Adapted impact model (hygiene) for the isolation of pathogenic and pathogen-containing microorganisms in the control of infections related to medical service

Introduction: Safe patient care, including the prevention of infections, is a priority in all healthcare settings.Aim: The aim of this article is to analyze the theoretical aspects of the epidemiological effectiveness of health care-associated infections (HCAIs) and to propose a structural model with an applied program to improve the health control of HCAIs at the regional level.Materials and Methods: HCAI normative documents were used as well as analyses and laboratory studies from the country and regional health inspectorates (RHIs). The methods applied were documentary, statistical and graphical. For the management and proper functioning of the macrosystem - state health control (regional practices), a complex system approach is required for all the components included in the two systems - epidemiological surveillance and organizational management structure. Two subsystems are included in the structure of epidemiological surveillance: information (functioning at regional, national, European and world level) and diagnostic (including clinical, microbiological, virological, immunological, antibiotic policy monitoring of medical institutions)Conclusion: An adapted hygiene model was proposed for the isolation of pathogenic and conditionally pathogenic microorganisms of the extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, E. coli, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA) family

Evaluation of the health condition of organized children and student communities in the Dobrich area for the period 2017-2018

Introduction: The problem of protecting the health of children and students in our country is a particularly acute and current one. The reasons are many, but among the most important are unfavorable demographic indicators and trends on the one hand, and the decisive role of the health state of the young generation for the development of the intellectual production potential of the country.Aim: The aim of this article is to study the physical development of children and pupils in organized communities in the Dobrich region. The included indicators are body, body weight, capacity and dispensary monitoring according to the International Classification of Disease Diagnosis (ICD) for 2017-2018.Materials and Methods: Ordinances, reports, analyses, data from the healthcare offices in the kindergartens and schools in Dobrich district, about preventive examinations and dispensarization were used. The methods used were: methodology for conducting prophylactic examinations in children from 0 to 18 years, graphic and statistical analysis.Results: The health offices registered in the Dobrich region are in 53 kindergartens and 62 educational establishments. The total number of kindergartens in the Dobrich region is 102, and the total number of schools is 73. Of the total number of 4990 children from organized communities 4892 were studied, which is 98.03%. Of the 1,6015 students studied, 14,700 were studied, which equals 91.78%. Physical development as an indicator growth and the weight of children and students in organized communities were studied on the basis of individual assessment of anthropometric indicators in three groups: first group - norm, second group - extended norm, third- out of norm – pathological deviations.Conclusion: In prophylactic examinations it was established that children had a higher incidence of diseases than students. Most of the children were with newly registered cases of asthma and obesity, followed by chronic diseases of the tonsils and adenoid vegetation. Obesity was at the top in the number of registered cases of illness in pupils in the Dobrich region during the 2017/2018 school year

Survey Of The Necessity For Improving The Quality Of Health Care Training

The globalization of processes poses the problem of the quality of training of health care professionals in the higher education institution. The teaching process at the higher school has the important social task of preparing specialists capable of carrying out quality professional work with the virtues built up, needed for the daily professional activity.The actuality of the research problem is determined by the need to improve the quality of health care education in the higher school. This requires an adequate assessment of the professional training of future medical specialists, in accordance with changing demographic processes, morbidity, chronic disease and human attitudes towards his or her own health as its highest value.The purpose of the scientific communication is to reveal and outline the need to improve the quality of health care education at the higher school.Tasks of the survey are: to examine the need to improve the quality of health care education in the higher education institution; to reveal the role of higher education; to investigate the effectiveness and relevance of health care education in the higher school; to determine the degree of satisfaction with their performance.The methods used in the research are questionnaire survey, programmed interview, purposefully included observation and pedagogical experiment. Subject of the survey is the necessity to improve the quality of healthcare education in the higher school with the students of the specialty "nurse" at the Medical University - Varna, Sliven Affiliate.Object of the survey is the process and conditions under which the need to improve the quality of healthcare education is being studied.   The analysis of the results has led to the conclusion that it is necessary to periodically increase the quality of healthcare education, in line with the growing needs of the population for proper and timely health care. This requires good organization and management of the learning process; provision of active and planned learning activity; acquiring of professional and moral knowledge, skills and competencies; formation of professionally significant personal qualities of the medical specialist

Are We Prepared to Act Quickly If a New Viral Hepatitis Appears?

Hepatitis is an acute or chronic inflammation of the liver. Out of all five different hepatitis viruses (A, B, C, D, and E), only B and C can become chronic and progress to cirrhosis and carcinoma.Aim and tasks. To study the structure of viral hepatitis in the country of Bulgaria and the region of Dobrich in particular during the period 1995–2020 and to evaluate the impact of the COVID-19 pandemic in 2020 on the incidence of VH.Materials. Data about the registered cases of acute viral hepatitis from official announcements and reports. Information from the Regional Health Inspectorate (RHI) in Dobrich, Ministry of Health (MH), the National Center of Infectious and Parasitic Diseases (NCIPD), and internet sources.Methods. Statistical, graphic, and documentary epidemiological analysis.Results. There is an adequate organization of work in the healthcare network as well as in the units involved in the fight against viral hepatitis virus (VH), in the region of Dobrich. This network includes general practitioners (GPs), diagnostic and specialized units, Departments of Infectious Diseases, and Regional Health Inspectorates.Systematic epidemiological surveillance and control of VH in the Dobrich region is carried out in a timely manner, from its initial diagnosis and treatment to the health-hygiene prophylaxis (for HAV and HEV) and the immunoprophylaxis (for HAV and HBV).Conclusions Over the past 24 years, the country and the Dobrich region in particular have seen a downward trend in the incidence of viral hepatitis. The interepidemic period is long—up to 10 years. In 2020, in a pandemic COVID-19 situation, there were sporadic cases of HAV, HЕV, and HCV, but HBV and HDV were not registered. One year after the introduction of immunoprophylaxis against hepatitis in 1992, the incidence among children dropped significantly. There were only a few cases among children aged 1-4 years old; the illness mostly affected elderly people. During preventive examinations conducted in 2020, 18 persons with a positive HCV result and 27 persons with a positive HBsAg (Hepatitis B surface antigen blood test) were found. (One of them was of immunization age, but no data confirming actual immunization was found.) The good organization of the work in the national healthcare network and its units provides an opportunity for an adequate and prompt response to any potential new viral hepatitis. The central laboratory at NCIPD in Sofia has the capacity and necessary equipment to quickly analyze any samples collected and transferred there in a timely manner

Health and safety during clinical practices and pre-graduation internships of students training to become a nurse

INTRODUCTION. Damaged health, injuries and illnesses related to the workplace, are causes of immense human suffering. Safety is essential during the working process or the ongoing training. Each participant in the therapy and health care has a responsibility to comply with the measures for healthy and safe working conditions. During their training, students in the Nurse program are part of this process and have an obligation and responsibility to the patients, the staff and themselves to ensure healthy and safe working conditions.AIM: The aim of the present study is to explore the knowledge about the safety of students in the Nurse program at the Medical University of Varna, during clinical practice and internship before graduating.MATERIALS AND METHODS: This paper examines the opinions of 146 of the total 205 students from 1st to 4th year in the Nurse program at the Medical University of Varna. The study was conducted by direct anonymous questionnaire for the period from January to March, 2016. Analysis of literature sources and a questionnaire method were used. The data were processed by statistical and graphical analysis.RESULTS: The opinion of the respondents is firm regarding the need for protective equipment during clinical practice and internship before graduating. A significant part of the students cited as the most frequent incidents: contamination of the skin with blood and body fluids, followed by pricks from sharp objects (needles), as well as aggression by patients. The analysis of the results shows that more than a half of the surveyed students are familiar with the regulations for the protection of medical personnel in an accident

Anthropometry, physical ability and dispensary observation of school-age children - contribution to health prevention and public health

INTRODUCTION: Morphological /anthropometric/ indicators are the basis for assessing the physical growth of children of school age, the relevant organs and the whole body. External factors affect growth and development, especially during puberty. We set ourselves the task to analyze anthropometric studies of stu­dents in organized groups in Varna - on height, body weight, activity, and their dispensary observation by ICD for a period of two years - 2012 - 2014.MATERIALS AND METHODS: We have used reports, analyses, tests, data from prophylactic examinations and dispensary, anthropometric measurements, laboratory tests of RHI Varna, examination of physical abil­ities and more. Our methods included documentary, statistical, laboratory tests, physical abilities and more.RESULTS: We explored the physical development of 80 771 students in organized groups in Varna - 33 669 for the 2012-2013 school year and 42 918 for 2013-2014, divided into three groups: first group - norm, second group - extended norm and third group - outside the norm. We analyzed the physical abilities to pass and not pass the tests for norm and out of norm and the ones free from physical education and remedial gymnastics.CONCLUSIONS: The share of anthropometric measurement of height and weight within the norm is high­est in schoolchildren in group I (norm) - 87.0% for a height and 84.0% for a bodyweight. However, it is signifi­cantly lower in group II (extended norm) - 8.57% for height and 9.85% for body mass. The detected and regis­tered main diseases and abnormalities in prophylactic examinations were: obesity, visual disturbances, spine curvature disorders, and asthma

Admistrative-punitive approach in the health control of sites of importance for the health of the population in Dobrich region for the period 2008 -2016

Въведение: Издаването на административни актове представлява изключително важна част от дейността на администрацията. Чрез актовете държавната администрация изразява своята воля и финализира своето решение. Разнообразието на административните актове отговаря на разнообразието на функциите и дейностите в държавната администрация и на Регионалните здравни инспекции (РЗИ), натоварена да ги извършва. Цел и задачи: 1. Да бъдат проучени законовите и подзаконови нормативни актове, прилагани при упражняване на държавния здравен контрол от РЗИ-Добрич като държавна администрация и да анализираме организацията, обхвата и приложените административни актове по видове, години и дейности за 2008-2016 г. Материали: нормативни документи, отчети на РЗИ-Добрич, проверки, административни актове. Методи: документален, исторически. Резултати: В нашата страна условията и редът за упражняване на държавен здравен контрол се уреждат с наредба №36 от 21 юли 2009 г. и обхваща: обектите с обществено предназначение; продуктите и стоките със значение за здравето на човека; дейностите със значение за здравето на човека; факторите на жизнената среда. В Добричка област за периода 2008-2016 г. се извършва от РЗИ със заповед на директора, който определя обхвата на извършвания контрол за всеки държавен инспектор и издава служебна карта. Подлежащите на контрол обекти от 8443 за 2008 г., 3778 за 2011 г., намаляват до 3650 за 2012 и 3689 за 2016 г. Свързани са със създаване на агенцията за храните с част от служителите на РЗИ. Взискателността на контрола, изразена в издадени административни актове, е за сметка на предписанията, следвани от актовете и заповедите. Изводи: Намаляването 2,5 пъти на обектите е свързано с увеличаване на кратността на проверките от 1,84 за 2008 г., 1,84 за 2011 г., 1,91 за 2012 до 2,0, като се задържа трайно 3 години – 2014-2016 г. Мерките за административна принуда са за сметка на предписанията до 72.24%, следвани от актовете за санитарни нарушения – 19.98%, и заповеди – 7.57%. Заповедите за спиране на експлоатация са 51%, спиране на реализация - 25%, спиране на дейност - 20%, и 4% - унищожаване или пренасочване.Introduction: The issuance of administrative acts is an extremely important part of the administration‘s activity. By means of the acts the state administration expresses its will and finalizes its decision. The variety of administrative acts corresponds to the variety of functions and activities in the state administration and the Regional Health Inspectorates (RHIs) charged with carrying them out. Aim: The aim of the paper is to study the legal and regulatory acts applied in the exercise of the state sanitary control by RHI Dobrich as a state administration and to analyze the organization, scope and administrative acts applied by species, years and activities for the period 2008-2016. Materials and Methods: We have used normative documents, reports of RHI Dobrich, inspections, administrative acts. Our methods were documentary and historical. Results: In our country, the terms and procedures for exercising state health control are regulated by Ordinance No. 36 of July 21, 2009 and encompass: the objects of public use, products and goods of importance to human health, activities of importance for human health, factors of the living environment. The control in the Dobrich district for the period 2008 – 2016, is carried out by RHI by an order of the director, which determines the scope of the control exercised by each state inspector, who is issued an official card. The controlled objects were 8443 for 2008, 3778 for 2011, then decreased to 3650 for 2012 and 3689 for 2016. They are linked to the establishment of the Food Agency with some RHI staff. The rigor of control expressed in issued administrative acts is at the expense of prescriptions followed by acts and orders. Conclusions: The 2.5-fold decrease in sites is related to an increase in the frequency of inspections from 1.84 in 2008, 1.84 in 2011, 1.91 in 2012, to 2.0 remaining permanent for 3 years - 2014-2016. Administrative enforcement measures are at the expense of prescriptions of up to 72.24%, followed by sanitary offenses - 19.98% and orders -7.57%. Suspension orders are 51%, stopping sales - 25%, stopping activity - 20% and 4% destruction or redirection

Analysis Of Infections Related To Medical Care In University Hospital Of Ruse For The Period 2014-2016

Профилактиката и контролът на вътреболничните инфекции (ВБИ) представляват интердисциплинарна дейност и отговорност на целия персонал на всяко лечебно заведение. Включват специфични елементи, насочени към защита на пациентите и персонала на лечебните заведения с цел ограничаване до възможния минимум възникването и разпространението на ВБИ.Цел и задачи: Да проучим преминалите болни, разпространението на инфекциите, свързани с медицинското обслужване (ИСМО), приложението на антибиотици в условията на УМБАЛ АД – Русе по отделения за 2014-2016 г.Материали: Анализи, отчети, достъп до обществена информация от РЗИ – Русе, МЗ, НЦЗИ – София.Методи: документален, статистически, графичен.Резултати: Над средната за областта е заболяемостта от ВБИ в УМБАЛ – Русе АД, както в абсолютен брой, така и в относителен дял през целия проучван период. През 2014 г. 530 (1.67%) при 616 (1.86%) за 2013 г. През 2015 г. 401 случая (1.26%) и 2016 г. 486 случая (1.51%)Изводи:1. Преминалите болни през УМБАЛ АД – Русе нарастват плавно от 71 501 през 2014 г. до 80 081 души до 2016 г., при показатели средно за окръга два пъти по-ниски – 31 801 за 2014 г. и 32 105 за 2016 г.2. Заболеваемостта в УМБАЛ АД – Русе формира повече от половината заболяемост от нозокомиални инфекции на окръга, нарастване в УМБАЛ АД – Русе през 2015 и 2016 г. (1,26% и 1,51%, при задържане на показателя за окръга – 0,66%, 0,67%).3. Очертава се висока употреба на антибиотици в Отделението по педиатрия (84,96%) за 2015 г. и (86,55%) за 2016 г., а в Урология (85,40%), Гинекология (70,45%), Инфекциозно отделение (61,12%) за 2015 г.4. Регистрация на ВБИ през 2013 г. и 2014 г. има в 14 отделения, през 2015 и 2016 г. в 20 отделения на УМБАЛ АД – Русе.5. Водещи отделения в регистрацията на ИСМО са: Анестезиология – 9,86% (2015) и 15,41% (2016), Отделението за интензивно лечение с терапевтична насоченост (ОИЛЗТН) – 4,67% (2015) и 7,52% (2016), Урология – 6,48% (2015) и 5,79% (2016), Неонатология – 4,03% (2015) и 5,09% (2016).Introduction: The prevention and control of nosocomial infections is an interdisciplinary activity and the responsibility of the entire staff of each medical institution. It includes specific elements aimed at protecting patients and healthcare staff in order to minimize the occurrence and spread of in-hospital infections.Aim: The aim of this article is to conduct a research on patients, the spread of infections related to medical care, the application of antibiotics under the conditions of the University of Medicine and Pharmacy of Rousse for the years 2014-2016.Materials and Methods: We have included analyses, reports, access to public information from RHI Ruse, MH, NCHI - Sofia. The methods used were documentary, statistical, and graphic.Results: Above the average for the area is the incidence of in-hospital infections in the University Hospital of Rousse, both in absolute terms and in relative terms during the whole period. There were 530 cases (1.67%) 2014, lower than in 2013, when the number was 616 (1.86%). In 2015 there were 401 cases (1.26%) and 486 cases (1.51%) in 2016.Conclusion: 1. The number of patients undergoing treatment at the University Hospital of Rousse is gradually increasing from 71 501 in 2014 to 80 081 persons by 2016, with indicators for the county twice as low: 31 801 for 2014 and 32 105 for 2016; 2. The morbidity rate in the University Hospital of Rousse represents more than half the morbidity of nosocomial infections in the county, with an increase in he University Hospital of Rousse in 2015 and 2016 of 1.26% and 1.51%, respectively, without significant changes in the indicator for the county (0.66%, 0.67%); 3. There was an increased use of antibiotics in the Pediatric Ward - 84.96% in 2015 and (86.55%) in 2016; in the Department of Urology - 85.40%; Gynecology - 70.45%; and Infectious Diseases – 61.12%, for 2015; 4. In-hospital infections were registered in 14 departments in 2013 and 2014, and in 2015 and 2016 - in 20 departments of the Hospital. 5. The departments with the highest incidence of in-hospital infections related to medical care were: Anesthesiology - 9.86% in 2015 and 15.41% in 2016; Intensive Care - 4.67% in 2015 and 7.52 % in 2016; Urology - 6.48% in 2015 and 5.79% in 2016; Neonatology -  4.03% in 2015 and 5.09% in 2016

Epidemiological characteristics of viral hepatitis in the Varna region for 2014-2019. Part two

Viral hepatitis is identified as a major global public health problem affecting several hundred million people. The severity of the hepatitis infection is not evenly distributed worldwide. Every year, 1.4 million people die from viral cirrhosis and hepatitis-related liver cancer. However, the majority of the infected population is unaware of their status. Therefore, prevention remains the best strategy to reduce viral hepatitis.Aim To study the epidemiology of viral hepatitis in Varna for the period 2014-2019.Materials Quick notifications, registration documents, reports, analyzes of laboratory tests of the Regional Center for Transfusion Hematology (RCTH) Varna and Virology Laboratory of RHI Varna, NCIPD Sofia, health education materials.Methods Documentary, statistical, laboratory, partial epidemiological analysis, graphic presentation of results.Results Viral hepatitis by settlement have a high relative share of 86.12% in cities as opposed to 11.55% in villages. A total of 1557 people were contacted, and 99.2% of them were examined according to the normative requirements. Mainly adult men with small fluctuations in age are ill. Morbidity in men between 30-34 years of age is (37.97%ооо) in 2014, for 2015 the leading age is 45-49 years with morbidity (33.47%ооо) in 2017, > 65-year-olds with morbidity (13.20% ооо) in 2016 and 2019.Conclusions The comparative shares of ill people when divided into groups are: for students - (5.11%), for Kindergarteners - (1.37%), for workers in a food establishment - (0.37%). Age-related morbidity shows that there are no diseases up to 1 year, while there are single cases for the age group of 1-4 year-olds. A prophylactic study in RHI and RCTH in blood donation revealed a total of 857 positive samples for HBsAg and HCV

Epidemiological characteristics of viral hepatitis in Varna region for 2014-2019. First part. Incidence of viral hepatitis in Varna and Bulgaria for 2014-2019 - a comparative analysis

Hepatitis is a polyetiological disease. Viral hepatitis is one of the most common infectious diseases in the world, including in our country. Hepatitis is highly contagious (with hepatitis B being 100 times more contagious than HIV). Hepatitis B and C together are one of the biggest global health threats, killing approximately 1 million people a year. In Bulgaria in 1951. mandatory registration begins of hepatitis called „epidemic hepatitis“. Separate registration by three types of hepatitis began in 1981: VHA, VHV, VH Indefinite.Aim To make a comparative characteristic of the registered incidence of viral hepatitis in Varna and Bulgaria for the period 2014-2019.Materials Quick notifications, registration documents, reports, analyzes of laboratory tests of RCTH Varna and Virology Laboratory of RHI Varna, NCIPD Sofia, health education materials.Methods Documentary, statistical, laboratory, partial epidemiological analysis, graphic presentation of the results.Results There is a great variety of types of hepatitis in different years. The morbidity is small. VHA is leading with significantly lower incidence, followed by VHV, VHN and VHC. No registered VHD for the entire period.Conclusions 1. The incidence of VHA in Varna district is two to four times lower than in the country for 2014-2019. 2. The incidence of VHN is higher than that for the country, as autoimmune, toxic, metabolic, and other non-infectious hepatitis are included here. 3. Good organization has been established for registration, examination, hospitalization and study of epidemic outbreaks in the district of Varna, pursuant to Ordinance 43/1995 of the Ministry of Health