For the organization and formation of the structure and staffing of the central district hospitals, the order of the Ministry of Health of the USSR of 26.09 is applied. 1978 No. 900 "Staff standards medical personnel and workers in the kitchens of central and district hospitals in rural areas, central district clinics in rural areas, city hospitals and clinics (outpatient clinics) of cities and urban-type settlements (workers, resorts and cities) with a population of up to 25 hours. human".
The structure of the central district hospitals includes (Scheme 4).
regular CRH timetable is formed in accordance with the forms and principles covered by us in the section on the formation of the staffing table of a rural district hospital ( order of the Ministry of Health of the Russian Federation No. 16 dated January 18, 1996 "On the introduction of forms of staffing of healthcare institutions").
The functions of the central district hospital, on the one hand, provide for specificity for each structural unit, on the other hand, their organic relationship to provide the population with qualified specialized public medical care for the population of the entire rural area.
The CRH polyclinic carries out:
Providing qualified outpatient care to the attached population of the district and the district center;
Organizational and methodological guidance and control over the activities of outpatient departments of the district (polyclinic medical care at the level of district and district hospitals, outpatient clinics, FAPs and health centers);
Planning and carrying out activities aimed at preventing and reducing morbidity, temporary disability and disability;
Timely and widespread introduction into the practice of all outpatient clinics of new methods of prevention, diagnosis, treatment and medical and social rehabilitation.
To ensure the tasks set, when calculating the staffing table, the standards are applied, approved by orders of the Ministry of Health of the Russian Federation, which determine the number of a particular position of a specialist doctor per 10,000 population (Table 4).
The staffing table of the Central District Hospital can include positions of various specialists: phthisiatricians, neuropathologists, dermatologists and venereologists, etc. The need for a particular specialist is determined on the basis of morbidity rates (general and primary), its structure, mortality, etc.
| Name of medical position | Number of positions per 1000 population | |||||
| Living in a village | Living in an assigned area | Living in the rest of the territory | ||||
| Vzr. | Det. | Vzr. | Det. | Vzr. | Det. | |
| Physician general practitioner | 0,59 | - | 0,59 | - | - | - |
| Therapist | - | - | - | - | 0,3 | - |
| District pediatrician | - | 1,25 | - | 1,25 | - | - |
| Pediatrician | - | - | - | - | - | 0,02 |
| Surgeon, urologist (total) | 0,07 | 0,04 | 0,07 | 0,04 | 0,01 | 0,01 |
| etc. |
Table 4
At present, in connection with the Decree approved by the Government of the Russian Federation "Program of state guarantees for the provision of medical care citizens Russian Federation free medical care to the population ”of July 24, 2001 No. 550, the calculation of the number of positions of medical personnel is carried out on the basis of the standards for the volume of medical care per 1000 population and the standards for time spent per visit. This approach helps in a differentiated way, taking into account the order of the Ministry of Health of the USSR No. 900 of September 26. 1978 to determine the specified need for the number positions cardiologist, urologist, etc. This is due to the fact that the standards for the number of visits per 1000 population for the republican (regional), city and district health care institutions have different standards.
The structure of the organizational and methodological department (cabinet) includes such services as economic, personnel and statistical. For only with the unity of the above structural divisions it is possible to ensure the development of plans taking into account the required indicators of the state of health of the population and the activities of the network of health institutions of the territory.
In order to strengthen the organizational and methodological offices of the central district hospitals in rural areas, in addition to the standards provided for these offices in the table of paragraph 97 of Appendix 1 to the order of the USSR Ministry of Health of September 26, 1978 N 900, the following positions are established.
- Order of the Ministry of Health of the USSR of September 26, 1978 N 900 “On staffing standards for medical, pharmaceutical personnel and kitchen workers of central district and district hospitals in rural areas, central district polyclinics in rural areas, city hospitals and polyclinics (outpatient clinics) of cities and urban-type settlements with a population up to 25 thousand people, district hospitals, outpatient clinics in rural areas and feldsher-obstetric stations ”(with changes and additions) (not valid)
Order of the Ministry of Health of the USSR of September 26, 1978 N 900 “On staffing standards for medical, pharmaceutical personnel and kitchen workers of central district and district hospitals in rural areas, central district polyclinics in rural areas, city hospitals and polyclinics (outpatient clinics) of cities and urban-type settlements with a population up to 25 thousand people, district hospitals, outpatient clinics in rural areas and feldsher-obstetric stations ”(with changes and additions) (not valid)
Information about changes:
By order of the USSR Ministry of Health of June 24, 1981 N 685, changes were made to the name of this order
Order of the USSR Ministry of Health of September 26, 1978 N 900
“On staffing standards for medical, pharmaceutical personnel and kitchen workers in central district and district hospitals in rural areas, central district polyclinics in rural areas, city hospitals and polyclinics (outpatient clinics) of cities and towns with a population of up to 25 thousand people, district hospitals, outpatient clinics in rural areas and feldsher-obstetric stations "
With changes and additions from:
July 24, 1979, April 10, June 24, 25, October 23, 1981, October 11, 1982, July 11, 1985, May 30, December 23, 1986
In order to further improve medical and preventive care for the population of rural areas, more rational placement and use of personnel in accordance with the Resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR of September 22, 1977 N 870, on the basis of the resolution of the Council of Ministers of the USSR of July 17, 1968 N 548:
Information about changes:
By order of the USSR Ministry of Health of June 24, 1981 N 685, paragraph 1 of section I of this order was amended
1. Staffing standards for medical, pharmaceutical personnel and kitchen workers of central district and district hospitals in rural areas, central district polyclinics in rural areas, city hospitals and polyclinics (outpatient clinics) of cities and urban-type settlements (working, resort and urban) with a population of up to 25 thousand .person (Appendix N 1).
2. Staffing standards for medical, pharmaceutical personnel and workers in the kitchens of district hospitals (Appendix No. 2).
3. Staffing standards for medical personnel of outpatient clinics located in rural areas (Appendix N 3).
4. Staff standards for medical personnel of feldsher-obstetric stations (Appendix No. 4).
Extracts from the staff standards of medical personnel of individual health care institutions and normative documents on their application, used in the calculation of the states of central district and district hospitals and, in appropriate cases, the states of city and district hospitals (Appendix No. 5).
Ministers of Health of the Union and Autonomous Republics, Heads of Territorial and Regional Health Authorities:
Information about changes:
By order of the USSR Ministry of Health of June 24, 1981 N 685, paragraph 1 of section III of this order was amended
1. Checkout in in due course staff of medical personnel and kitchen workers of central district and district hospitals in rural areas, central district clinics in rural areas, city hospitals and polyclinics (outpatient clinics) of cities and urban-type settlements with a population of up to 25 thousand people, district hospitals, outpatient clinics in rural areas and feldsher- obstetric stations in accordance with the staff standards approved by this order, within the plan and budget of health care. Ensure that the calculation of the number of posts due to institutions, the issuance of certificates of planned indicators for the implementation of this work and the filling in, in appropriate cases, of the sheet for the replacement of posts in relation to the procedure and forms provided for by the Methodological Letter of the USSR Ministry of Health of January 8, 1969 N 02-14 / 4 to the order of the Minister of Health of the USSR of April 30, 1968 N 340.
Information about changes:
3. The Ministers of Health of the Union Republics to reproduce this order in the required quantity and bring it to each interested head of the health care institution.
1. Orders of the Minister of Health of the USSR of November 11, 1966 N 830 and of November 12, 1975 N 1007.
2. Appendix N 2 to the orders of the Minister of Health of the USSR of July 2, 1970 N 440, of March 18, 1976 N 270 and of December 15, 1972 N 1020.
3. Circular letters of the Ministry of Health of the USSR of April 29, 1969 N 02-8 / 99, of December 3, 1973 N 02-14 / 86, of December 31, 1974 N 02-14 / 64, of March 13, 1974 Mr. N 01-15/140.
4. Individual permits for the states of medical, pharmaceutical personnel and employees of the kitchens of institutions, the staffing standards for which are approved by this order.
Minister of Health of the USSR
Boss
USSR Ministry of Health
Boss
planning and financial management
USSR Ministry of Health
Boss
planning and financial management
USSR Ministry of Health
*(1) - See staffing standards approved by orders of the Minister of Health of the USSR dated 04/30/68 N 340, dated 07/02/70 N 440, dated 01/12/71 N 25, dated 12/15/72 N 1020, dated 09/14/73 N 730 and by orders of the Ministry of Health of the USSR dated March 18, 1976 N 270, dated December 10, 1976 N 1164.
* (2) - See staffing standards approved by order of the Minister of Health of the USSR of 04/30/68 N 340.
* (3) - See staffing standards approved by order of the Minister of Health of the USSR dated 19.08.69 N 605.
* (4) - See staffing standards approved by order of the Minister of Health of the USSR dated 16.08.71 N 595.
* (5) - See staffing standards approved by order of the Minister of Health of the USSR of 03.02.69 N 82.
* (6) - See the staffing standards approved by the orders of the Minister of Health of the USSR of 03.02.69 N 82 and of 08.19.69 N 605 and the Ministry of Health of the USSR of 10.12.76 N 1164.
* (7) - See staffing standards approved by order of the Minister of Health of the USSR dated 10.04.65 N 233.
* (8) - See the Uniform departmental norms of time and prices for dental work, approved by order of the Minister of Health of the USSR of 09.09.64 N 496 (with subsequent changes and additions, approved by orders of the Minister of Health of the USSR of 22.02.65 N 109, of 02.01. 68 N 6 and by order of the USSR Ministry of Health of December 30, 1976 N 1250 (Appendix N 6).
* (9) - See staffing standards approved by orders of the Minister of Health of the USSR dated 19.08.69 N 605, dated 03.02.69 N 82.
* (10) - See the staffing standards approved by order of the Minister of Health of the USSR of 04/30/68 N 340 and by order of the Ministry of Health of the USSR of 03/17/78 N 250.
* (11) - See staffing standards approved by orders of the Minister of Health of the USSR dated 04/30/68 N 340, dated 02/03/69 N 82 and the Ministry of Health of the USSR dated 12/10/76 N 1164.
* (12) - See staffing standards approved by order of the Minister of Health of the USSR dated 12/23/61 N 570.
* (13).
* (14) - See the circular letter of the Ministry of Health of the USSR dated 13.03.65 N 03-14 / 28.
* (15) - See staffing standards approved by orders of the Minister of Health of the USSR dated 08/19/69 N 605 and dated 04/30/68 N 340.
* (16) - According to the Decree of the Council of Ministers of the USSR of December 27, 1968 N 1034, the current procedure for establishing positions and staffing standards for medical and pharmaceutical personnel of the USSR Ministry of Health should be applied by the Councils of Ministers of the Union Republics, ministries and departments of the USSR.
* (17) - In accordance with the order of the Minister of Health of the USSR of 04.05.70 N 280, instead of the positions of ophthalmologists, the positions of ophthalmologists should be established.
* (18) - Taking into account the changes made by the order of the Minister of Health of the USSR of July 15, 1970 N 480.
* (19) - The list of enterprises and professions whose employees are subject to medical examinations, which is currently in force, is given in the Instructions for conducting mandatory preventive medical examinations of persons entering work and working in food enterprises, at water supply facilities, in children's institutions, etc., approved by the USSR State Sanitary Inspectorate and agreed with the All-Union Central Council of Trade Unions on February 6, 1961 N 352-61 with subsequent changes and additions.
* (20) - as amended by the order of the Minister of Health of the USSR dated March 19, 1976 N 280.
* (21) - At present, staffing standards are in force, provided for by order of the Ministry of Health of the USSR N 238/144 dated 11.03.76 and c.p. Ministry of Health of the USSR N 02-14/14 dated 13.03.78.
* (22) - See the order of the Minister of Health of the USSR of 15.07.70 N 480.
* (23) - At present, staffing standards approved by order of the USSR Ministry of Health of September 26, 1978 N 900 are in force.
* (24) - See the order of the Ministry of Health of the USSR of 18.03.77 N 234.
* (25) - At present, staffing standards approved by order of the Ministry of Health of the USSR of 04.03.65 N 135 are in force.
Order of the USSR Ministry of Health of September 26, 1978 N 900 “On staffing standards for medical, pharmaceutical personnel and kitchen workers of central district and district hospitals in rural areas, city hospitals and polyclinics (outpatient clinics) of cities and urban-type settlements with a population of up to 25 thousand people, district hospitals, outpatient clinics in rural areas and feldsher-obstetric stations "
By order of the Ministry of Health of Russia dated September 16, 2016 N 708, this order is recognized as not valid on the territory of the Russian Federation
This Order has been amended by the following documents:
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ORDER of the Ministry of Health of the Russian Federation dated August 30, 1991 N 245 “On the standards for the consumption of ethyl alcohol for health care, education and social security institutions”
In order to improve the quality of medical care for the population and more rational use alcohol I say:
1. Standards for the consumption of ethyl alcohol for healthcare institutions, education and social security(Attachment 1).
2. Approximate norms for the consumption of ethyl alcohol for units of medical institutions (Appendix 2).
3. Approximate consumption rates of ethyl alcohol per medical procedures(Appendix 3).
1. To the Ministries of Health of the Union and Autonomous Republics, heads of regional, regional and city health authorities, main pharmacy departments and associations "Pharmacy" of the Ministries of Health of the Union Republics, regional, regional and city pharmacy departments (associations "Pharmacy"):
1.1. When determining the needs of healthcare, education and social security institutions in ethyl alcohol, be guided by the standards approved by this order (Appendix 1).
1.2. Develop and approve, if necessary, standards for the consumption of ethyl alcohol for individual institutions, departments and offices, as well as consumption rates for various medical procedures, taking into account the equipment used, treatment methods and the amount of work.
1.3. Grant the right to heads of healthcare institutions to distribute ethyl alcohol between departments and offices within the total volume of alcohol allocated to the institution, using, if necessary, the norms given in Appendix 2 of this order.
1.4. When distributing the needs of pharmacies in ethyl alcohol, the calculation should be made taking into account only the extemporaneous formulation.
1.5. Allow pharmacy departments (associations "Pharmacy") to distribute the total amount of alcohol for the manufacture of medicines among pharmacies, taking into account the specifics of the formulation, setting, if necessary, individual standards.
1.6. The release of ethyl alcohol to health care institutions is carried out on the basis of requirements signed by the head of the institution (department) and certified by the seal of the institution under a separate power of attorney, issued in the prescribed manner and giving the right to receive alcohol within one month. Alcohol is sold in weight measurement at a price set for medical institutions.
1.7. Establish that the heads of health care institutions are personally responsible for the correct appointment, storage, accounting and dispensing of ethyl alcohol and the rationality of its use.
3. To impose control over the implementation of this order on the Main Directorate of Public Health and Medical and Social Programs of the Ministry of Health of the USSR (comrade Karpeev A.A.) and on V / O Soyuzfarmatsiya (comrade Apazov A.D.).
I authorize you to reproduce the order in the required quantities and bring it to the attention of healthcare institutions.
Deputy Minister
A.M.MOSKVICHEV
Attachment 1
to the order of the Ministry of Health of the USSR
dated August 30, 1991 N 245
BRIEF REFERENCE PHYSIOTHERAPIST. Guidelines. Part 1
Federal Agency for Health and Social Development Bashkir State Medical University Research Institute of Restorative Medicine and Balneology Ministry of Health of the Republic of Bashkortostan
Chairman of the Scientific Council of the Russian Academy of Medical Sciences and the Ministry of Health and Social Development
of Russia in restorative medicine, balneology and physiotherapy,
Director of RRC VMiK
QUICK REFERENCE PHYSIOTHERAPIST
Ufa 2007
UDC 61 BBK54.132 K78
Organization-developer: Bashkir State Medical University, Research Institute of Restorative Medicine and Balneology
Compiled by: L. T. Gilmutdinova, S. A. Vecherova
Reviewers: Professor Yu. O. Novikov, Professor R. S. Nizamutdinova
Recommended for use in the practice of restorative medicine specialists, physiotherapists, balneologists, general practitioners, IPO cadets, interns, students of higher medical educational institutions. UDC 61 BBK54.132 SBN 978-5-94423-119-2
‘ Research Institute of Restorative Medicine and Balneology, BSMU, 2007
REQUIREMENTS FOR REGISTRATION OF PASSPORTS OF OFFICES AND PHYSIOTHERAPY ROOMS
The basic rules for the organization of physiotherapy departments and rooms are regulated by the state standard OST 42-21-16-86 “Design, operation and safety of physiotherapy departments (rooms)”, approved by Order of the Ministry of Health of the USSR No. 1453 of November 4, 1986. Based on this document a "passport" of the department (office) of physiotherapy is issued.
The passport is a filing of regulatory documentation used in the work of the service: name of the health facility, location, full address; indication of the type of physiotherapy; the order of work of the department (office) 1-1.5- or 2-shift work; sanitary and hygienic characteristics of the premises: the number of rooms, the area, the presence and type of ventilation, water supply, sewerage, the location of the equipment; list of equipment according to the scheme: Table 1
List of regulatory documents in the passport of the physiotherapy department:
1. Journal of safety briefing and journal of routine inspection and repair of equipment (the form is attached to OST 42-21-16-85).
2. Order No. 1440 of December 21, 1984 “On the approval of conventional units for the performance of physiotherapy procedures, time standards for massage, regulations on physiotherapy units and their personnel.” The order approved the provisions on the physiotherapy clinic and the hospital, the coefficients of the procedures performed by the nurses of the physiotherapy rooms.
3. The positions of physiotherapists and nurses are determined by orders of the USSR Ministry of Health No. 999 of October 1, 1982, No. 600 of June 6, 1979 and No. 900 of September 26, 78. 4. Order of the USSR Ministry of Health No. 1000 of September 23, 1981 d. “On measures to improve the organization of the work of outpatient clinics”, which stipulates the norms for the workload and duration of the working day of a physiotherapist and a physiotherapy nurse.
5. Order of the Ministry of Health of the Russian Federation No. 337 of August 20, 2001 “On measures for the further development and improvement of sports medicine and exercise therapy” on the norms for the workload of doctors in physiotherapy exercises, sports medicine, massage nurses and exercise therapy instructors.
6. Order of the Ministry of Health of the RSFSR No. 245 of August 30, 1991 "On the standards for the consumption of ethyl alcohol for healthcare, education and social security institutions."
7. Collection of official guidelines for the organization of cancer care 1985
8. Decree of the Government of the Russian Federation No. 101 of February 14, 2003 “On the duration of working hours medical workers depending on their position and (or) specialty.
9. Standard instruction on labor protection for personnel of departments, physiotherapy rooms, approved by the Ministry of Health of the USSR on August 8, 1987.
10. Letter of the Ministry of Health of the USSR No. 02-14/28 dated May 30, 1978 “On the positions of nurses for physiotherapy in tuberculosis and infectious diseases hospitals”.
11. Order of the Ministry of Health of the Russian Federation No. 377 dated October 15, 1999 “On approval of the regulation on the remuneration of healthcare workers”. The order stipulates benefits and a 15% supplement to the salary.
12. Decree of the Ministry of Labor and social protection of the Russian Federation of June 8, 1992 No. 17, section 2, clause 24 “On a 15% surcharge to official salary doctors and nurses working with laser systems.
13. Order of the Ministry of Health of the Russian Federation No. 90 dated March 14, 1996 “On mandatory when applying for a job and periodic (at least once a year) medical examination FTO staff.
14. Collection of staff standards and standard staff of health care institutions. / Ed. S. P. Burenkova. M.: Medicine, 1986.
15. Order of the Ministry of Health of the USSR No. 1-M dated January 3, 1956 "On staffing standards for sanatorium-and-spa institutions."
16. Decree of the All-Union Central Council of Trade Unions of 1986 on staffing standards and norms for the workload of medical personnel in sanatorium-and-spa institutions.
17. Order of the Ministry of Health of the Russian Federation No. 249 dated August 19, 1997 "On the qualification characteristics of specialists with secondary medical and pharmaceutical education".
20. "Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens" No. 5487-1 of July 22, 1993;
21. Standard rules for compulsory medical insurance.
22. Register of medical services.
23. Tariffs of medical services in the system.
26. Order of the Ministry of Health of the Russian Federation No. 296 dated July 1, 2003 “On Improving the Organization of Rehabilitation Treatment in the Russian Federation”. This order approves the regulation on the organization of the activities of the Center for Restorative Medicine and Rehabilitation and instructions for referral and selection of patients for rehabilitation treatment.
27. Order of the Ministry of Health of the Russian Federation No. 1453 dated November 4, 1986 “On the Entry into Force of the Industry Standard OST 42-21-16-86 SSBT. Departments, physiotherapy rooms. General safety requirements”.
28 Order of the Ministry of Health of the Russian Federation No. 534 dated August 22, 2005 “On measures to improve the organization of neurorehabilitation care for patients with the consequences of stroke and traumatic brain injury”.
30 Decree of the Government of the Russian Federation No. 124 dated June 6, 2003 "On the Enactment of Sanitary and Epidemiological Rules and Regulations SanPiN 2.1.3.1375-03".
32 Order of the Ministry of Health of the USSR No. 288 dated March 23, 1976 “On approval of the Instruction on the sanitary and anti-epidemic regime of hospitals and on the procedure for the implementation by the bodies and institutions of the sanitary and epidemiological service of the state sanitary supervision of the sanitary condition of medical institutions”.
33. Order of the Ministry of Health of the Russian Federation No. 1000 dated April 24, 2003 “On introducing amendments and additions to the order of the Ministry of Health of the Russian Federation No. 377 of October 15, 1999”.
34. Order of the Ministry of Health of the Russian Federation No. 52 dated January 31, 2006 “On Amendments to the List of Compliance of Medical and Pharmacist Specialties with the Positions of Specialists, approved by Order of the Ministry of Health of the Russian Federation No. 377 of August 27, 1999”.
35. Order of the Ministry of Health of the Russian Federation No. 241 dated June 9, 2003 on making an addition to the order of the Ministry of Health of the Russian Federation No. 377 of August 27, 1999 “On the nomenclature of specialties in healthcare institutions of the Russian Federation”.
36. Order of the Ministry of Health of the Russian Federation No. 434 dated September 16, 2003 "On approval of the requirements for the qualification of a doctor in physical therapy and sports medicine."
37. Order No. 753 of December 1, 2005 “On equipping outpatient and inpatient polyclinic institutions with diagnostic equipment municipalities". In addition to the specified regulatory documentation, the “passport” of the office is supplemented with orders for the profile of the institution and the sanitary and epidemiological regime of the institution (orders on AIDS, PLO, hepatitis prevention, etc.).
Copies of the following documents are also required:
1. Certificate with the application of the licensing and accreditation commission under the Ministry of Health of the Republic of Belarus
2. License and protocol to it.
3. The act of checking the sanitary and hygienic condition of the premises of the physiotherapy department (office).
4. Sheets of branding of physiotherapy equipment.
5. Conclusions on compliance with fire safety requirements at the license applicant's facilities.
6. Conclusions on the state of medical equipment (contracts with a medical equipment company)
7. Technical report on the commissioning and testing of the electrical installation.
8. Protocol for checking the presence of a circuit between the ground loop and grounded elements.
9. Protocol for testing the insulation resistance of electrical equipment.
10. Protocol for measuring the spreading resistance of the main ground electrodes.
11. Regulations on the physiotherapist of the health facility.
12.Regulations on the nurse for physiotherapy at health facilities.
13. Job description of a physiotherapist.
14. Job description of the PTO nurse (office).
15.Methods of physiotherapy treatment used in this institution.
16. Monthly and annual reports on the work done by doctors and nurses according to the scheme: for everyone specialist working in the department individually(additions are possible at the discretion of the administration): total patients (including primary), total procedures (medical, nursing), completed treatment (received 7 or more procedures) patients, number of procedures per patient who completed treatment (for each type of treatment), total units (for doctors and nurses according to orders in the specialty individually),% of patients who completed treatment, the number of days worked, the workload per shift per specialist (by the number of admitted patients or units according to orders by specialty individually), in the presence of people with disabilities, visually impaired, stipulate the load; load on each medical device (simulator) per shift (for nurses and doctors, if they release medical procedures). The number of procedures per patient is calculated from the indicators: total procedures for this species treatment and the number of patients who completed treatment, divided by each other.
The number of procedures received per one treated in a medical facility (sanatorium) is the sum of all types of treatment offered in this institution, including medical ones.
The basis of a rational approach to meeting the annual planned needs of health care institutions for physiotherapy equipment is the development of a form of physiotherapy equipment.
The form is based on the Register of Medical Equipment Products. The form is a list of the necessary devices and devices for non-invasive treatment with preformed physical factors, sufficient to meet the needs of the physiotherapy service of medical and preventive and sanatorium-resort institutions different levels and profile. The form can include up to 60 items of devices and devices contained in the Register of Medical Equipment. Formulary restrictions provide significant cost savings.
When developing a formulary list, each institution should take into account:
2. ABC-analysis, which allows you to get an objective picture of the spending of the budget of a medical institution. Represents the distribution of devices in three groups in accordance with the frequency of their use (A the most frequently used, for which up to 70-80% of the budget is used; B average level use, C low frequency of use).
3. VEN - analysis of physical methods of treatment in accordance with their classification into vital ( vital ) methods important for saving life and necessary for its maintenance; necessary ( Essential ) effective in the treatment of less dangerous but serious diseases and conditions and secondary ( Non — essential ) methods of treatment of mild and non-life-threatening diseases.
Table 3 Approximate form of physiotherapy equipment
1. INTRODUCTION
Sanitary and bacteriological control is a valuable auxiliary method in the sanitary inspection of objects, which makes it possible to objectively assess the level of sanitary maintenance of the surveyed enterprises. Catering and trade.
The use of unified research methods makes it possible to obtain comparable reliable data characterizing the sanitary well-being of a separate section of an enterprise, as a whole or a number of enterprises, and also to generalize these data.
According to the results of sanitary and bacteriological studies, one can judge the observance of the sanitary regime at the enterprise, the possible violation of the technology of cooking or food storage conditions, the observance of personal hygiene rules by personnel, and epidemiological safety finished products and etc.
Thus, sanitary and bacteriological control is indispensable for conducting sanitary inspections of public catering and trade enterprises and, therefore, is mandatory for use in the practice of daily work of sanitary and epidemiological stations and departmental sanitary and food laboratories.
2. GENERAL
2.1. The goals of sanitary and bacteriological control:
— final goal– prevention of food poisoning of a bacterial nature and acute intestinal infections by ensuring the release in catering establishments and the sale in food stores of benign and epidemically safe food products;
- the immediate goal is to identify the causes of release in production or when sold in trading network products that are of poor quality or dangerous in an epidemic sense, and contribute to the elimination of these causes.
2.2. Principles for evaluating the results of sanitary and bacteriological control:
- criterion High Quality sanitization of equipment, utensils, inventory, etc. is the absence of sanitary-indicative, as well as pathogenic microorganisms on the surface of the processed items;
- detection of significant microbial contamination of finished products with saprophytic microflora should be regarded as an indicator of the sanitary problem of the object;
- the detection of high contamination of finished products with sanitary indicative microorganisms should be regarded as an indication of the possibility of contamination of these products with pathogenic microorganisms;
- the detection of pathogenic microorganisms in finished manufactured or sold products (in certain quantities of the product) is regarded as an indicator of the epidemic unfavorability of the object;
- the results of sanitary and bacteriological studies should be compared with the indicators of standards or recommendations on the permissible level of contamination of products with microorganisms.
2.3. Planning of sanitary-bacteriological researches.
Sanitary and bacteriological studies are carried out:
a) during scheduled sanitary inspections of public catering and trade facilities, carried out in the order of current sanitary supervision;
b) when surveying objects in the order of preventive sanitary supervision for the purpose of hygienic assessment of the technological line for the production of new types of food products (dishes); new types of technological and commercial equipment, as well as when commissioning new or reconstructed enterprises;
c) during sanitary inspections of objects in arbitration;
d) according to sanitary and epidemiological indications;
e) unscheduled - during sanitary inspections of enterprises on the instructions of higher organizations, etc.
In the event of food poisoning, studies are carried out in accordance with the current "Instruction on the procedure for investigating, recording and conducting laboratory tests in institutions of the sanitary and epidemiological service in case of food poisoning", N 1135-73.
2.4. Objects of sanitary and bacteriological examination:
a) ready-made meals, culinary products, perishable and especially perishable food products in public catering and trade establishments;
b) in some cases, raw materials and semi-finished products (in the course of technological process- according to epidemiological indications, with a high bacterial contamination of finished products, dishes, etc.);
c) equipment, inventory, utensils, etc. in order to verify the effectiveness of sanitization;
d) washes from hands, sanitary clothes, personal towels (in order to verify compliance with personal hygiene rules by staff);
e) water from the central water supply and especially from local water sources (water intake points and taps).
2.5. General order conducting sanitary and bacteriological examinations.
Food facilities where the preparation of food products or individual stages of the technological process are the most dangerous in sanitary and epidemiological terms, as well as enterprises that are unfavorable in terms of sanitary and technical condition, are subject to priority control. For example, objects that produce culinary, confectionery cream products or other especially perishable food products (pates, herring oil, jellies, jellies, etc.) require more attention, and objects that are in poor sanitary and technical condition, which makes it difficult to normal operation and maintenance of the proper sanitary regime at the enterprise (incomplete set of premises, their insufficient area, lack of refrigerators, interruptions in hot and cold water, bad job sewers, etc.).
In the trading network, priority examinations are mainly specialized shops or sections of grocery stores that sell especially perishable goods (milk and dairy products, meat and fish culinary products, cream products, etc.).
Sanitary examination with sampling for laboratory research is carried out by a sanitary doctor or his assistant in the presence of the head of the enterprise or his substitute without prior notification.
The results of the research reflect the quality of food products, make it possible to identify violations of the sanitary maintenance of enterprises, detect vulnerable points that are potentially dangerous in relation to product contamination, answer the question about the causes and sources of product contamination, characterize the level of sanitary culture of personnel, outline ways to eliminate the identified shortcomings.
Each survey is drawn up by an act in 2 copies in the prescribed form, which is signed by the person conducting the survey and the head of the enterprise.
The results of each examination must be brought to the attention of the administration and personnel of the enterprise and discussed at the production meeting of the enterprise no later than 3 days after the completion of the research. The generalized results of laboratory studies should be periodically discussed at meetings in higher organizations (trusts, canteens, auctions, URSs) or other organizations to which enterprises are subordinate.
Based on the data of the sanitary-bacteriological survey of enterprises, the administration should develop specific measures to eliminate the identified shortcomings, with a mandatory subsequent verification by the sanitary and epidemiological stations of the effectiveness of the measures taken.
2.6. Planning of sanitary and bacteriological control.
The plan for conducting sanitary and bacteriological control of public catering and trade enterprises should be drawn up by sanitary doctors of the operational departments of the SES together with laboratory workers. When planning, the number of objects subject to sanitary and bacteriological control is established, the frequency of their examination, taking into account the capabilities of the laboratory. Sanitary and bacteriological examinations should be carried out in accordance with the approved schedule, while the principle of surprise should be preserved for the objects being examined. Recommended frequency of planned inspection of enterprises:
The frequency of the examination may vary depending on total number food objects controlled by this SES, the significance of objects, epidemiological conditions, etc., but not less than indicated in the "Standards for conducting basic sanitary and bacteriological studies of objects environment"(guidelines), M., 1983. Approved. Ministry of Health of the USSR, N 2671-83.
a) in the warm season (at an outside air temperature of +10 degrees C or more):
- safe objects - 1 time per month for public catering establishments and 1 time in 2 months for trade enterprises;
- epidemiological (unfavorable) - 2 times a month for public catering enterprises and 1 time per month for trade enterprises;
b) in the cold season (when the outside air temperature is below +10 degrees C):
- safe objects - 1 time in 2 months for public catering enterprises and 1 time in 4 months for trade enterprises;
— epidemiological objects — once a month for public catering establishments and once every 2 months for trade enterprises.
2.7.1. Sampling of food products and washings for sanitary and bacteriological studies.
Samples and swabs should be taken by a health officer or assistant health officer. AT necessary cases it is advisable to take samples and swabs together with laboratory workers to ensure that they are carried out correctly.
When sampling food products, the research methods of which are provided for by the relevant GOST, OST, TU and ST SEV, one should be guided by the instructions of the "sampling" section, and in the absence of a special standard for sampling rules and these Guidelines, and in addition, take into account specific circumstances at the site being examined.
Before sampling products, a representative of the sanitary epidemiological station must familiarize himself with the documentation available for this batch of product (waybills, certificates, etc.); make an external inspection of the entire batch, paying attention to the condition of the container (serviceability, deformation, pollution, etc.); the appearance of the product; conditions of storage (realization) and transportation. If a defective container is found that could affect the quality of the product, each defective packaging unit should be opened (except as specified in the standards).
After inspection of the batch, individual packaging units are opened and samples are taken for organoleptic examination on site and for examination in the laboratory.
The number of packaging units to be opened is established current standards, OST, TU, etc. for the respective products.
When inspecting products for which there are no standards or specifications, open up to 5% of the packaging units of their total quantity in the batch, but not less than 5 units.
In the process of sampling, a sampling report is drawn up in the prescribed form (N 342-y - for food products, N 344-y - for culinary products), which indicates: the date and hour of sampling, the exact name of the enterprise being examined, the place and point of sampling (section, workshop, workplace etc.), detailed description sample taken, etc.
An exact direction for research is drawn up in the form of N 378-y.
2.7.2. Sampling of ready-made meals at catering establishments and products sold in the distribution network.
The following prepared dishes and products are subject to research:
a) cold food
- vinaigrettes and salads from boiled vegetables and fruits;
- meat and fish jellies, aspic;
- liver and meat pates;
- herring oil, cheese oil and other fillers;
- cold meat and fish;
– meat and fish cooking;
b) first cold dishes:
- botvinia, beetroot, etc .;
c) second hot dishes:
- products from minced meat or fish (cutlets, meatballs, schnitzels, meatballs, etc.);
- products from finely chopped meat (goulash, stew, azu, etc.);
- products from by-products;
d) side dishes (to the second hot dishes):
— pasta boiled;
- vegetable and other side dishes;
- compotes from dry and fresh fruits, jelly;
- whipped cream, mousses, jelly, etc.;
- drinks made in catering establishments;
e) confectionery with cream;
h) food products:
- milk and dairy products (kefir, cream, condensed milk, ice cream, sour cream, cottage cheese, curd mass);
- rennet and processed cheeses;
- sausages, especially boiled, liver and offal, smoked pork;
— fish products (caviar), fish gastronomy;
- egg powder, egg melange;
— mineral drinks, soft drinks, low alcohol drinks, beer;
– wines in cask and in original packaging;
- fats: butter, ghee, margarine;
- confectionery (caramel, marshmallow, marmalade, cookies);
Hot food studies are carried out to determine the residual microflora in order to verify the effectiveness of heat treatment, as well as secondary contamination during the implementation process. Studies of cold dishes are carried out to determine the total number of microorganisms, the titer of bacteria of the Escherichia coli group - in order to establish secondary contamination in the process of preparing or selling these dishes.
The quality assessment of especially perishable foodstuffs and dishes based on the results of bacteriological analyzes is carried out in accordance with the “Temporary recommendations on microbiological standards for a number of especially perishable foodstuffs and methods for their research”, approved by the USSR Ministry of Health on December 30, 1981 for N 2510-81.
2.7.2.1. Sampling of food products during the inspection of the technological process of production.
If, according to the results of bacteriological studies, it is established that individual dishes, food products are systematically contaminated with sanitary-indicative microorganisms, then a sanitary-bacteriological examination of the production of this dish or product during the technological process is carried out in order to establish the stage at which the product is contaminated with microflora. It is advisable, in parallel with the sampling of products at different stages of the technological process, to make swabs from equipment, inventory and utensils with which the product has come into contact.
For example, when examining the process of preparing a salad or vinaigrette, all the initial components that make up the dish are subjected to bacteriological examination, according to the stages of their processing: boiled vegetables - after they are cooled and cleaned, then - after grinding; boiled meat - after cooling, after grinding; green peas and other components of the dish are also being studied. Then a sample of the dish is taken after mixing all the ingredients, but without dressing and pickled vegetables. Refueling is investigated separately. At the same time, flushes are made from inventory and equipment, cutting boards, knives, table tops, vegetable cutters, dishes, hands of cold shop workers.
2.7.2.2. Sampling technique.
For sampling products and dishes in the laboratory, sterile jars are prepared, covered with two layers of paper and tied with twine, sterile spoons, sterile tweezers and knives wrapped in paper.
Samples of products are recommended to be taken together with the involvement of a representative of the institution being examined as an assistant. The assistant holds the jar in one hand, and opens the lid with the other as needed. At this time, the person taking the sample deploys the required spoon or tweezers, picks up the material and transfers it to the jar. If it is necessary to take a sample from a large piece, cut off part of it with a sterile knife and tweezers.
If the sample of the dish is taken in the dispenser, then the entire portion is transferred from the plate to the jar; if a sample is taken in production from a large mass of the product (from a pan, from a large piece of meat), then a sample weighing about 200 g is taken, liquid dishes - after thorough mixing; dense - from different places in the depth of the piece. Mineral, non-alcoholic, low-alcohol drinks and beer are taken in the amount of 1 bottle of factory packaging and 200 ml of a drink made at the enterprise.
2.7.3. Sanitary and bacteriological control by the method of studying swabs.
In the practice of current sanitary supervision of public catering facilities, trade networks, food units of children's, preschool and adolescent institutions, as well as canteens-distributing medical institutions (including sanatoriums, rest homes, etc.), the flushing method is widely used to control the effectiveness sanitization of inventory, equipment, utensils, sanitary clothing and personnel hands. The flushing method makes it possible to objectively assess the sanitary content of the examined institutions.
When conducting sanitary and bacteriological studies of swabs, they are mainly limited to the detection of bacteria of the Escherichia coli group, their detection is regarded as one of the confirmations of a violation of the sanitary regime.
When a secondary massive contamination of the finished product is detected with a significant excess of the total number of microbes in the washings, it is also necessary to determine the total bacterial contamination and the presence of bacteria of the genus Proteus and St. aureus.
Particular attention during flushing is paid to the control of equipment and apparatus that are used in the course of the technological process of preparing products that are not subjected to further heat treatment (cold shop).
Bacteriological control by the method of washings from the surfaces of inventory, equipment, hands and sanitary clothing of personnel can pursue two goals:
a) to establish the effectiveness of sanitization, for this, washings from inventory, equipment, hands and sanitary clothing of personnel are carried out before starting work or, if this is not possible, during breaks, after hands and equipment have been sanitized, i.e. swabs are produced from clean objects. In addition, handwashes are taken from staff after using the restroom until work resumes;
b) determine the role of equipment and personnel hands in bacterial contamination of a product or a finished dish during the technological process of production, paying attention Special attention for the production of products and ready-made meals that have undergone heat treatment or are eaten without pre-treatment (some vegetables, gastronomic products, salads, vinaigrettes, etc.). To solve the problem, at the same time as taking swabs, repeated samples of food products are taken (washouts are taken from untreated hands and surfaces).
The number of objects under control, the frequency of their examination, the number of swabs delivered are determined not only by the capacity of the laboratory, the specific conditions of each sanitary and epidemiological station, but also by the epidemiological situation, which can be of decisive importance.
If a more detailed sanitary and bacteriological examination of individual production areas is necessary, for example, checking the quality of washing tableware and cutlery, the mode of cooking, sampling and washings are taken according to a special program drawn up for each specific object. Directly at the enterprise, during each examination, specific points for taking swabs are established. During repeated examinations, swabs should be taken from the same objects and, if possible, at the same hours.
When taking swabs from equipment, inventory, dishes, cutlery, the following is recorded: the sample number in order, the place where the swab was taken, in what technical and sanitary condition the equipment (equipment, dishes, etc.) was, from which the swab was taken.
When taking swabs from hands, the following is recorded: number in order, last name, first name and patronymic of the employee, work performed (profession and area of work).
An act of taking swabs is drawn up in 2 copies, signed by the person who took the samples and a representative of the administration of the enterprise. 1 copy of the act is left at the facility. The results of the study are brought to the attention of the head of the enterprise within 5 days.
2.8. Sample delivery.
Samples should be delivered in thermal containers (with refrigerated liners).
The time of delivery of samples of products and washings to the laboratory for the implementation of the study should not exceed 2 hours, since the delay in this period affects the reliability of the analysis results.
3. WASHING TECHNIQUE
When taking swabs, the following guidelines should be followed:
1) Of the equipment, attention should be paid to cutting boards, meat grinders, production tables for prepared food, especially in the cold appetizers workshop. Washouts in the shops for the production of confectionery cream products are produced in accordance with the "Guidelines for conducting sanitary and bacteriological studies at enterprises producing confectionery cream products", M., 1976.
2) Washes from hands, from sanitary clothes, towels are taken mainly from workers who deal with products that are not subjected to further heat treatment (kitchen staff, cold shop, distributors, barmaids, waiters, sellers). The procedure is defined in section 2.7.3, paragraph "a".
3) Washouts from large equipment and inventory are taken from a surface of 100 sq. cm, to limit surfaces use a template (stencil) made of wire, a metal plate. The stencil has an area of 25 square meters. cm to take swabs from an area of 100 sq. cm, it is applied 4 times in different places on the surface of the controlled object.
4) When taking swabs with small tools the entire surface of the object is wiped; when taking swabs from the plates, the entire inner surface is wiped. When taking swabs from small objects, three objects of the same name are wiped with one swab - three plates, three spoons, etc. At cutlery, wipe their working part.
5) When examining glasses, wipe the inner surface and the upper outer edge of the glass 2 cm down.
6) When taking swabs from the hands, wipe the palmar surfaces of both hands with a swab, swiping at least 5 times on each palm and fingers, then wipe the interdigital spaces, nails and subungual spaces.
7) When taking swabs from sanitary clothing, wipe 4 areas of 25 square meters. cm - the lower part of each sleeve and 2 platforms from the upper and middle parts of the front floor of the overalls. Towels are taken from various places in 4 areas of 25 square meters. cm.
Swabs are taken using sterile moistened cotton swabs. Sterile cotton swabs on glass, metal or wooden sticks mounted in test tubes with cotton plugs are prepared in advance in the laboratory. On the day of taking swabs, 5 ml of a sterile 0.1% aqueous solution of peptone or isotonic sodium chloride solution is poured into each tube with a swab (in boxing conditions above the burner) so that the cotton swab does not touch the liquid.
Immediately before taking the flush, the swab is moistened by tilting the test tube or lowering the swab into the liquid. During the collection of swabs, repeated wetting of swabs is recommended.
4. PROCEDURE FOR CARRYING OUT SANITARY-BACTERIOLOGICAL
FOOD RESEARCH
During the planned sanitary and bacteriological control of food products, the following are subject to investigation:
- the number of mesophilic aerobic and facultative anaerobic microorganisms (MAFAnM) - (total number of microbes);
The total number of microbes is not determined in products containing specific microflora: fermented milk products, seasoned salads, vinaigrettes with pickled vegetables, since the count of bacteria in such cases cannot be indicative.
- the number of bacteria of the group of Escherichia coli (CGB), and in terms of products - the number of CGB by the most probable number method (MPN);
In cases where the coli-titer is less than 1, it is advisable to characterize the contamination of the investigated liquid product in the form of a coli-index.
- coagulase-positive staphylococci (St. aureus);
- bacteria of the genus Proteus;
- bacteria of the genus Salmonella in 25 g of the product.
The number of mesophilic aerobic and facultative anaerobic microorganisms (MAFAnM), the number of bacteria of the Escherichia coli group, St. aureus and Proteus are determined by the following methods. A study for the absence or presence of salmonella is carried out in accordance with the current "Instructions on the procedure for investigating, recording and conducting laboratory tests in institutions of the sanitary and epidemiological service in case of food poisoning", N 1135-73.
The content or absence of the above microorganisms in a certain mass of the test product must comply with the standards set forth in the “Temporary guidelines on microbiological standards for a number of especially perishable food products and methods for their research”, N 2510-81. If there is a GOST for methods of bacteriological analysis (for example, GOST 9958-81 "Sausage products and meat products"), the analysis is carried out in accordance with GOST, and to assess the quality of products, use the "Temporary instructions", N 2510-81.
In those cases when, according to GOST, a sample of the product is used for analysis that exceeds the standard (for example, in GOST 9958-81, the bacteria of the Escherichia coli group in brawn are determined in 1 g, and in the "Temporary instructions", N 2510-81, the standard for white brawn I c and gray II c - absence of CGB in 0.5 g), then a conclusion is made about the conformity of product quality in terms of microbiological indicators, if CGB is not found in 1 g of the product.
If BGKP is found in 1 g, then the SES bacteriologist has the right to inoculate a sample weighing 0.5 g.
When developing GOSTs for non-guested catering products and revising the current regulatory and technical documentation, it is necessary to be guided by the methods set forth in these " Guidelines».
4.1. Preparation of food samples for bacteriological examination.
Food products are classified according to physical properties into dense and liquid, therefore, the methods of processing them before the study should be different. Before examining a sample, a sample is first prepared, which should characterize the entire delivered sample. Samples of the product are taken in sterile box conditions from different places of the sample, from the surface and from the depth.
The preparation of a sample of food products for which there is a GOST for research methods is carried out in accordance with the requirements of the latter.
For products that do not have GOST for research methods (second courses, side dishes, cereals, vinaigrettes), a sample is taken in the amount of 15 g on a technical scale of class 1 from an average sample.
A portion of dense products is ground in a sterile porcelain mortar with sand or homogenized in a tissue microgrinder with the gradual addition of 135 ml of a 0.1% peptone solution in water or isotonic sodium chloride solution and left at room temperature for 15 minutes. Then, for crops, the suspension is taken with a sterile pipette with a wide end. It is assumed that 1 ml of the prepared suspension contains 0.1 g of the initial product.
Products of a liquid consistency - milk, compotes, drinks made in public catering facilities, are sown without pre-treatment; acidic food products (pH 4.0 - 6.0) are neutralized with a sterile 10% sodium bicarbonate solution to a slightly alkaline reaction (pH 7.2 - 7.4) before testing. The reaction of the medium is checked using a pH meter or universal indicator paper.
For research on Salmonella, a separate sample weighing 25 g is taken from the averaged sample.
4.2. Preparation of food dilutions for sowing.
For food products of liquid and semi-liquid consistency that do not require prior grinding and grinding, dilutions are prepared as follows:
Take a number of tubes (usually no more than 5), each tube should contain 9.0 ml of sterile 0.1% peptone solution or isotonic sodium chloride solution. 1.0 ml of the test product is added to the first test tube with a sterile graduated pipette, then, after very thorough mixing, the contents of the 1st test tube in an amount of 1 ml are transferred to the next test tube with a new sterile pipette, without touching the surface of the liquid in this test tube, etc.
As a result, the test product is diluted 10, 100, 1000 or more times in accordance with the number of tubes taken. 1 ml of suspension in the first tube contains 0.1 g (ml) of the product (1st dilution), in the second tube - 0.01 g (ml) of the product (2nd dilution) and so on.
In the study of food products of a dense consistency, a 10% suspension is used as the first dilution, obtained after mechanical processing of the product in a mortar or homogenizer, as described above (clause 4.1).
4.3. Method for determining the amount of mesophilic aerobic and facultative anaerobic microorganisms in 1 g (ml) of the product (Total microbial number - TMC) - "MAFAnM".
The method is based on the ability of mesophilic aerobes and facultative anaerobes to grow on nutrient media a certain composition at a temperature of 30 degrees. C with the formation of colonies, visible at a magnification of 2 times.
To determine the amount of mesophilic bacteria, dilutions should be chosen, when inoculated on cups, at least 30 and no more than 300 colonies grow.
From each sample, inoculation is done by the deep method on 2 parallel Petri dishes from 2 to 3 consecutive dilutions in the amount of 1.0 ml, using 2% agar prepared from dry nutrient agar. It is more reliable and easier to control the temperature if agar is poured in small portions into test tubes (12-15 ml). Agar in test tubes melts faster and cools more evenly to the correct temperature. Cups are filled with molten and cooled to 45 degrees. With agar immediately after the introduction of the material. Otherwise, an uneven distribution of colonies in the form of separate clusters in the thickness of the agar may be observed; for a more even distribution of the inoculum, in addition, the contents of the cup are mixed with rotational movements.
After the agar has solidified, the plates with the cultures are placed upside down in a thermostat, incubated according to the FAO/WHO recommendations at 30°C. C within 72 hours; if necessary, preliminary accounting is carried out after 48 hours. The number of colonies is counted on each of the seeded cups. The colony count on the plates is carried out using a bacterial colony counter or a magnifying glass. For better visibility, colonies are counted against a dark background (dark paper is placed under the cup), the cups are placed upside down. Each colony is marked on the bottom of the dish with ink or ink.
When counting, the following rules are followed:
a) if a small number of colonies, approximately 100, have grown on the dish, count all the colonies;
b) if the colonies are distributed evenly and their number is measured by several hundred (200 - 300 colonies), it is allowed to count colonies on at least 1/3 of the cup area. In these cases, the bottom of the dish is divided into 6 sectors with a pencil and colonies are counted in 3 sectors. Then they recalculate for the entire area of the cup: calculate the average number of colonies per area of one sector and multiply the resulting number of colonies per sector by 6;
c) if more than 300 colonies grow on the dish, they are distributed
evenly and it is not possible to repeat the analysis, then,
using a bacterial colony counting device, 10 fields are counted
view area of 1 sq. see in different places of the cup. Received
The numbers are added and the arithmetic mean is taken. To calculate
the number of colonies on the entire plate, the resulting average
multiply by the area of the cup (pi R). Usually cup diameter is 8.5
- 10 cm, pi = 3.14. Substituting the data into the formula, we get at
cup diameter equal to 10 cm, cup area 78.5 sq. see at
in the absence of a device for counting bacterial colonies, you can use
ordinary graph paper, in which a “window” with an area of \u200b\u200bis cut out
1 sq. see Counting colonies produced with a magnifying glass, as above.
Example. If the average number of colonies per 1 sq. cm is 18, the diameter of the cup is 10 cm, then the number of colonies in the entire area of the cup is 18 x 78.5 = 1413, rounded in the answer, indicate 1400.
The number of colonies grown on the plate should reflect the number of viable microorganisms contained in the inoculated volume of the test material. Since the latter is usually inoculated in a diluted form, the number of colonies grown on the dish is multiplied by the degree of dilution taken, the arithmetic mean is calculated and the number of mesophilic aerobic and facultative anaerobic microorganisms per 1 g (ml) of the product is established.
When establishing the number of mesophilic bacteria, not all dishes can be used to calculate the arithmetic mean:
a) it is impossible to use crops to calculate the arithmetic mean if the number of grown colonies on the plates is less than 30. In this case, the contamination indicators obtained by counting the colonies on only one or two plates, the number of colonies on which is more than 30, are entered into the research protocol. less than 30 colonies on inoculated plates in the analysis results, the following wording is recommended: “Growth of single colonies during inoculation (indicate the amount of inoculated product)”;
b) crops are not used to calculate the arithmetic average on those cups on the surface of which creeping growth of spore-forming microorganisms is observed on the surface of more than 1/2 of the area, the latter may mask the growth of other bacteria. There are cases when the growth of spore microorganisms is obtained on the plates from all dilutions and the counting of isolated colonies is practically impossible. In these cases, the study protocol should indicate: "Growth of spore-forming microorganisms."
Calculation example. If on Petri dishes, when inoculating 0.1 g of the product, an average of 135 colonies grew, and when inoculating the 2nd dilution (0.01 g of the product) - 9 colonies, then the results of the study take into account the digital data obtained when inoculating the 1st dilution , i.e. the number of microorganisms 135 x 10 = 1350 in 1 g of the product.
To obtain more accurate data on the number of mesophilic bacteria, it is advisable to compare the results of counting colonies obtained on plates with inoculations of material from serial dilutions. The number of counted colonies should approximately correspond to the multiplicity of dilutions taken. If the number of colonies on plates with inoculations from subsequent dilutions (1:10, 1:100) almost coincides or differs little, this indicates insufficient mixing of the inoculum during the preparation of dilutions and before inoculation.
4.4. Method for determining the number and titer of bacteria of the Escherichia coli group.
To bring the indicator "bacteria of the Escherichia coli group" into line with the accepted international nomenclature (Coliformes - FAO / WHO and CMEA), as well as with the current GOST 2874-82 ("Drinking water") in these "Guidelines" for bacteria of the Escherichia coli group gram-negative, non-spore-forming rods fermenting lactose with the formation of acid and gas at a temperature of 36 degrees. C +/- 1 deg. C.
If necessary, further research is carried out with identification to E. coli.
In cases where there is a standard for the product - the absence of bacteria of the Escherichia coli group in a certain mass of the product (alternative indicator), then the result is recorded in accordance with the amount of the product subjected to microbiological analysis. For example, "bacteria of the Escherichia coli group are absent in 1 g."
Where a product must contain relatively
dairy products - cottage cheese, children's dietary sour cream, etc.),
determination of BGKP is carried out by the method of the most probable number (MPN).
In cases where the product has a valid GOST, which provides for a standard for coli-titer, or it is necessary to identify significant degree contamination of the BGKP product, determine their coli-titer.
4.4.1. The method of sowing products with an alternative definition of BGKP.
For sowing, the amount of the product is used, in which the corresponding NTD provides for the absence of BGKP. In this case, products of a liquid consistency (drinks, kissels, compotes) are inoculated directly into the Kessler medium with lactose (with a float) or into the KODA medium, observing the ratio of product and medium 1:10. Products of a dense consistency are prepared for sowing in accordance with clause 4.1. Crops are placed in a thermostat at a temperature of 37 degrees. C for 24 hours. In the absence of signs of growth - gas formation or a change in the color of the medium - they give a conclusion on the compliance of the investigated product with the standard (for example, there are no BGKP in 1 g). If there are signs of growth on the KODA medium, they give a conclusion about the non-compliance of the product with the standard for BGKP. If there are signs of growth on the Kessler medium with lactose, it is necessary to inoculate from gas-positive test tubes on plates with Endo medium in order to make a final conclusion about the presence of BGCP in the product. Cups are placed in a thermostat with a temperature of 37 degrees. C at 18 - 20 hours. Crops are being looked at. Smears are prepared from colonies suspicious or typical of CGB, Gram-stained, and microscoped. The detection of gram-negative rods indicates the presence of CGB.
4.4.2. Determination of the number of bacteria of the Escherichia coli group by the method of the most probable number - MPN (Coliformes - FAO / WHO and CMEA).
The group of coliform bacteria includes all aerobic and facultative anaerobic gram-negative non-spore-forming rods that ferment lactose with the formation of acid and gas for 24-48 hours at 36 degrees. C +/- 1 deg. C related to E. coli, Citrobacter, Enterobacter, Klebsiella and Seratia. Due to the fact that in paragraph 4.1 of these "Guidelines" it is customary to determine BGKP by lactose fermentation at 36 degrees. C +/- 1 deg. C within 24 - 48 hours, then the groups of microorganisms related to "coliform bacteria" and CGB, in these "Guidelines" are as close as possible and are essentially identical.
Therefore, the method for determining NPs for coliform bacteria also reflects the determination of the most probable number of CGBs in the test volume of the product.
4.4.2.1. Research progress.
The homogenate prepared according to clause 4.1, or a liquid product diluted 1:10, is pipetted in an amount of 1.0 ml and transferred to a test tube containing 9 ml of 0.1% peptone water or isotonic sodium chloride solution, mixed carefully, collecting and blowing out of the pipette 10 times, thus getting product dilution 1:100. Then dilutions of 1:1000 are prepared, each time transferring 1 ml of the prepared dilution with a sterile pipette into the next test tube with 9 ml of 0.1% peptone water. Shake all dilutions gently.
Add 1 ml of dilution of the product 1:10 into 3 test tubes with 10 ml of KODA medium. In the same way, two subsequent dilutions of 1:100 and 1:1000 are inoculated, each time using a clean sterile pipette for these purposes.
Crops are incubated at 36 degrees. C +/- 1 deg. C within 24 hours.
Record all tubes showing gas formation or media color change after 24 hours. Tubes without signs of growth are incubated for another 24 hours and then those tubes with signs of growth are recorded. Then a test is carried out confirming the presence of CGB in the test product, for which one complete loop is transferred from each positive tube with KODA medium to separate tubes with bile-lactose broth containing brilliant green (p. 6.6) - LB medium, and these tubes are incubated at 37 deg. C within 24 - 48 hours. According to the formation of gas in the floats, the number of positive test tubes is recorded, which confirm the presence of BGKP.
4.4.2.2. Calculation of the most probable number (MPN) of BGKP.
The most probable number of BGKP is calculated depending on the number of test tubes with a positive test for gas formation in the WLB according to Table 4.4.2.3. For example, positive gas formation was noted in 3 culture tubes of a 1:10 dilution, in 1 culture tube of a 1:100 dilution, and 0 tubes from a 1:1000 dilution. The table shows that the MPN for this combination of positive reactions is 43 bacteria per 1 g of the product. In conclusion, they indicate: "1 g or 1 ml of the product contains 43 BGKP."
HF CONVERSION TABLE AND LIMITS WITH 95% PROBABILITY
Rules
organization of the office of a rheumatologist
1. These Rules establish the procedure for organizing the activities of the office of a rheumatologist (hereinafter referred to as the Cabinet), which is a structural unit medical organization.
2. The Cabinet is created for the implementation of advisory, diagnostic and therapeutic assistance in the field of "rheumatology".
order of the Ministry of Health and social development of the Russian Federation of July 7, 2009 N 415n (registered by the Ministry of Justice of the Russian Federation on July 9, 2009, registration N 14292), as amended by order of the Ministry of Health and Social Development of the Russian Federation of December 26, 2011 N 1644n (registered by the Ministry of Justice of the Russian Federation on April 18, 2012, registration N 23879), majoring in rheumatology.
4. The structure and staffing of the Cabinet are established by the head of the medical organization in which the Cabinet was created, and are determined based on the volume of ongoing medical and diagnostic work and the number of people served, taking into account the recommended staffing standards provided for in Appendix No. 2
Appendix N 3 to the Procedure for the provision of medical care to the adult population in the profile "rheumatology", approved by this order.
7. The main functions of the Cabinet are:
consultative, diagnostic and therapeutic assistance to patients with rheumatic diseases and a high risk of their development;
referral of patients with rheumatic diseases for medical care in hospitals;
dispensary observation of patients with rheumatic diseases;
implementation of diagnostic and therapeutic intraarticular and periarticular manipulations;
referral of patients with rheumatic diseases for medical and social expertise;
organizational and methodological assistance and participation of a rheumatologist in the clinical examination of patients with rheumatic diseases;
development and implementation of sanitary and educational activities;
participation in the organization and work of schools for patients with rheumatic diseases;
introduction into practice of new methods of prevention, diagnosis, treatment and rehabilitation of patients with rheumatic diseases;
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Rheumatologist |
1 per 50,000 attached population |
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Nurse |
1 to 1 rheumatologist |
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0.25 per cabinet |
2. For areas with low population density and limited transport accessibility of medical organizations, the number of positions of a rheumatologist in the office of a rheumatologist is established based on the smaller size of the adult population.
Decree of the Government of the Russian Federation of August 21, 2006 N 1156-r (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2006, N 35, Art. 3774; N 49, Art. 5267; N 52, Art. 5614; 2008, N 11, Art. 1060; 2009, N 14, item 1727; 2010, N 3, item 336; N 18, item 2271; 2011, N16, item 2303; N 21, item 3004; N 47, item 6699; N 51, article 7526; 2012, N 19, article 2410), the number of positions of a rheumatologist is established regardless of the size of the attached population.
Standard
rheumatologist's office equipment
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Quantity, pcs. |
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Work table |
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Work chair |
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Fridge |
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Height meter |
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Desk lamp |
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For children up to a year |
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Cabinet for storing medical documents |
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Tape measure |
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Bactericidal air irradiator |
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Stethophonendoscope |
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Negatoscope |
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Medical thermometer |
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on demand |
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Rules
organizing the activities of the rheumatology department
1. These Rules determine the procedure for organizing the activities of the rheumatology department of a medical organization providing medical care in the field of "rheumatology" (hereinafter referred to as medical care).
3. The department is headed by the head, appointed to the position and dismissed from the post by the head of the medical organization, in which the Department was created.
The positions of the head of the Department and the rheumatologist are appointed by specialists who meet the requirements of the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by order
4. The structure and staffing of the Department are established by the head of the medical organization in which the Department was created, and are determined based on the volume of diagnostic and treatment work carried out and the number of people served, taking into account the recommended staffing standards provided for in Appendix No. 5 to the Procedure for providing medical care to the adult population on the profile "rheumatology", approved by this order.
5. The equipment of the Department is carried out in accordance with the standard of equipment provided for in Appendix No. 6 to the Procedure for the provision of medical care to the adult population in the profile "rheumatology", approved by this order.
7. The department performs the following functions:
providing diagnostic, therapeutic and preventive care to patients with rheumatic diseases;
providing advice to doctors of other departments of the medical organization on the prevention, diagnosis and treatment of patients with rheumatic diseases;
development and implementation of measures aimed at improving the quality of diagnostic and treatment work and reducing mortality from rheumatic diseases;
development and implementation of measures to improve and introduce new methods of diagnosis, treatment, medical examination and prevention of rheumatic diseases, as well as medical rehabilitation of patients;
introduction and maintenance of educational programs for patients in order to prevent rheumatic diseases;
conducting sanitary and hygienic education of patients and their relatives;
carrying out examination of temporary incapacity for work;
maintaining accounting and reporting documentation, providing reports on activities in the prescribed manner, collecting data for registers, the maintenance of which is provided for by law.
8. To ensure its activities, the department uses the capabilities of the diagnostic and treatment and support units of the medical organization, in which it is organized.
9. The department can be used as a clinical base for medical educational organizations secondary, higher and additional vocational education and scientific organizations.
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Job titles |
Number of positions |
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Head of the department - rheumatologist |
1 for 30 beds |
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Rheumatologist |
1 for 15 beds |
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ward nurse |
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1 for 30 beds |
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Older nurse |
1 per department |
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Nursing Assistant Nurse |
4.75 for 15 beds (to ensure round-the-clock work) |
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Mistress Sister |
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1 (for work in the buffet); 1 (for cleaning premises); 1 (for sanitary treatment of patients) |
Equipment standard for the rheumatology department
1. Standard for equipping the rheumatology department (with the exception of the treatment room for intra-articular manipulations)
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Name of equipment (equipment) |
Quantity, pcs. |
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functional bed |
by number of beds |
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oxygen supply |
1 per bed |
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Anti-decubitus mattresses |
on demand |
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Bedside table |
by number of beds |
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Bedside information board (marker) |
by number of beds |
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Wheel chair |
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Trolley (wheelchair) for transporting patients |
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Trolley cargo interhull |
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Fridge |
at least 2 |
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Height meter |
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Negatoscope |
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Blood pressure monitor with cuff |
1 for 1 doctor |
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Stethophonendoscope |
1 for 1 doctor |
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Bactericidal air irradiator, including portable |
on demand |
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Cardiac monitor with non-invasive measurement of blood pressure, respiratory rate, blood oxygen saturation |
on demand |
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Tanks for collecting household and medical waste |
2. Standard for equipping a treatment room for intra-articular manipulations
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Name of equipment (equipment) |
Quantity, pcs. |
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Work table |
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Fridge |
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Cabinet for storing medicines and medical instruments |
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First aid kit with antishock drugs for emergency medical care |
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Blood pressure monitor with cuff |
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Stethophonendoscope |
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Tanks for collecting household and medical waste |
Rules
organizing the activities of the therapy room with genetically engineered biological preparations
1. These Rules establish the procedure for organizing the activities of the cabinet of therapy with genetically engineered biological products (hereinafter referred to as the Cabinet), which provides specialized, including high-tech, medical care.
2. The office is created as a structural unit of a medical organization.
3. A specialist who meets the requirements of the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by order of the Ministry of Health and Social Development of the Russian Federation dated July 7, 2009 N 415n, is appointed to the position of a rheumatologist of the Cabinet, according to majoring in rheumatology, vocational training on the use of therapy with genetically engineered biological preparations.
4. The structure and staffing of the Cabinet are established by the head of the medical organization in which the Cabinet was created, and are determined based on the volume of ongoing medical and diagnostic work and the number of people served, taking into account the recommended staffing standards provided for in Appendix No. 8 to the Procedure for providing medical care to the adult population on the profile "rheumatology", approved by this order.
6. The equipment of the Cabinet is carried out in accordance with the equipment standard provided for in Appendix No. 9 to the Procedure for the provision of medical care to the adult population in the profile "rheumatology", approved by this order.
7. The Cabinet performs the following functions:
carrying out therapy with genetically engineered biological preparations of patients for medical reasons;
analysis of efficacy and tolerability when using therapy with genetically engineered biological preparations;
implementation information support specialists and the public about various aspects of the use of therapy with genetically engineered biological preparations;
implementation of advisory activities on the use of therapy with genetically engineered biological preparations;
implementation modern methods therapy with genetically engineered biological preparations for rheumatic diseases;
participation in the development and implementation of regional programs and other documents for the protection of public health;
providing organizational, methodological and advisory assistance to medical organizations on issues of therapy with genetically engineered biological preparations;
maintaining accounting and reporting documentation, providing reports on activities in the prescribed manner, collecting data for registers, the maintenance of which is provided for by law.
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Job titles |
Number of positions |
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Rheumatologist |
1 in 500 patients |
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Treatment room nurse |
1 for 1 post of rheumatologist |
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0.25 per office (room cleaning) |
2. For areas with low population density and limited transport accessibility of medical organizations, the number of positions of a rheumatologist in the office of therapy with genetically engineered biological preparations is established based on the smaller size of the adult population.
3. For organizations and territories subject to service by the Federal Medical and Biological Agency, in accordance with the Decree of the Government of the Russian Federation of August 21, 2006 N 1156-r, the number of positions of a rheumatologist is established regardless of the size of the assigned population.
Standard
equipping the therapy room with genetically engineered biological preparations
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Name of equipment (equipment) |
Required quantity, pcs. |
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Treatment couch |
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Workplace of a rheumatologist |
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Workplace of a nurse |
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Table for medicines and medical devices |
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Stand for long-term infusion |
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Cabinet for medicines and medical products |
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Refrigerator medical |
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First aid kit |
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Cardiological monitor (ECG) |
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Infusion dosing pump (infusion regulator) |
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Multichannel electrocardiograph |
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Defibrillator |
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Tracheostomy set |
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Manual breathing apparatus |
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Medical digital thermometer (electronic) |
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Phonendoscope |
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Meter of arterial pressure manometric membrane |
2. The Center is created as an independent medical organization or a structural subdivision of a medical organization. 3. The Center is headed by a head appointed and dismissed by the founder of the medical organization or the head of the medical organization in the case when the Center is organized as a structural unit of the medical organization. The position of the head of the Center is assigned to a specialist who meets the Qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare, approved by order of the Ministry of Health and Social Development of the Russian Federation of July 7, 2009 N 415n, specializing in rheumatology. 4. The structure and staffing of the Center are established by the founder of the medical organization or the head of the medical organization in cases where the Center is organized as a structural unit of the medical organization, based on the volume of medical and diagnostic work, the number of people served, taking into account the recommended staffing standards provided for in Appendix No. 11 to The procedure for providing medical care to the adult population in the profile "rheumatology", approved by this order. 5. The equipment of the Center is carried out in accordance with the standard of equipment, provided for in Appendix No. 12 to the Procedure for the provision of medical care to the adult population in the profile "rheumatology", approved by this order. 6. The main functions of the Center are: providing specialized, including high-tech, medical care to patients with rheumatic diseases; therapy with genetically engineered biological preparations; coordination, organization and implementation of measures for the prevention of rheumatic diseases; interaction with the office of a rheumatologist, rheumatology department; monitoring and analysis of the main medical and statistical indicators of morbidity, disability and mortality from rheumatic diseases; conducting health schools for patients with rheumatic diseases; information support on the organization of medical care in the field of "rheumatology", treatment and prevention of rheumatic diseases; organizational and methodological guidelines for prevention, diagnosis, treatment, medical rehabilitation and dispensary observation of patients with rheumatic diseases; organizing the identification of persons with early stages of rheumatic diseases or with suspicion of their development; development of modern methods of prevention, diagnosis and treatment of rheumatic diseases and the introduction of new medical technologies; organization of dispensary observation of patients with the following inflammatory rheumatic diseases: rheumatoid arthritis, seronegative spondylitis, acute rheumatic fever, systemic connective tissue lesions and systemic vasculitis, as well as gout and osteoarthritis; carrying out examination of temporary incapacity for work; maintaining accounting and reporting documentation, providing reports on activities in the prescribed manner, collecting data for registers, the maintenance of which is provided for by law. 7. The Center in its work interacts with clinical, educational and research organizations, scientific communities of doctors. 8. The Center can be used as a clinical base for educational organizations of secondary, higher and additional professional education, as well as scientific organizations. Appendix No. 11 Recommended Staffing Rates
Appendix No. 12 Equipment standard
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In accordance with sub. "h" p. 37 sect. X of the Uniform Recommendations (approved by the decision of the Russian tripartite commission dated December 25, 2015, protocol No. 12), the formation of staffing tables must be carried out taking into account the Nomenclature of positions of medical workers and pharmaceutical workers, approved by order of the Ministry of Health of Russia dated December 20, 2012 No. 1183n.
With regard to the staffing standards of the organizational and methodological departments of medical organizations in Soviet time The following orders were made:
↯ More articles in the journal
1. Order of the Ministry of Health of the USSR of 06.06.1979 No. 600.
2. Order of the Ministry of Health of the USSR dated September 26, 1978 No. 900.
3. Order of the Ministry of Health of the USSR dated May 31, 1979 No. 560.
These documents have not been officially canceled by the Ministry of Health of the Russian Federation and are advisory in nature (Order of the Ministry of Health of the USSR dated August 31, 1989 No. 504).
In this connection, they can be used as a basis for the development of labor rationing systems established in medical organizations. When applied specified documents it should be borne in mind that the names of the positions of medical and other personnel of healthcare institutions must comply with the Nomenclature of the positions of medical workers and pharmaceutical workers (approved by order of the Ministry of Health of the Russian Federation of December 20, 2012 No. 1183n).
According to the Program for the gradual improvement of the remuneration system in state (municipal) institutions for 2012 - 2018, the formation of the staffing of institutions should be carried out using labor rationing systems, taking into account the need for high-quality provision of state (municipal) services (order of the Government of the Russian Federation dated November 26, 2012 No. 2190 -R).
In accordance with the Labor Code of the Russian Federation, labor rationing systems are determined by the employer, taking into account the opinion of the representative body of employees, or are established by a collective agreement.
Thus, the staffing level, taking into account labor standards, should ensure the need for the provision of public services, namely, the volume of medical care included in the Program of State Guarantees of Free Medical Care for Citizens for 2016 (approved by Decree of the Government of the Russian Federation of December 19, 2015 No. 1382) .
In accordance with paragraph 8 of the Guidelines for the development of labor rationing systems in state (municipal) institutions (approved by order of the Ministry of Labor of Russia dated September 30, 2013 No. 504), when determining labor standards, it is necessary to be guided by standard labor standards approved by federal authorities executive power in accordance with the Decree of the Government of the Russian Federation of November 11, 2002 No. 804.
At present, the Ministry of Health of Russia has developed standard industry standards for the performance of work related to a visit by one patient to a district pediatrician, a district therapist, a general practitioner (family doctor), a neurologist, an otorhinolaryngologist, an ophthalmologist and a doctor - an obstetrician-gynecologist (Order of the Ministry of Health of Russia dated 02.06.2015 No. 290n).
However, until standard labor standards are developed for all medical workers, institutions can independently develop appropriate labor standards, taking into account the recommendations of the organization exercising the functions and powers of the founder, or with the involvement of relevant specialists in the prescribed manner (clause 16 of the Guidelines, approved by order of the Ministry of Labor of Russia dated September 30, 2013 No. 504).
Previously, the calculation of the staffing of medical personnel was carried out in accordance with methodological recommendations on the regulation of the work of medical personnel (approved by the letter of the USSR Ministry of Health dated 02.10.1987 No. 02-14 / 82-14), where you can familiarize yourself with the detailed calculation methodology.
Please tell me the current order on staffing standards for kitchen staff, others, workers in healthcare institutions (hospital) of the Moscow Region. Order No. 900 of 26.09.1978 not valid, by what order to make the calculation?
Answer
Answer to the question:
Currently current order, which would provide for staffing standards for kitchen staff, others, workers in health care facilities (hospital), no.
Valid only:
Order of the Ministry of Health of the USSR dated 06/18/1981 No. 664 On staffing standards for workers in kitchens and canteens in medical institutions http://budget.1kadry.ru/#/document/99/901733353/
Staffing standards and model staffs of hospitals, polyclinics, institutions for the protection of motherhood and childhood (approved by Order of the Ministry of Health of the USSR of December 26, 1955 N 282-m).
In addition, it should be noted that such standards are not mandatory. But the staffing table, as a rule, is agreed with the founder, so you need to coordinate this issue with him.
In accordance with clause 4 of part 3 of article 37 federal law dated November 21, 2011 No. 323-FZ "On the basics of protecting the health of citizens in the Russian Federation", the recommended staffing standards of a medical organization, its structural divisions are included in the procedures for providing medical care, which are developed for its individual types, profiles, diseases or conditions (groups of diseases or states).
It is necessary to be guided by the procedures for the provision of medical care approved by the Ministry of Health of Russia in accordance with Article 37 of the Federal Law of November 21, 2011 No. 323-FZ "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation".
But, this applies to workers involved in the provision of medical care.
Details in the materials of the System Personnel:
1. Answer: How to determine the number of employees of an organization or unit
N.Z. Kovyazin
The number of employees of an organization or a separate unit is determined by its head in accordance with the structure of the organization, its functions and levels of management.
As a general rule, employers are free to determine both the staffing by positions and professions, and the number of employees who perform a particular job function.
At the same time, for certain types of activities, as well as institutions and organizations, there are statutory headcount standards that are mandatory for execution. To a greater extent, this concerns public institutions and departments. So, for example, the structure and staffing of the central office of the federal executive body is approved by its head within the limits of the payroll fund and the number established by the president or the Government of the Russian Federation, taking into account the register of positions and other acts that determine the standard number of the relevant units (clause 1.5 of the resolution Government of the Russian Federation dated July 28, 2005 No. 452). Another example is the procedure for forming the structure and staff of the Central Office of Rospotrebnadzor (Order of Rospotrebnadzor dated November 9, 2005 No. 768).
At the same time, there are a number of legislative acts to determine the staffing level, which are advisory in nature. In particular, such Recommendations are provided for budget organizations. In this document, the calculation of the staffing is based on labor standards, on the basis of which the required number of employees is calculated to perform a particular labor function.
The number of employees based on labor standards can be determined by the formula:
The normative fund of working time of one employee per year is conditionally taken as 2000 hours.
In addition to the methodology itself, the Recommendations contain a list of intersectoral labor standards that can be used in determining the number of employees, both budgetary and commercial organizations(Appendix 1 to the Recommendations). Similar standards are approved, in particular, for employees:
legal service (Decree of the USSR State Labor Committee, the USSR Ministry of Justice, the Secretariat of the All-Union Central Council of Trade Unions of July 10, 1990 No. 273/K-14-440/11-41);
accounting and financial services (Resolution of the Ministry of Labor of Russia dated September 26, 1995 No. 56);
With respect and wishes for comfortable work, Ekaterina Zaitseva,
Expert Systems Personnel