Dangerous factors in the work of a medical worker. Practical study of the influence of harmful factors on the health of middle medical professionals. Procedure and research procedures

The modern hospital is a complex complex of departments that provide the most various treatment-rehabilitation functions. It can meet a wide variety of harmfulness that may adversely affect the health of the health worker. Among them may be harm caused by the forced body position, the voltage of individual organs and systems, the effects of physical factors (X-ray, ionizing, ultraviolet and laser radiation, ultrasound, electromagnetic fields). In the air of hospitals there are pairs and aerosols of antibiotics, vitamins, hormones, anesthetics, etc. in concentrations of up to 5 times larger than MPC, for example, in operational, the ether's concentration is often 2-6 times higher than the MPC.
The work of the health worker belongs to the most difficult and responsible types of activity, is characterized by a significant mental load, an increased responsibility for the result of treatment. Requires a large physical and psychological endurance when care for patients, especially in extreme situations.
The harmful effects of production factors on health care products indicates that among them mortality up to 50 years is 32% higher than the population, and surgeons are up to 40%, and the highest incidence in the country. In the first place - gynecological diseases, complications of pregnancy, hypertonic disease, diseases of bones and joints, CHS, pneumonia, liver disease, biliary tract, pancreas.

The most frequent diseases of the physicians in the first 5 years of work is up to 92% chronic diseases The upper respiratory tract and the gastrointestinal tract, the skin, the urogenital sphere caused by the conditionally pathogenic flora, which became aggressive in the hospital. The highest incidence of doctors in burns, purulent, general mercy and resuscitation compartments, intensive care blocks. This is due to the decrease in immunity in the first 5 years of operation under the influence of pathogenic hospital microflora. Subsequently, as immunity increases, the incidence is reduced.
But at the same time, health workers have low medical activity: 75 out of 100 health workers have chronic diseases polling, but only 40% is treated.

Every year in the country among health workers, up to 500 professional diseases are celebrated, among which 62% - tuberculosis, 9% - serum hepatitis, 6% - bronchial asthma, 5% - allergies to medicines; 4% - dermatitis. Women make up 86% of the diseased, incl. Nurses - 60%, doctors - 13%, paramedic - 4%. The main causes of occupational diseases: safety disorders - 21%, unsatisfactory equipment of jobs - 11%, violations of the day (overvoltage) - 5%, the absence of personal protective equipment (gloves) - 4%, imperfection of technology - 2%.

High remains injuries among physicians. So, if in Moscow in 2003-2005 more than 90% of health institutions worked without accidents, about 250 cases of injuries were registered. Among them, 37-50% are injuries for falling in rooms or on challenges, 22% of road traffic accidents. Up to 15% injuries are applied to doctors with patients or their relatives as a result of hooligan actions on their part.
Therefore, compliance with the rules of labor protection and personal hygiene, excerpt and tact in communicating with patients and colleagues is a strict responsibility for the health worker.

Types of harmful professional factors in LPU in workers of various specialties and their impact on professional diseases

Professional harm to healthcare facilities LPU are divided into:
(Slide number 95)
1) Mechanical, 2) physical, 3) chemical, 4) biological and 5) psychogenic.

1. Mechanical - mostly refers to surgical profile personnel (surgeons, gynecological obstetricists, operating sisters, dentists, masseuses) - forced position of the body during operations, manipulations; voltage of individual organs and systems; Static stress of skeletal muscles ("Surgeon's Pose"), overvoltage of the nervous system. As a result of the forced posture (when standing), the foot area increases and after 4-6 years there are varicose veins on the legs, and the IBS and atherosclerosis of the brain vessels are developing from the overseas of the century.

2. Physical - X-ray (X-ray Cabinet workers), radiological (oncoboles), ultrasound (ultrasound) and electromagnetic (physiotherapy offices), radiation. Electromagnetic radiation When using a laser as a scalpel in gynecology, ophthalmology, microscopic studies.

Physical factors include the action of the production microclimate of individual professions:
Increased temperatures and humidity -cause overvoltage of thermoregulation, leading to a decrease in immunity, frequent colds (when working on dezers, carrying out thermal disinfection of medical instruments and dishes in the LPU, bacteriological laboratories, in balneological, mud departments, laundries);
increased temperature for reduced air velocity (when carrying out operations). In some professions, there is an elevated noise from working devices and aggregates (oxygen supply shop, compressor).
Impact coldthere is a place in the freezers of transactors and morgues.
More often, physical factors are not found in pure form, but in combination, for example: the forced position of the body in surgeons + overvoltage of individual organs + chemical impact on essential vapor + elevated temperature + reduced air ventilation and + psychogenic load.
When burning the tumor with a laser into the air, the products of tumor burning - aerosols, harmful chemicals - phosgene, light acts on the cornea of \u200b\u200bthe operator, can cause closet of lens. In the x-ray-office, ozone and nitrogen oxides are added to the radiation. In physiocabines, with poor ventilation and the absence of wet cleaning, the concentration of positive aeroions is dramatically increasing in the air, which makes breathing and leading to premature aging of the body.

3. Chemical- the impact of a huge arsenal of products of the chemical and pharmaceutical industry - medicinal, drug and disinfectants, vitamins, etc.;

4. Biological- viruses, microbes, antibiotics, vaccines, serums. In the hospital and the clinic, an infectious factor acts - often the patient is sources of infection and in non-compliance with the rules of hospital and personal hygiene. The health worker can become infected with flu, AIDS, infectious hepatitis, cholera and other infections on the branch profile. Therefore, health workers are ill often than the population, flu 2-3 times, with infectious hepatitis 4-10 times (if not vaccinated) and DR manipulation associated with blood (fence and laboratory testing of blood, operations, injections, etc.) require special attention and observance of labor protection rules for the prevention of AIDS and infectious hepatitis.

5. Psychogenic - These are intelligent and emotional loads associated with the intensity of medical work. As a rule, they belong to the 3rd harmfulness and occur in connection:
a) with the process of communication with the patient is a psychological and emotional tension, a sense of responsibility for the life of the patient, for the accuracy of the diagnosis and prescribed treatment;
b) with the state of starting readiness for the adoption of emergency and important for sick measures (at the resuscitation, with a critical situation, at the midwife during childbirth, etc.);
c) with an inorganized labor regime - the presence of daily and night duty, night operations, which necessitates the biorhythms; With the lack of fixed lunch breaks; With a large workload of the working day.
The integrated effect of these factors, for example, the obstetrician - childbirth + possible complications + night duty + readiness for a difficult situation - it leads to neuro-emotional breakdowns, the elimination of which in organizing a rational labor day and rest.

Optimization of the labor of health workers. Measures to prevent the action of harmful and dangerous factors on health of health workers

(Slide №96)

1. In the selection of students, trade intensity and trade protection in the specialty, which are subject to increased requirements (resuscitation, surgeon);

2. Optimize labor and rest mode - not allowed unreasonable overload, duty; comply with the rational regime of labor and recreation;

3. Do not allow air pollution in the workplaces - over the place of pollution to equip the exhaust and work with it; ventilation and UFL-irradiation of the premises;

4. Passing medical examinations - preliminary upon admission to work and periodic - once a year, with examinations therapist, surgeon, neuropathologist, ophthalmologist, gynecologist;

5. Comply with labor protection rules, industrial and personal hygiene (protect eyes, skin, mucous, light, avoid electric shock);

6. Constantly increase its production skills;

7. Certification of workplaces on labor protection in categories of harm with the preparation of a program to reduce their pathogenic action or their elimination.

(Slide number 97)

Production injury - This is all damage gained in production. Injuries are mechanical, chemical, thermal and electric - it depends on production.

(Slide №98)

Causes of injuries:

1. Equipment malfunction is a sudden stop, breaking transmissions, etc. - as a result of poor-quality / formal / irregular preventive repair. Prevention: Constant attention of labor protection engineer, head of the workshop to these issues;

2. Violation of the normal course of the technological process - as a result of a rush, violation of the requirements of instructions placed in a prominent place and other prevention: timely briefing, testing of safety knowledge, the presence of alarm mechanization, automation;

3. Malfunction of a manual tool - a bad sharpening, a bad fastening of the handles and others. Prevention: periodic testing of the tool, withdrawal of worn, instructing working;

4. Lack of safety fences around moving machines or parts;

5. Insufficient training of workers to the correct methods of work - the introductory and current safety instructions are needed;

6. Unsatisfactory sanitary condition of work premises, territory, overworking of working (chauffeurs);

7. Lack of or malfunction of overalls - gloves or holes in them.

For prophylaxis electricalravwhich end up in 15% fatal, it is necessary to comply with the safety requirements.
Eye injury It is found in 25% injuries - more often in the metallurgical industry (grinders, turners, gribers). Metal chips fall into the eye. Prevention: It is necessary to wear protective glasses, masks, shields, equip a hood at the place of formation of dust.
Skin lesions are most frequent pyodermia -gnove on the skin. They arise due to the dusting of the room, microtrase leather chips, handling with dirty rags in oil or emulsion. Prevention: Complex measures - conducting measures to reduce temperature in the workshop, effective air extractor; Local measures - chips from the machines to fit out not with hands or random rags, but by special hooks or brushes, preliminary sterilization of the wooing material; the presence in the workshop of the aidhekk (with iodine) and protective pastes for hands from oils and emulsions; Regular inspection of workers in the workshop by a dermatologist (surgeon) - identify patients and treat.

Hygienic foundations of therapeutic and prophylactic nutrition
In accordance with Article 222 of the Labor Code of the Russian Federation (2001) on works with harmful working conditions, the employer is obliged to issue medical and prophylactic nutrition (LPP) to employees for free on established standards. The use of LPPs is directed to: (Slide №99)

1. blocking the suction of incoming toxic substances into the gastrointestinal tract;

2. Delay in the flow of them into the blood;

3. Restriction of accumulation in the body;

4. Accelerated neutralization and removal from the body.

It is assumed that full-fledged additional medical and prophylactic nutrition reduces the action of harmful factors that fell into the body helps the body in their excretion, increases the body's resistance to them and contributes to the prevention of occupational diseases.

The diet of the LPD depends on the presence of harmful substances at a particular production.
(Slide №100)
List of industries, professions and posts, Working in which it gives the right to free receipt of the LPL, approved by the Resolution of the Ministry of Labor of Russia of March 31, 2003 No. 14.

List of harmful production factorsWhen exposed to which the use of milk or other equivalent products in preventive purposes is approved by the relevant order of the Ministry of Health of the Russian Federation of 28.03.03 g No. 126.

Norms issue Milk and equivalent food products approved by the Decree of the Government of the Russian Federation of November 29, 2002 No. 849 "On the procedure for approving the rules and the conditions for free issuing to employees engaged in the work with harmful working conditions, milk or other equivalent foods, as well as medical and prophylactic nutrition "

Developed 5 types of rations of LPP - from №1 to №5 and a daily set of products in them. It may include milk or equivalent foods (cottage cheese, cheese, egg, fish). For example: Milk is issued working with disinfection means; Dairy and dairy products and jams - working with lead; Vitamins - workers of hot shops, etc. The issuance of the LPP can be produced in enterprises in the form of hot breakfasts before starting work or dinner. In this case, its issuance is carried out based on the layout menu for 5-6 days. It is not issued and not compensated by the LPL on weekends, on vacation, business trip, in the days of the disease.

Dangerous and harmful factors of professional activities of the medical sister. "

Health Department of the Tyumen Region

State autonomous professional educational institution of the Tyumen region

"Tyumen Medical College"

Abstract on the topic:

"Dangerous and harmful factors of professional activity of a medical sister."

Performed: Student Branch

"Nursing",

course 3, group 312,

Davydova D.V.

full-time education

Teacher:

Nikitin V.M.

Harmful and dangerous conditions of the middle medical staff are associated, first of all, with direct contact with infectious agents, adverse effects on the body of drugs, chemically aggressive substances and stressful impact on nervous system.

In the process of work, medical sisters have to constantly contact with a whole complex of pharmaceutical agents who adversely affect the health of representatives of this profession. Drugs fall on the skin, in the form of aerosols and vapors are often found in the breathing zone of the nurse, causing various diseases of a professional nature, as well as infertility, miscarriage and anomalies of the development of the fetus.

In addition, in the conditions of lack of personnel in hospitals and clinics, medical sisters often work out by natives. In this case, they are inevitably contact with such harmful factors as chlorine, hydrogen peroxide, ammonia and other substances that can cause poisoning, various diseases of the respiratory organs, including an allergic nature.

Harmful working conditions in health care are implied by the presence of stress factors. Doctors and nurses are constantly communicating with severely ill patients, see their suffering, are witnesses of deaths. This causes chronic emotional tension, depression, severe neurosis.

The health of nursing staff is inevitably reflected on the quality of the provision of professional assistance to the population.

Risk Factors for Medical Sister in LPU

One of the most important tasks in creating a safe hospital environment is the definition, identification and elimination of various risk factors for medical personnel in the LPU. In the activities of the medical sister, four groups of professional factors can be distinguished, which adversely act on her health:

1) physical risk factors;

2) chemical risk factors;

3) biological risk factors;

4) Psychological risk factors.

Physical risk factors in the LPU for a medical sister:

1) physical interaction with the patient;

2) the impact of high and low temperatures;

3) Action different species radiation;

Physical interaction with the patient.

In this case, all activities related to the transportation and movement of patients are meant. They are the main cause of injury, back pain, the development of osteochondrosis at nurses.

The impact of high and low temperatures. Avoid the adverse effects of high and low temperatures (burns and supercooling) due to the execution of manipulations will allow the implementation of any nursing intervention strictly according to the algorithm.

Radiation sources in LPU are x-ray, scanners, accelerators (radiation therapy devices) and electronic microscopes. Medicine is also widely used by the preparations of radioactive isotopes used to diagnose and treat a number of diseases.

Currently, other radiations are used in medical institutions for therapeutic, preventive and diagnostic purposes, adversely affecting medical personnel health:

* ultrahigh frequency;

* ultraviolet and infrared;

* Magnetic and electromagnetic;

* Light and laser.

Violations of the rules of operation of electrical equipment.

In his work, a medical sister often uses electrical appliances.

Chemical risk factors in the LPU for a medical sister.

Chemical risk factors in the LPU for a medical sister consist of the effects of different groups of toxic substances contained in disinfectants, detergents, drugs.

The most frequent manifestation side effect Toxic substances are professional dermatitis - irritation and inflammation of the skin of varying severity. In addition to it, toxic substances cause damage to other organs and systems.

Biological risk factors in the LPU for a medical sister

The biological factors acting on the medical sister in the LPU should be attributed to the danger of infection of VBI. Preventing professional infection and security of medical staff is achieved by strict compliance with anti-epidemic regime and disinfective measures in the LPU. This allows you to preserve the health of the medical personnel, especially working in reception and infectious departments, operating, dressing, manipulative offices and laboratories, that is, having a higher risk of infection as a result of direct contact with potentially infected biological material (blood, plasma, urine, pussy and so Further.). Work in these functional units requires individual anti-infectious protection and observance of safety regulations by personnel

Medical waste heads the list of the most dangerous. Work with them is regulated by SanPine 2.4.2.2821-10 "Rules for the collection, storage and disposal of waste of therapeutic and preventive institutions."

In matters of vibments in hospitals, younger and medium medical personnel are given a major role: the organizer responsible for the contractor, as well as the controller. The daily strict compliance with the requirements of the sanitary and hygienic and anti-epidemic regime during the performance of their professional duties and is the basis of the List of Events on HBBI Prevention.

Psychological risk factors in the LPU for a medical sister.

Emotional security mode is important in the medical sister's work. Work related to sickness care requires special responsibility, large physical and emotional tension. Psychological risk factors in the work of a medical sister can lead to different types of violation of psycho-emotional state.

Psycho-emotional tension.

Psycho-emotional stress at a medical sister is associated with a constant disruption of dynamic stereotype and systematic disorders of daily biorhythms associated with work in different shifts (day-night). The work of the medical sister is also associated with human suffering, death, colossal loads on the nervous system, high responsibility for the life and well-being of other people. By themselves, these factors are already leading to physical and emotional overvoltage. In addition, psychological risk factors include: fears of professional infection, frequent situations associated with communication problems (alarming patients, demanding relatives). There are still a number of factors that increase overvoltage: dissatisfaction with the results of labor (lack of conditions for effective assistance, material interest) and overestimated medical requirements, the need to combine professional and family responsibilities.

Stress and nervous exhaustion.

Standing stress leads to nervous exhaustion - loss of interest and lack of attention to people with whom a nurse is working. Nervous exhaustion is characterized by the following features:

* Physical exhaustion: frequent headaches, lower back pain, reduced performance, deterioration of appetite, problems with sleep (drowsiness at work, insomnia at night);

* Emotional overvoltage: depression, feeling of helplessness, irritability, closedness;

* Mental tension: negative attitude towards himself, work surrounding, weakening attention, forgetfulness, scattered.

Bibliography

1. Decision of the Government of the Russian Federation of December 1, 2004 No. 715 "On approval of a list of socially significant diseases and a list of diseases representing the danger to others" // Meeting of legislation Russian Federation dated December 6, 2004, No. 49, Art. 4916.

2. Artamonova V.G. Professional diseases: Tutorial / Artamonova VG, Mukhin N.A. - M.: Medicine, 2004.

3. Malov V.A. Nursing case with infectious diseases: tutorial. - M.: Academy, 2007.

4. Marchenko D.V. Labor protection and prevention of occupational diseases: Tutorial. - Rostov N / D: Phoenix, 2008.

1) physical risk factors;
2) chemical risk factors;
3) biological risk factors;
4) Psychological risk factors.

Physical risk factors in the LPU for a medical sister:

physical interaction with the patient;

the effects of high and low temperatures;

action of various types of radiation;

violations of the rules of operation of electrical equipment.

Physical interaction with the patient. In this case, all activities related to the transportation and movement of patients are meant. They are the main cause of injury, back pain, the development of osteochondrosis at nurses.

Allocate the following rules for lifting and displacement of weights:

1) clothes should be free;
2) Shoes should make a tight leg, sole - the minimal slide on the floor. Preferably leather or dense cotton fabrics with a wide heel with a high height of no more than 4 - 5 cm;
3) You can not lift gravity and work, tilting the torso ahead. The load (pressure on intervertebral discs) with an increase in the angle of inclination increases at 10 - 20 times. This means that when picked up or transferring an item weighing 10 kg with a slope of the body forward, a person is loaded 100-200 kg;
4) When lifting heavy loads, it is located as close as possible to the chest and only on the bent and most pressed to the chest. The further the person removes the subject from himself, the greater the load falls on the spine;
5) the load on the hands is distributed evenly, the back always hold straight;
6) If you need to raise the object from a low position, for example from the floor, sit down next to the subject, keeping direct position backs, take it in hand and pressed to the body, and then get up, keeping the straight back;
7) If you need to help the patient lying in bed, for example, moving it or help to take a sedentary position, it is not allowed to be incurred over it and do not reach it to the far edge of the bed, but stand on the edge of the bed on one knee and, fiery help the patient;
8) legs put on the width of the shoulders, feet - parallel to each other;
9) if the raised load must be shifted to the side, they turn not only top bodies (shoulders and hands, keeping legs in the same position), and all body;
10) You should always look for the opportunity to facilitate the load: use the help of the patient (its ability to pull up, push off, rely on, etc.) and others;
11) It is necessary to use special devices to facilitate the work: supports, transport boards, rotary circles, lifts for patients, etc.

Action of radiation. High doses of radioactive irradiation are deadly. Small doses lead to blood diseases, the occurrence of tumors (primarily bones and the mammary glands), a violation of the reproductive function, the development of cataracts.

Radiation sources in LPU are X-ray devices, scanners and scanning devices, accelerators (radiation therapy) and electron microscopes. Medicine is also widely used by the preparations of radioactive isotopes used to diagnose and treat a number of diseases.

To protect against harmful emissions, it is necessary to be at the far distance from their sources as far as possible, wearing individual means of protection. When you stay next to the source of radiation, all manipulations need to be performed quickly. To provide physical support to the patient during an x-ray study or treatment can be possible only in case of emergency. Pregnancy of the medical sister is contraindicated for this kind of service. Risk Medical Personnel Professional

Currently, other radiations are used in medical institutions for therapeutic, preventive and diagnostic purposes, adversely affecting medical personnel health:

* ultrahigh frequency;
* ultraviolet and infrared;
* Magnetic and electromagnetic;
* Light and laser.

To prevent their damaging effects on the human body, it is necessary to comply with safety equipment when working with appropriate instruments.

Violations of the rules of operation of electrical equipment. In his work, a medical sister often uses electrical appliances.

Electric current damage (electric shock) are associated with improper operation of equipment or its malfunction.

When working with electrical devices, security rules should follow.

Technical means of protection against short circuit (automatic or cork fuses) in the power grid must be in good condition. It is strictly forbidden to use homemade fuses for this purpose (slices of wire, bugs).

Before using the electrical appliance, you need to explore the instructions for its operation.

Electrical appliances must be kept in a good condition and repair timely. Their repair should be carried out only by specialists.

Only grounded equipment should be applied.

Under the constant control there should be a state of insulation of electrical wiring, electrical equipment and other elements of the electrical network.

Electricity elements, electrical equipment and electrical appliances can be repaired and replaced after de-energization.

It is impossible to confuse wires. Before use is convinced of their integrity.

The device is included in the customer in the following order: first the cord is connected to the electrospode, and only then to the network. Disconnect it in the reverse order. You can not pull the plug by pulling the cord

Electrical appliances should be used in premises with non-conductive electric shock floors. They should not be operated in wet premises, near the baths, shells or outdoors.

It is impossible to allow network overload, i.e. Include several electrical appliances into one socket.

Chemical risk factors in the LPU for a medical sister consist of the effects of different groups of toxic substances contained in disinfectants, detergents, drugs.

The most frequent manifestation of the side effects of toxic substances is professional dermatitis - irritation and inflammation of the skin of varying severity. In addition to it, toxic substances cause damage to other organs and systems.

Toxic and pharmaceutical preparations can affect respiratory organs, digestion, blood formation, reproductive function. Various allergic reactions are especially frequent until the development of serious complications in the form of bunches of bronchial asthma, swelling of quinqu, etc.

Compliance with preventive measures of a medical sister reduces harm from the effects of toxic substances.

1. It is necessary to obtain a complete picture of the drugs used: chemical name, pharmacological action, side effects, Storage and application rules.
2. If possible, potential stimuli must be replaced by harmless substances. Chemical substancesWith disinfectant properties, can be replaced by cleaning agents and disinfection with high temperatures. They have equal or even greater efficiency and cheaper.
3. Use protective clothing: gloves, bathrobes, aprons, protective shields and glasses, boils, masks and respirators. If the rubber gloves in people with increased sensitivity provoke dermatitis, you can wear silicone or polychlorvinyl gloves with cotton fabric lining. With powders, it is necessary to work only in cotton gloves, but they poorly protect the skin at contact with liquid chemicals.
4. It should be carefully studying guidelines On the use of certain means of protection when working with toxic substances.
5. Preparation of disinfecting solutions should be carried out in specially equipped rooms with supply and exhaust ventilation.
6. Do not apply local action drugs in unprotected hands. Wear gloves or use a spatula.
7. It is necessary to carefully care for the skin of the hands, process all wounds and abrasions. It is better to use liquid soap. After washing, it is necessary to wipe your hands well. Protective and moisturizing creams can help restore the natural fat layer of the skin, lost when exposed to certain chemicals.
8. With accidents, if the drug got:
8.1) In the eyes - immediately washed with a large amount of cold water;
8.2) mouth - immediately washed with water;
8.3) on the skin - it is immediately washed off;
8.4) Clothes - it is changed.

The biological factors acting on the medical sister in the LPU should be attributed to the danger of infection of VBI. Preventing professional infection and security of medical staff is achieved by strict compliance with anti-epidemic regime and disinfective measures in the LPU. This allows you to preserve the health of the medical personnel, especially working in reception and infectious offices, operational, dressing, manipulation offices and laboratories, i.e. Having a higher risk of infection as a result of direct contact with potentially infected biological material (blood, plasma, urine, pus, etc.). Work in these functional premises and branches requires an individual counter-infectious protection and compliance with the rule of safety personnel, compulsory disinfection of gloves, exhaust material, using disposable tools and linen before their disposal, regularity and thoroughness of current and general cleaning.

In the LPU, there must be three most important requirements from the profile:

1) minimizing the possibility of infection;
2) the exclusion of intra-hospital infections;
3) the exclusion of incidence of infection beyond the hospital.

Medical waste heads the list of the most dangerous. Work with them is regulated by SanPine 2.1.7.728-99 "Rules for the collection, storage and disposal of waste of therapeutic and preventive institutions."

The following highlights should be remembered to maintain sanitary and hygienic and anti-epidemiological regime:

* Affect infection can only be pure healthy skin and mucous membranes;
* About 99% of causative agents of infectious diseases can be removed from the surface of the skin with the help of hand washing with ordinary soap;
* It is necessary to take a daily hygienic shower after the end of working with patients;
* Even minor damage on the skin of the hands (scratches, abrasions, burdens) must be treated with a diamond green and put it with a waterproof plaster;
* providing assistance to the patient, the medical sister should use individual means of protection according to the current rules;
* remove the room where the patient is located in rubber gloves;
* Handles of washbasins, doors, switches and phone tubes as the most commonly used items need to wash daily and wipe with disinfecting solutions;
* Before you close the washcloth after washing the hands, it must be flushed in the same way as the hands;
* If the patient has an infectious disease transmitted by air, it is necessary to work in a mask;
* In one mask it is impossible to work more than 4 hours, if silence, and more than 1 hour, if you have to talk in a mask:
* When you recalculate the patient's bed, you should not beat the pillows and shake the sheets - it contributes to lifting and moving dust, and with it microbes and viruses;
* food is taken in a specially designated room and be sure to remove working workwear (bathrobe);
* when leaving for sick with infectious disease, for example tuberculosis, polio, diphtheria, it is necessary to make preventive vaccinations.

Psychological risk factors. Emotional security mode is important in the medical sister's work.

The work associated with the departure of PAIs in patients is required by special responsibility, large physical and emotional tension. Psychological risk factors in the work of the nurse can lead to various types of violation of psycho-emotional state.

Psycho-emotional tension. Psycho-emotional stress at a medical sister is associated with a constant disruption of dynamic stereotype and systematic disorders of daily biorhythms associated with work in different shifts (day-night). The work of the medical sister is also associated with human suffering, death, colossal loads on the nervous system, high responsibility for the life and well-being of other people. By themselves, these factors are already leading to physical and emotional overvoltage. In addition, psychological risk factors include: fears of professional infection, frequent situations related to communication issues (concerned patients, demanding relatives).

There are still a number of factors that increase overvoltage: dissatisfaction with the results of labor (lack of conditions for effective assistance, material interest) and overestimated medical requirements, the need to combine professional and family responsibilities.

Stress and nervous exhaustion. Standing stress leads to nervous exhaustion - loss of interest and lack of attention to people with whom a nurse is working. Nervous exhaustion is characterized by the following features:

* Physical exhaustion: frequent headaches, lower back pain, reduced performance, deterioration of appetite, problems with sleep (drowsiness at work, insomnia at night);
* Emotional overvoltage: depression, feeling of helplessness, irritability, closedness;
* Mental tension: negative attitude towards himself, work surrounding, weakening attention, forgetfulness, scattered.

To begin to carry out measures to prevent the development of nervous exhaustion, it is necessary as early as possible. In order to prevent the negative impact of stressful situations, a medical sister in its activities should rely on the following principles:

1) a clear knowledge of their official duties;
2) planning your day; define objectives and priorities using the characteristics "Urgent" and "Important";
3) understanding the importance and significance of their profession;
4) optimism, the ability to focus on the positive thing that managed to do in the day, considering the result only successes;
5) Compliance healthy image life, full-fledged vacation, ability to relax, "switch";
6) rational nutrition;
7) Compliance with the principles of medical ethics and deontology.

The purpose of the study is to establish the dependence of the impact of professional harm on occurrence various diseases Medical medium health workers.

Research Subject - Professional Harmfulness negative influence On the health of the middle-level medical worker.

The object of the study is the middle medical personnel of various structural units.

Based on the purpose of a practical study, tasks are defined:

Determine the severity of the harmful impact on medical personnel of various structural divisions

Reveal risk factors and determine the severity of their impact on medical personnel

Estimate the effectiveness of the currently existing methods of individual and group protection

Conclusion

The goal, the task of a practical study of the influence of harmful factors on the health of middle-level health workers has been achieved and solved:

Conclusions:

? Based on the review of primary sources, the concept of "harmful factors" is determined
? Carried out a practical study of employees of various functional units.
? Analyzed the results and draw conclusions:

Having reduced the psycho-emotional load, you can improve the quality of work, as well as reduce the risk of occurrence emergency situations and infection of the medical worker by professional diseases.

Significant changes in the psychological picture honey. The employee contributes:

? High patient mortality;
? Suffering patients;
? Increased for the last lately "Young" contingent of patients;
? "Grim" psychological microclimate in the department;
? Severe psycho-emotional load when performing manipulations with patients;
? Continuous contact with incurable patients and palliative care;

The employees of the oncological dispensary are more exposed to emotional burnout.

In the course of a practical study, there was a need to expand its borders and cover additional branches.

The practical significance of the work is that individual work with employees of offices has been carried out, the risk factors have been established for the risk of development of occupational diseases.

Thus, the conclusion made by us indicates a special role of preventing the impact of harmful factors on the emergence and development of professional diseases of medium-sized medical workers.

In this regard, we developed the following practical recommendations.

in order to prevent the negative impact of stressful situations, a medical sister in its activities should rely on the following principles:

) Clear knowledge of your official duties;

) planning your day; define goals and priorities using the characteristics of "urgently" and "important";

) understanding the importance and significance of your profession;

) optimism, the ability to focus on the positive thing that managed to do in the day, considering the result only successes;

) Compliance with a healthy lifestyle, a full-fledged rest, the ability to relax, "switch";

) balanced diet;

) Compliance with the principles of medical ethics and deontology.

when working with electrical devices, security rules should follow.

to reduce the risk of emergency situations with biomaterials, when working should be strictly followed by the OST 42.21.2.85

together with the supervisor, a memo was developed, containing information about the methods of combating psycho-emotional overvoltage.

Risk factors for a medical sister.

§ Professional:

1. Physical

2. Chemical

3. Biological

4. Psychological

Physical risk factors

1. Physical interaction with the patient

2. The impact of high and low temperatures

3. Action of various types of radiation

4. Violations of the rules of operation of electrical equipment.

(Details on ergonomics)

) Avoiding the impact of high and low temperatures is possible due to the strict execution of manipulations by the algorithm.

) To protect yourself from harmful emissions, it is extremely important to be as far as possible from their sources, wearing individual means of protection., Manipulation perform quickly

Radiation, diligently affecting medical staff:

) Ultrahigh-frequency

) Ultraviolet and infrared

) Magnetic and electromagnetic

) Light and laser

For the prevention of their damaging

actions on the human body

it is imperative to comply with safety equipment

when working with the appropriate devices!.

) In its work, the nurse often uses electrical appliances. Electrotok defeat is associated with improper operation of equipment or its malfunction. It is necessary to explore the safety rules before exploiting electrical equipment and follow safety rules.

Chemical risk factors.

) In LPU, nursing staff is exposed

the effects of different groups of toxic

detergents, drugs

Toxic effects on the body:

§ Professional dermatitis

§ Respiratory system

§ digestion

§ Bloodmaties

§ Reproductive function

§ Allergic reactions (swelling of quinque, bronchial asthma, etc.)

Compliance with preventive measures reduces harm to the effects of toxic substances!

Biological risk factors.

§ VBI, it is extremely important to strictly observe and perform sir

§ Work in the functional rooms with high risk of infection (laboratory, dressings, etc.) - It is extremely important to comply with the safety regulations and the use of individual anti-refective protection measures, compulsory disinfection of gloves, spent material, the use of disposable tools, linen, their disposal, carrying out current and general cleaning.

Three important requirements

1. Minimizing the ability of infection

2. Exception of intrahospitals

3. Exception of incidence of infection beyond the limits

Psychological risk factors lead to:

) Psycho-emotional tension (fears of professional infection, concerned patients, demanding relatives, etc.)

) Stress, nervous exhaustion, (headache, decline in working capacity, insomnia, drowsiness, depression, irritability, closure, diffraction, etc.)

) Professional burnout syndrome.

Prevention of negative impact of stressful situations:

1. Clear knowledge of their official duties.

2. Planning your day, define the goals and priorities using the characteristics''SOW''''''''Vazhny

3. Understanding the importance and significance of your profession.

4. Optimism is the ability to focus on the positive thing that managed to do the day, considering the result only success.

5. Compliance with a healthy lifestyle, a full-fledged rest, the ability to relax, 'reversed.

6. RATIONAL POWER

7. Compliance with the principles of medical ethics and deontology.

Professional burnout syndrome is A complex psychological phenomenon, which is often found from specialists whose work implies a continuous direct contact with people and the provision of psychological support.

Risk factors for a medical sister. - Concept and species. Classification and features of the category "Risk factors for a medical sister." 2017, 2018.