Immunization against tuberculosis in children exposed to HIV.

The article deals with the issues of vaccination against tuberculosis of children born to women with HIV. The completeness of vaccination coverage against tuberculosis of HIV-exposed children and the reasons for the lack of vaccination were analyzed. According to the size of the vaccine scar and the results of the Mantoux test, the effectiveness of vaccination against tuberculosis was assessed.В статье рассмотрены вопросы вакцинации против туберкулеза детей, рожденных от женщин с инфекцией В20. Проанализированы полнота охвата прививками против туберкулеза ВИЧ- экспонированных детей и причины отсутствия вакцинации. По размеру вакцинального рубца и результатам пробы Манту проведена оценка эффективности вакцинации против туберкулеза

Professional risks of hemocontact infections for medical personnel (on the example of Sverdlovsk region)

In the dynamics from 2003 to 2016. the indicators of the frequency of accidents with exposure to blood (AEB) from medical personnel are presented. The characteristics of the AEB are given, taking into account the professional orientation of the employees, the age, medical experience, the time of occurrence of AEB during the week, the circumstances of the injury, etc. The conditions and nature of the specific prophylaxis performed in AEB with HIV-infected patients are analyzed taking into account the risk of possible infection. Recommendations are given to reduce the risks of emergencies.В динамике с 2003-го по 2016 год представлены показатели частоты аварий с экспозицией крови (АЭК) у медицинских сотрудников. Дана характеристика АЭК с учетом профессиональной ориентированности сотрудников, возраста, медицинского стажа, времени возникновения АЭК в течение недели, обстоятельствами получения травмы и др. Проанализированы условия и характер проводимой специфической профилактики при АЭК с ВИЧ-инфицированными пациентами с учетом степени риска возможного инфицирования. Даны рекомендации по снижению рисков возникновения аварийных ситуаций

The occupational risk factors of blood-contact infections among health care workers and risk-management

The occupational risk of healthcare workers blood-contact infections is usually implemented through invasive procedures. Biological factor is risk factor of healthcare workers. The hepatitis B, hepatitis С and HIV are prevalence in the population of healthcare workers. We are consider the management of healthcare workers occupational risks, such as vaccination and personal protective equipment.Риск заражения медицинских работников гемоконтактными инфекциями, как правило, реализуется при проведении инвазивных процедур, в связи с чем биологический фактор является ведущим из всех факторов, оказывающих влияние на здоровье медицинских работников. Наиболее актуальна проблема заражения медицинских работников вирусами гемоконтактных инфекций - гепатитов В, С и ВИЧ, что обусловлено их значительной распространенностью в популяции. В работе представлен материал по различным направлениям управления рисками: вакцинопрофилактика, антиретровирусная терапия и средства индивидуальной защиты

A new model of the organization of medical care on the example of the polyclinic №5 children’s hospital №11

The new model of the organization of primary care is one of the priority projects of the Ministry of Health aimed at improving the quality of polyclinics, which was approved by the Presidium of the Presidential Council for Strategic Development and Priority Projects on July 26,2017. Since August 2017, Polyclinic No. 5 of the Main Educational Institution “DGKB No. 11" has entered the “Lean Polyclinic” project in order to increase the availability and quality of medical care to the population. Repair work was carried out, and then optimization of the work of medical personnel by eliminating obvious losses. Work was carried out on 5 projects: 'Open Registry, 'Improving the quality of patient care in the district doctor's office', 'Optimizing the work of the vaccination room', 'Organizing routine check-ups for minors in organized teams on the principles of a continuous flow of patients', 'Optimizing preventive examinations of unorganized patients \ All projects were effective, showed a decrease in the time of the process (in some projects by 2-3 times). As a result, the satisfaction of the population increased to 85%, the waiting time in queues decreased from 1 hour to 10 minutes, the quality of patient care improved.Новая модель организации первичной медицинской помощи [5] - один из приоритетных проектов Министерства здравоохранения. направленный на качественное улучшение работы поликлиник, который был утвержден президиумом Совета при Президенте Российской Федерации по стратегическому развитию и приоритетным проектам 26 июля 2017 года. С августа 2017 года в проект «Бережливая поликлиника» вступила поликлиника №5 МАУ «ДГКБ №11» с целью повышения доступности и качества медицинской помощи населению. Были проведены ремонтные работы, а затем оптимизация работы медицинского персонала за счет устранения явных потерь. Проведена работа по 5 проектам: «Открытая регистратура», «Улучшение качества обслуживания пациентов в кабинете участкового врача», «Оптимизация работы прививочного кабинета», «Организация профилактических осмотров несовершеннолетних в организованных коллективах на принципах непрерывного потока пациентов», «Оптимизация профилактических осмотров неорганизованных пациентов». Все проекты оказались результативными, показали снижение времени протекания процесса (в некоторых проектах в 2-3 раза). В итоге выросла удовлетворенность населения до 85%. уменьшилось время ожидания в очередях с 1 часа до 10 минут, улучшилось качество обслуживания пациентов

Risks of HIV Infection for Medical Staff. Postexposure Prophylaxis (by the Example of the Sverdlovsk Region)

Introduction. The Sverdlovsk region is on the second place among all subjects of the Russian Federation on the level of infestation of the population is HIV. The prevalence of HIV-infected residents of the Sverdlovsk region is 1.6%. This corresponds to a generalized stage of infection. Annually in medical institutions of the Sverdlovsk region up to 4 million patients with HIV infection receive various types of medical care. In these conditions increase the risk of infection employees related to their professional activities.Aims of this study was to assess the completeness and timeliness of post-exposure antiretroviral therapy to employees in case of accidents with exposure to blood and to determine their professional the risks of infection.Materials and methods. The study was conducted on the basis of the Sverdlovsk Regional Center for Prevention and Control of AIDS and the Department of epidemiology of the Ural State Medical University. The authors analyzed 1678 strategic messages in an emergency for 2013-2016.Results. In medical organizations of Sverdlovsk region in 2013 was introduced registration of all emergencies, regardless of the HIV status of the patient. The number of registered accidents was 6.7 ± 0.3 cases per 10 thousand employees. The frequency of emergency situations doctors have1.7 times higher than the average staff and nurses. Among nurses there was a trend to increasing frequency of emergencies, with an annual growth rate of 3.0%. Changes in the frequency of emergency situations, the doctors and nurses are not installed. The authors found considerable variation in the number of accidents according to the official registration and results of the employee survey. The frequency of emergency situations is determined by the profile of the Department, business process, profession, work experience of the employee, day of week and time of day. The number of persons who received chemoprophylaxis during emergency situations, reduced annually. Reasons for the decline were later appeal for help, the failure of prevention and the absence of indications to antiretroviral therapy in low risk of infection. The proportion of doctors who are not receiving antiretroviral treatment was higher than the proportion of paramedical staff and nurses.Conclusion. The prevention of occupational infections require legal regulation. Preventive actions should be focused on the set in the process of research risks