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Report
about the work done for 2008 -2010
Orthopedic nurse
dental clinic
Federal Government Institution Healthcare "Siberian Clinical Center"
Federal Medical and Biological Agency
For certification to the highest qualification category
majoring in "Nursing"
Krasnoyarsk, 2011
1. Autobiographical certificate
2. Characteristics of the institution
4. Occupational health and safety
5. Sanitary education work
Conclusions and offers
Bibliography
dentistry orthopedics health population
1. Autobiographical certificate
I, Zezyulya Natalya Alekseevna, was born in 1976.
After graduating from secondary school, she entered in 1992 and graduated from the Krasnoyarsk City School in 1995 medical School No. 2 in the specialty "nurse".
From 08/01/1995 to 11/05/1997 worked at the Berezovskaya Central District Hospital as nurse in dentistry.
From November 10, 1997 to June 26, 1998 worked as a nurse in a medical center where?.
From 07/01/1998 to 08/09/1999 worked as a nurse in a medical center where?.
From 03/13/2000 to the present I have been working at the Federal State Health Institution SCC FMBA of Russia as a nurse in the orthopedic department of the dental clinic.
In 1995 I was awarded the second qualification category, and in 2003 the first qualification category in the specialty of laboratory diagnostics.
She improved her qualifications at the State Obninsk Criminal Procedure Code No. 1 under the Ministry of Health of the Russian Federation on the cycle “ Modern methods clinical trials in laboratory diagnostics":
in 1996 - certificate No. 1247, certificate No. 11289;
in 2000 - certificate No. 1465, certificate No. 190;
in 2005 - certificate No. 1530 to certificate No. 190.
General medical experience - 33 years.
2. Characteristics of the institution
One of the priority goals and objectives of modern healthcare reform is to improve the quality medical care provided to the population. The dental health of the region's residents is significant factor health status of the population as a whole.
The relevance of this strategic task is due to the high dental morbidity of the population. 97% of residents suffer from diseases of the hard tissues of teeth, of which the vast majority have more serious pathology associated with disease in periodontal tissues. Confirmation of the unfavorable situation is the indicator of the intensity of caries in children 12 years of age, assessed as a result of a special epidemiological research. It is on average 3 times higher than their peers in the USA and China.
Federal State Institution "Siberian clinical center Federal Medical and Biological Agency" was created on January 1, 2009 on the basis of an order of the FMBA of Russia by merging three subordinate specialized medical institutions located on the territory of Krasnoyarsk. The Siberian Clinical Center included:
Federal State Medical Institution No. 96 FMBA of Russia;
Branch of Clinical Hospital No. 51 - Medical Unit No. 46;
Branch of the Federal State Institution "SOMC Roszdrav" - Yenisei clinical Hospital.
August 12, 2009 by order of the Government Russian Federation a decision was made to merge the Federal State Institution “Clinical Hospital No. 42 of the Federal Medical and Biological Agency” and the Federal State Institution “Blood Transfusion Station of the Federal Medical and Biological Agency in Krasnoyarsk”.
The Siberian Clinical Center is a multidisciplinary specialized healthcare institution serving more than 100 thousand people, which includes:
Therapy center with three therapeutic departments;
Neurorehabilitation Center - as part of the department's center;
Center for Traumatology and Orthopedics;
Center for Endovideosurgical Technologies - surgical department;
Sports Medicine Center;
Diagnostic center and radiology department;
Clinical diagnostic laboratory, physiotherapy department;
Central sterilization department.
Within the framework of the concluded Agreement on the procedure for carrying out functions for the provision of public services in the field of healthcare to residents of the Krasnoyarsk Territory between the FMBA of Russia and the Government of the Krasnoyarsk Territory, the Siberian Clinical Center serves the assigned population under the compulsory health insurance system.
Within the framework of the Agreement on cooperation and interaction between the Siberian Regional Center of the Ministry of Emergency Situations of Russia and the Federal Medical and Biological Agency, the Siberian Clinical Center of the FMBA of Russia is the coordination center for the provision of health care to employees of the institutions of the Ministry of Emergency Situations of Russia in the Siberian federal district and members of their families.
The dental clinic, which is part of the Federal State Health Institution SCC FMBA of Russia, provides free qualified outpatient medical care.
As part of the program of state guarantees to provide citizens of the Russian Federation with free medical care, using new modern equipment from leading European manufacturers, effective materials that meet the requirements of patients, the following is provided:
Providing dental care for toothache, exacerbation of chronic diseases;
Diagnostics, painless treatment and tooth extraction, outpatient surgeries;
Consultations with a periodontist for the purpose of diagnosing periodontal tissue diseases and further treatment planning in a specialized periodontal office;
X-ray diagnostics.
The dental clinic of the SCC is represented by two services:
Department orthopedic dentistry, consisting of offices for receiving orthopedic doctors and dental laboratories;
Branch curative dentistry, which consists of rooms: therapeutic, surgical, periodontal, radiological, sterilization and registration.
Staffing schedule of the dental department
|
Job title |
By state of rates |
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Head of the clinic |
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Dentist-therapist |
|||
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Dental surgeon |
|||
|
Orthopedic dentist |
|||
|
Senior nurse |
|||
|
Nurse |
|||
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Dental Technician |
|||
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Sister-hostess |
|||
|
Nurse |
|||
|
Medical registrar |
I have been working as a nurse in the orthopedic department of the dental clinic of the Federal State Health Institution SCC FMBA of Russia since 2000.
The orthopedic department includes:
3 orthopedic doctor's offices;
4 dental laboratories (including a laboratory for the manufacture of metal-ceramic dentures);
Foundry.
All dental equipment in the clinic meets the requirements modern dentistry. Dental rooms in the department are equipped with:
1. Dental units: “Diplomat-Economy”, “Diplomat-Adent”, “Sirona”.
2. Glasperlene sterilizer "Sirio" - to ensure fast and reliable sterilization of small dental instruments. working temperature 230 C ensures the elimination of microorganisms in a matter of seconds, the duration of sterilization is from 5 to 15 seconds.
3. “Ultralight” chamber - for storing sterile medical instruments.
4. A cabinet with a bactericidal lamp for storing finished dentures.
5. Device for polymerization of photocomposites “Megalux Soft Start” - for curing fillings made of photopolymerizing materials.
Dental laboratories are equipped with the latest electronic equipment from leading Western companies:
1. Dental micromotor.
2. Furnace for metal ceramics
3. Muffle furnace
4. Trimmer.
Dental care is provided to residents of Krasnoyarsk and residents of the region.
Provides preferential dentures to pensioners, war and labor veterans, and disabled people.
For the manufacture of dentures, materials of 3-4 generations are used. The following types of services are provided to the population:
Manufacturing of metal-ceramic crowns;
Simple prosthetics with titanium nitride coating;
Manufacturing of removable dentures;
Manufacturing of clasp dentures;
Manufacturing of plastic crowns;
Making tabs.
The department has modern equipment for carrying out therapeutic measures:
1. Desensitron II - iontophoresis device - a device for the treatment of dentin hypersensitivity caused by erosion, exposed root surfaces, enamel wear or hypoplasia.
2. Diathermocoagulator “Sensimatic 500 SE” - an electric pulse device for surgical manipulations. Indicated for use in dental surgery for periodontitis, orthodontics, prosthetics, for cutting crowns and bridges.
3. Digital tester for checking the vital activity of the pulp - Electronic Digitest.
4. The Formatron device is a digital electronic measuring device that is fixed in the oral cavity and accurately determines the location of the apex of the tooth root.
5. Device for depophoresis “Original” - for the treatment of complicated caries with poor passable channels, apical periodontitis, cyst.
6. Ultrasonic scaler “Piezon - Master 600” - for removing dental plaque and treating root canals.
Quantitative performance indicators of the orthopedic department for 2010
|
Types of manufactured prostheses |
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Number of people who received prostheses |
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Complete removable dentures manufactured |
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Manufactured partial removable dentures |
|||
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Manufactured stamped bridges: a) metal crowns b) cast teeth c) facets d) crowns with veneer |
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Metal-ceramic prostheses manufactured: a) bridges b) crowns c) artificial teeth |
|||
|
Made of plastic crowns |
|||
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Manufactured single crowns with veneer |
|||
|
Manufactured single metal crowns |
|||
|
Manufactured clasp dentures |
In my functional responsibilities includes:
1. Preparing for work the workplace of an orthopedic dentist: instruments, medications, dental material.
2. Assisting an orthopedic surgeon during orthopedic interventions and manipulations.
3. Maintain order in the offices, ensure compliance with the rules of asepsis and antiseptics, and process instruments within the limits of their qualifications.
4. Ensuring timely receipt of medications and filling materials from the head nurse.
5. Maintaining documentation on the nomenclature of the dental department.
6. Compliance with internal labor regulations, labor protection, and safety regulations.
7. Improvement of professional qualifications by attending classes organized in the department for secondary medical personnel.
My working day begins with preparing the office to receive patients.
I monitor the wet cleaning, after finishing I turn on the bactericidal irradiator and ventilate the office.
I connect dental equipment to the network: unit, chair, compressor. I dilute disinfectant solutions.
I load the Ultralight chamber with sterile medical instruments, observing the rules of asepsis and antiseptics.
I prepare the material for sterilization (cotton rolls, napkins, balls), pack it in craft bags and send it to the central sterilization room for sterilization.
I'm preparing workplace dentist appointment: checking availability dental material, necessary solutions, personal protective equipment (hats, masks, gloves).
During the appointment, I give the doctor an individual dental kit, consisting of a set of instruments (tray, dental mirror, tweezers, dental probe), a craft bag with cotton swabs, a craft bag with tweezers (for working with sterile instruments).
After seeing the patient, I disinfect the surfaces of objects located in the treatment area.
I carry out disinfection, pre-sterilization treatment and sterilization of instruments.
1. I immerse the used medical instruments in a closed container with a disinfectant solution for disinfection and pre-sterilization treatment.
Exposure according to the instructions of the disinfectant used. In my work I use disinfectants: Biolok, Heksanios, Ultradez-Bio.
2. After exposure, I clean each piece of equipment in the same container using the brushing method for at least 1 minute. per unit.
3. After disinfection and pre-sterilization treatment, I rinse the instruments under running water until the smell of the disinfectant completely disappears for at least 10 minutes.
4. Rinse with distilled water.
5. Drying in a dry-heat oven at 85 C until the moisture completely disappears.
6. I control the quality of pre-sterilization cleaning by performing an azopyram test for the presence of blood residues and the completeness of washing of products from alkaline components detergents. 1% of each type of product is subject to control, but not less than 3-5 products of each type. The control results are recorded in the quality log of pre-sterilization treatment f. No. 366 /у.
Azopyram test - before performing the test, mix equal amounts of azopyram, 3% hydrogen peroxide solution and then work with this reagent for 1-2 hours.
Technique for performing an azopyram test: moisten a cotton swab with the reagent and wipe the instrument with it, or apply 2-3 drops of the reagent with a pipette onto the product, placing a gauze pad under it.
Evaluation of sample results: the result is taken into account before 1 minute has elapsed. If a brown color appears within 1 minute, this means the presence of rust or chlorine-containing residues. disinfectants. If a purple, blue or pink-lilac color appears within 1 minute, this means that there are alkali residues from the cleaning solution or traces of blood on the instruments. If staining occurs within more than 1 minute, then this result is not taken into account.
The original azopyram solution is stored in the refrigerator for up to 2 months, at room temperature for no more than 1 month.
Control of instruments breakdown of azopyram and phenolphthalein
7. Sterilization in a dry-heat oven at t-180C, exposure time - 60 minutes. All instruments and products that come into contact with the wound surface, blood, and individual species medical instruments that, during operation, come into contact with the mucous membrane and can cause damage to it.
I place sterile instruments under aseptic conditions in a UV-bactericidal chamber, which is designed for storing sterilized instruments in order to prevent their secondary contamination by microorganisms.
As prescribed by a doctor, I can perform the following manipulations:
I prepare impression materials;
Filling materials: for temporary fillings, cements, for filling canals, amalgams, composites.
I have practical skills in coating teeth with fluoride varnish. Brush your teeth, dry them, and apply rollers. First apply as a thin film to teeth lower jaw, then on the teeth upper jaw. Dry for 3 minutes. For a course there are 3-4 procedures every other day. Brushing teeth after 12 hours. After the procedure, do not eat for 2 hours.
During various dental interventions, complications and threatening conditions sometimes arise that require urgent measures. The group of complications that arise at any stage of dental intervention, at any time, regardless of the nature of the disease, includes:
1. Spicy vascular insufficiency: fainting, collapse, shock.
2. Allergic conditions: anaphylactic shock.
3. Heart rhythm disturbance - paroxysmal tachycardia, extrasystole.
4. Dizziness.
5. Neurotic conditions.
Algorithm for carrying out emergency measures.
1. Place the patient in a horizontal position.
2. Free from tight clothing, ensure flow fresh air(open the window, turn on the fan).
3. Moisten a swab with a 10% solution of ammonia, let it inhale several times in a row, and wipe the temples.
4. If the reaction is weak, administer 1 ml of a 10% caffeine solution subcutaneously.
Anaphylactic shock.
In my practice there were no cases of anaphylactic shock, but independently emergency assistance I can provide it.
1. Immediately stop administering medications and other allergens, applying a tourniquet proximal to the site of allergen injection.
2. Call a doctor.
3. Lay the patient down and fix the tongue to prevent asphyxia.
4. Introduce 0.5 ml of 0.1% adrenaline solution subcutaneously at the site of allergen injection and 1.0 ml of adrenaline solution intravenously.
Medical assistance:
1. If blood pressure does not increase, repeat intravenous adrenaline after 10-15 minutes
2. Administer steroid hormones intravenously: prednisolone 75-150 mg, dexamethosone 4-20 mg, hydrocortisone 150-300 mg. If it is impossible to administer intravenously, administer intramuscularly.
3. Antihistamines: pipolfen 2-4ml 2.5% solution s.c.
In case of asphyxia and suffocation, administer 10-20 ml of 2.4% aminophylline solution intravenously.
4. If signs of heart failure appear, administer corglicon 1.0 ml of 0.06% solution in isotonic sodium chloride solution, Lasix 40-60 mg IV bolus.
5. Hospitalization in a hospital.
Prevention of occupational infection.
To prevent infection of medical personnel, disposable gloves, masks, and protective goggles are used. If necessary, protective helmets and aprons are used. Disposable bibs, cups, and syringes are provided for the patient.
Each doctor's office is equipped with a first aid kit for the prevention of HIV infections.
Algorithm of actions in the event of an emergency:
1. In case of a cut or puncture with an instrument in contact with biological fluids:
Remove gloves;
If there's blood coming out don't stop;
If there is no blood, then squeeze out a few drops of blood, treat the wound with 70% alcohol, wash your hands under running water with soap twice, then treat the wound with a 5% alcohol solution of iodine.
2. In case of contact with biological fluids:
For unprotected skin - treat the skin with 70% alcohol, wash your hands twice with soap and running water, re-treat with 70% alcohol.
In the eyes - rinse with a stream of water and drop in a 20% solution of albucid or rinse with a 0.05% solution of potassium permanganate;
In the nose - rinse with a stream of water and treat with a 0.05% solution of potassium permanganate;
In the mouth - rinse with water and then with a 0.05% solution of potassium permanganate or 70% ethyl alcohol.
I maintain documentation on the nomenclature of the dental department:
1. Logbook for recording the quality of pre-sterilization treatment (F No. 366/u).
2. Logbook for monitoring the operation of air and steam autoclave sterilizers (F No. 257/u).
3. Logbook for registration and control of the bactericidal installation (R.3.5.1904-04).
4. Logbook for registration of general cleaning (SanPin 2.1.3.1375-03).
5. Journal of recording of potent drugs.
6. Emergency register.
In my work I am guided by orders, instructions and methodological instructions on organizing the work of the department:
Order of the Ministry of Health of the Russian Federation No. 408 dated July 12, 1989. “On measures to reduce morbidity viral hepatitis in the country";
Order of the Ministry of Health of the Russian Federation No. 720 dated August 31, 1978. “On improving medical care for patients with purulent-surgical diseases and strengthening measures to combat nosocomial infections”;
Order of the Ministry of Health of the Russian Federation No. 342 dated November 26, 1998. “On strengthening and improving measures for the prevention of typhus and pediculosis”;
Order of the Ministry of Health of the Russian Federation No. 170 dated August 16, 1994. “On measures to improve the prevention and treatment of HIV-infected patients in the Russian Federation”;
Order of the State Healthcare Institution No. 42 of 1990 “On the state of the incidence of scabies in the Krasnoyarsk Territory and measures to reduce it”;
Order of the Ministry of Health No. 326 of November 10, 1997 “On the rules for writing prescriptions for medicines and dispensing them in health care facilities”;
Order of the Ministry of Health No. 245 dated August 30, 1991 “On consumption standards ethyl alcohol in healthcare institutions";
OST 42-21-2-85 dated 02.21.85. “Sterilization and disinfection of products medical purposes. Methods, means, modes";
Order of the Ministry of Health of the Russian Federation No. 32/69 of April 13, 1994 “On conducting anti-epidemic surveillance of cholera on the territory of the Russian Federation”;
Order of the Ministry of Health of the Russian Federation No. 36 dated 02/03/97 “On improving measures for the prevention of diphtheria”;
Order No. 37/676 of August 7, 1994 “On the organization of epidemic surveillance of cholera in the Krasnoyarsk Territory”;
Order of the Ministry of Finance of the Russian Federation No. 288 of March 23, 1976 “On approval of the instructions for the sanitary and epidemiological regime of hospitals and on the procedure for the implementation by bodies and institutions of the sanitary and epidemiological service of state sanitary supervision over the sanitary condition of health care facilities”;
Order of the Ministry of Justice of the Russian Federation No. 297 of July 9, 2001 “Prevention of occupational infections when providing medical care to HIV and AIDS-infected people”;
San. Pin 2.1.7.728-99 “Rules for the collection, storage and disposal of waste in health care facilities”;
Order of the Ministry of Health of the Russian Federation No. 314 of 08/09/2001 “On approval of the regulations on the procedure for obtaining qualification categories by specialists working in the healthcare system of the Russian Federation”;
Guidelines No. 28-6-13 dated May 26, 1988 on quality control of pre-sterilization cleaning of medical products using the Azopyram reagent;
Order No. 109 of March 21, 2003 “On improving anti-tuberculosis measures in the Russian Federation”;
Order of the Ministry of Health of the Russian Federation No. 747 dated December 27, 1984 “On approval of instructions for recording medicines, dressings and medical products in health care facilities";
San.Pin. 2.1.3.2630-10 dated May 18, 2010 “Sanitary and epidemiological requirements for organizations engaged in medical activities.”
4. Occupational health and safety
Labor protection is a system for ensuring the safety and health of workers in the process of work, including legal, socio-economic, organizational and technical, sanitary and hygienic, treatment and preventive, rehabilitation and other measures.
Labor and health in the Russian Federation are protected by the Constitution, Article 7.37; labor code Russian Federation.
As for the staff of the dental clinic, only persons with completed training are allowed to work. medical education who have a specialist certificate and have passed the mandatory medical checkup, vaccination against hepatitis B, induction training at the workplace, certified for group 1 in electrical safety. The briefing is carried out according to plan.
In our work, we strictly observe the rules of personal safety: work in special clothing, on working equipment, and follow the labor protection and safety instructions that are available at each workplace.
Organization of work in case of emergencies and man-made disasters.
Our city is a large administrative and economic center, located on the banks of a powerful water artery, with chemical, explosion and fire hazardous enterprises and an extensive railway junction.
Emergency situations that are possible in our city:
1. Emergencies of natural origin: earthquakes, storms, hurricanes, snow drifts, frosts, ice, high levels water, floods.
2. Emergencies associated with human activity: fires and explosions, accidents on highways, at chemically hazardous enterprises, emissions into the atmosphere harmful substances(chlorine, ammonia are the greatest danger!), loss of radioactive sources, accidents on power systems, utility life support systems, wastewater treatment plants, extreme pollution of the air and drinking water, catastrophic flooding as a result of the accident and destruction of the Krasnoyarsk and Sayano-Shushenskaya Hydroelectric power station.
To gain the attention of the population in extreme conditions before the transmission of information, sirens and intermittent beeps of enterprises are turned on and Vehicle, this means the civil defense signal "ATTENTION ALL".
Having heard this signal, you must immediately turn on the radio and television and listen to the message from the headquarters of the Civil Defense and the Ministry of Emergency Situations, and act in accordance with the instructions.
In case of an accident at an enterprise, the following rules must be observed:
maintain composure in any situation;
at your workplace, do everything possible to reduce the disastrous consequences of the accident: evacuate patients from the office, turn off all equipment, turn off electricity, shut off steam and water communications, while observing safety precautions.
I am not part of the non-paramilitary forces, so I must act in accordance with the instructions of the leadership and the civil defense and emergency services authorities.
5. Chealth education work
In our clinic, a lot of attention is paid to sanitary education work.
The basic principle of sanitary educational work: hygienic education of the population, propaganda healthy image life, prevention of dental diseases.
Sanitary education work plays great importance in the prevention of dental diseases, instilling oral care skills and preventing the development of a number of diseases, in particular carious lesions.
Sanitary bulletins are issued on the following topics:
on the prevention of dental diseases, AIDS, hepatitis;
about oral hygiene;
care of removable dentures;
about products (toothpastes) and methods of oral hygiene.
The main method of preventing dental diseases is oral hygiene, therefore our patients are offered booklets on methods and means of oral hygiene, on the prevention of dental diseases, etc.
Conclusions and offers
The work of a nurse, along with the work of a doctor, plays important role V healing process. Strictly observing the main tasks of a dental nurse, I ensure timely and high-quality completion of the treatment process.
In my work I am guided by legislative and regulatory documents of the Russian Federation on issues of public health, as well as orders and instructions of higher authorities and officials.
I rationally organize work at my workplace.
I ensure infectious safety: compliance with the rules of sanitary-hygienic and anti-epidemiological regime, proper storage, processing, sterilization and use of medical products.
I perform preventive and therapeutic procedures in a timely and high-quality manner. I assist when a doctor performs diagnostic and treatment procedures.
Ensure proper storage and accounting medicines.
I maintain approved medical records and reporting documents.
I carry out sanitary and educational work to promote health and prevent diseases, and promote a healthy lifestyle.
Whenever emergency situations I can provide first aid.
I continuously improve my specialized knowledge and skills. I'm studying methodological instructions, orders, instructions from the head of the department and the head nurse.
I educate myself, read specialized literature on dentistry, attend conferences and classes held in the department.
Prospective tasks:
In my future activities I plan:
Systematically improve your professional level and practical skills;
Attend educational conferences, lectures;
Continue to master and apply innovative technologies to provide quality medical care within the scope of their competence;
Be attentive, honest, kind, follow the rules of ethics and deontology;
Participate in carrying out sanitary educational work among patients;
Mastering related professions;
Handle medical equipment with care
Every five years, improve your qualifications at advanced courses in your profile and then receive a certificate.
Bibliography
1. Buyanov V.M. First medical aid / V.M. Buyanov. - M.: Medicine, 2000. - 189 p.
2. Muravyannikova Zh.G. Prevention of dental diseases / Zh.GMuravyannikova. - Rostov-on-Don: Phoenix 2007. - 448 p.
3. Mukhin M.V. Guidelines for nurses in dental clinics / M.V.Mukhin, D.E.Panfilyev. - M.: Medicine 1974. - 240 p.
4. Obukhovets T.P. Nurse's Directory / T.P. Obukhovets, O.V. Chernova, N.V. Borykina, etc. - Rostov-on-Don: Phoenix, 2009. - 672 p.
5. Occupational safety and health provision for workers in medical institutions: tutorial/ E.S. Tregubova, N.A. Petrova, A.S. Nekhoroshev. - M.: GOU VUNMC Ministry of Health of the Russian Federation, 2001. - 144 p.
6. Practical guide to the use of disinfectants and sterilization in medical institutions / Ed. A.V.Avchinnikova. - Smolensk: SGMA, 2002. - 200 p.
7. Magazine " Clinical dentistry" Ed. 2008-2010
8. Magazine "Nurse". Ed. 2008-2010
9. Magazine "Nursing". Ed. 2008-2010
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The next meeting of the dental expert groupplanned for
T testing from 09.00. Start of work of the commission: at 10.00
Location: conference hall AUZ RSP
ATTENTION DENTISTS!
In pursuance of the order of the Ministry of Health of the Republic of Belarus dated February 18, 2013 No. 391-D “On the organization of testing within the framework of expert group meetings when medical and pharmaceutical workers receive qualification categories,” from March 5, 2013, testing in transfusiology and AIDS is carried out on the day of certification along with testing in sections dentistry.
There is no need to put a mark on the qualification sheet about passing the AIDS and transfusiology tests.
ATTENTION CERTIFIED!
Meetings of the dental expert group are held regularly every fourth Thursday of the month, except January ( annual reports), July, August (vacations).
Certification materials are accepted four months before the deadline qualification category.
G chief doctors and managers dental clinics Before submitting certification materials to the secretary of the dental expert group, they must coordinate the work with the chief freelance dentist of the Ministry of Health of the Republic of Belarus
The location of the certification materials in the folder is in the following order:
1. DOWNLOAD Attestation sheet , fill out on the computer, print on one sheet on both sides
2. DOWNLOAD Protocol , print on one sheet on both sides PRINTING IS MANDATORY!
3. Review. List of reviewers
4. DOWNLOAD Application
5. Extract from the decision of the Medical Council of the medical organization
6. Characteristics from the place of work in the certification sheet and on a separate sheet (for private practitioners, an additional characteristic from StARB)
7. Copies of documents duly certified by the HR department:
Diploma
- internship certificates
- work book
- certificates of completion of advanced training in the certified specialty
- certificate in the certified specialty
-certificate of qualification category (if there is a category).
8. Report on professional activity specialist, agreed upon with the head of the organization and certified by its seal, including an analysis of professional activities over the last three years of work - for specialists with higher vocational education and for Last year work - for workers with secondary vocational education with their personal signature. Download a sample title page.
9. X-rays clinical cases(before and after treatment)
10. Form No. 39 for the last 3 years (dentists and dental technicians for 1 year)
All documents, except for the application and review, must have the seal and signature of the head of the healthcare facility.
11. List scientific works over the last 5 years for dentists applying for the highest qualification category (required).
The certification sheet must have 2 stamps:clause 6 (signature of the HR employee and seal of O.K.), clause 22 (after the characteristics, seal and signature of the head of the organization)
Certification work of a dentist
therapist of the highest category
Clinic …………… (name)
…………………(FULL NAME)
for 2004-2006
Moscow, 2007
I. Brief CV 3
II. Brief description of the work of the dental office 4
III. Analysis of work for 3 years (2004-2006) 14
IV. Introduction into practice of elements of scientific organization of labor, new forms of therapy, testing of new medical equipment 23
V. Work with medical personnel of department 34
VI. Sanitary education work 35
VII. List of published works (2004-2006) 36
I. Brief CV
I, …. (full name), born on …… (date) in ………. (place of birth), in the family……….. (origin).
…. (information about studies)
…. (job information)
…. (information about advanced training, courses and cycles)
…. (information about academic degrees)
…. (information about professional achievements)
…. (information about publications and printed works).
II. Brief description of the work of the dental office
There are certain standards and requirements for the organization of a dental office, determined, on the one hand, by the equipment used, and on the other, by the volume of work and the use of potentially hazardous materials, which, if used incorrectly, can have an adverse effect on the health of medical personnel: we are talking about amalgam , which contains mercury.
According to the current situation, a dental office per doctor must occupy an area of at least 14 m2. If several chairs are installed in the office, then its area is calculated based on the additional standard - 7 m2 for each chair. If the additional chair has a universal dental unit, its area increases to 10 m2.
The height of the cabinet should be at least 3 m, and the depth with one-sided natural lighting should not exceed 6 m.
In connection with the use of amalgam for filling teeth Special attention paid to the finishing of the floors, walls and ceiling of the office. The walls of the dental office should be smooth, without cracks. Corners and junctions of walls, floors and ceilings should be rounded, without cornices or decorations. Walls and ceilings are plastered or rubbed with the addition of 5% sulfur powder to the solution to bind sorbed mercury vapor into a durable compound (mercury sulfide) that is not subject to desorption, and then painted with silicate or oil paints. The floor of the office is first covered with thick cardboard, and rolled linoleum is laid on top, which should extend onto the walls to a height of 10 cm. The junction of the linoleum sheets, as well as the places where the pipes exit, must be puttied and covered with nitro paint. These measures are necessary to ensure effective sanitation and cleaning without the possibility of mercury accumulation.
Walls and floor in dental office it is necessary to paint in light colors with a reflectance coefficient of at least 40. It is advisable to use a neutral light gray color that does not interfere with the correct color discrimination of the mucous membranes, skin, blood, teeth and filling materials. Doors and windows in the office are painted with enamels or oil paint in White color. Door and window fittings should be smooth and easy to clean -
The dental office should have natural light. It is advisable to orient the windows of the office to the northern directions in order to avoid significant differences brightness in workplaces due to direct exposure sun rays with other types of orientation, as well as overheating of premises in the summer. In offices that have incorrect orientations, in the summer it is recommended to resort to shading of windows using curtains, blinds, awnings and other devices.
The light coefficient (the ratio of the glazed surface of windows to the floor area) should be 1:4 - 1:5. The office must have general artificial lighting provided by fluorescent or incandescent lamps. For general fluorescent lighting, it is recommended to use lamps with an emission spectrum that does not distort color rendering, for example, fluorescent lamps with corrected color rendering or fluorescent lamps of cool natural color. The illumination level of the office when using fluorescent lamps should be 500 lux.
General lighting lamps are placed so that they do not fall into the field of view of the working doctor.
Dental offices, in addition to general lighting, must also have local lighting in the form of a reflector on dental units. The illumination created by the local source should not exceed the level of general illumination by more than 10 times, so as not to cause light readaptation that is tiring for the doctor’s vision when moving his gaze from differently illuminated surfaces.
A prerequisite for working with amalgam is the presence in the office of a fume hood in which it is prepared. In such a cabinet, autonomous mechanical draft must ensure an air velocity of at least 0.7 m/s and air must be removed from all zones of the cabinet. A plumbing sink with a mercury trap should be installed in the cabinet. Inside the cabinet there is a cabinet for storing a daily supply of amalgam and utensils for preparing amalgam, as well as demercurization agents. The amalgam mixer, which eliminates manual operations when preparing silver amalgam, should be kept in a fume hood at all times.
The dental office must be provided with supply and exhaust ventilation with an air exchange rate of 3 times per hour for exhaust and 2 times per hour for inflow, and also have vents and transoms.
The doctor's office must have a quartz lamp (table or portable), which is used to quartz the air in the office. This procedure is usually performed during a break between shifts or after the end of the working day.
The dental office must have workplaces for a doctor, a nurse and an orderly. The doctor's workplace includes a dental unit, a chair, a table for medicines and materials, and a screw chair. The nurse's workplace should include a table for sorting instruments, a dry-air cabinet, a syringe sterilizer, a sterile table and a screw chair. For a nurse to work, there must be a table for sorting used instruments and a sink for washing instruments. In addition, the office should have a cabinet for storing materials and tools, a cabinet for poisonous and a cabinet for potent medicinal substances and a desk.
Currently, there is a tendency towards more complex dental equipment. A modern dental unit is a complex set of pneumatic, electrical, hydraulic and electronic components. The installation includes an automatic control chair, a reflector lamp, a compressor and a device for carrying out the necessary manipulations in the oral cavity: preparation of hard tissues, removal of dental plaque, removal of saliva and dust. The preparation of tooth tissue is carried out with instruments that rotate with at different speeds. The modular block of the dental unit has 2-3 hoses for the micromotor and turbine tips. The kit may contain an ultrasonic unit for removing dental plaque, and there should be a gun for supplying water and air. Micromotors allow you to rotate the bur from 2000 to 12,000-15,000 rpm, and turbine tips rotate the bur at a speed of 300,000-450,000 rpm. Some dental units are equipped with light curing lamps. Modern dental...
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Report on the work done by a dental nurse
Report
about the work done
for the period 1999-2000.
dental nurse
Due to the high prevalence of dental diseases, dental care in our country is one of the most widespread forms of medical care.
More than 80% of all patients with dental pathology occur in outpatient services. An even larger proportion of dental patients (98.5%, i.e. the vast majority) are indicated for treatment in a clinic setting.
This is explained by the high incidence of dental caries and its complications.
Every year, conservative methods of treating both therapeutic and surgical diseases occupy more and more space. The number of goiters removed is reduced and the number of cured ones increases. If in the recent past the ratio of extracted teeth to cured teeth was 1:1, now it is 1:10. This has been achieved thanks to the therapeutic and practical success of dental science.
New diagnostic and treatment methods are introduced into dental practice every year, which make it possible to diagnose, treat patients and carry out rehabilitation.
According to order No. 8 of March 26, 2001. The Federal State Institution “Central Clinical Hospital of the Ministry of Health of the Russian Federation” was reorganized in the form of a merger into the State Institution “State Medical Center of the Ministry of Health of the Russian Federation” and is a medical and preventive institution, being a structural subdivision of the center.
It includes a hospital and a clinic where patients receive emergency and routine medical care.
The dental service is represented by a network of clinics with dental offices; in addition, dental offices have salaries and ports.
The dental department provides assistance to the assigned contingent of departmental organizations that have entered into contracts for medical care with Clinical Hospital No. 1, and patients are admitted for cash payment. The dental department of clinic No. 1 is represented by two services:
Here, pre-registration is made by telephone and the information necessary for patients is given; assistance is provided to patients at home, as well as to those who are being treated in a hospital.
A nurse provides preparation for departure and assistance to the doctor.
The dental department has undergone a complete technical re-equipment and renovation of offices. The offices are equipped with Eurostar dental units (made in Italy), medical furniture for dental offices, and also have all the necessary equipment and tools for work.
To improve the quality of diagnostics, modern electronic equipment is used, for example, a tip with an apex locator “Marita” (Japan) and a device for determining pulp viability “Didi test” (USA). An X-ray room is equipped with a Trophy Elitys radiovisiograph (France) with computer wiring to all work rooms.
Each office has:
Glasperlin sterilization (Italy) for immediate sterilization of necessary instruments.
“Piezo-Master” devices (Switzerland) for removing dental plaque with different attachments, as well as for treating root canals.
Ultraviolet boxes “TAU-steril” (Italy) for storing sterile instruments.
Halogen lamps (USA, Germany) for placing fillings made of light-curing materials.
Germicidal lamps have been installed.
Monitors installed for viewing R-images
Medical dental furniture “Lotus” (Italy), which includes a workplace for a nurse and a doctor.
Air conditioners are built in.
Nurses are the closest assistants to the dentist and make a huge contribution to the prevention and treatment of dental diseases. At each nursing station, hermetically sealed plastic containers are installed for pre-sterilized cleaning and disinfection of instruments and separate containers for burs.
Pre-sterilization cleaning and disinfection are carried out simultaneously using a 5% Alaminole solution; exposure time is 1 hour.
Alaminol is a blue, odorless liquid. It is effective against bacteria, fungi of the genus Candida dermatitis, viruses (including pathogens HIV, ARVI, HB, herpes, rotaviruses).
Has cleaning properties. The “Alaminol” product is intended for disinfection of indoor surfaces, furnishings, devices, and equipment. For this purpose, a 1% solution of alaminol is used, exposure time is 60 minutes. Ultrasonic devices “Serga” and “Transonic” are also used for mechanical and pre-sterilization cleaning of instruments.
Cleaning is carried out in a working solution according to the following scheme:
1. Preparation “Biolot” - 3.0 g.
2.Chlorhexidine bigluconate – 2.5 mg (standard solution)
3.Ethyl alcohol – 2.5 mg
4.Distilled water up to 1000 mg.
The instructions were compiled by the Central Research Institute of Dentistry.
Thermal time indicators are used to control the quality of sterilization. Diapers, gauze wipes, waterrolls are sterilized in autoclaves. All material is pre-packed in craft bags.
In the dental department, sterilization of instruments is carried out in a separate, specially designated room.
After soaking and processing, surgical instruments are packaged in special bags and sterilized in a dry-heat oven. The advantage of these bags is that they remain sterile for two weeks.
For the prevention of nosocomial infections, strict adherence to sanitary and epidemiological regulations in the department, as well as adherence to asepsis and antisepsis, is of great importance.
The senior nurse monitors the implementation of these rules.
In order to prevent infection, medical personnel use disposable gloves, masks, and protective goggles. If necessary, protective helmets and aprons. Scented, deodorizing tablets are used to rinse the mouth. Disposable bibs, glasses, and syringes are used for the patient.
Job responsibilities of a dental assistant include:
Preparing the workplace for a doctor's appointment.
Preparation of the necessary instruments and medications for anesthesia, applications, preparation of filling material.
Call a patient.
Seat and ensure a comfortable position for the patient in the chair, both for him and for the doctor.
Invite the dentist to the patient as soon as he is ready.
Adjust the dental light.
Presenting the instruments to the doctor.
Ensure the prevention of infectious contamination of patients and staff.
Use a saliva ejector and vacuum cleaner.
Carry out hygiene measures independently, determine indices and, together with a doctor, evaluate the effectiveness of preventive measures.
Together with the administrator, schedule the patient for a follow-up visit.
So, the efficiency of a dentist working with a nurse is 50% higher than that of a dentist working without a nurse.
To administer local anesthesia, carpule aspiration syringes and sterile disposable needles are used.
Anesthetics such as “Ultracaine, ubestezin” are used. Syringes are disinfected during operation by wiping them twice with an alcohol-based sterile gauze swab before and after the procedure.
At the end of the shift they are sterilized in a dry-heat oven at a temperature of 180 0 - 60 minutes.
Immediately after use, dental mirrors are soaked in a 5% Alaminol solution for 60 minutes, then rinsed under running water, dried with a sterile cloth and stored in a sterile U.F. tray. boxing
Immediately before admission, the patient is sterilized for 60 seconds in an eyepearlin sterilizer.
Used disposable syringes, gloves, saliva ejectors are disinfected in a 3% chloramine solution, then collected in bags and disposed of centrally.
The needles, also pre-disinfected, are collected in a special container and disposed of.
Cotton and gauze swabs are disinfected in a 3% solution of chloramines for 120 minutes, after which they are disposed of.
Disinfection is carried out in closed containers in special rooms.
The premises are cleaned twice a day using a 1% chloramine solution with 0.5 SMS, followed by ventilation and UV irradiation for 30 minutes.
General cleaning of therapy rooms is carried out once a month using a 3% chloramine solution.
Walls, furniture and equipment are treated with a 1% Alaminol solution; exposure time is 60 minutes - single ventilation.
After general cleaning, the office is bathed in UV light for 2 hours.
General cleaning of the surgical room is carried out using the same products once a week.
As a result of the operation of bactericidal lamps, the air in the room is ionized, nitrogen oxides and ozone are formed.
All work in this direction is carried out on the basis of the methodological letter “On the organization of sanitary-hygienic and disinfection-sterilization regimes in dental institutions” - developed by the State Committee for Sanitary Inspection of R.F.
All rooms are equipped with eye-perlin sterilizers, which provide immediate sterilization.
It is a container (up to one liter) filled with ceramic balls, which are heated to t-240 0.
The working surface of the tool is placed in this environment:
Mirror – 60 seconds
Burs and endontic instruments – 20 seconds
Tweezers, probes, scalpels – 15 seconds
The main advantage of this sterilization method is:
Short instrument sterilization time
Small dimensions and constant readiness of the device for work
Possibility of sterilization in the presence of the patient
Dental handpieces are disinfected by wiping the outer surfaces and the bur channel twice (before and after use) with a sterile gauze swab moistened with 70% ethyl alcohol.
After use, small endodontic instruments and burs are placed to remove organic particles in a solution consisting of equal parts of 10% ammonia and 3% hydrogen peroxide solution.
Then it is subjected to disinfection and pre-cleaning.
In a 5% Alaminol solution for 30 minutes.
Instruments with plastic holders are sterilized in an eye-perlin sterilizer for 20 seconds.
Quality control before sterilization cleaning is carried out by a senior nurse at least once a week using an azopyram test.
The quality of cleaning from SMS and medical devices is checked using a phenolphthalein test.
Each office is equipped with a first aid kit for the prevention of HIV infections.
| Name | Quantity | Type of packaging | Shelf life | Purpose |
| 1. 70% ethyl alcohol | 100 | Bottle with a tightly closed stopper | For treating the skin for rinsing the oropharynx | |
| 2. 5% alcohol solution of iodine | Pharmacy packaging | For treating damaged skin | ||
| 3. “Weighed portion” of potassium permanganate 0.1 g. | 1 | Break-in bottle | 0.05% solution for washing mucous skin | |
| 4. Distilled water 200.0 ml. | 1 | Break-in bottle | 30 days | Washing mucous membranes |
| 5. Clean pipettes | ||||
| 6. Plaster | ||||
| 7. Sterile dressing material; cotton wool, bandage | ||||
|
8. Gloves |
||||
| 9. Scissors | To open the bottle | |||
| 10. Stick | For stirring |
If contaminated or suspicious material comes into contact with the skin, treat it with a 70% ethyl alcohol solution, wash with soap and water and re-disinfect it with a 70% ethyl alcohol solution.
If infected material gets on the mucous membranes, immediately treat them with a 0.05% solution of KMnO, rinse the mouth and throat with a 70% solution of ethyl alcohol. Don't rub.
In case of injections or cuts, immediately squeeze out the blood from the wound and treat the wound with a 5% iodine solution.
The staffing schedule of the dental department provides
Head of department – 1 position
Doctor-dentist – 9.25 rates
Surgeon-dentist – 1 rate
Periodontist – 1 rate
Senior med. sister – 1 bet
Honey. sisters – 10 bets
Nurse – 4.75 rates
All bets are off.
Reporting data for 2001
Total patients admitted – 30,226
primary patients – 13,940
teeth filled – 28253
regarding caries – 21,260
for complicated caries – 6,900
teeth treated in one visit due to complicated
caries – 2,816
a course of treatment for periodontal disease was completed – 1,106
a course of treatment for diseases of the oral mucosa was carried out - 405
teeth removed – 2240
Preventative work:
inspection in accordance with planned sanitation - 7,522
of those examined were in need of sanitation - 1852
sanitized from among those identified during planned sanitization – 1822
standard units of labor intensity generated – 75,350
The Department of Orthopedic Dentistry has on its staff:
Orthopedic dentist – 4 rates; not busy – 2
Orthodontist – 1; not busy – 1
Dental technicians – 8; not busy – 4
Foundry worker – 1;
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Nurse – 6; not busy – 3
Nurse – 2; not occupied – 1.5
Medical registrar – 1; --------
Reception in the orthopedic department is carried out in two shifts, by two orthopedic doctors.
The dental laboratory is equipped with the latest electronic equipment from leading Western companies.
For the manufacture of dentures, materials of 3-4 generations are used.
The following types of services are provided to the population:
Manufacturing of metal-ceramic crowns.
One-piece dentures.
Removable dentures.
Clasp dentures with locking fastening.
Manufacturing of plastic crowns.
Dental nurses have the knowledge and skills necessary to work with doctors in all offices of the department. If necessary, they can replace each other in the workplace (surgery, periodontology). During work, they perform the role of a doctor’s assistant, maintain all the necessary documentation, and, in addition, conduct therapeutic and preventive conversations with patients. They explain how to properly care for your mouth, what pastes to use, rinses, etc. Five nurses have qualification category I, almost all have a specialist certificate.
There is an atmosphere of friendly support and mutual assistance among the employees.
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