour non-standard (f. 025-9 / 4-y-96) and ін. At the submission of these regional documents, there is a daily sound (f. 30), in one (in section P, p.
The stagnation of the values of the forms of statistical oblast documentation allows for the processing of the necessary information for the analysis of the performance of the dentists at all levels. In case of rational registration of views, which can be found in these documents, it is possible to correct a number of certain indicators that characterize the political and professional work of the dental service in the whole and in the setting of conditions
Indicators of prophylactic robots in dental units
Number of sanctions per day per one drug:
All sanuvati in the order of planned sanitation and after the beasts A number of working days
Pitoma for the sanation of the animals (insurance for the doctor, according to the statement, polyclinics):
The number of sanuvati for the atrocities of the original ailments100 \%
The countless number of primary ailments
Pitoma for the sanation of preventive robots:
Number of sanuvati from the number of manifestations
with planned sanitation 100 \%
__________________________________________________
The number of people who need to be sanitized from the number of
Some indicators of proactive robots may be of the greatest importance when servicing the child population.
There are a lot of children who have taken medication for the prevention of care:
The number of children who took preventive medication 100 \%
A number of them will look back in the planned order
Hunting for children sanitation (\%):
(Health + earlier sanovani + sanovani) 100 \%
Number of children for the list
Number of accelerated carriages for 1000 children:
Number of types of accelerated cards for
teeth of tim-hour (or post) bite 1000
The number of more mature children
A lot of children from the backward hygienic camp of the empty company:
Number of children
gіgієnіchny camp empty company 100 \%
The number of more mature children
General indicators of business robots
Average number of visits per day:
The majority of those who have taken illnesses are all for
singing period (місяць, рік)
Specialty teeth and teeth:
All teeth are sealed
(Tim-hour and post-bite)
Forced teeth in a permanent bite
Average number of UST (labor units) per day per one likar:
The initial number of vibrated UTs for the last period
Number of working days in the period
Number of UT on one view:
Zagalnaya number of vibrated UЄT
viconanikh likarem
for the singing period _______________
All vidvidvan to lykar
Of particular importance are the indicators of dispensary examination, before any offensives:
Dispensary visualization of hunting:
The number of ailments for singing ailments (periodontitis, leukoplakia, in.)
At the starry rotsi 100 \% ______________________
The number of ailments registered for ailments
The chasteness of the hunt for the ailments by the dispensary visualization:
The number of ailments, uzyatikh pid with caution from the date
new and new 100 \%
The number of new ailments given to ailments
To assess the effectiveness of a dispensary, start by:
There are a lot of ailments who know from the dispensary ward in the call of the ills:
The number of ailments, znyatih from the dispensary with a warning to the call
Z likuvannyam 100 \%
There are a lot of ailments, the health of those who have been deprived without a snake:
The number of ailments, the camp is healthy
those who have been surpassed without a change 100 \%
A large number of ailments, as they work on a cloud on an ear of rock
The frequency of relapses in ailments who took a course of treatment:
Number of zagostrenia (relapses) in individuals who took a course of treatment 100 \% Number of individuals who completed a course of treatment
Indicators of robots in therapeutic dentistry
Average number of teeth sealed per liter per day:
All teeth are sealed for a given period
Number of working days in the period
The average number of insertions for the removal of one tooth (including the drive for caries, pulp, periodontitis):
Number of reviews for all
Number of sealed teeth
Alignment of forked teeth with fixed, carriage up to forked teeth with accelerated carriage:
The number of forked teeth with a fixed frame
The number of forked teeth with an accelerating slot
Frequency of acceleration of endodontic treatment (okremo with pulpitis and periodontitis):
Number of accelerated endodontic treatment 100 \%
Total number of endodontics
Frequency of restocking of seals:
Number of restorations * 100 \%
Number of seals applied
Indicators of robotics in surgical dentistry
Average number of tooth teeth held per day:
The initial number of teeth bite
for the singing period __________________
Number of operations per day (except for teeth):
The total number of operations performed during the singing period
Number of working days of the surgeon in the period
There are a lot of ailments who are hospitalized for being shown in special hospitals (shown, polyclinics):
The number of ailments hospitalized in
special stationary staff 100 \%
A large number of ailments who have taken on a surgical treatment
Accelerated frequency surgical engagement:
The number of accelerated hours of surgical interventions 100 \%
The initial number of surgical procedures
Frequency of failure diagnoses in the clinic and the hospital:
The number of diagnoses of diagnoses of the polyclinics and the stationary 100 \%
The initial number of those fixed on the stationary
Indicator of operational activity (in \%):
Number of operations 100 \%
Zagalnaya number of ailments
Frequency of clinical and cytological diagnoses for visible fluffs and fluffy-like statements of slit-facial disease:
Number of clinical and cytological diagnoses 100%
I will look at those who are on the surgical reception with an important distribution of robots for dentists and the examination of unreasonableness, it is of the utmost importance to ensure that the most important indicators of conquest due to the time-consuming lack of loss.
Indicators of robotics for dental prosthetics
Number of visits per day per one doctor of an orthopedic dentist:
Working days per period
Middle term of orthopedic medicine (okremo for small and familiar prostheses):
The total number of days of orthopedic treatment
The number of individuals, who were rendered orthopedic treatment
Pitoma vag of natural single crowns:
Number of natural single crowns 100 \%
Number of single crowns
Average number of supporting crowns in bridges:
Number of supporting crowns in bridges
Number of bridges
Pitoma of clasp prostheses:
Number of clasp prostheses 100 \% ____________
Sum of all partial lamellar and clasp prostheses
The average number of perforations for one sick person, such as trimming the prostheses:
Number of visits for prosthetics
The number of individual prostheses
Frequency of replacement of dentures (until the end of the warranty term):
Number of overgrown dentures 100 \%
The initial number of ready-made prostheses
Frequency of repairs to dentures:
The number of repairs to important prostheses 100 \%
The initial number of known prostheses
Part of a dental prosthetics without a dental prosthesis:
The number of individuals, who rendered prostheses without braces 100 \%
The initial number of individuals who have rendered prostheses
Indicators of robots in orthodontics
Average number of visits per day per one doctor of an orthodontist:
Number of all indications for the singing period
Number of working days in the period
Indicators of completeness of orthodontic aid:
The number of children who finished orthodontic treatment 100 \%
The number of children who received orthodontic assistance
Pitoma of the vaga of the internal, unintelligent mechanical devices:
mechanical action 100 \%
A countless number of orthodontic appliances
Pitoma of the vaga of the internal, ignorant devices of the functional and directing action:
Number of internal, unknown devices
functional and directing action 100 \%
A total number of available orthodontic appliances
Pitoma of the internal compartment of the internal equipment functional activity:
Number of internal equipment
functional _action 100 \%
The initial number of internal equipment
Pitoma of the vag in ready-made prostheses:
Number of prostheses (familiar and ignorant) 100 \%
The total number of orthopedic constructions
Indicators of robotics of ancillary pediatric patients in the dental clinic
Average number of physiotherapeutic procedures per day:
Number of available procedures for the singing period
Number of working days of the physiotherapeutic
cabinet in period (lіkarya abo medical sister)
Average number X-ray signs in a day:
The total number of X-ray signs for the singing period
The number of working days of the X-ray office in the period
(Likarya abo x-ray laboratory assistant)
Indicators of the disease of the population of the dental aid
Indicators that characterize the level of hepatitis in the population of the dentist, dozylnogo rorahovuvati on the scale of a particular territory of service (place, region, district, etc.). At a particular value, it is the information about the brutality of the population for dental care and the level of availability of the rest.
Indicator of the beasts of the population for dental care:
The number of first-time visits per pik 100 \%
The number of residents of the territory, who will be serviced
Indicator of availability of dental assistance:
The number of primary connections 100 \%
The number of patients who require dental assistance
For the assessment of the possibilities of dental assistance, the value of the indicator of the disease of the population of dental work and dental professionals is of great importance.
Population safety with active dental work machines per 10,000 inhabitants:
Number of dental workers 10,000
Population safety by dentists (dental doctors) per 10,000 inhabitants:
The number of dentists (dental doctors) 10000
The number of people to be serviced
The state standards of the stomatological polyclinics are approved by the order of the Ministry of Health Protection of Ukraine dated 01.10.1976 r No. 950.
4.0 planted doctors in total for therapeutic and surgical dentistry per 10,000 elderly population of the city;
4.5 planted - total number of therapeutic, surgical dentistry and orthodontics per 10,000 children in the city;
1.0 planted a doctor of an orthopedic dentist per 10,000 elderly population of the city;
To assess the possibilities of a dental stationary, it is possible to develop an indicator of a disease of the population of dental patients:
The number of nursing mothers for the dental profession 10,000 Average population size
Indicator of the level of stomatological assistance
For the assessment of the efficiency of the dental service, the order with the specified parameters, it is possible to select a special indicator, proponated by P.A.
de: K - the average number of non-sealed unsealed disease teeth; A - the average number of visible teeth, which are not renewed by prostheses, KPU - the average value of the rate of intensity of the carious process (caries, filling, vision).
Criteria for the assessment of the level of dental aid:
> 10 \% - low r_ven,
10-49 \% - lack of food;
50-74 \% - good money;
75 \% і> - good rіven.
Special features of dental assistance to residents of the Silk city
It is a great drink of rural residents in the foreign structures of the population of the country and a high level of expansion of stomatological congregations of crops;
The specifics of the minds of the pratsi, the seasonality of the Silk-Gospodar robots, the distance to a number settlements, Low density of the population accelerate the provision of dental assistance to the villagers. Until then, the safety of the rural population by the dentists of the dental profile is just lower than the safety of the local population. At the link with the digitalization and the introduction of the most effective forms of organization of dental care and the approach to the inhabitants of the country, it is necessary to be one of the most important institutions of the health protection authorities.
I will look at the specific difficulties in providing dental assistance to the rural population, it is necessary to take into account in the villages before that, it appeared in a planned manner at all the time of the medical establishment in the clinic, hospital and district dental clinics. ... To that organizational specialty of the provision of dental care to the help of the inhabitants of the village is not a problem.
A great part of the introduction to the dentist's profession (except for the orthopedic dentistry) by the villagers is brought to the dental offices of the medical clinic and the outpatient clinic. To that end, the quality of the dental assistance to the rural population in general, it is quite possible to lay down the roots of the organization on the Silk Likarskiy dilyantsi. The Lanka itself in the organization of dental assistance is guilty of paying special respect to the side of the organs to protect health.
best effective method robots of the Silk dental office є differentiation of the reception of stomatological ailments in the presence of 4-5 ths. residents. It is recommended to start the next graph of the robot: at the reception for the treatment of the therapeutic ailments, it is entered 2 days per day, for the reception for the treatment of the medical ailments - 1 day. Planned preventive sanitation of organized groups of the population is guilty of being carried out 3 times per day. Whole zrozumilo, so we are sick with the help of the pain, we can help to nadayutsya for the beasts.
For planovoї sanatsії porozhnini company organіzovanih kolektivіv dіtey i have grown, SSMSC prozhivayut in villages de Absent dentist dotsіlno organіzuvati statsіonarnі stomatologіchnі kabіneti on feldshersko-akusherskih points in profіlaktorіyah abo schools Cudi perіodichno Mauger viїzhdzhati lіkar dentist dіlnichnoї lіkarnі, lіkarskoї ambulatorії abo tsentralnoї district lykarna.
At the dental office for the sick, it is guilty that they have placed the robot of the doctor-dentist in the medical clinic, as well as at the paramedic station. The organization of such cabinets allows the economy of the working hour of the doctor to relocate, to increase the term of accessibility of possession, to increase the ability of the robot to provide the qualified dentist with additional help.
As much as one third of the out-of-town dental care service is available to the villagers in the central district clinics, when there are dental services and offices, as well as overseas offices in the middle of the city. The graph of robots in the dental profession in the district clinic will be guilty of such a situation, so that the citizens of the city could get help in the first half of the day. At the same time, we follow the principle of maximum power for additional assistance in a single examination of single-session methods for the development of accelerated forms of teeth caries. Dosvid show, that a silsky resident is going to be killed to the district lykarna in the main in the period very painful... However, since a doctor-dentist knows a lot, the patient for the end of the treatment is often not є. To that, in the minds of the village, especially in the period of active people in the village, it is necessary to widely use one-session methods of treatment, since we are able to increase the speeding up of unfinished drinking.
In the oblast policlinics of the village, I will take out consultative and legal assistance for referrals from doctors of regional dental facilities. Fakhivtsi regional polyclinics also provide dental assistance during planned visits to districts and in warehouses of specialized brigades in villages.
During the period of planned visits of provincial economies of the regional polyclinics, the order of organizing and methodical assistance to the Silk institutions is to provide consultative and educational assistance to the population. Schedule of trips to visit the district hospitals and establish it in advance, since the robot was prepared on the machines of the bullet. Before the arrival of the sick people, ask for a consultation, the lists of dispensary ailments are checked out, who are going to the oblast in the region, so in the district hospital, which can also be requested at the reception before the holiday,
Those who are sick, who require treatment from the provincial workers, should be sent immediately to the regions of polyclinics, and not to the stationary reports of the region's doctors, so as often they will send those who are ill, who can be better off in half. The procedure for the hospitalization of ailments, which require a stationary treatment, is approved by the body for managing the health protection of the region.
One of the important distributions of the performance of all dental implants of the muscle, such as in the place, is the planned sanitation of the organs of the empty company and teeth. The necessary sanitation for children of preschool and school age, podlitki, vіtnі women, pratsіvniki sіlskohospodarskogo virobniztva, think about who can take the development of dentists. Look around at the most often carried out at the center, for which, in case of oblast diseases, or for the centralized laboratory, the robot of overseas dental offices will be organized
The dermal suction room is responsible for all the main types of dental assistance, including orthopedic. The robot is planned to be in such a rank that it will be delivered to the skin government for 2 msec. At rotsi canopies and sunsets. In overseas cabinets, there is additional help in front of the organized groups of a childish and mature population
The graph of robots of overseas rooms is to blame for the occupation of the population on the Silk-Gospodar robots and for the long time to be brought to the view of the bulk of the population. At the same time, in a general order, it is necessary to ensure the size of the population, the availability and quality of the roads, the work of the huge transport, the breadth of dental ailments, and the variety of special features of the specific territory.
