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preparation of experts of sisterly business in conditions of reforming, public health services

Successful reforming of system of public health services in Russian. Federations it is possible only in the event that the role seyostrinskogo the personnel in realisation medical-diagnostic, profilakyoticheskoj and the rehabilitational help will be reconsidered.

Therefore it is carried out kompleksyonyj the approach to the decision of this problem, including the following nayopravlenija [39]:

1. Legal adjustment of sisterly activity: a recognition avyotonomii activity of sisterly service with definition of duties and responsibility;

2. Definition of a place of the sisterly personnel in system zdravoohrayonenija on the basis of working out and acceptance of model of sisterly business;

3. Acceptance of sisterly process as basic standard sestrinyoskoj activity;

4. Modification of vocational training system sestyorinskih shots on the basis of integrated approach in training;

5. Training to bases of management and formation liderskih qualities at medical sisters.

Development of sisterly business should enter into the general strategy razviyotija public health services of the Russian Federation. Today before medical sister demands to performance of professional problems by it increase, its role varies. Therefore at the present stage of development of system of public health services, proishoyodit modernisation of educational process, change of its maintenance, structure and principles, as traditional methods obuchenija'javljajutsja already ineffective.

Priority direction of the national project is proveyodenie active personnel selection. It is very important, that qualified employees came to system zdravoyoohranenija more, and the competence of medical sister [67] raised. Attraction young, the experts possessing modern level of knowledge для* professioyonalnoj of activity in public health services Is necessary. The decision задач* priority nayotsionalnogo the project in public health services sphere is possible by creation of system of standardization in public health services and a medical education, koyotoraja will allow to provide, on the one hand, qualitative service of patients, and with another - to frame favorable professional medium for medical workers.

To the primary goals in the field of standardization in public health services otyonosjat:

- Standard maintenance of realisation of laws in the field of protection zdoyorovja citizens and the concept of development of public health services of an i-medical science in the Russian Federation;

- Establishment of demands to conditions of rendering, medical aid; creation of uniform system of an estimation of quality of medical services, maintenance vzaimodejstvijamezhdu the subjects participating in their rendering;

- Establishment of uniform demands to licensing and accreditation of medical institutions;; to preparation, certification; and certifications spetsiali-. CTOB.

In opinion ■ the academician of the Russian Academy of Medical Science ’ professors MMA - of I.M.Setchenov И:Н. Denisov, a problem of a modern medical education; consist that demands to medical, to formation - to, and to average — are identical to the higher, as, first, it is necessary to carry out the social order, i.e. to correspond, to needs and inquiries of public health services;.

Secondly, an education system; there should be effective, i.e. results proportional vklayodyvaemym to resources; in the third, successive (a combination of traditions and innoyovatsy); in the fourth, competitive (the control, qualities) and, in the fifth, continuous (to - and poslediplomnoe formation) [39].

In the state report «About a population state of health» for 2005. It is presented; a disproportion; in; maintenance of establishments of public health services; medical shots; [132]; the Parity «the doctor; - the average medical worker» in Russia 1:2,2, whereas in the developed foreign countries it pochyoti in 2 times above (1:4).

The international council of medical sisters gives the most exact opreyodelenie «ukomplektovannosti shots» which means, that in any vreyomja available there should be a sufficient number of workers necessary kvalifiyokatsii; and specialisations; for; maintenance; necessary leaving of patients and safe uslovij'truda.

The academician of LIMES V.I.Starodubov in.svoem the report at the second Vserosyosijsky congress of average medical workers! Has noticed, that! In uchrezhdeniyojah public health services of Russia successfully work about 1,4 million average mediyotsinskih workers and security the given professional category on 10

Thousand population makes 96,9, but every year their number umenyoshaetsja [39]. In ‘ on one doctor 2,46 average were necessary to 1996 mediyotsinskogo the worker, and in 2003 — 2,26. The parity of number of experts of different professional groups also mismatches today potrebnoyostjam public health services РФі On 1 younger medical sister it is necessary 22 professional medical sisters. It means that spetsialiyostam sisterly business it is necessary to carry out not functions inherent to them.

From shortage of the sisterly personnel first of all suffer patsiyoenty. For last 20 years in the different countries the considerable quantity of researches which prove direct dependence of shortage meditsinyoskih сестер* with the raised frequency of occurrence of complications at razlichyonoj to a pathology at patients is spent, and the risk of their development is enlarged with povyyosheniem loads by medical sister [43]. Thus, excessive nagruzyoka medical sisters not only affects on состоянии*пациентов, but also raises probability of occurrence of "emotional burning out», stress ' and a dissatisfaction with work.

In Moscow meditsinyoskih sisters various medical - preventive establishments, rabotajuyoshchih sociological researches have been carried out in units of a various profile, for the purpose of revealing of the factors influencing leaving of medical sisters from a trade [132].

Among the reason of discontent of medical sisters by the trade have been taped are an insufficient possibility of career growth, a low material standard of living, emotional attrition. From all perechisyolennyh factors which can influence trade change by medical sisters, principals of sisterly services can influence only last factor by means of the correct organisation of work of the podchiyonennyh.

In 1998-99 experts of Pensilvansky university (USA) had been carried out scale international research of efficiency
Works of medical hospitals, in eight countries of the world. This research has shown, that bad working conditions are one of the major reasons of poor quality of work of medical sisters and adverse klinicheyoskih outcomes at patients. In all countries, including Russia, where provodiyolis researches; it has been noted ¾mnogo the similar: results; for example, - «a syndrome of emotional burning out» [4,59]:

In 2001 komanda.issledovatelej.nachala in dvuh.rossijskihbolniyotsah the program of accreditation "Magnet"; which has been developed in Є1UA on a basis: indicators and стандартов* сестринской* experts, medical sisters accepted by Ameriyokansky association; the Program; "Magnet" allows to extend the best sisterly practice in scales of all world. poyosle introductions: programs - of sister have noted improvement of working conditions. OdYOnim from program parametres partner relations of nurses and doctors are; as it is well-known, that in hospitals where such to relations are adjusted, clinical indicators of patients improve-; and; also: quality; sisterly-leaving and satisfaction of medical sisters the work.

Following the results of the spent researches it is noticed also, that the key role in program introduction is played by organizational support, training of medical sisters and favorable: the worker: a situation; In turn qualitative sisterly leaving promotes good clinical rezulyotatam and to depression of a mortality of patients.

One of problems of modern public health services — leaving young speyotsialistov sisterly business from a trade. The appreciable percent vcherashyonih graduates-not goes to work on a speciality. Outflow of the medical personnel speaks such reasons, as low level of payment.truda, absence of prospect of the professional growth, insufficient sotsialyonaja security of medical shots; the raised load [64].

In this occasion organizers of sisterly services sound alarm. So, in training centre of shots and poslediplomnogo obrazova -

nija Department of public health services of Moscow a theme of "a round table» became social partnership of medical educational institutions - and? lechebnoyoprofilakticheskih establishments [86 1. As: participants «круглого1 stoyola» consider, the social partnership is necessary for qualitative; preparations meyoditsinskih shots, especially when it is a question of realisation of two natsionalyonyh projects - "Formation" and "Health"; It is supposed, that close interaction: sciences and experts will define weak places sisterly obyorazovanija, will plan real ways of its perfection;

In the Voronezh base medical college it is carried out moniyotoring on a workarrangement of graduates within 5 years, allowing vyyojavit the reasons of leaving of young experts from a trade (tab. 1. G).

The table of 1.

Workarrangement of graduates of the Voronezh base medical college by data from 2003 for 2007.

(In % to a result)

ToYO

dy

Work

On a speciality

Leave in other spheres

Activity

; Arrive

vvuz

No

Data

Total
2003 73,5 4,4 8,1 14,0 100,0
200,4 88,6 1,5 4,8; 5,1 100,0
2005 86,8 7,1 - ■ 6,1 100; 0
2006 72,5 13,3 9,6 4,6 100,0
2007 68,9 11,8 7,3 12,0 100,0

The accurate tendency - to reduction of number of graduates was outlined, rabo - -

Thawing on a speciality and. To-specific gravity rising: young spetsiayo

Sheets; working in other fields of activity; (the gain has made 106,2

% In 2007 in comparison with 2003). Leakage of shots in 2007 sostayovila more than 31,1 %.

The college administration aspires to keep the graduates in a trade. For the decision of this problem it is formed social partnerst -

, In between college and treatment-and-prophylactic town establishments

t

Voronezh and area.

For improvement of quality of preparation of experts of sisterly business to

* To the control medical institutions, organizers of the sisterly are involved

"Services which are a part of the commission on total state atte -

■ statsii. One of the purposes of the national project is attraction in sis -

‘ a theme of a professional training of the employer, having given the chance to it to accept nepoyo

sredstvennoe participation in preparation of experts.

Realisation of active state personnel selection includes in

Itself both vocational training of experts of sisterly business, and work on attraction and deduction of sisterly shots in lechebnoyoprofilakticheskih establishments. Therefore, at a current stage reformirova -

, nija public health services systems becomes actual timely vyjavyo

lenie at the future experts of sisterly business negative predstavle - ny, negative emotional reactions in the activity to reduce probability of change of a trade medical sisters.

Thus, the analysis of data of the literature has shown, that the majority of researches is devoted studying of a state of health of children, teenagers and

’ students of higher educational institutions; to the analysis of their risk factors zabole -

і

1 vaemosti; to working out of the preventive references, wearing collective -

, nyj character. The works devoted to researches of a state of health stu -

dentov medical colleges, are small, and among executed nedos -

I tatochno the researches analyzing a state of health of students on re -

> gionalnom level (base medical college) and representing

?

I comparative characteristic of a state of health of students from small go -

Sorts and the regional centre. Stated above has formed a basis for razra -

, botki the complex program of socially-hygienic research with -

"Standings of health of students of base medical college.

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A source: KUPRIJANOVA ELEONORA VIKTOROVNA. SOCIALLY-HYGIENIC ASPECTS of the STATE OF HEALTH of STUDENTS of MEDICAL COLLEGE And the WAY of PREVENTIVE MAINTENANCE of THEIR CASE RATE. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. Voronezh - 2008. 2008

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