Professional retraining in the organization of nursing throughout Russia. Modern aspects of management, health economics What is the organization of nursing

MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

All-Russian Educational-Scientific-Methodological Center

for Continuing Medical and Pharmaceutical Education

2.16. Providing first aid in emergency conditions.

2.17. Participation in carrying out activities to organize the activities of a medical institution in extreme conditions.

3.1. Have access to the information necessary for quality performance functional duties nursing and junior medical staff.

3.2. To improve the system of organizing the work of middle and junior medical personnel on the basis of best practices and the introduction of new technologies.

3.3. To improve the system for evaluating the work of middle and junior medical personnel in the new economic conditions.

3.4. Make proposals to the management on improving the quality of medical care for the population.

3.5. Apply (public influence or verbal disciplinary action, recommend other measures to the administration of the medical institution for violations in the work of middle and junior medical staff.

3.6, Apply to the administration for the issuance of moral and material incentives for middle and junior medical personnel.

3.7. Participate in the work of professional medical associations.

3.8. Improve qualifications and be certified for the assignment of qualification categories.

4. RESPONSIBILITY

A specialist for non-fulfillment of his professional duties shall be liable under the current legislation.

Cycle: “Modern aspects of management, health economics”

Specialty: “Organization of nursing”

Position: “Chief nurse, head nurse of an outpatient clinic acting as departments within a medical institution”

1. T E O R I A

Health system and policy in Russian Federation for the protection of public health. Concepts for the development of health care in the Russian Federation. Primary health care. The role of the chief nurse in the implementation of federal programs to protect the health of the population. Determination of population health indicators. Analysis of statistical indicators of public health. and analysis of indicators of medical and social efficiency of medical institutions.

Application of the basics of office work in the work of the chief nurse of health care institutions in the analysis of the activities of health facilities: analysis of annual statistical reports and primary medical documentation reflecting the activities of middle and junior medical personnel.

Planning a system of measures to organize and control the activities of the nursing service in an outpatient setting, in a specialized hospital.

Evaluation of the effectiveness of management activities. Carrying out marketing research and adjusting the needs of the population in various types results-based nursing care marketing research, and their implementation in practical health care.

Organization of work on personnel planning specialists with secondary medical education, placement, use, training and qualification assessment. Monitoring the implementation of the nursing process during the internship.

Management of material resources of health care. Accounting and liability. Participation of the chief nurse in the inventory of material assets in health facilities. Receipt, implementation of proper storage, accounting, spending and delivery to the state fund of products containing precious metals.

Rationing of work of average medical personnel. Calculation of the standard number of positions of middle and junior medical personnel.

Budgeting for major items. Carrying out calculations for items of expenditure. Calculation of the cost of medical care,

Conducting an analysis of the quality of medical care by paramedical personnel.

Infection control and infection safety. The role of the chief nurse in the organization and control of the sanitary and epidemiological regime in healthcare institutions, in structural divisions: quality control of the processing of medical instruments and care items; in the prevention of occupational infection with viral hepatitis and HIV infection and nosocomial infection of patients.

The role and participation of the chief nurse in the immunoprophylaxis of infectious diseases, in the organization of the sanitary and epidemiological regime in the detection of especially dangerous infections.

The system for organizing the interaction of health care institutions with institutions of a sanitary and epidemiological profile: for the sanitary condition of medical facilities, catering and canteen departments.

The role and participation of the head nurse in the organization of medical support for the population in emergencies and disasters.

2. P R A C T I C A.

Planning a system of measures on the prospects for the development of the nursing service of medical institutions using scientific and managerial approaches to improve the quality of nursing care for the population.

Analysis of statistical indicators for assessing the health of the population and correction of the needs of the population in various types of nursing care, taking into account the analysis data. Analysis of performance indicators medical institution.

Analysis of the form of annual statistical reports and primary medical documentation, reflecting the activities of middle and junior medical personnel. Control over the correct maintenance of medical records in the structural divisions of health facilities. At practical classes, analyze the performance indicators of health facilities and various forms annual reports(Note: according to the results homework or seminars).

Organization of nursing care for patients on the basis of the nursing process and the implementation of control over the care of incurable patients. In the classroom, analyze nursing histories.

Organization and control to ensure medical and protective, sanitary and epidemiological regimes in a medical institution. At the practical session, provide for a visit to the central sterilization, procedural and other departments of the hospital with a subsequent analysis of the results.

Organization of control over sanitary-educational and anti-epidemic work with the population of paramedical personnel.

Acquaintance with the organization of work of institutions of a sanitary and epidemiological profile. Implementation of current and preventive sanitary supervision in health facilities. Control of the sanitary condition of the catering department, food preparation technology, food storage. At a practical lesson with a visit to the catering department, conduct a hygienic assessment of the prepared food, establish the compliance of the prepared dishes with the diet number. Explore regulations, regulating the activities of dairy kitchens.

Planning a system of measures for organizing the work of the nursing service of outpatient clinics, specialized hospitals, FAPs, health centers, emergency and emergency medical care, medical institutions for the protection of maternal and child health.

On the practical exercises all educational questions on this section to study and develop in the relevant health facilities.

Organization of work on personnel planning for specialists with secondary medical education for advanced training and retraining, attestation and certification. Monitoring the implementation of individual professional job descriptions for nursing and junior medical personnel. Organization of industrial practice for students of colleges and schools.

Analyze in class typical mistakes on personnel work, on attestation, etc. (Note: based on materials submitted by the attested to the central attestation commissions, on the analysis of listeners' answers).

Management of material resources of health care, pharmaceutical provision of medical institutions; regulation of labor of middle and junior medical personnel.

In practical classes, study the issues of receiving, accounting, storing, using, inventorying material assets, medicines, study regulatory documents. Use and study the regulatory documents for the operation of medical equipment and equipment, safety and labor protection.

Calculate the number of positions planned for hospitals and polyclinics. Make a budget for the main items. Calculate the cost of medical care with the application of labor standards. Assess the quality and effectiveness of nursing care against standards.

In practical classes on the basics of medical informatics, study the principles of computer operation, work with the Norton Commander program, with files, text editing, text printing, work with spreadsheets. Familiarize yourself with the ACS of the hospital, polyclinic.

At practical classes in disaster medicine, develop training activities on medical support for the activities of a medical institution; provision of first aid in emergency situations.

JOB REQUIREMENTS FOR A NURSING SPECIALIST WORKING IN

POSITIONS CHIEF NURSE, SENIOR OUTPATIENT NURSE,

OPERATING ON THE RIGHTS OF DEPARTMENTS AS A PART OF THE MEDICAL AND PREVENTIVE INSTITUTION.

(POSTGRADUATE TRAINING)

SKILLS

Fundamentals of social hygiene and healthcare organization.

Theoretical foundations of nursing.

System and health care in the Russian Federation.

Fundamentals of medical and preventive care for the population.

Health system management.

Fundamentals of legislation and law in health care.

Organization of planning, economic and financial activities medical institutions in the new economic conditions.

Infection control and infection safety.

Fundamentals of medical informatics.

The use of a personal electronic computer in medicine.

Modern principles of organizing medical support for the population in emergencies and disasters.

regional component.

Population health statistics.

Demographics.

Statistical indicators for assessing the activities of health care institutions.

Fundamentals of business.

health statistics.

Nursing, nursing process.

Medical ethics, bioethics.

Fundamentals of general and medical psychology.

Priorities of the concept of healthcare development in the Russian Federation.

Fundamental documents for the protection of public health.

Fundamentals of PHC.

Fundamentals of the organization of medical care for the urban population in outpatient settings.

Fundamentals of the organization of medical care for the urban population in the conditions of specialized hospitals.

Fundamentals of the organization of medical and preventive care for the rural population.

Organization of nursing in medical institutions for the protection of maternal and child health.

Fundamentals of the organization of medical and preventive care for children.

Organization of work on medical care for workers of industrial enterprises.

Organization of work of ambulance and urgent medical care.

Fundamentals of the organization of drug treatment, oncological and anti-tuberculosis care for the population of the Russian Federation.

Technologies and standards for the performance of work by a nurse in the admission and diagnostic department, ward and procedural nurses.

Fundamentals of organizing the work of the operating room, toxic-reanimation department.

Fundamentals of the organization of medical and dietary nutrition in medical institutions.

Personnel management.

Management of material resources.

Accounting and liability.

Medical technology and safety in healthcare facilities.

Rationing of labor of paramedical personnel.

Fundamentals of professional and legal regulation of nursing, legal responsibility in the field of health care.

Fundamentals of planning and financing of medical institutions in conditions market economy, budget, estimates, pricing and taxation.

Examination of the quality of medical assistance to the population.

Sanitary and epidemiological regime in health care facilities.

Processing of medical devices.

Prevention of occupational infection with infectious diseases.

Particularly dangerous infections.

Regulatory orders and instructions.

Fundamentals of medical informatics. The principle of computer operation, keyboard, external devices.

Work with programs. Editing and printing of texts.

Application of PC in medicine.

Fundamentals of disaster medicine.

1. Actual health problems.

2.Targeted regional programs in the field of health protection.

3. An in-depth study of specific sections or relevant for a given region (at the discretion of the methodological association of the school.)

Analyze statistical indicators of population health assessment. Adjust the need of the population for various types of nursing care based on the analysis of criteria and indicators of the state of health of the population.

Analyze indicators of medical and social efficiency activities of medical institutions.

Analyze the forms of annual statistical reports and primary medical documentation reflecting the activities of middle and junior medical personnel. Monitor the correctness of maintaining medical records in the structural divisions of the medical institution.

Organize the introduction of nursing and nursing care based on the nursing process, taking into account violated human needs, bioethics.

Organize work taking into account the basics of general and medical psychology, pedagogy; use communication skills.

Carry out teaching and mentoring activities.

Organize the work of medical institutions for rehabilitation treatment and rehabilitation with the implementation of the basic principles of PHC.

Carry out sanitary and educational work with the population of paramedical personnel.

Use scientific and managerial approaches to organizing and improving the quality of nursing care for the urban population.

Plan a system of measures for the prospects for the development of nursing services in polyclinics.

Adjust the need of the population for various types of nursing care based on the analysis of criteria and indicators of the state of health of the population.

Monitor the correctness of maintaining medical records in structural units. Organize health check-ups for the population.

Reception of the population, work with letters and appeals of citizens.

To use modern office equipment for the activities of the polyclinic, to introduce the scientific organization of labor into the work of polyclinics.

Use regulatory documents regulating the activities of outpatient clinics.

To study, use and popularize the best domestic and overseas experience organization of nursing in outpatient settings.

Use the managerial functions of planning, organizing and coordinating the work of the nursing staff of hospitals.

Use directive documents regulating the activities of hospitals in the new economic conditions.

Organize nursing care for patients based on the nursing process.

Organize nursing care for incurable patients based on the nursing process.

Master the technique of nursing manipulation.

To study, use and popularize domestic and foreign nursing organizations in health care facilities.

Provide advisory assistance to nursing staff serving rural areas. Organize control of their activities in all aspects.

To organize and control the work of the medical staff of the obstetric and gynecological service. Monitoring compliance with the sanitary and anti-epidemic regime. Organize work to prevent nosocomial infections.

Organize and supervise the work of the nursing staff of the children's hospital.

Provide assistance and control to the paramedic of the health center in planning and conducting preventive and therapeutic work at the industrial site.

Carry out activities for the medical and social rehabilitation of patients.

To organize and carry out control of the middle and junior medical personnel of stations (departments) of emergency and emergency medical care in timely obtaining information about the patient, the use of modern equipment, transport.

To organize the defect-free work of the middle and junior medical personnel of the narcological, oncological and anti-tuberculosis services.

To organize and control the work of the ward and procedural nurse in accordance with technology and standards.

Organize the work of middle and junior medical personnel of the surgical dressing and resuscitation department in accordance with regulatory orders and instructions.

Prepare medical nutritional documentation.

Develop a food catalogue. Create menus, layout menus.

Monitor compliance with sanitary and hygienic requirements for the catering departments of healthcare facilities, food products.

Identify the causes of food poisoning and implement preventive measures.

To organize work on personnel planning for specialists with secondary medical education in a medical institution. Organize work on the placement, use, training and assessment of the qualifications of paramedical personnel.

Organize work on advanced training and retraining, development professional career, attestation and certification of paramedical personnel, provide medical care and advice to nursing and junior medical personnel.

To control the main actions of a nurse undergoing industrial practice for the nursing process. Data collection for nursing medical history. Conducting a physical examination of patients. Collection of laboratory data. Interpretation of data, assessment of their significance, formulation of a nursing diagnosis. Determining the needs of the patient, the necessary measures. Priority actions. Consultations. Writing a nursing diagnosis.

Rationally use the resources of the medical institution. Use in the work documents regulating the procedure for issuing, receiving, accounting, storing, especially the use and inventory of material assets in health facilities. To organize and control the work of the sisters of the housewives of the departments.

Use in the work documents regulating the procedure for prescribing, receiving, accounting, storing, using medicines and materials. Proper storage of medicines in hospitals. Organize training and control the storage, prescription and accounting of narcotic drugs.

Provide therapeutic medical equipment.

Carry out labor protection and safety measures, training sessions on the operation of medical equipment and equipment.

Calculate the normative positions of paramedical personnel per 1 position of an outpatient doctor. Calculate the number of positions planned for one round-the-clock post in hospitals. Calculate the number of posts to ensure the operation of a round-the-clock post, to ensure the operation of the post at night, on holidays and. Calculate the number of posts of middle and junior medical staff in the therapeutic and pediatric departments, taking into account the 3-degree and 2-degree system.

To carry out professional and legal regulation of the work of the middle and junior medical staff of health facilities.

Use the fundamental policy documents governing the activities of the medical institution. Make a budget for the main items. Make calculations for each item of expenditure.

Assess the quality and effectiveness of nursing care. Compare actual and standard settings. Conduct an analysis of the quality of medical care in terms of structural, procedural and resultant analysis.

Organize and control work to ensure sanitary-hygienic and sanitary-epidemiological regimes in a medical institution (admission department, treatment room, sterilization department, etc.). Organize control over anti-epidemic work with the population of paramedical personnel.

To organize training and control of the prevention of occupational infection of medical personnel, the prevention of nosocomial infection.

Train and monitor the knowledge and skills of medical personnel in identifying especially dangerous infections.

Use electronic computers in the activities of a medical institution and in the work of the head nurse.

To issue the main activities in peacetime in the event of major accidents, catastrophes, natural disasters and other extreme situations. Carry out activities to protect the population, sick, injured and personnel of the disaster medicine service. Provide first aid in emergency situations. Improve professional knowledge, skills and abilities. Prepare medical facilities to receive patients in case of mass catastrophes and accidents.

The role of the head nurse in the organization of nursing in health care facilities

In modern conditions, when the healthcare reform in our country has begun, the tasks of the chief nurses of medical institutions for organizing work are immeasurably increasing. nursing staff in accordance with the new complex problems being solved in the reformed healthcare institutions.

Improving the quality and efficiency of the management activities of chief nurses is possible only through the use of modern science about management.

Nursing personnel management is a purposeful activity of the heads of nursing services of medical institutions (HCIs) and their departments, using various management mechanisms and communication channels to ensure well-coordinated, qualified work of nursing personnel to provide patients with nursing care of the appropriate quantity and quality. Thus, outpatient clinics should ensure the work of nursing staff in the newly organized day hospitals, hospitals at home, outpatient surgery centers, general practitioner services, etc. Very difficult tasks are facing the nursing staff of hospitals after their restructuring into hospitals for intensive observation, rehabilitation treatment, as well as hospitals for the treatment of patients with chronic diseases and hospitals for medical and social care.

In health care facilities, the organizational structure of nursing staff management includes:

subjects of nursing staff management, i.e. those who manage nursing staff;

objects of management, i.e. nursing staff managed by the subjects of management;

management mechanisms - various types of managerial influences, with the help of which the effective management of nursing staff and the fulfillment of the tasks assigned to them are ensured;

Methods and channels for transmitting information (direct - management decisions and reverse - information on the progress of management decisions) between subjects and objects of management. Relationships of elements organizational structure management of nursing staff to solve the problems of nursing in health care facilities can be represented as the following diagram:

3. Control mechanisms

Principles

1. Subjects of management

Nursing in health care facilities

2. Control objects

Direct Feedback

4.Methods and channels for transmitting information

Performance standards

Job Descriptions

Inspection materials

Bypass materials

Statistical reports

Raid materials

As can be seen from this diagram, all four elements of the organizational structure for managing the nursing staff of the health facility closely interact with each other to ensure the high quality of nursing in the institution.

There should be constant two-way communication between the subjects and objects of management: the subjects of management bring management decisions to the objects of management, and the objects of management send information, reporting and other information about the progress of these decisions to the subjects of management. The most important obligatory feedback channel of objects of management with subjects of management is control over the progress of implementation of management decisions and the effectiveness of the nursing staff.

The management mechanisms used by the head of nursing services make it possible to determine the goals of management in relation to the work of this healthcare facility, clarify the main directions (functions) of the management activities of chief nurses, carry out management activities based on the most important management principles and widely use organizational, administrative, socio-psychological and economic management methods.

Thus, the organizational structure of the management of nursing personnel of a healthcare facility is a complex, interconnected management system that can function successfully and ensure the high quality of nursing in a healthcare facility only if effective use all the potentialities of each of its elements.

Let us consider sequentially what each of the elements of the organizational structure of the management of the nursing staff of the healthcare facility is.

Subjects of nursing personnel management

nursing staff management

The subjects of management of the nursing staff of health facilities are the heads of nursing services of medical institutions:

chief nurses or deputy chief physicians for work with nursing and junior medical personnel, directors of hospitals (houses) of nursing care and hospices.

In recent years, in a number of large medical institutions, the positions of deputy chief physicians for working with nursing and junior medical personnel have been introduced, which has contributed to improving the quality of nursing staff management and raising the authority of the heads of nursing services of medical institutions.

As for nursing homes (hospitals) and hospices, they are institutions that mainly employ nurses and junior medical staff, and, therefore, the heads of these institutions are also the heads of the nursing services of these health facilities. Unfortunately, these much-needed institutions are still not openly enough.

Chief nurses, as well as chief midwives and chief paramedics - this is the main group of heads of nursing services of health facilities who manage the work, primarily of senior nurses of health care units: senior nurses, senior operating room nurses, senior midwives, senior paramedics, etc. and provide a strategy for improving nursing in healthcare facilities.

In the clinics of the Moscow Medical Academy. THEM. Sechenov introduced the positions of chief nurses of clinics while maintaining the position of chief nurse in the management of all clinics, and each individual clinic also provides for the positions of senior nurses.

In accordance with the Nomenclature of positions of medical and pharmaceutical personnel and specialists with higher professional education in healthcare institutions, the positions of heads of institutions include the main nurse. Therefore, the head nurse is official institutions with all the ensuing rights and responsibilities.

The tariff and qualification characteristics for the chief nurse (Appendix 2 to the Decree of the Ministry of Labor of Russia dated August 27, 1997 N ° 43) stipulate that a higher education is required to occupy this position medical education without presenting requirements for work experience or secondary medical education and work experience in the profile of at least 5 years.

Order of the Ministry of Health of Russia dated June 19, 1997 No. 249 "On the nomenclature of specialties of nursing and pharmaceutical personnel" established that persons holding the positions of chief nurses must have the specialty "organization of nursing". This order approved the Regulations on specialists in the organization of nursing (hereinafter referred to as the Regulations) and the Qualification characteristics for these specialists.

The Regulation specifies the requirements for admission to work in the specialty "organization of nursing". TO professional activity As a specialist in the organization of nursing, persons with a higher medical education in the specialty "Nursing" or a secondary medical education in the specialties: "Nursing", "General Medicine", "Obstetrics" and a certificate in the specialty "Organization of Nursing" are allowed .

Along with the general requirements, the Regulation sets out in detail the duties, rights and responsibilities of these specialists, which allows it to be used as a basis for developing job descriptions for chief nurses.

The qualification characteristic for specialists with secondary medical and pharmaceutical education in the specialty "Organization of Nursing" includes a detailed list of general and special knowledge and general skills that these specialists must possess.

The same requirements are provided for attestation and certification of chief nurses.

The head nurse is appointed and dismissed from work by order of the head physician of the health facility.

To improve the efficiency of the managerial activities of chief nurses, services of chief nurses have been established in a number of large health facilities. So, the services of chief nurses include the so-called. chief specialists in certain areas of activity - chief (senior) nurses of hospitals for surgery, pediatrics, etc.; on work with ward nurses, procedural nurses, operating nurses; on training nurses and monitoring their work, etc. In a number of health facilities, methodological rooms for training have been created, etc. *

The following basic requirements are imposed on the subjects of nursing personnel management, that is, mainly on the chief nurses.

When appointing chief nurses to the post, it is necessary to take into account their desire to engage in managerial activities and not appoint them to this position against their will.

Candidates for the positions of chief nurses must have a certain set of personal universal qualities, without which it is impossible to manage people.

Managers must have sufficient vocational training in accordance with the requirements of the Qualification characteristics for specialists in the organization of nursing and to own detailed information about the activities of the health facility in which they work (or will work).

Chief nurses should have knowledge about the activities of the mandatory health insurance funds (CHI) and especially about the requirements they impose on health facilities.

Effective work of managers is possible only if there is a clearly defined range of duties, rights, responsibilities and subordination. It is especially important to determine the immediate superiors of the chief nurse who have the right to give her orders and instructions. As a rule, it is advisable to limit them to the chief physician, and in his absence - to the person replacing him. As for other heads of health facilities, the head nurse should cooperate with them on an equal footing, that is, on partnership terms.

The circle of persons reporting to the head nurse should be limited to senior nurses (midwives, paramedics, pharmacists).

6. Comprehensive, systematic, purposeful work of chief nurses, their coverage of all urgent problems of the activities of the nursing staff of healthcare facilities is possible only if there are detailed and approved work plans and regulations for their activities for a month.

The revitalization of the work of the Council of Nurses and especially the creation of a management apparatus in the form of introducing the positions of chief specialists of health care facilities in areas (in surgery, pediatrics, etc., senior nurses for training and control, senior ward, procedural, operating rooms, district nurses of the institution, etc.), the creation and organization of the work of educational and methodological rooms, etc. It is extremely important for the chief nurses to master the rules for delegating their routine functions to senior nurses and chief specialists.

7. In connection with the work begun on reforming health care - structural adjustment inpatient care, the redistribution of inpatient care to the outpatient level, the development of a network of day hospitals, outpatient surgery centers, consultative and diagnostic centers, the creation of a general practitioner service and other areas for the development and transformation of medical services - it is extremely important to intensify work on organizing and adapting the activities of nursing personnel to work in reformed and transformed healthcare facilities.

9. Effective management of the work of nursing staff is possible only if they are constantly taken care of: about their health, labor protection, creating a favorable psychological microclimate in the work team, optimizing the workload, convenient work schedule, providing those who wish to receive additional income, etc.

10. Heads of nursing services should constantly improve their qualifications, study new normative materials, literature on the development of nursing, the experience of leading heads of nursing services and other healthcare facilities, implement their positive experience in their work.

11. Nursing leaders should seek leadership in their organizations and influence others in such a way that they work effectively to achieve the goals of effective nursing care for patients, while subordinates must firmly know that their efforts will be known to the leader and he will properly evaluate them .

12. When evaluating the effectiveness of nursing leaders' leadership, it is advisable to use the "management grid modified by Blake and Mouton. This grid uses two main criteria: the degree of consideration for the interests of people and the degree of consideration for the interests of production, while the degree of "care for the person" and the degree of "care about production" are ranked on a scale from 1 to 9.

The management grid of Blake and Mouton, indicating the middle and four extreme positions, is shown in the following diagram.

Consider the positions indicated on the "grid" as assessed by the heads of nursing services:

1.1 - impoverished management (fear of poverty) - the manager makes minimal efforts just to avoid being fired. Such a style essentially cannot be called leadership, since there is practically no leadership of nursing staff;

9 - management in the spirit of a country house (rest home) - the head almost completely focuses on creating favorable conditions for subordinates, but practically does not care about improving the performance of nursing staff to provide them with full-fledged nursing care;

1 - power - subordination (authority - subordination) - the leader completely ignores the concern for subordinates and is focused on ensuring the effectiveness of the work of nursing staff, using their authority. This is a very rigid management style;

5 - organizational management (organization) - effectively managing nursing staff and taking care of subordinates, the head of nursing services achieves both an acceptable quality of nursing care for patients and a favorable moral and psychological climate in the work team and satisfaction of subordinates with caring for them;

9.9 - group management (team) - the most effective leadership style, because due to increased attention to subordinates, caring for them and ensuring effective management of nursing staff, the leader ensures that subordinates consciously participate in the implementation of the goals of the health facility and provide effective nursing care for patients. This style of leadership also provides an excellent moral and psychological climate in the work team and satisfaction of subordinates with the constant care of their leaders.

Therefore, every head of nursing should strive for a management style consistent with positions 5.5 and 9.9. At the same time, leadership styles corresponding to positions 1.1, 1.9 and 9.1 are unacceptable for heads of nursing services, which should be taken into account by the first heads of health facilities.

It is advisable to use the indicated criteria for the "management grid" to assess the leadership style of senior nurses.

13. Effective managerial activity of the heads of nursing services of health facilities is possible only on the condition that the first heads of medical institutions will fully support the chief nurses in their efforts to develop nursing in health facilities and skillfully adjust their work. It is very important that the heads of nursing staff be provided with optimal working conditions: comfortable working premises, reliable communication with all services of healthcare facilities, personal computers and the necessary office equipment, decent wages, etc.

Nursing personnel management objects

The objects of management of nursing and junior medical personnel include positions of paramedical and pharmaceutical personnel, junior medical and pharmaceutical personnel listed in the Nomenclature of positions of medical and pharmaceutical personnel and specialists with higher professional education in healthcare institutions *.

In a number of health facilities, along with the above, new positions have appeared: nurses - consultants for patient care, nurse coordinators, day hospital nurses, etc.

In recent years, special services have been created in health care facilities to analyze and record work with insured persons under compulsory medical insurance, where a large and hard work led by nurses, medical statistics and medical registrars.

Operational departments (dispatch services) have been organized in a number of health facilities, where medical registrars and nurses are successfully working.

1. Employees employed in the positions of paramedical and pharmaceutical personnel must have the appropriate education, confirmed by a state diploma, a specialist certificate and, preferably, an attestation category.

2. Employees must clearly know their job duties, rights and responsibilities.

Employees must perform nursing manipulations in strict accordance with the performance standards approved in the prescribed manner and brought to the attention of employees.

The workload of employees, set by the head of the institution, must correspond to the physiological capabilities of employees to perform their duties in a quality manner.

It is necessary to create favorable conditions for employees: draw up optimal work and vacation schedules; to provide them with means of small-scale mechanization of labor; create dispatching (operational) and transport (interdepartmental) services; to enter positions of couriers in the institution; organize a centralized drug service (CSN); to introduce a single computer network that unites automated workstations (AWP); effectively organize the work of the centralized sterilization department (CSO) and other services that provide assistance primarily to paramedical workers in medical departments. It is especially important to introduce the most important principle of work organization in institutions: all health care facilities work to maximize the satisfaction of the needs of medical departments.

It is necessary to provide workers with safe working conditions, protection of their health, etc.

It is extremely important that managers use all available opportunities of the current legislation for decent remuneration of employees (increases, allowances, additional payments, bonuses, use of compulsory medical insurance funds, etc.).

The most important factor in ensuring effective work paramedical and pharmaceutical workers - creating conditions for continuous improvement of their qualifications, self-training, certification and certification, as well as the inclusion of the best and promising workers in the personnel reserve to fill the positions of managers and other most important nursing positions in healthcare facilities.

Literature:

1. Kheifets A.S. Article "Management activities of the chief nurses of hospitals to monitor the work of nursing and junior medical personnel." - Chief nurse, 2000, No. 1, p. 29; No. 2, p.7.

2. Articles: L.V. Spirin and G.I. Panasyuk (Chief Nurse, 2000, No. 0, pp. 41-43); N.D. Lada and Zh.V. Yoon (Chief Nurse, 2000 No. 1, pp. 41-43); T.I. Kareva and M.G. Leushina (Chief Nurse, 2000, No. 1, p. 44-47).

Meskon M.Kh., Albert M., Heudori F. Fundamentals of management / Per. from English. - M.: Case LTD, 1944, p. 493 - 498.

Associate Professor of the Department of Public Health and Healthcare, Ph.D. T.V. Matveychik Minsk 2010

slide 3

Milestones in the Development of the Nursing Profession

1966 - the decision of WHO experts on the development of professional thinking of the sister, necessary for making independent decisions; 1977 - The ILO adopts the convention "On Nursing Personnel" (the need for higher nursing education; 1979 - the USSR ratified the ILO convention; 1989 - the All-Union Conference decides on the organization of higher nursing education; 1999 - the beginning of the training of nurses from higher education at the Grodno State Medical University; 2001 - creation of the course "Organization of nursing" in BelMAPE.

slide 5

Map of achievements in the activities of the course "Organization of nursing"

The work of 3 courses "School of the Head Nurse" was organized. 7 republican conferences, seminars, readings were organized. 19 manuals, 7 instructions, production standard were published. 3 master classes on the ideology of health were held. colleges Conducted and published 4 medical and sociological studies Assistance was provided to practical healthcare in the form of conferences and individual counseling Cooperation with the Belarusian Orthodox Church (4 conferences, 3 fairs, exhibitions, 3 charity events) In the Year of Health (2008) 4 republican events were organized A meeting was held 5 round tables

slide 6

Share of nursing staff in healthcare organizations (2008)

Slide 7

Features of education of the XXI century (under the motto of UNESCO: higher education for all professions)

commercialization of education and educational services administrative and political requirements for the transition to the Bologna agreements the tendency to preserve the established traditions of education the need for a transition to distance learning

Slide 8

Tasks for continuous self-development of a nurse with higher education

Increasing the requirements for the level of intellectual abilities of specialists, the formation of sustainable motivation for learning throughout life. Creation of synergistic learning relationships (through educational conferences on the main problems of practical health care). Building a model of knowledge generation, its dissemination and effective use in constantly changing circumstances. Creation of conditions for a better use of intellectual property, increasing the prestige and worthy evaluation of work. Formation of the intellectual property market by facilitating their implementation in the results of new medical technologies and services Creation of our own model for the purposeful development of individual personality traits

Slide 9

Quote by A. Einstein

If you want to change something small in your life, change your attitude, but if you need big changes- change your thinking.

Slide 10

Republican Conference March 26, 2010 "Problems, status and prospects in the organization of the BSU"

slide 11

Message of the President to the Belarusian people and the National Assembly (2010)

The main reference point in all spheres of activity is quality. Quality of goods produced and services rendered. The quality of management. And the most important thing is the quality of people's lives... Health care is also a national priority for us.

slide 12

“It is necessary to form a common culture of quality in the country. To instill in our people a steady desire to live, work, study, and fulfill the duties assigned to them. It should become a way of life! Because quality begins with a specific person, with each of us - our qualifications, responsibility.

slide 13

Thank you for attention!

View all slides

SAMARA STATE MEDICAL UNIVERSITY

DEPARTMENT OF NURSING

abstract

on the topic: “The development of nursing in present stage”

Performed:

faculty student

GSO 186 groups

Barinova Yulia Yurievna

Checked:

Karaseva Larisa Arkadevna

Syzran 2000

Plan

I.Introduction.

II.Nursing program.

1. Basic concepts used in the program.

2. Terms and stages of the program implementation.

3. Resource support for the program.

4. Organization of program management and control over the course of its implementation.

III.Program content.

1. The main objectives of the program.

2. Program principles.

3. The main activities of nursing staff.

IV.Improving the organization of work of nursing staff.

v.Improvement of personnel policy.

VI.Improving vocational education and development scientific research in nursing

VII.Development of professional associations, associations and unions.

VIII.Program implementation mechanism.

IX.Conclusion.

The development of nursing at the present stage.

In the recent past, nursing was treated as an activity that did not require much special training.

I will consider how the official Soviet ideology interpreted the concepts of "nurse" and "care for the sick." These definitions, on the one hand, demonstrated the attitude of society towards the activities and status of nurses, and, on the other hand, shaped it. So, in the Decree of the People's Commissariat of Health (1927) it was said: "The average health worker should only be an assistant to the doctor, work according to his instructions and under his supervision, must be fully prepared to perform all the procedures prescribed by the doctor, and have precisely developed technical skills."

In the 1963 Popular Medical Encyclopedia, a nurse is described as: "A person of average medical qualification working under the direction of a physician and carrying out his prescriptions and certain procedures"; The Brief Medical Encyclopedia of 1994 defines a nurse as "a specialist with a secondary medical education working under the direction of a doctor in a health facility."

In 1993, the main principles of the philosophy of nursing in Russia were formulated for the first time, according to which a nurse is "a specialist with a professional education who shares the philosophy of nursing and has the right to nursing work. She acts both independently and in cooperation with others professional workers health care". First in educational institutions, and then in treatment-and-prophylactic the concepts of "nursing process", "nursing diagnosis", "nursing medical history", "patient's needs" began to be considered.

NURSING DEVELOPMENT PROGRAM

The state program for the development of nursing in the Russian Federation was developed in accordance with the order of the Ministry of Health of the Russian Federation of December 31, 1997 No. 390 "On measures to improve nursing in the Russian Federation."

At present, it has become obvious that a complex of unfavorable demographic, socio-economic, political and environmental factors that have emerged in recent years in the country has had an extremely negative impact on the health of the population.

The increase in demand for medical services occurs against the backdrop of an ever-increasing shortage of material and financial resources. The amount of health care financing from the budgets of all levels and at the expense of the mandatory health insurance cannot provide the population with publicly available free medical care.

In the current situation, nursing personnel, who constitute the largest category of health workers, and the services they provide are seen as a valuable health resource to meet the needs of the population for accessible, affordable and cost-effective medical care.

The reform of nursing education carried out in the country under the leadership of the Ministry of Health has yielded concrete results, expressed in the creation of a multi-level system for training nursing personnel, improving the quality of vocational education, and for the first time in Russia, specialists with higher nursing education have been trained.

At the same time, the absence legal basis activities of nursing professionals, mechanisms for its regulation, means and methods of social protection and motivation of qualified personnel leave declared, but so far not realized the need for practical health care to use the existing nursing potential. The industry retains a significant staffing imbalance in the ratio between doctors and nursing staff, the outflow of qualified

nursing staff from public institutions health care, workloads, staff dissatisfaction and social tensions are increasing.

In this regard, there is an urgent need for a well-thought-out state program reform and development of nursing. The program should be based on the real conditions and possibilities of state and municipal health care. The main directions, approaches and principles laid down in the Program should serve as a guideline for programmatic and other management actions at the regional and local levels.

Basic concepts used in the Program:

Nursing - an integral part of the health care system that includes health promotion, disease prevention, psychosocial assistance and care for people with physical and (or) mental illness as well as the disabled of all age groups. Nursing encompasses the physical, intellectual, and social aspects of life as they affect health, disease, disability, and death.

Such assistance should be provided by nursing staff in health care facilities and any other institutions, as well as at home, in other words, wherever there is a need for it.

Nursing staff - these are employees who have a medical education in the specialties of nursing, obstetrics, general medicine (qualification of a paramedic) and are admitted to professional activities in the prescribed manner.

The diversity of roles nurses perform requires an understanding of the factors that affect health, the causes of disease, how it is treated and rehabilitated, and the environmental, social and political contexts in which care is provided and the health system operates.

Terms and stages of the program implementation

To ensure consistency in the implementation of the main directions of the Program, work on its implementation will be carried out in stages in 1998-2005.

The first stage - 1998-2000 includes the preparation of priority, urgent measures (creation of legal, material and

technical and organizational base) for the implementation of the Program.

The second stage - 2001-2005. includes the implementation of cost-effective forms and methods of nursing services in the healthcare system of the Russian Federation.

Resource support of the program

The program is being implemented at the expense of the federal budget, funds from the budgets of the constituent entities of the Russian Federation and extra-budgetary sources attracted for its implementation, which do not contradict the existing legislation.

Financial support for resolving issues that are under the joint jurisdiction of the Russian Federation and its constituent entities is carried out mainly at the expense of the budgets of the constituent entities of the Russian Federation.

Organization of program management and control over the course of its implementation

Management and control over the implementation of the Program is carried out by the Ministry of Health of the Russian Federation. The main directions and provisions of the Program are annually refined and monitored based on the progress of its implementation and the effectiveness of the use of funds.

Evaluation of the effectiveness of medical - social and economic consequences of the implementation of the program

The medico-social and economic efficiency of the Program will be assessed based on the indicators of the effectiveness and quality of the nursing services of the nursing staff of healthcare institutions, education and social protection of the population, as well as their structural divisions, in the course of implementing the main directions, provisions and activities of the Program.

Important role in the healthcare reform, ensuring the availability and quality of services provided to the population, strengthening the preventive focus, solving the problems of medical and social assistance, it is assigned to specialists with secondary medical and higher nursing education and constituting the largest category of healthcare workers.

For the rational and efficient use of the existing human resources nursing potential in the current situation, the formation of state policy in the field of nursing and increasing the responsibility of authorities at all levels for its implementation are becoming important.

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted on http://www.allbest.ru/

GBOU SPO "Volgograd Medical College".

Discipline abstract

Legal support of professional activity

On the topic of: "Organization of Nursing"

Completed by a student of group M 33

Avsetsina Evgenia

Checked by Marochkina K.A.

Volgograd 2015.

Introduction

1. History of SD

2. SD in Russia and other countries

3. Prospects for the development of SD

4. Job Responsibilities nurses

5. Organization of health care

Conclusion

Introduction

nursing medicine patient qualification

Currently, in healthcare, most developed countries the system of nursing activity is considered as an independent field of medicine. Nursing professionals, along with other medical professionals, work as part of an interdisciplinary team. The term "nursing" itself was proposed by WHO to refer to the activities of a large group of health workers who perform the functions of nurses. This professional group is the most numerous category of medical workers. It makes a significant contribution to public health. In many cases, it is nurses who are the first and last, and sometimes the only link connecting the patient with the health care system. Nursing is increasingly seen as one of the most economic resources for the delivery of health services, and in particular in areas such as public health and primary health care.

History of nursing

Florence Nightingale, the first researcher and founder of modern nursing, made a revolution in public consciousness and in views on the role and place of a nurse in public health.

For the first time, she singled out two areas in nursing - care for the sick and care for healthy people, she defined care for the healthy as "maintaining a person in such a state in which the disease does not occur," care for the sick as "helping the suffering from illness to live the most complete a life of satisfaction." For the first time in history, she applied scientific methods to solving nursing problems.

In Russia, the sisters of mercy first appeared during the Crimean War of 1854-1855 in the besieged Sevastopol, and will even argue that their appearance is connected with the name of the great Russian surgeon Nikolai Ivanovich Pirogov. But this will not be a completely true statement, because the institution of sisters of mercy owes its appearance not so much to Pirogov as to one remarkable woman, once very famous, and now, unfortunately, very rarely remembered - Grand Duchess Elena Pavlovna.

In 1856, at the request of the same Elena Pavlovna, a medal was minted to reward especially distinguished sisters of the Exaltation of the Cross.

Nursing activity in Russia and in other countries

To date, nursing is very relevant, as there are problems, the implementation of which will radically change the current situation in nursing, as an integral part of the organizational technology of healthcare, aimed at solving the problems of individual and public health of the population in today's complex and rapidly changing conditions.

Nursing personnel constitute the largest category of healthcare workers today and the services they provide are regarded as a valuable industry resource to meet the needs of the population for affordable and cost-effective medical care. But for a number of reasons, there is an outflow of nursing personnel, the burden on the remaining nursing staff is increasing, their dissatisfaction and social tension are growing. Nurses are in a very difficult position. For many years, the importance of nursing in our country has been underestimated. The nurse was considered only as a technical assistant to the doctor, and not as an independent specialist capable of assessing the patient's condition and providing qualified assistance within their competence. This was the reason for the decline in the prestige of this profession, and low wages for this work are added here. At present, the following factors have been added to this:

1. New technologies in health care, new methods of diagnostics and treatment (conditions close to competitive), increased requirements for the quality of nursing care.

2. The actual reduction in the amount of funding and the change in its principles (with a focus on the volume and quality of medical care).

3. Dissatisfaction of the population with the quality of medical care provided by specialists of various levels, including the quality of nursing care for the patient.

4. Shortage of nursing staff.

5. The need to raise the prestige of the activities of nurses (independent provision of certain types of activities, fully responsible for their final result).

6. Difficult medical, social and demographic situation (aging of the population, a large percentage of chronic diseases, etc.)

7. Management of the activities of the institution does not correspond to the realities of the time.

Decree of the Government of the Russian Federation dated 05.11.97 No. 1387 "On measures to stabilize and develop healthcare and medical science in the Russian Federation" provides for the implementation of a reform aimed at improving the quality, accessibility and cost-effectiveness of medical care to the population in the conditions of the formation of market relations. An important role in the healthcare reform, ensuring the availability and quality of services provided to the population, strengthening the preventive focus, and solving the problems of medical and social assistance is assigned to specialists with a secondary medical education, elevated level education and higher medical education in the specialty "nursing" and constituting the largest category of health workers.

Prospects for the development of nursing activities focused on the needs of the patient.

Significant changes have taken place in the organization and provision of nursing activities that have affected the quality of the provision and provision of medical services. These changes are:

adoption of laws on nursing (which determined the autonomy of the profession, responsibility and competence, place in the healthcare system);

recognition of the nursing process as a standard for the practice of a nurse (which ensured continuity and systematic work with the patient, taking into account his individual needs, the introduction of nursing documentation (nursing intervention map), analysis and reporting of nursing work;

changes in the education of nursing professionals;

development of a quality and control system;

development of scientific research in nursing.

Thus, following the organization of nursing activities, there are significant changes in the role of nursing staff in meeting the health needs of the population, since the nurse spends 45% of her working time working with patients, using professional knowledge and skills in psychology and communication, management and leadership, etc. In fact, sensitivity and attention to the needs of the patient on the part of each medical worker will help to achieve success in improving the patient's condition.

Order of the Ministry of Health and social development of the Russian Federation (Ministry of Health and Social Development of Russia) dated July 23, 2010 N 541н Moscow

"On the approval of the One qualification handbook positions of managers, specialists and employees, section " Qualification characteristics positions of workers in the field of healthcare"

Nurse

Job Responsibilities. Provides pre-hospital medical care, collects biological materials for laboratory research. Provides care to patients in a medical organization and at home. Performs sterilization of medical instruments, dressings and patient care items. Assists in the doctor's treatment and diagnostic manipulations and minor operations in outpatient and inpatient settings. Conducts preparation of patients for various kinds of research, procedures, operations, for outpatient doctor's appointments. Ensures fulfillment of medical orders. Carries out accounting, storage, use of medicines and ethyl alcohol. Maintains personal records, information (computer) database of the health status of the population served. Supervises the activities of junior medical staff. Maintains medical records. Carries out sanitary and educational work among patients and their relatives on health promotion and disease prevention, propaganda healthy lifestyle life. Collects and disposes of medical waste. Carries out measures to comply with the sanitary and hygienic regime, the rules of asepsis and antisepsis, the conditions for sterilizing instruments and materials, the prevention of post-injection complications, hepatitis, HIV infection.

Must know: laws and other regulatory legal acts of the Russian Federation in the field of healthcare; theoretical basis nursing; the basics of the treatment and diagnostic process, disease prevention, promotion of a healthy lifestyle; rules for the operation of medical instruments and equipment; statistical indicators characterizing the state of health of the population and the activities of medical organizations; rules for the collection, storage and disposal of waste from medical organizations; fundamentals of the functioning of budget-insurance medicine and voluntary medical insurance; fundamentals of valeology and sanology; basics of dietology; the basics of clinical examination, the social significance of diseases; basics of disaster medicine; rules for maintaining accounting and reporting documentation of a structural unit, the main types of medical documentation; medical ethics; psychology of professional communication; fundamentals of labor legislation; internal rules work schedule; rules on labor protection and fire safety.

Qualification Requirements. The average professional education in the specialty "General Medicine", "Obstetrics", "Nursing" and a certificate of a specialist in the specialty "Nursing", "General Practice", "Nursing in Pediatrics" without presenting requirements for work experience.

Senior nurse - secondary vocational education (advanced level) in the specialty "General Medicine", "Obstetrics", "Nursing" and a certificate of a specialist in the specialty "Nursing", "General Practice", "Nursing in Pediatrics" without presentation work experience requirements.

Article 29 Health Organization

1. The organization of health protection is carried out by:

1) state regulation in the field of health protection, including regulatory legal regulation;

2) development and implementation of measures to prevent the occurrence and spread of diseases, including socially significant diseases and diseases that pose a danger to others, and to promote a healthy lifestyle of the population;

3) organizing the provision of first aid, all types of medical care, including to citizens suffering from socially significant diseases, diseases that pose a danger to others, rare (orphan) diseases;

4) ensuring the sanitary and epidemiological well-being of the population;

5) providing certain categories of citizens of the Russian Federation with medicines, medical devices and specialized products medical nutrition in accordance with the legislation of the Russian Federation;

6) management of activities in the field of health protection on the basis of state regulation, as well as self-regulation carried out in accordance with federal law.

Conclusion

The purpose of the development of nursing is improving the quality of nursing care through the rational use of the potential of nursing staff, which ensures an increase in the quality and life expectancy of the population, contributing to patient satisfaction with the quality of medical services, their availability and cost-effectiveness.

As noted in the Concept for the development of the healthcare system in the Russian Federation until 2020, the effective functioning of the healthcare system is determined by the main system-forming factors:

· improvement of the organizational system, which makes it possible to ensure the formation of a healthy lifestyle and the provision of high-quality free medical care to all citizens of the Russian Federation (within the framework of state guarantees);

· development of infrastructure and resource support for healthcare, including financial, material, technical and technological equipment of medical institutions based on innovative approaches and the principle of standardization;

· the presence of a sufficient number of trained medical personnel capable of solving the tasks set for the healthcare of the Russian Federation.

An important role in the healthcare reform, ensuring the availability of medical care, strengthening the preventive focus, and solving the problems of medical and social assistance belongs to specialists with a secondary medical education.

Bibliography

1. "Constitution of the Russian Federation"

2. the federal law"Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens" dated 22.07.1993

3. http://sneek.ru/

4. http://www.rg.ru/

5. http://www.sisterflo.ru/

Hosted on Allbest.ru

Professional retraining in the organization of nursing throughout Russia. Modern aspects of management, health economics What is the organization of nursing

Milestones in the Development of the Nursing Profession

Map of achievements in the activities of the course "Organization of nursing"

Quote by A. Einstein

Send your good work in the knowledge base is simple. Use the form below

Similar Documents