Provision of medical care for children in a polyclinic

Children's polyclinic in the Russian Federation - a state institution. It can be an independent institution or as a structural unit to be a part of a children's city hospital or a city polyclinic. In the area of ​​its activity, the children's city polyclinic( department) provides medical and preventive care for children up to 14 years of age( 14 years 11 months and 29 days).The provision of medical care is provided directly in the polyclinic, at home, in preschool and in schools. The area of ​​activity of the polyclinic is determined by the health authority by the subordination of the institution. From the number of posts of outpatient doctors depend on the positions of nurses, laboratory technicians, roentgenologists, physiotherapists, physicians in physiotherapy exercises, functional diagnostics. Servicing of children on the site is carried out by a "single" pediatrician from the moment of discharge from the hospital and before being transferred to a teenage doctor's office. The system of a "single" pediatrician ensures a close relationship between the doctor and his family and constant monitoring of the health of children. The total number of children in the medical sector under the age of 15 years should not exceed 800. For each pediatric site, one post of a district doctor is provided.

The positions of the district nurses are set at the rate of 1.5 posts per 1 district pediatrician. Positions of feldshers or nurses to strengthen preventive work among healthy children are set at the rate of one post in the service of a polyclinic to 10 thousand children and 2 - more than 10 thousand. To directly serve children in kindergartens and schools, one nurse or paramedic is provided for:100 children of kindergartens;700 pupils of schools;50 children of sanatorium kindergartens;300 students of auxiliary schools.

In accordance with the position of the district doctor, his main tasks are to further reduce the incidence and mortality of children of all ages, to ensure optimal physical and neuropsychic development of children through the wide introduction of a set of preventive measures of a specific and non-specific nature. To this end, the district pediatrician is required to:

• keep in touch with the women's consultation, ensure continuity in monitoring pregnant women, especially at risk;

• visit the home of the newborn in the first 3 days after discharge from the maternity hospital and monitor the visit of the newborn at home by the district nurse;

• to receive children in a polyclinic, prescribe a regimen, rational nutrition, specific and non-specific prevention of rickets, assess the physical and neuro-psychological development of children;

• to conduct preventive supervision of children in accordance with methodological recommendations, refer them to other specialists for advice and necessary laboratory tests, plan( together with the district nurse) preventive vaccinations, timely and reasonably draw up medical evidences from them;

• to carry out dynamic medical supervision of children taken for dispensary registration, along with other specialist doctors, to revitalize them, to analyze the effectiveness of medical examination;

• organize a survey, necessary health and preventive activities for children before entering pre-school and school;

• to visit children at home on the day of receiving the call, provide them with the necessary medical assistance, appoint physiotherapeutic treatment, exercise therapy, monitor the sick child until recovery, hospitalization or permission to visit the polyclinic;

• a sick child of the first year of life observe daily;

• inform the management of the polyclinic about all seriously ill patients on the site who are not hospitalized for any reason;

• inform SES in the established order when an infectious disease is detected or suspected, carry out a set of preventive measures aimed at reducing the infectious morbidity;

• send a child to hospital for treatment, take all necessary measures in case of emergency hospitalization;

• carry out the registration and selection of children in need of health due to sanatorium treatment;

• work on improving the qualification of the district nurse, supervise its activities.

The district pediatrician conducts planned sanitary and educational work on the development of a healthy child;his hygienic education;the formation from the early age of a conscious attitude towards the strengthening of their health as a public domain, a healthy lifestyle, a negative attitude towards alcohol and smoking. This work he performs differentially, depending on the age, individual and other characteristics of children and adolescents, living conditions and education in the family. In addition, it creates on its site a sanitary asset from the population and attracts it to carry out preventive measures.

The main assistant of the district pediatrician is the district nurse. She must have a sufficiently high level of theoretical training and professional knowledge, possess the technique of performing medical manipulations, and also possess such qualities as love of children, observance, conscientiousness, the ability to quickly establish contact with the child and members of his family. Of great importance are the relationship between the district doctor and the nurse, mutual trust, respect, and their psychological compatibility.