Turkina, Natalia Viktorovna - General nursing: a textbook for medical students. Types of medical and preventive institutions

Russian Federation

N.V. Turkina A.B. Filenko

General care

UNDER GENERAL EDITION

Academician of the Russian Academy of Medical Sciences I.N. Denisova

Corresponding Member of the IAS VSh N.V. Turkina

Saint Petersburg

Introduction

a common part

Types of medical and preventive institutions

Hospital structure

Reception department

Pediculosis and anti-pediculosis treatment technology

Structure of the medical department

Therapeutic and protective regime of the department

Operating block structure

Method of general examination of the patient

Fever

Rules for measuring temperature

Types of fevers

Character of the temperature curve

Stages of fever

Treatment of febrile conditions. Antipyretic drugs

Creating a state of comfort for the patient while maintaining bed rest

Change of bed linen

Change of underwear

Giving a bedpan to a bedridden patient

Basic hygiene procedures

Skin care

Carrying out a hygienic shower

Carrying out a hygienic bath

Skin care for seriously ill patients

Washing feet in bed

Washing the patient

Oral care

Ear care

Nose care

Eye care

Transporting and shifting the patient

Organization of feeding patients

Diet therapy

Organization of meals for patients in the department.

Artificial nutrition

The simplest physiotherapeutic procedures in organizing patient care

Segmental reflex therapy

Mustard plasters

Medical banks

Using a medical heating pad

Using an ice pack

Compresses

Hirudotherapy

Basic manipulations

Injections

Characteristics of syringes

Needle characteristics

Algorithm for performing the manipulation

Set of medicinal solution from an ampoule

Intradermal injections

Subcutaneous injections

Intramuscular injections

Intravenous injections

Administration of enemas

Gastric lavage

Urethral catheterization

Insertion of gas tube

Administration of suppositories

Bedsores

Special part

Caring for patients with cardiovascular diseases

Caring for patients with diseases of the nervous system.

Caring for patients with kidney and urinary tract diseases

Care of operated patients

Hemostasis

Types of bleeding

Ways to stop bleeding

Transport immobilization

Terminal states

Electrical injury

Animal bites

Snake bites

Long-term crush syndrome

Frostbite and hypothermia

General cooling (freezing)

Drowning

Acute poisoning.

Resuscitation measures

Applications

a common part

Types of medical and preventive institutions

In Russia, a wide network of medical and preventive institutions (HCI) has been created to provide medical care to the population. The following types of treatment and preventive institutions are distinguished:

stationary

outpatient

sanatorium-resort

TO stationary(health care facilities) include hospitals And hospitals. They are intended to provide emergency medical care, as well as planned treatment, perform complex and voluminous diagnostic procedures and studies in cases where this is not possible on an outpatient basis for medical reasons or for technical reasons. There are monoprofile ones, i.e. specialized hospitals that are designed to treat patients with any one disease and multidisciplinary. A multidisciplinary hospital includes several departments, for example, surgical, therapeutic, gynecological, etc. Inpatient facilities also include maternity, whose functions include obstetrics, treatment of pregnant women and postpartum women.

Hospitals They mainly provide medical care to current and former employees of law enforcement agencies, war veterans, as well as persons injured as a result of hostilities.

Clinic(clinical hospital) is an inpatient institution in which, in addition to medical work, scientific research is mandatory and training of students and specialists is carried out.

In addition to inpatient ones, there are also outpatient, sanatorium-resort and ambulance stations.

The functions of outpatient facilities vary.

Dispensaries provide therapeutic and preventive care to certain groups of patients (rheumatological, dermatovenerological, psychoneurological, anti-tuberculosis, oncology and other dispensaries). The scope of this assistance includes: active identification of specialized patients among the population; systematic active monitoring of identified patients (patronage); provision of specialized medical care; prevention activities. In addition, the dispensary conducts morbidity studies and health education work among the population and patients.

Clinics – multidisciplinary treatment and preventive institutions (HCI) – designed to provide medical (including specialized) care and examination of patients on a territorial-precinct basis.

Outpatient clinics - These are healthcare facilities, in contrast to clinics, that provide specialized medical care on a smaller scale. Doctors provide consultations only in basic specialties. The principle of operation of outpatient clinics is also local, but they are located mainly in rural areas, not far from medical and obstetric centers.

Paramedic and midwife station ( FAP)– outpatient clinic in rural areas. It is organized in rural areas if the locality is more than 4-6 kilometers away from other medical institutions. It works on a local basis. Part of a rural or central district hospital. As a rule, the staff of a FAP is: paramedic - midwife - nurse. FAP staff provides first aid at outpatient appointments and at home. He is responsible for carrying out doctor’s prescriptions, attracting residents of the site for routine examinations, participating in medical examinations of the population and carrying out preventive measures. An important section of the work of the FAP is the provision of medical care during pregnancy and childbirth, obstetrics, monitoring of postpartum women at home, after their discharge from the hospital, monitoring of children under the age of 3 years, medical care of preschool institutions and schools on the site. FAP workers ensure early detection of infectious patients, carry out anti-epidemic measures, sanitary supervision of populated areas, production facilities, water supply, catering establishments, trade, and communal facilities. FAP employees provide emergency and emergency first aid. The structure of the FAP provides beds for hospitalization of women in labor, as well as for temporary isolation of infectious patients. There should be a pharmacy for the sale of ready-made medicines and sanitary and hygiene items.

Health centers Usually they are not independent health care facilities and are part of either clinics or medical units. They are usually located close to the workplace of the service population (large workshop, construction site, etc.) and come in two types: medical and paramedic. They provide pre-medical and first medical aid for injuries, poisoning, and sudden illnesses. Health center staff actively participate in medical examinations and health education work.

Outpatient facilities also include antenatal clinics . Their functions include early detection, treatment and medical examination of patients with gynecological diseases; dispensary observation, and, if necessary, treatment of pregnant women. An important place in their work is given to health education and teaching pregnant women the necessary skills to care for newborns.

Medical and sanitary unit (MSCh) is a complex of health care facilities designed for medical care of workers and employees of industrial enterprises and organizations. It operates on the principle of shop locality and is as close as possible to the place of work of workers and employees. The medical unit may include: a clinic, a hospital, health centers, a dispensary, etc. Functions of the medical unit: providing outpatient and inpatient medical care, conducting medical examinations, developing a set of preventive measures aimed at improving working conditions, identifying and monitoring occupational hazards.

Territorial medical association (TMO), like the medical unit, is a complex of health care facilities, but the medical center provides medical care not on a production basis, but on a territorial basis.

Ambulance stations – medical institutions that provide emergency medical care to the population around the clock (in case of injuries, poisoning, wounds, life-threatening sudden illnesses) at the pre-hospital stage, as well as during childbirth, and hospitalization of patients in need of hospital treatment, or women in labor in maternity hospitals. In large cities there are linear ambulance substations and specialized ones, such as cardiology, intensive care, psychiatric, etc.

To institutions sanatorium This type includes sanatoriums, dispensaries and other institutions whose activities are based on the use of predominantly natural healing factors (climate, healing mud, mineral springs, etc.) for the treatment and prevention of diseases, as well as diet therapy, physiotherapy and exercise therapy.

The hospital includes an admissions department, treatment and diagnostic departments, administrative and utility blocks.

Hospitalization is the placement in a hospital of a medical institution of persons in need of examination, treatment or obstetric care. Hospitalization can be of two types - emergency and planned.

Emergency hospitalization (usually with delivery of the patient to the hospital by linear and specialized ambulance and emergency teams) is carried out in cases where the patient’s condition requires urgent qualified or specialized medical care in a hospital setting (patients with injuries, burns, acute or exacerbations of chronic diseases).

During planned hospitalization, the patient is admitted by a doctor at an outpatient clinic in cases where the ongoing diagnostic and treatment measures are not effective or cannot be carried out at home. Depending on the severity of the patient’s condition, his age, and household factors, he can be delivered to the emergency room by ambulance or come on his own: by transfer from another hospital after preliminary consultations with specialists, agreement and consent of the patient and the administration of these medical institutions.

In some cases, the patient may be transferred from another hospital.

The patient can also seek help without a referral, in cases where, for example, an accident occurred close to the hospital or the person felt unwell and independently went to the nearest hospital.

Hospital structure

All departments of the hospital can be divided into 2 large groups:

Treatment and diagnostic;

administrative and economic.

The diagnostic and treatment part includes:

reception department;

specialized medical departments (therapeutic, surgical, gynecological, etc.);

opera block;

diagnostic laboratories (clinical, biochemical, cytological, immunological, etc.);

diagnostic departments and offices.

The administrative and economic part includes:

offices of the chief physician and his deputies,

office;

accounting;

catering unit;

laundry;

• sterilization department;

  blood transfusion department;

  boiler room

Upon admission to the hospital, in most cases the patient goes through emergency department . Properly organized and clearly carried out work of the admission department largely determines the work of the hospital as a whole. The quality of care, the accuracy and speed of sorting patients form their first (and often the main) impression of the hospital and its employees.

Reception department

The reception department consists of the following premises:

Lobby (waiting room for relatives and accompanying persons);

Dispatch post (reception);

Examination rooms, incl. specialized (gynecological, surgical, traumatological, etc.);

Sanitary checkpoint;

Isolators for infectious and socially dangerous patients;

Procedural and dressing room;

Reanimation room (“shock” ward);

Laboratory and X-ray room;

• Auxiliary premises (staff rooms, storage rooms, luggage storage for hospitalized patients, etc.).

Functions of the reception department

Providing emergency assistance and anti-shock therapy;

Patient registration;

Primary diagnosis;

Sorting and screening of infectious and non-core patients;

Taking tests;

Sanitation (full or partial);

Organization of patient transportation to departments.

Sequence of operation of the reception department:

Patient registration;

A thorough examination to identify external signs of highly infectious diseases and head lice;

Examination of the patient by the doctor on duty and making a preliminary diagnosis (in case of hospitalization not according to the profile - refusal of hospitalization or transfer to a specialized hospital);

The doctor determines the type of sanitization and transportation (on foot, on a wheelchair, on a gurney);

Sanitation is carried out;

The patient is transported, accompanied by a nurse, to the specialized department of the hospital.

In cases requiring emergency care, this sequence is not followed, the patient’s stay in the emergency department is reduced to a minimum, sanitization is either minimal (partial) or not performed.

Responsibilities of the duty nurse of the admission department

Registers patients in the “Register of admission of patients and refusals of hospitalization” (form No. 001/u), checking passport data and referral data for hospitalization:

last name, first name and patronymic of the patient;

the year of his birth;

home address;

where and by whom the patient was delivered (type of hospitalization);

diagnosis of the referring institution.

In case of refusal of hospitalization, indicates the reason for the refusal and the measures taken (outpatient care provided, referred to another hospital);

Fills out the passport part of the “Medical Card of an Inpatient” (form 003/u), repeating the entries made in the “Register of admission of patients and refusals of hospitalization.” She also enters information about her place of work and profession, telephone number: home or relatives (friends), if the sick person is alone. Information about any existing disability must be noted. Indications for hospitalization are noted (emergency, planned, transfer from another hospital, “gravity”). In case of emergency hospitalization, the time after which the patient was delivered by ambulance is noted.

Then the nurse fills out the passport part and the left side of the “Statistical card of a person leaving the hospital” (form No. 066/u).

Draws up an act for money, valuables, clothing and personal belongings of patients accepted for storage, filling out a receipt - a statement of the established procedure. Accepted documents and valuables of the patient are transferred to the hospital administration and stored there in a safe.

In the examination room, the nurse performs thermometry on the patient, measures blood pressure, takes anthropometric measurements, and notes the results in the medical history.

Carefully examines the patient’s hairy parts and head to identify lice, and the skin and mucous membranes to identify elements of the rash;

Provides first aid to patients, carries out the orders of the doctor on duty; if necessary, calls specialist doctors and laboratory assistants and assists in their work.

After examining the doctor on duty and his notes, the nurse completes the registration in the “Logbook of registration and admission of patients and refusals of hospitalization” (form No. 003/u) see figure). She writes in the journal:

diagnosis by the emergency department doctor upon admission;

department where the patient was sent.

On admission

patients under 16 years of age unaccompanied by adult relatives

patients in an unconscious state or in a condition that directly threatens his life, as well as in the event of his death in the emergency department, the nurse is obliged to give a telephone message to his relatives (if the telephone number is known), making an entry in the “Telephonogram Log”. In addition to these cases, the telephone message is transmitted to relatives if the patient is transferred from the emergency department to another hospital.

If the injury is of a criminal nature, an injury received as a result of an accident and when teenagers under 16 years of age are admitted due to accidents, a telephone message is given to the internal affairs bodies (the duty officer at the Internal Affairs Directorate). The nurse also gives a telephone message upon admission of unknown patients, indicating the signs of the unknown: gender, approximate age, hair color, height, physique, special signs - birthmarks, scars; called the clothes he is wearing. The nurse must write down in the “Telephone Message Log” the contents of her telephone message, the date, time of its transmission and who received it at the police department.

Organizes and controls the sanitary treatment of patients;

Organizes and controls the transportation of patients to departments;

Maintains the sanitary and epidemiological regime of the reception department.

In cases where the patient's condition is critical, he can be admitted directly to the intensive care unit, bypassing the emergency department. Then all medical documentation is completed by a nurse in the intensive care unit.

In cases where, after examination and observation by the doctor on duty of a patient who was admitted to the emergency department with a referral for hospitalization, it is determined that there are no indications for hospitalization, the patient can be sent home. The nurse makes an entry about this in the “Register of admissions of patients and refusals of hospitalization” (form “001/у”). If the patient was admitted “by gravity”, and after examination by a doctor it is determined that he does not need hospitalization, then he is provided care as an outpatient. He is sent home, about which the nurse must make an entry in the “Outpatient Registration Journal” (form 074/u).

Errors in the preparation of a medical history, a statistical map, a “Recording Journal”, a “Telephone Log”, a journal for the hospital help desk, violations in their registration can become a source of mental, moral and legal problems for the patient and medical staff. The admissions department nurse must be very careful when filling out and maintaining medical documentation, an inventory of the receipt of documents and valuables from the patient, which are legal documents and may be required by insurance organizations, law enforcement and justice agencies.

Pediculosis and anti-pediculosis treatment technology

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State budgetary educational institution of higher professional education "Orenburg State Medical Academy" of the Ministry of Health and Social Development of the Russian Federation "Agreed" Vice-Rector of the UVSR Professor I.V. Miroshnichenko Approved by the Faculty Central Committee Professor O.V. Bugrova “__”_________2011 “__”_________2011 Dean of the Faculty Professor T.V. Chernysheva Approved by the Faculty Academic Council Professor T.V. Chernysheva "__"_________2011 "__"_________2011 WORK PROGRAM OF EDUCATIONAL PRACTICE CARE OF THERAPEUTIC AND SURGICAL PATIENTS Department of Propaedeutics of Internal Diseases Direction of training - 060101.65 general medicine QUALIFICATION (DEGREE) OF THE GRADUATE "SP" ECIALIST" Considered at a meeting of the Department of Propaedeutics of Internal Diseases " April 25, 2011 Head. Department, Doctor of Medical Sciences, Professor ____________ K.M. Ivanov 1. Goals of educational practice:  acquisition by students of general theoretical knowledge on the general care of medical and surgical patients;  training students in qualified patient care, basic principles of medical ethics and deontology; - training in the use of medical equipment and instruments. 2. Objectives of educational practice:  formation of theoretical knowledge in students on the implementation of qualified nursing care;  formation of students’ understanding of medical ethics and deontology;  students study the basic principles of the work of medical institutions;  students study the work of junior and nursing staff in therapeutic and surgical departments;  mastering practical skills (medical manipulations related to caring for patients with diseases of various organs and systems). 3. The place of educational practice in the structure of the educational program: The educational practice “Nursing therapeutic patients” belongs to the cycle of educational and work practice (C5) of the Federal State Educational Standards disciplines in the specialty 060101.65 General Medicine of higher professional medical education, studied in the first and second semester. a) Previous disciplines and requirements for “input” knowledge: No. 1. Previous disciplines Biology of general education institutions Knowledge, skills, possessions a) know: - about biological objects, processes, phenomena, patterns, basic biological theories, ecosystem organization life, the relationship between the structure and functions of organs and organ systems, the body and the environment; - structure of the human body (structure and functioning of organs and systems); - the influence of environmental and social factors, mental and physical labor, physical education and sports on human health; - about the harmful effects of alcohol, drugs, smoking on the human body and its offspring; - about the structure and vital functions of the human body to justify a healthy lifestyle, compliance with hygiene standards, prevention of injuries and diseases; - about socially significant and most common diseases, poisonings, and injuries in the human population. b) be able to: - use educational, scientific, popular science literature, the Internet for professional activities; - prevent the development of bad habits (smoking, alcoholism, drug addiction). c) master: - methods of biological research; - methods of personal and public hygiene; - techniques of first aid, rational 2. Chemistry of general educational institutions 3. Physics of general educational institutions organization of work and rest. a) know: - about substances, their transformations and practical applications; - conceptual apparatus and symbolic language of chemistry. b) be able to: - analyze and objectively evaluate life situations related to chemistry; - plan environmentally friendly behavior in order to preserve health and the environment. c) possess: the basics of chemical literacy, skills of safe handling of substances used in everyday life. a) know: - about the system-forming role of physics for the development of other natural sciences, engineering and technologies; - the physical essence of natural phenomena (mechanical, thermal, electromagnetic and quantum), types of matter (matter and field); - basic ideas of atomic-molecular science about the structure of matter, elements of electrodynamics and quantum physics; - physical foundations and principles of operation of mechanisms, vehicles, household appliances, industrial technological processes, their impact on the environment; - awareness of the possible causes of man-made and environmental disasters. b) be able to: - apply scientific methods of cognition, observe physical phenomena; - carry out simple experimental studies, direct and indirect measurements using analog and digital measuring instruments; - understand the inevitability of errors in any measurements; - plan your actions in everyday life using the acquired knowledge of the laws of mechanics, electrodynamics, thermodynamics and thermal phenomena in order to preserve health. c) master: - the basics of the safe use of natural and artificial electric and magnetic fields, electromagnetic and sound waves, natural and artificial ionizing radiation in order to avoid their harmful effects on the environment and the human body. b) disciplines and practices for which completion of this educational practice is necessary as a previous one: No. Name of the provided (subsequent) disciplines No. of the modules of this educational practice necessary for studying the provided (subsequent) disciplines 1 2 3 4 + + 10. Otorhinolaryngology + + 11. Ophthalmology + + 12. Obstetrics and gynecology + + 13. General surgery, radiation diagnostics + + 15. Faculty surgery, urology + + 16. Hospital surgery, pediatric surgery + + 17. Oncology, radiation therapy + + 18 Traumatology, orthopedics + + 1. Dermatovenerology + 2. Neurology, medical genetics, neurosurgery + + 3. Psychiatry, medical psychology + + 4. Propaedeutics of internal diseases, radiation diagnostics 5. Faculty therapy, occupational diseases + + 6. Hospital therapy, endocrinology + + 7. Infectious diseases + + 8. Phthisiology + 9. Polyclinic therapy + + 14. Anesthesiology, resuscitation, intensive care 19. Internship “Assistant to junior medical staff” + + + + 20 Internship “Assistant ward nurse” + + + + 21. Internship “Procedural Nurse Assistant” + + + + 4. Forms, place and time of educational practice “Nursing therapeutic and surgical patients”: educational. - training simulation center of OrGMA; - NUZ OKB at the station. Orenburg. 1st, 2nd semesters. Duration of practice Duration of practice (in hours) 144 hours. Labor intensity of practice (in units) 6 credit units. Form of practice Practice bases 5. The student’s competencies, formed as a result of practical training: A graduate in specialty 060101.65 - general medicine with the qualification - specialist, special title - a doctor must have the following competencies: Competencies Content according to the Federal State Educational Standard  General cultural ability and willingness to analyze socially significant OK-1 problems and processes, use in practice the methods of the humanities, natural sciences, medical-biological and clinical sciences in various types of professional and social activities with the ability and readiness to analyze ideological, socially and OK-2 personally significant philosophical problems, basic philosophical categories, to self-improvement  Professional ability and willingness to implement ethical and deontological aspects of medical practice PC-1 in communication with colleagues, nursing and junior medical personnel, adults and adolescents, their parents and relatives ability and willingness to conduct and interpret surveys, PC- 5 physical examination, clinical examination, results of modern laboratory and instrumental studies, morphological analysis of biopsy, surgical and sectional material, write a medical record of an outpatient and inpatient patient with the ability and willingness to use aseptic and antiseptic methods, PC-7 use medical instruments, carry out sanitary treatment of medical and diagnostic facilities of medical organizations, possess the technique of patient care, the ability and willingness to carry out basic therapeutic measures PC-19 for the most common diseases and conditions in the adult population and adolescents that can cause severe complications and (or) death: diseases of the nervous, endocrine, immune, cardiovascular, respiratory, digestive, genitourinary systems and blood, promptly identify life-threatening disorders (acute blood loss, respiratory failure, cardiac arrest, coma, shock), use methods for their immediate elimination, carry out anti-shock measures with the ability and willingness to use regulatory documentation, PC-27 adopted in healthcare (laws of the Russian Federation, technical regulations, international and national standards, orders, recommendations, terminology, international systems of units (SI), current international classifications), as well as documentation for assessing the quality and efficiency of medical organizations 6. Volume, structure and content of educational practice: a) Volume of educational practice and types of educational work: Total hours I semester II semester Classroom classes (total) Including: Lectures (L) 144 64 80 32 16 16 Practical classes (PL) 112 48 64 Type of educational work Independent work (total) Including: Preparation of an oral answer for current control 72 32 40 28 12 16 Independent work to develop practical skills 28 12 16 Doing homework in workbooks for independent work 4 2 2 Preparation of the “Study Diary” practice" 6 3 3 Preparation for intermediate control 6 3 3 Test Type of intermediate certification. 216 hours 6 credit units Total labor intensity b) Structure of educational practice: No. 1. 2. 3. 4. Discipline module Organization of the work of therapeutic medical institutions Care of a therapeutic patient Organization of the work of surgical medical institutions Nursing for a surgical patient Credit From Weeks Types of educational work, including independent work of students and per semester labor intensity (in hours) Lectures Prak. Self r and busy. work I 1-5 8 20 12 I II II II 6 - 12 1-9 10 - 15 16 8 8 8 - 28 36 24 4 20 20 20 Milestone control points and final control (forms of control) and week Current control: - testing; - Practical skills. Midterm control (week 5): - testing. Current control: - testing; - Practical skills. Midterm control (week 12): - testing. Current control: - testing; - Practical skills. Midterm control (week 8): - testing. Current control: - testing; - Practical skills. Midterm control (week 15): - testing. Intermediate control Total 16 32 112 72 (week 16): - oral examination on tickets; - reception of practical skills. Test at the end of the spring semester (week 16) c) Content of modules of educational practice: No. Name of sub-module of the discipline Total labor intensity 1. Organization of the work of therapeutic medical institutions 40 hours Content of the module (in didactic units) Competencies Philosophy and theory of nursing. OK-1,2 History of nursing. Fundamentals of nursing philosophy. Biomedical ethics in PC-1,7,27 medical practice. General principles of communication with the patient. Factors that promote and hinder communication. Iatrogenic diseases. Medical secrecy. Moral and legal responsibility of medical personnel. Code of Conduct. Hospital structure. Types of medical care. The main directions of providing medical care to the population: preventive, therapeutic and diagnostic, medical and social, rehabilitation. Types of healthcare facilities. Medical institutions. Hospital, main structural units. Types of nurses, their responsibilities. Emergency room. Hospital structure. Structure of the reception department. Functions of the reception department. Responsibilities of a nurse in the admission department. Paperwork. Sanitizing patients. Pediculosis, sanitary treatment of the patient when pediculosis is detected. Transportation of patients. Carrying, shifting the patient. Structure and functions of the therapeutic department. Structure and functions of the therapeutic department. Organization of the work of the therapeutic department. Construction and equipment of wards and utility rooms. Guard nurse, her duties. Organization of the work of the nursing station: equipment, medical documentation, procedure for reception and delivery of duties. Anthropometry. Measuring the patient's height and chest circumference. weight, Types of hospital regimes. Types of hospital regimes. Therapeutic and protective regime: daily routine, ways to ensure mental and physical comfort, and patient safety. Individual motor mode: strict bed, bed, ward, general. Sanitary and epidemiological regime. The concept of nosocomial infection. Pathogens of nosocomial infections, transmission mechanism. Disinfection. Types of disinfection: preventive and focal. Disinfection methods. Requirements for disinfectants. Levels of disinfection. 2. Catering in a medical institution. Basic principles of rational nutrition for a healthy person. The main components of food: proteins, fats, carbohydrates, minerals, vitamins and water. Basic principles of therapeutic nutrition. Therapeutic diets. Catering. Distribution of food. Active nutrition. Passive nutrition: indications and contraindications, methods. Feeding the seriously ill. Artificial nutrition: enteral and parenteral nutrition. Feeding the patient through a gastrostomy tube, through a nasogastric tube. Rules for the transfer and storage of products in the department. Personal hygiene of the patient. Position in OK-1,2 Bed care. Oral care. Ear care. therapeutic care of the nasal cavity. Eye care. PC patient skin care for 56 hours. Features of observation and care of 1,5,7,27 bedridden patients. Perineal care. Use of vessels and urinals. Change of bed and underwear. Bedsores: causes and stages. Skin care in the presence of bedsores and their prevention. Features of observation and care for elderly and senile patients. The simplest physiotherapy. Impact on the patient’s body: simple physiotherapy. Mustard plasters. Compresses: cold compress, hot compress, wet warming compress, dry warming compress. Leeches. Hot water bottles. Ice pack. Hydrotherapy: baths, showers, douses. Indications and contraindications for use, algorithm of action, complications. Observation and care of patients with respiratory diseases. Patient complaints of respiratory diseases: cough, chest pain, shortness of breath, asthma attack, hemoptysis, care features. Counting the frequency of respiratory movements. Sputum collection for laboratory tests: general sputum analysis, sputum collection for Mycobacterium tuberculosis, atypical cells, bacterial culture. Preparation for instrumental methods of studying the respiratory system. Oxygen therapy: inhalation and non-inhalation methods. Observation and care of patients with circulatory diseases. Complaints of a cardiac patient: pain in the heart, palpitations and irregularities, increased and decreased blood pressure, edema, shortness of breath, asthma attack, care features. Palpation of the pulse, characteristics of the pulse: symmetry, frequency, rhythm, filling and tension. Method of measuring blood pressure. Technique for taking an electrocardiogram. 3. Organization of the work of surgical medical institutions 64 hours Principles of organizing surgical OK-1,2 assistance to the population. Organization of surgical care for the population. Features of receiving PC-1,7,27 surgical patients. The structure of the surgical department, its layout, dressing room, surgical ward. The division of surgical nurses depending on the duties performed: dressing nurse, operating nurse. Asepsis and antiseptics in the surgical clinic. The concept of nosocomial infection in surgery, the route of infection. Clinical environmental hygiene. Requirements for sanitary processing of instruments and equipment in medical institutions. Sterilization. Control of pre-sterilization treatment, control of sterilization. Dressing room. Medical waste: types, disposal. Clinical hygiene of medical personnel in a surgical clinic. Appearance requirements. Three levels of hand treatment. Safety rules when working with blood. HIV infection, routes of transmission, clinical manifestations, prevention. Methods of using medicinal substances. Dispensing and storing medications. Organizing the distribution of medications in the department. External use of drugs. Enteral administration of drugs. Parenteral administration of drugs. Organization of the work of the treatment room. Discharge, storage of narcotic drugs. Types of syringes, needles and their design. Intradermal injections. Subcutaneous, intramuscular, intravenous injections. Complications. First aid. Catheter care. Caring for a patient with physiological disorders. Enemas, types of enemas. Indications and contraindications for performing an enema, complications. Gastric lavage: indications and contraindications, possible complications. Placement of a gas outlet tube: indications and contraindications, possible complications. Monitoring of patients with diseases of the digestive system. Complaints of the gastric patient: pain, dyspeptic disorders, nausea and vomiting, care features. Probing of the stomach: technique, indications and contraindications. Observation and care of patients with impaired renal and urinary tract function. Complaints of a renal patient: pain, swelling, increased blood pressure, urination disorder, care features. Collection of urine for laboratory tests: general urine analysis, urine collection according to Nechiporenko, Kakovsky-Addis, Amburge, Zimnitsky, dilution and concentration test. Bladder catheterization. Care of an indwelling catheter. 4. Care of a surgical patient 52 hours for Care of a patient in the preoperative OK-1,2 period. Patient care in the preoperative period. Psychological preparation, preparation of PC-1.5, respiratory system, circulatory system, 7.27 digestion. Preparation of the surgical field. Preparing patients for planned operations. Preparing patients for emergency operations. Patient care during operating periods. Structure and equipment of the operating unit. Sanitary and hygienic regime in the operating unit. Patient care during the operating period. Responsibilities of the operating room nurse. Operating room cleaning. Processing medical equipment in the operating room. Patient care in the postoperative period. Care of the surgical wound, drainages, probes, catheters. Features of postoperative management and care of patients after various types of abdominal surgery. Features of postoperative management and care of patients after various types of surgery. Desmurgy. Materials for dressings. Classification of dressings by type of dressing material, purpose, method of fixation. Basic rules of desmurgy. Bandage-free and bandage dressings. Hemostasis. Types of bleeding. Methods for temporarily stopping bleeding. Pressure bandage. Finger pressure. Maximum limb flexion. Application of a tourniquet. Tight wound tamponade. Applying a clamp to the vessel. Transport immobilization. Principles of transport immobilization. Types of transport tires. Features of transport immobilization in case of damage to various parts of the body. Immobilization using improvised means. Gypsum bandage. General care for trauma patients with various localizations of injuries depending on the treatment methods used. d) Elements of competencies formed by this educational practice: OK-No. 1,2 PC-No. 1,5,7,27 1. OK-No. 1 - ability and willingness to analyze socially significant problems and processes, use humanitarian methods in practice, natural sciences, biomedical and clinical sciences in various types of professional and social activities 1.1. Component - ability and willingness to analyze socially significant problems and processes 1.1.1. Content - able, in the course of professional activities, to identify and analyze problems and processes that are relevant to society. Each section of educational practice analyzes current problems of modern medicine and society in order to develop in students an active professional and civic position, the ability to identify the essence of problems and processes that are relevant 1.1. 2. Technology - organization of educational and independent work of students aimed at developing the skills of conducting discussions, public speaking, reasoned expression of one's opinion, analyzing educational and scientific literature, legal and ethical documents, solving situational problems, writing abstracts 1.1.3. Control - survey in practical classes, seminars, assessment of solutions (orally and in writing) to situational problems, testing, reviewing abstracts, editing speeches 2. OK - No. 2 - ability and readiness to analyze ideological, socially and personally significant philosophical problems, basic philosophical categories , to self-improvement 2.1. Component - ability and readiness for self-improvement 2.1.1. Content - able to constantly improve one’s cultural and professional level. Each topic of educational practice emphasizes the need for self-education, constant work on oneself in order to form in students an understanding of the duty of a physician to the patient and to society 2. 1.2. Technology - organization of educational and independent work of students aimed at developing the moral character of a doctor; studying the philosophy of medicine; using fiction, films and personal experience of the teacher as an example 2.1.3. Control - individual and frontal questioning at seminars, assessment of solutions to situational problems, checking workbooks, reviewing abstracts, editing speeches 3. PC - No. 1 - ability and willingness to implement the ethical and deontological aspects of medical practice in communication with colleagues, nursing and junior medical staff , adults and adolescents, their parents and relatives 3.1. Component - the ability and willingness to implement the ethical and deontological aspects of medical practice in communication with colleagues, nursing and junior medical personnel 3.1.1. Content - capable of observing the principles of medical ethics and deontology with colleagues in professional activities. At each lecture and practical lesson, students’ attention is focused on medical ethics and deontology in order to develop in students such integral qualities of a doctor as honesty, devotion, dedication, mercy, kindness and humanity, patience and tolerance, the ability to respect the work of colleagues, nurses, and aides 3.1.2. Technology is the organization of educational and independent work of students aimed at developing the moral character of a doctor: accuracy, sensitivity, goodwill, accuracy and commitment, endurance and self-control; use as an example of fiction, films, personal behavior of a teacher during practical classes in departments of medical organizations 3.1.3. Control - individual survey at seminars, assessment of solutions (orally and in writing) to situational problems, testing, terminological dictation, reviewing abstracts, editing notes of speeches 3.2. Component - the ability and willingness to implement the ethical and deontological aspects of medical practice in communication with adults and adolescents, their parents and relatives 3.2.1. Content - is able to be guided by the principles of medical ethics and deontology in professional activities when communicating with children, adolescents, and their parents. In the learning process, lectures and practical classes emphasize the need to cultivate qualities that promote mutual understanding with a sick child, his parents and other relatives - unselfishness, dedication , dedication to the chosen profession, the ability to receive moral satisfaction from one’s work 3. 2.2. Technology - organization of educational and independent work of students aimed at developing the moral character of a doctor, studying factors that promote and hinder communication; using fiction, films and the personal experience of the teacher as an example 3.2.3. Control - individual survey at seminars, assessment of solutions (orally and in writing) to situational problems, testing, terminological dictation, reviewing abstracts, editing notes of speeches, assessment of student behavior in the clinic 4. PC - No. 5 - ability and willingness to conduct and interpret surveys, physical examination, clinical examination, results of modern laboratory and instrumental studies, morphological analysis of biopsy, surgical and sectional material, write a medical record for an outpatient and inpatient patient 4.1. Component - ability and willingness to conduct and interpret interview, physical examination 4.1.1. Contents - is able to collect the patient’s complaints, ask relatives, assess the patient’s general condition, consciousness, motor activity, skin, measure height, weight, body temperature, blood pressure, count the pulse rate and the number of respiratory movements, assess the patient’s ability to self-care During the course educational practice examines the theoretical and practical aspects of physical research methods in order to develop students' practical skills in clinical examination of patients 4.1.2. Technology - organization of educational and independent work of students aimed at acquiring practical skills in collecting complaints, collecting and assessing anamnesis in therapeutic practice, methods of general examination of the patient, assessing vital signs and anthropometric data 4.1.3. Control - individual survey at seminars, testing, testing of practical skills 4.2. Component - ability and willingness to write a medical record for an inpatient 4.2.1. Contents - is able to draw up a medical record of an inpatient patient. When undergoing practical training, the structure of a medical record of an inpatient patient is studied, skills are acquired in filling out the title page of a medical record of an inpatient patient (U.F. 003), referral forms for laboratory and instrumental research methods, a temperature sheet, entering their results in the medical record 4.2.2. Technology - organization of educational and independent work of students aimed at acquiring practical skills in working with basic medical documentation in the emergency room and therapeutic departments 4. 2.3. Control - individual survey at seminars, testing, drawing up a “training” medical history, temperature sheet 5. PC - No. 7 - ability and willingness to apply aseptic and antiseptic methods, use medical instruments, sanitize treatment and diagnostic premises of medical organizations, own equipment nursing care 5.1. Component - ability and willingness to use medical instruments 5.1.1. Content - capable and ready to use medical instruments in the course of professional activities. During educational practice, practical skills in the use of medical instruments are developed to perform various manipulations to care for a therapeutic patient (tube feeding, oxygen therapy, etc.) 5.1.2. Technology - organization of educational and independent work of students to develop practical skills using various medical instruments on the basis of a training simulation center and at the clinic 5.1.3. Control - individual survey at seminars, testing, testing of practical skills 5.2. Component - the ability and willingness to use aseptic and antiseptic methods, to carry out sanitary treatment of medical and diagnostic premises of medical organizations 5.2.1. Content - able and ready to apply the basic rules of asepsis and antisepsis in the course of professional activities. During educational practice, the basic principles of asepsis and antisepsis are studied, practical skills are consolidated in carrying out preventive and focal disinfection of the hospital environment and patient care items, dishes, etc. in the department. hygienic treatment of the hands of medical personnel, disinfection of medical waste in order to develop in students the concept of a “safe hospital environment” 5.2.2. Technology - organization of educational and independent work of students aimed at mastering theoretical knowledge on the issues of asepsis and antisepsis, disinfection, on the basis of which practical skills are formed: cleaning premises, preparing instruments for sterilization, hygienic hand washing, waste disposal 5.2.3. Control - individual survey at seminars, testing, testing of practical skills 5.3. Component - master the technique of caring for patients 5.3.1. Content - is able to create favorable conditions for recovery for the patient, alleviate the patient's suffering, prevent the development of complications. During educational practice, theoretical and practical aspects of manipulative nursing techniques are studied in general and special care of therapeutic patients in ensuring personal hygiene, feeding seriously ill patients, transportation, methods simple physiotherapy 5. 3.2. Technology - organization of educational and independent work of students aimed at mastering theoretical knowledge on issues of caring for a therapeutic patient, on the basis of which practical skills of general and special care are formed 5.3.3. Control - individual survey at seminars, testing, terminological dictation, testing of practical skills 6. PC - No. 19 - ability and willingness to carry out basic treatment measures for the most common diseases and conditions in adults and adolescents that can cause severe complications and (or) lethal outcome: diseases of the nervous, endocrine, immune, cardiovascular, respiratory, digestive, genitourinary systems and blood, promptly identify life-threatening disorders (acute blood loss, respiratory failure, cardiac arrest, coma, shock), use methods for their immediate elimination, carry out anti-shock activities 6.1.1. Component - the ability and willingness to carry out basic treatment measures for the most common diseases and conditions in adults and adolescents that can cause severe complications and (or) death: acute blood loss, use methods for their immediate elimination, carry out anti-shock measures 6.1.2. Contents - able and ready to apply methods to temporarily stop bleeding, determine the type of bleeding and select the most optimal methods of temporary hemostasis, master the technique of applying a pressure bandage, applying a hemostatic tourniquet, digitally pressing the arteries to the bone, maximal flexion of the limb 6.1.3. Technology - organization of educational and independent work of students aimed at mastering theoretical knowledge on the use of hemostasis; demonstration of educational videos; practicing practical skills using simulation equipment 6.1.4. Control - individual survey at seminars, testing, terminological dictation, testing of practical skills 7. PC - No. 27 - ability and willingness to use regulatory documentation adopted in healthcare (laws of the Russian Federation, technical regulations, international and national standards, orders, recommendations, terminology , international systems of units (SI), current international classifications), as well as documentation for assessing the quality and efficiency of medical organizations 7.1. Component - the ability and willingness to use regulatory documentation adopted in healthcare (laws of the Russian Federation, technical regulations, international and national standards, orders, recommendations, terminology, international systems of units (SI), current international classifications) 7. 1.1. Content - able and ready, in the course of professional activities, to rely on orders, regulations and standards of the central and local level for the provision of medical care to the population. During the course of training, students become familiar with the basic regulatory documentation used in professional activities; learn to work with international and national standards; study generally accepted terminology 7.1.2. Technology - organization of educational and independent work of students aimed at mastering theoretical knowledge on the use of regulatory documentation; developing practical skills in patient care based on federal and regional standards 7.1.3. Control - individual survey at seminars, testing, terminological dictation, testing of practical skills e) Structure of modules and types of independent work of educational practice: No. Subject of practical classes (seminars) Labor intensity (hours) Weeks in the semester 2 1 2 2 2 3 5 7 4 1 4 2 4 3 4 4 4 5 12 1-5 Module 1 Organization of the work of therapeutic medical institutions 1. Classroom work 1 2 3 4 1 2 3 4 5 a) Lectures Philosophy of nursing. Biomedical ethics in nursing practice. The concept of general care in therapeutic practice. Medical assistance to the population: organization and structure. Catering in a medical institution. b) Practical classes Philosophy and theory of nursing. Biomedical ethics in nursing practice. Hospital structure. Reception department: functions and structure. Pediculosis. Therapeutic department of the hospital. Types of hospital regimes. Nosocomial infection. Disinfection. Catering in a medical institution. c) Terminal control Control points: - testing. 2. Independent extracurricular work a) Mandatory *Forms of work 1. Preparation of an oral response for current control. 2. Independent work to develop practical skills. 3. Preparation for intermediate control. 4. Doing homework in workbooks for independent work. 5.Keeping a “Diary of educational practice”. *Types of control 1. Testing theoretical and practical knowledge during a practical lesson or test. 2. Testing on given topics. 3. Checking workbooks and the “Diary of educational practice”. b) Optional 1. Participation in the creation of visual teaching aids. 2. Creating presentations. 3. Creation of educational films. 4. Conducting health education work (conversations) among patients (development of a health bulletin, posters). 5. Writing an abstract. Up to 20 hours 1-5 2 2 2 9 11 13 2 15 4 6 4 7 4 4 4 8 9 10 4 11 4 12 20 6-12 Up to 20 6-12 Module 2 Caring for a therapeutic patient 1. Classroom work a) Lectures 1 2 3 4 1 2 3 4 5 6 7 Personal hygiene. Monitoring and caring for an elderly patient. Observation and care of patients with circulatory diseases. Observation and care of patients with respiratory diseases. b) Practical exercises Simulation module “Basics of caring for seriously ill patients.” Part 1. Personal hygiene of the patient. Caring for elderly and senile patients. Simulation module “Basics of caring for seriously ill patients.” Part 2. Personal hygiene of the patient. Features of observation and care of bedridden patients. Skin care in the presence of bedsores and their prevention. The simplest physiotherapy. Part 1. The simplest physiotherapy. Part 2. Monitoring of patients with circulatory diseases. Monitoring of patients with respiratory diseases. c) Terminal control Control points: - testing. 2. Independent extracurricular work a) Mandatory *Forms of work 1. Preparation of an oral response for current control. 2. Independent work to develop practical skills. 3. Preparation for intermediate control. 4. Doing homework in workbooks for independent work. 5. Keeping a “Diary of educational practice”. *Types of control 1. Testing theoretical and practical knowledge during a practical lesson or test. 2. Testing on given topics. 3. Checking workbooks and the “Diary of educational practice”. b) Optional 1. Participation in the creation of visual teaching aids. 2. Creating presentations. 3. Creation of educational films. 4. Conducting health education work (conversations) among patients (development of a health bulletin, posters). 5. Writing an abstract. hours Module 3 Organization of the work of surgical medical institutions 1. Classroom work 1 2 3 4 1 2 3 4 5 6 7 8 9 a) Lectures Asepsis and antiseptics. Clinical hygiene of a surgical hospital. Methods of using drugs in surgical practice. Caring for gastroenterology patients in the surgical department. Observation and care of patients with impaired renal and urinary tract function. b) Practical classes Principles of organizing surgical care for the population. Clinical hygiene of a surgical hospital. Antiseptics and asepsis in a surgical clinic. Sterilization. Medical waste. Simulation module “Asepsis and antiseptics”. Methods of using medicinal substances. Simulation module “Parenteral administration of drugs”. Observation and care of patients with diseases of the digestive system. Simulation module “Probe manipulations”. Simulation module "Enemas". Observation and care of patients with impaired renal and urinary tract function. Simulation module “Catheterization of the bladder”. c) Terminal control Control points: - testing. 2. Independent extracurricular work a) Mandatory *Forms of work 1. Preparation of an oral response for current control. 2. Independent work to develop practical skills. 3. Preparation for intermediate control. 4. Doing homework in workbooks for independent work. 5. Keeping a “Diary of educational practice”. *Types of control 1. Testing theoretical and practical knowledge during a practical lesson or test. 2 1 2 3 2 5 2 7 4 1 4 4 2 3 4 4 4 4 4 5 6 7 4 9 20 1-9 2. Testing on given topics. 3. Checking workbooks and the “Diary of educational practice”. b) Optional 1. Participation in the creation of visual teaching aids. 2. Creating presentations. 3. Creation of educational films. 4. Conducting health education work (conversations) among patients (development of a health bulletin, posters). 5. Writing an abstract. Up to 20 hours 1-9 2 9 2 11 2 2 13 15 4 10 4 11 4 4 4 12 13 14 4 15 20 9-16 Up to 20 hours 9-16 Module 4 Care of the surgical patient 1. Classroom work 1 2 3 4 1 2 3 4 5 6 a) Lectures Clinical hygiene of the surgical patient in the preoperative period and surgical periods. Clinical hygiene of a surgical patient in the postoperative period. Hemostasis. Transport immobilization. Care of trauma patients. b) Practical exercises Observation and care of patients in the preoperative and surgical periods. Observation and care of patients in the postoperative period. Basics of desmurgy. Simulation module “Desmurgy”. Simulation module “Hemostasis”. c) Terminal control Control points: - testing. 2. Independent extracurricular work a) Mandatory *Forms of work 1. Preparation of an oral response for current control. 2. Independent work to develop practical skills. 3. Preparation for intermediate control. 4. Doing homework in workbooks for independent work. 5. Keeping a “Diary of educational practice”. *Types of control 1. Testing theoretical and practical knowledge during a practical lesson or test. 2. Testing on given topics. 3. Checking workbooks and the “Diary of educational practice”. b) Optional 6. Participation in the creation of visual teaching aids. 7. Creating presentations. 8. Creation of educational films. 9. Conducting health education work (conversations) among patients (development of a health bulletin, posters). 10. Writing an abstract. g) As a result of studying educational practice, the student must master: No. 1. Type of professional activity: general professional. 1.1. Professional task: general professional. PC-1 a) know:  moral and ethical standards, rules and principles of professional medical behavior;  rights of the patient and doctor; - duties, rights, place of a doctor in society. b) be able to: - build and maintain working relationships with other team members; - build and maintain relationships with patients and their relatives. a) possess: - skills of questioning and informing patients and their relatives in accordance with the requirements of the rules of “informed consent”. 2. Type of professional activity: preventive. task: carrying out preventive and 2.1. Professional anti-epidemiological measures aimed at preventing the occurrence of infectious diseases. PC-7 a) know: - signs of pediculosis;  types of sanitary treatment of patients in the emergency department;  types of sanitary treatment of patients in therapeutic and surgical hospitals; - types and methods of disinfection; - types and methods of sterilization; - rules of asepsis and antiseptics;  types and methods of pre-sterilization treatment of instruments;  features of preoperative preparation for emergency and planned operations;  features of observation and care of surgical patients in the pre-, peri- and postoperative periods; - basic rules of personal hygiene. b) be able to: - change the patient’s underwear and bed linen; - carry out prevention and treatment of bedsores;  carry out sanitary treatment of the patient upon admission to the hospital and during his stay in the hospital; - monitor and care for patients with respiratory, circulatory, and urinary diseases; - care for stomas and drainages. a) know: - methods of disinfection of medical instruments, materials and patient care products;  basic methods of caring for therapeutic patients;  basic methods of caring for elderly and seriously ill patients. 3. Type of professional activity: diagnostic. 3.1. Professional task: diagnosis of diseases and pathological conditions in adults and adolescents based on proficiency in propaedeutic research methods. PC-5 a) know: - possible complaints of patients with surgical pathology of the respiratory, cardiovascular, gastroenterological and urinary systems in the pre- and postoperative periods;  possible complaints from patients with diseases of the respiratory, cardiovascular and urinary systems;  modes of physical activity; - types of consciousness; - basic characteristics of the pulse; - standard blood pressure values. b) be able to: - assess the general condition and consciousness of the patient; - assess the patient’s position in bed; - assess the condition of the skin;  make anthropometric measurements; - assess the condition of the postoperative wound and dressing. a) have: - general inspection skills; - skills of palpation of the pulse on the radial and carotid arteries; - skills in determining blood pressure; - skills in determining the frequency of respiratory movements. 3.2. Professional task: diagnosis of emergency conditions in adults and adolescents. PC-5 a) know: - the main complaints of patients with diseases of various organs and systems of therapeutic patients;  main complaints of patients with diseases of various organs and systems of surgical patients. b) be able to: - identify clinical manifestations of emergency conditions in surgical patients; - identify clinical manifestations of emergency conditions in therapeutic patients. a) have: - skills in identifying the main complaints and clinical manifestations of emergency conditions in surgical patients;  skills in identifying the main complaints and clinical manifestations of emergency conditions in therapeutic patients. 4. Type of professional activity: rehabilitation. 4.1. Professional task: the use of physical therapy, physiotherapy, alternative methods of therapy (reflexology, herbal medicine, homeopathy) and the main resort factors in the adult population and adolescents in need of rehabilitation. PC-7 a) know: - the mechanism of action of the main physiotherapeutic factors.  basic principles of nutrition for a healthy and sick person; - medical tables. b) be able to: - apply methods of simple physiotherapy. a) master: - basic methods of simple physiotherapy in therapeutic and surgical practice;  feeding skills for seriously ill patients;  skills in feeding patients through a gastrostomy tube and nasogastric tube. 5. Type of professional activity: organizational and managerial. 5.1. Professional task: maintaining medical records and reports. PK-5, 27 a) know:  medical documentation of the emergency room and nursing station. b) be able to:  draw up a cover page for a medical record of an inpatient;  fill out an insert in the medical history; - issue a temperature sheet;  draw up an appointment sheet;  submit a portion request;  draw up a log of reception and delivery of duties. a) possess: - skills in medical documentation of the emergency room and nursing station. Professional task: organizing occupational safety and equipment measures 5.2. safety, prevention of occupational diseases, monitoring compliance and ensuring environmental safety. PC-27 a) know:  occupational diseases transmitted through blood;  safety rules when working with patient biological fluids; - types and methods of disposal of medical waste. b) be able to:  organize the disposal of medical waste; - carry out a set of preventive measures in case of contact with the patient’s blood. a) possess: - skills to prevent occupational diseases when working with blood. 7. Types of independent work in educational practice: Mandatory extracurricular intermodular independent work is not provided. Additional extracurricular independent work: Type of work Participation in the creation of visual educational aids Creation of presentations Creation of educational films Conducting health education work (conversations) among patients Writing an abstract 8. No. Labor intensity (hour) 4 Type of control Ready-made manual 2 8 Presentations Educational film 2 Development health bulletin; leaflet development; development of posters Defense of an abstract in a practical lesson. 4 Organization of certification based on the results of educational practice: Certification form Labor-intensive Weeks in the first semester (hours) Test c) Forms of control Stage 1 Analysis of the “Diary of educational practice”. Stage 2 Practical skills. List of practical skills 1. Subcutaneous injection. 2. Intramuscular injection. 3. Intravenous injection. 4. Technique for filling an intravenous infusion system. 5. Catheterization of the female bladder. 6. Catheterization of the male bladder. 7. Ear care. 8. Eye care. 9. Putting drops in the ears, drops in the eyes. 10. Applying a damp warming compress. 11. Performing a cleansing enema. 12. Applying bandages. Deso bandage. 13. Applying bandages. Spiral bandage on the forearm. 14. Applying bandages. Divergent tortoiseshell bandage by 0.5 2 (II semester) 16 week knee joint. 15. Applying bandages. Converging turtle bandage for the elbow joint. 16. Applying a “bonnet” bandage. 17. Applying a bandage to the finger. 18. Applying a pressure bandage. 19. Technique for inserting a gastric tube. Stage 3 Oral survey on tickets. List of questions for testing: 1. Ethics, medical ethics, medical deontology. Sections of medical deontology. 2. Requirements for the appearance of a medical worker. Health worker hygiene. 3. Definition of the concept of general nursing. Components of general nursing care. Iatrogenic diseases. 4. Responsibilities of a junior nurse in caring for patients. Responsibilities of a nurse in caring for patients. 5. Admissions department (rest room) of the hospital. Types of emergency rooms. Functions of the reception department. 6. Structural and functional units of the reception department. 7. Reception department. Reception and registration of patients. Types of hospitalizations. 8. Responsibilities of the emergency room nurse. 9. Medical documentation of the emergency room nurse. 10. Technique for anthropometry of patients in the emergency department (thermometry, height measurement, weighing, measurement of chest and abdominal circumference). 11. Sanitation of the patient in the emergency room. 12. Treatment of the patient when lice is detected. 13. Types and techniques of transporting patients. Transferring patients. 14. Organization of the work of the therapeutic department of the therapeutic profile. Organization of nursing station. 15. Types of physical activity modes for patients. 16. Responsibilities of the ward nurse. 17. Catering in a medical institution. Participation of junior and nursing staff in the organization of nutrition for patients. 18. Basic principles of nutrition for a healthy and sick person. 1.5 19. Methods of eating. Passive nutrition: indications and contraindications, algorithm of action. 20. Methods of eating. Parenteral nutrition: indications and contraindications, algorithm of action. 21. Technique for measuring blood pressure using the Korotkov method. Normal blood pressure values. 22. Pulse. Pulse palpation. Characteristics of pulse. 23. Documentation of the guard nurse. Transfer of duty to a guard nurse. 24. Sanitary and hygienic regime of the medical department. Nosocomial infection. Pathogens, routes of transmission 25. Disinfection. Types of disinfection. Disinfection methods. 26. The concept of occupational diseases. Methods for preventing occupational diseases when working with blood. 27. Features of caring for a cardiac patient. 28. Symptoms of an angina attack. First aid. 29. Fainting. Collapse. First aid. 30. Caring for patients with acute myocardial infarction. 31. Features of caring for seriously ill patients. 32. Bedsores. Etiology, pathogenesis. Prevention of bedsores. 33. Features of care for patients with respiratory pathologies. 34. Shortness of breath, types of shortness of breath. An attack of bronchial asthma. First aid. 35. Oxygen therapy. Types and techniques of oxygen therapy from an oxygen cushion. 36. Sputum analysis: technique for collecting sputum for general analysis, for tuberculosis, bacterial culture. 37. Compresses, types. Cold compress, indications and contraindications, algorithm of action. 38. Warming wet compress. Indications, contraindications, algorithm of action. 39. Hydrotherapy. Main influencing factors. Classification of water procedures depending on water temperature, mechanism of action. 40. Mustard plasters. Indications, contraindications, mechanism of action, algorithm of action. 41. Oxygen therapy (inhalation method). Algorithm of action when supplying an oxygen-air mixture from an oxygen cushion. 42. Ice pack. Indications, contraindications, mechanism of action. 43. Symptoms of kidney and urinary tract diseases. Features of care. 44. Types of urination disorders in diseases of the kidneys and urinary tract. Help with acute urinary retention. 45. Method of collecting urine for general analysis, Nechiporenko’s test, Zimnitsky’s test. 46. ​​Method of collecting urine for bacteriological examination, performing stress functional tests. 47. Features of care for patients with kidney and urinary tract diseases (regime, nutrition). 48. Thermometry. Measurement rules. Measurement locations. Factors influencing body temperature. 49. Stages of fever. Caring for the patient in the first period of fever. 50. Stages of fever. Caring for patients in the second period of fever. 51. Stages of fever. Caring for patients in the third period of fever. 52. Clinical environmental hygiene of the surgical department. 53. The concept of nosocomial infection in surgery: pathogens, entrance gates, routes of penetration. 54. HIV infection, general concept, transmission mechanism. Prevention of occupational diseases when working with blood. 55. Rules for prescribing, storing and distributing medicines. Routes of drug administration. 56. Post-injection complications. 57. Preoperative preparation of the patient for planned surgery, emergency surgery. 58. Operating unit, structure, clinical hygiene of personnel. Features of the sanitary and epidemiological regime. 59. Postoperative period: periods, complications. Patient care in the postoperative period. 60. Features of surgical wound care. Drains: types, care. Ostomies: types, care. 61. Equipment of the intensive care ward. Documentation of the nursing station in the intensive care unit. 62. Main symptoms of gastrointestinal pathology. Vomiting of central and peripheral origin. First aid for vomiting. 63. Gastric lavage. Indications and contraindications. Methods, techniques. 64. Gastric bleeding, clinical signs. Emergency care for stomach bleeding. 65. Types of instrumental research methods. Preparing the patient for x-ray and endoscopic examination of the stomach. 66. Types of instrumental research methods. Preparing the patient for x-ray and endoscopic examination of the large intestine. 67. Gastric intubation, indications, contraindications. Methodology. 68. Duodenal intubation, indications, contraindications. Technique of duodenal intubation. 69. Enemas. Types of enemas. Cleansing enema. Indications and contraindications. 70. Fundamentals of deontology of general nursing care in surgery. The influence of the psychological component of care on the consequences of treatment of a surgical patient. 71. The concept of asepsis and antiseptics, disinfection, their types, features. 72. Terminal states. Signs of clinical death. Signs of biological death. 73. Resuscitation measures: methods of artificial respiration, indirect cardiac massage. 74. First aid for mechanical injuries in patients. Principles of transport immobilization. Plaster cast, possible complications. 75. Basics of desmurgy. Classification of bandages and dressings. Possible errors when applying bandages. 76. First aid for thermal injuries in patients. 77. First aid for frostbite and hypothermia. 78. Bleeding: types. Methods to temporarily stop bleeding. 79. First aid for bleeding. Methods to temporarily stop bleeding. Rules for applying a hemostatic tourniquet, possible errors when applying a tourniquet. 80. First aid for bleeding. Methods to temporarily stop bleeding. Finger pressing of the artery to the bone, anatomical places of pressing of the arteries. 81. Observation and care of the patient after transfusion of blood and its components. Blood transfusion complications. Assessment of students' knowledge is carried out in accordance with the point-rating system developed at the department. 9. Educational, methodological and information support for educational practice: No. 1. Bibliography a) basic literature: 1. N.V. Turkina, A.B. Filenko. General nursing: Textbook. M.: Partnership of scientific publications KMK, 2007, 550 pp., color. ill. 2. V.N.Oslopov, O.V.Bogoyavlenskaya. General patient care in a therapeutic clinic: Textbook. - 2nd ed., rev. and additional M.: GEOTAR-Media, 2005.- 400 pp.: ill. b) additional literature: 1. V.N. Chernov, I.I. Taranov, A.I. Maslov. Caring for surgical patients: Textbook. - Rostov n/d: Phoenix, 2006. - 224 pp. (Medicine for you). 2. S.V. Petrov, A.N. Shishkin, O.V. Fionik, L.A. Blind. Introduction to clinical medicine (Basics of patient care): Textbook. - St. Petersburg: St. Petersburg Publishing House. University, 2000.- 148 p. 3. A.A. Shevchenko. Clinical care of surgical patients. “Lessons of kindness”: textbook. - M.: GEOTAR-Media, 2007. - 416 pp., illus. 2 3 Teaching aids Databases, information reference and search systems a) mandatory: 1. Yu.A. Yudaeva, L.A. Sergeeva, I.G. Yulmetova. Student's workbook for practical classes in thermometry. Textbook. - Orenburg, 2011. - 23c. b) additional: 1. Yu.A. Yudaeva, L.A. Sergeeva, I.G. Yulmetova. Theoretical foundations of patient care. Textbook for 1st year students of the Faculty of Medicine. Orenburg, 2011.- 25 p. 2. Yu.A. Yudaeva, L.A. Sergeeva, I.G. Yulmetova. Catering in medical institutions. Textbook for 1st year students of the Faculty of Medicine. Orenburg, 2011.- 34 p. Internet resources corresponding to the subject of the discipline: - Student consultant (electronic library of a medical university), www.studmedlib.ru. Head of the library N.I. Vereshchagina 10. Logistical support for educational practice: No. Material and technical support 1 module Specially equipped office): office-ward. Technical equipment, dummies: 2 module 3 module 4 module - metal height meter RM-1; - Metal general medical bed; - Syringe Janet; - Gastric tube. Specially equipped rooms): office-ward and manipulation room. Technical equipment, dummies: - Tonometers IAD-01 “Adjutor”; - Electronic thermometers DT-632; - Metal general medical bed; - Electrocardiograph EK1T-1/3-07 “AXION”; - Mannequin for practicing nursing care skills; - Polymer bedstead "NT MIZ"; - Rubber bedpan No. 2 SRP-“Alpha”; - Rubber heating pad No. 2 GR-“Alpha”; - Ice pack; - Oxygen face mask; - Oxygen pillow; - Bandages; - Vata; - Mustard plasters; - Banks. Specially equipped rooms (module 3): treatment room. Technical equipment, dummies: - Instrument table 2-shelf - Trays LPMch-"Oka-Medic" - Model of the arm for injections - Model of the buttocks for intramuscular injections - Training pad for intramuscular injections - Box KF-3 - Simulator for urethral catheterization in men; - Urethral catheterization simulator for women; - Stand for intravenous infusions ШDV-03-MSG - Medical couch - Syringes - Systems for intravenous infusions - APEXMED spatula - Tweezers - Clamps - Training model of gastric lavage - Multifunctional nursing manikin. Specially equipped rooms): office-ward and manipulation room. Technical equipment, dummies: - Tonometers IAD-01 “Adjutor”; - Electronic thermometers DT-632; - Metal general medical bed; - Mannequin for practicing nursing care skills; - Oxygen face mask; - Oxygen pillow; - Bandages; - Vata; - Ice pack; - Tool table 2-shelf; - Trays LPMch-"Oka-Medic"; - Medical couch; - Medical surgical gowns; - APEXMED spatula; - Tweezers; - Clamps; - Hemostatic tourniquet; - Kramer tire; - Tonometers IAD-01 “Adjutor”; - Oxygen face mask. - Bandages. 9. Methodological recommendations for organizing the study of educational practice: 1. Order of the Ministry of Education and Science of the Russian Federation dated November 8, 2010 N 1118 “On approval and implementation of the Federal State educational standard of higher professional education in the field of training (specialty 060101 general medicine (qualification (degree) “specialist”)". 2. Appendix to the Order of the Ministry of Education and Science of the Russian Federation dated November 8, 2010 N 1118 "On approval and implementation of the Federal State Educational Standard of Higher Professional Education in the field of training (specialty) 060101 General Medicine (qualification (degree) “specialist”)". 3. Basic curriculum of GBOU HPE OrGMA in specialty 060101 general medicine. GBOU HPE OrGMA Ministry of Health and Social Development of Russia Department of Propaedeutics of Internal Diseases (place of work) Experts: GBOU HPE OrGMA Ministry of Health and Social Development of Russia Department of Faculty Therapy and Endocrinology (place of work) External State Budgetary Educational Institution of Higher Professional Education "Samara State Medical University of the Ministry of Health and Social Development of the Russian Federation", Department of Propaedeutic Therapy (place of work) Associate Professor (position) Yu.A. Yudaeva (initials, surname) Host department Head of department, professor (position held) Head of department, professor (position held) R. I. Sayfutdinov (initials, surname) Yu.V. Shchukin (initials, surname)

1

Designed for teaching the discipline “General Care” to 2nd year students of medical and pharmaceutical universities.

The textbook is written in accordance with the program approved by the Russian Ministry of Health.

The textbook is built in a classical form and includes three large sections:

1. The general part, which provides a definition of patient care, its purpose and objectives, examines the types of medical and preventive institutions in the Russian Federation, their structure and organization.

The concepts of medical ethics and deontology, the rules of the sanitary and epidemiological regime of various health care facilities are revealed.

The goals and objectives are examined in detail, as well as the organization and technique of carrying out general activities for patient care, such as: general examination of the patient, transportation, creating comfort while maintaining bed rest, feeding the patient and maintaining hygiene measures. In addition, the general part discusses the classification and methods of disposal of medical waste, taking into account the requirements of regulatory documents. Modern, most economical and harmless methods of disposal of medical waste are demonstrated.

In the general part, an analysis of modern skin antiseptics, means for disinfection and sterilization of medical products was carried out.

2. The next section “Basic manipulations” is devoted to the organization and methods of performing basic nursing manipulations. The most common manipulations in the practice of a nurse are considered, the mastery of which corresponds to the list of necessary skills in accordance with the state educational standard (injections, intubation and gastric lavage, administration of enemas, etc.). Methods of performing manipulations are presented in the form of algorithms, equipped with color photographs and illustrations.

In the same section, a separate chapter is devoted to the causes and prevention of the development of bedsores in bedridden patients, as well as the care of patients with already developed bedsores.

3. The final section “Special part” is devoted to consideration of the features of care for patients with diseases of organs of a particular system. The features of caring for patients with diseases of the cardiovascular system, respiratory organs, digestive tract, kidneys and urinary tract, nervous system, and for patients in the postoperative period are considered.

Separate chapters in this section are devoted to desmurgy, types of bleeding and methods of hemostasis, transport immobilization, emergency care for victims with thermal injury syndrome (burns, frostbite and electrical injuries), prolonged tissue crush syndrome, drowning, victims of snake or wild animal bites.

The textbook is written on 550 pages, equipped with 291 author's illustrations. Each chapter ends with test tasks for self-control.

The textbook was published in 2007. The textbook “General Nursing” is part of the Educational and Methodological Complex, which also includes the teaching aid “Workbook “General Nursing” and a multimedia teaching aid, “General Medical Practice (Family Medicine) Practical Skills” , published on CD.

Bibliographic link

Turkina N.V., Filenko A.B., Koroleva I.P., Koshcheeva N.A., Dzhurinskaya L.F., Petrova A.I., Zhuravskaya N.V., Ignatova G.Ya., Singaevsky S. .B., Prishvin A.P., Staroselsky E.M., Apresyan A.Yu., Shchurik B.B. GENERAL PATIENT CARE (textbook) // Advances in modern natural science. – 2010. – No. 2. – P. 50-50;
URL: http://natural-sciences.ru/ru/article/view?id=7683 (access date: 12/13/2019). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"