Who inspects private dentistry and which health authority. Sanitary and Epidemiological Service (SES): inspection

From the article you will learn about the typology of inspections, the procedure for conducting them, we will also understand the features of inspections caused by patient requests, and a number of other issues.

Inspections of dental clinics

We can talk about two types of checks: P lanovaya And V unplanned . Let's look at the features of each of them.

A scheduled inspection involves only an on-site inspection, while an unscheduled inspection can be both on-site and documentary.

Every dental clinic is sooner or later exposed to scheduled inspections, they are usually held once every three years. However, medical institutions are subject to permission to conduct more frequent inspections, although not more than 2-3 times in three years. The reason may be, for example, a change of actual address, a change in license, and so on. But most often, the inspection period is the same as for others, that is, 3 years after the opening of the clinic (obtaining a new license) or 3 years after the last scheduled inspection.

Everyone is checked, but the clinic has the advantage of being able to prepare, including conducting a free audit of patient documentation. A scheduled inspection is carried out in a similar way to an on-site inspection, that is, the inspection is carried out in the medical institution itself. Please note that the prosecutor’s office website contains the entire list of medical institutions that will soon be inspected, and the clinic will be notified three days before the start of the procedure.

Unscheduled inspection. Most often, the reason for its implementation is a complaint to Rospotrebnadzor from a patient who is dissatisfied with the quality of treatment; such checks are usually carried out as documentary checks, that is, the clinic will be required to provide Explanations (“unsubscribe”) and provide copies of the requested documents.

Periodically, the patient files a complaint or threatens to file it with all possible authorities; in this case, please note: only one authority will be inspecting the medical institution, which has jurisdiction over the information specified in the complaint. For example, when a patient is not satisfied with the quality/result of the service provided, the clinic will face an inspection by Rospotrebnadzor for violations of consumer rights. If the patient complains of medical complications, the local Ministry of Health will check.

There is a widespread opinion that “everyone will come” - the tax office, the prosecutor’s office, the Ministry of Health, Rozdravnadzor, etc. – is a fallacy and has no legal basis. For such mass inspections of one clinic, the patient would have to submit a separate application to each authority, indicating the violations within the jurisdiction of this authority; in practice, this happens extremely rarely, since the patient sends copies of the same application.

The legal basis for verification is the presence in the complaint of information about violations; if there is no threat of harm to health, the clinic is notified of the inspection at least 24 hours before the start of the inspection by any available means, and the procedure is pre-agreed with the prosecutor's office. A check of this kind is always documentary, that is, it requires written explanations.

Moreover, if the complaint indicates that as a result of medical activities, harm has been caused (or there is such a threat) to the life or health of the patient, then notification of the start of an unscheduled on-site inspection is not necessary; the prosecutor’s office is notified of the event already carried out within 24 hours.

Everything said above is indicated in the regulations: grounds for refusal to conduct an on-site unscheduled inspection(the prosecutor's office does not approve its implementation) are:
1. lack of confirmation of violations by documents and other evidence indicating the presence of signs of such violations
2. lack of grounds - statements of citizens about:

a) there is a threat of harm to life or health
b) causing harm to the life and health of citizens
c) violation of consumer rights
3) discrepancy between the subject of the unscheduled on-site inspection and the powers of the body
4) verification of compliance with the same mandatory requirements and requirements by several authorities.

In fact, The most common check is a documentary check based on a complaint, which occurs in 90% of cases.

Subject is information that is in documents of a legal entity:

• establishing the organizational and legal form, rights and obligations, documents used in the implementation of their activities and related to their fulfillment of established requirements, execution of instructions and resolutions of control bodies
• explanations on the complaint.

Please note that when conducting a documentary inspection, the control body does not have the right to request information and documents if they do not relate to the subject of the inspection.

If you have an on-site inspection, then prepare an Inspection Log (contains the fields: who, position, basis, subject, date and number of the prosecutor’s decision to approve the inspection). If the inspectors were unable to fill out all the fields of the log, then you can send them for the missing documents. Please note that they can check (and you must provide for verification) only what is relevant to the subject of verification. Also, take the time to find witnesses for the verification procedure - from among your employees. Based on the results, we can challenge the Act and the Resolution.

The basis for the inspection is the patient’s application to the supervisory authority. In accordance with the administrative regulations, the inspection body is obliged to provide a response to the patient within 30 days, and such a service (appeal) is free for the patient; this, by the way, is often abused by “consumer extremists.” When carrying out a procedure, a resolution of the supervisory authority on its conduct must be provided, describing the subject, timing and form of the inspection.

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What threatens the clinic based on the results of the inspection?

Most often, based on the results of the inspection, the clinic receives a warning or a fine. for violations of the requirements of PPRF 1006 (Resolution of the Government of the Russian Federation “On approval of the Rules for the provision of paid medical services by medical organizations”). The fine is 5,000 rubles. Here is a quote from a typical court decision: “ ...Having studied the contracts for the provision of paid dental services by Dentistry LLC, it was established that the contracts do not contain:

• list of works (services) that constitute the medical activities of a medical organization in accordance with the license, name, address of location and telephone number of the licensing authority that issued it
• terms of service provision
• responsibility of the “Patient” for failure to comply with the terms of the contract.

which led to a violation of the requirements of paragraphs. a), e), g) part 17 of the Rules for the provision of paid medical services by medical organizations, approved by the PPRF. No. 1006…. responsibility provided for in Art. 14.8 part 1 of the Code of Administrative Offenses...a fine in the amount of 5,000 rubles and warnings..."

Documents that are checked most often: according to the law “On the Protection of Consumer Rights” and PPRF No. 1006 “Rules for the provision of paid medical services” (valid from January 1, 2013).
1. Medical card
2. Agreement for the provision of paid medical services
3. Informed voluntary consent for the provision of paid medical services
4. Consent to the processing of personal data
5. Cash receipt (receipt)
6. Certificate of services performed
7. Rules for the provision of paid medical services in the clinic
8. List of paid medical services indicating prices in rubles
9. Information about medical workers, their level of professional education and qualifications
10. Working hours of a medical organization and work schedule of medical workers (information stand and website)
11. Warranty and service life provisions
12. Warning (a separate form or insert in the card) about the need to follow the doctor’s recommendations
13. Regulations on the medical commission
14. Order on the commercial name of the clinic.

If violations are detected, then it is necessary report in writing about the elimination of violations according to the model ( Response to inspectors):
« In response to Order N2115 of the official ... dated ......, we inform you that the identified violations of the law have been eliminated, namely, the following prescribed measures have been taken:

Measures to eliminate identified violations:

03/10/2017 a production control program has been drawn up, in accordance with which laboratory research and testing is carried out, with the involvement of an accredited laboratory;
03/10/2017 Instructions for waste management have been drawn up, the person responsible for waste management has been trained in....
…….
……
CEO . ……

As for the explanation of the complaint, in principle, it coincides with Response to a complaint, we adjust only the “header” of the document:
"Response to complaint
Dear......!
We express to you our understanding that you sincerely and conscientiously care about your health. The medical services provided to you are high-tech manipulations in the complex biological system of the human body, and assessing the quality of dental services also requires special medical knowledge, so let us clarify our point of view for you:

According to the medical card in the name of ...... You were provided with paid medical services for dental treatment.
Based on an analysis of complaints, medical history and objective medical data, your treatment was carried out in accordance with clinical recommendations (treatment protocols) intended for use in the healthcare system of the Russian Federation……list……….. All services were provided by doctors with valid specialist certificates , using equipment certified by the Russian Federation, medications were used according to treatment protocols.

The complaints specified in the complaint about ………… are not a significant drawback of the service (they do not interfere with the ability to use the prosthesis for its intended purpose (chewing food), and are removable. To eliminate the complaints, we invite you to an appointment for free medical services to eliminate these complaints ( free troubleshooting).
………
Thus, you were provided with medical services properly.
We invite you to come to an appointment to identify the clinical situation; if deficiencies are identified, they will be eliminated free of charge.”

Summarize:

Summary (check based on patient complaint):
1. Considers most complaints from patients about the quality of treatment Rospotrebnadzor for violations of consumer rights
2. complaint in 90% cases leads to an unscheduled documentary inspection. On your part, you need to provide copies of patient documentation and a written explanation, that is, in fact It’s easy to unsubscribe from a complaint.
3. To initiate an on-site inspection, grounds are needed - for example, harm to the patient's health; verification is underway exclusively in relation to the subject of inspection, that is, not everything is checked.
4. payments for patient claims (“ consumer extremism") significantly exceed the damage from the complaint (in the absence of anti-claim documentation).

Scheduled inspections by SES (Rospotrebnadzor) are carried out according to a pre-drawn schedule. Their frequency is equal to three years. This does not apply to medical enterprises. This schedule can be found on the official website of the organization. The head of the company or individual entrepreneur must be warned by the supervisory authorities about the upcoming scheduled inspection at least three days before it. This is due to the fact that in the absence of the boss such a check is impossible.

All newly organized firms and registered individual entrepreneurs are subject to routine inspection. The inspection commission can be either on-site or desk-based (documentary).

Unscheduled inspections of SES

Since 2015, Rospotrebnadzor has been given the right to conduct unscheduled inspections without prior warning. This happened in connection with changes in the Federal Law “On the quality and safety of food products”. Such an unexpected inspection of the SES theoretically threatens absolutely any trade, catering or production enterprise.

On what grounds are they carried out? You should wait for an inspection if the quality of the services provided or products sold is poor. In addition, SES inspections are quite frequent at the request of the buyer in connection with a complaint. Who has the right to file such a complaint? Almost anyone - from individuals (ordinary consumers or government officials) to control organizations. The legal literacy of the population is growing, and most consumers now know how to call the SES for an inspection, using this measure at the slightest violation.

The purpose and meaning of unscheduled inspections is to confirm or refute the facts contained in the complaint. Organizational managers are also notified about such events, usually within the previous 24 hours. As an exception, an urgent check is possible if a dangerous infection or serious poisoning is suspected.

Who's testing us?

What is this formidable Rospotrebnadzor (or SES - sanitary-epidemiological service)? Under this name lies a government structure whose function is to monitor the activities of a variety of organizations in order to protect the rights of consumers and their health. It includes a network of territorial SES, their task is to respond to complaints from the population about non-compliance with sanitation standards.

Where exactly is the SES authorized to control the situation? The check applies to absolutely all public catering outlets - from large restaurants to small canteens and cafes, manufacturing enterprises in one way or another connected with food products, non-residential and residential premises, and construction sites.

What will the SES require?

Rospotrebnadzor is authorized in organizations belonging to different forms of ownership to request any documents for checking the SES. We are talking about employment contracts, medical records, fire service reports, etc. The requirements of the SES relate to the availability of a log of sanitary measures, existing licenses and certificates for services and goods. Maybe she can check the operation of the cash register at any retail outlet.

Based on the results of detected violations, the SES issues instructions on how to correct them, draws up protocols and issues fines. She is responsible for monitoring the implementation of the law on the protection of consumer rights. SES is also involved in monitoring the air and water environment, soil, and waste disposal.

What does all this threaten?

What sanctions are provided in case of violation? Measures taken by the supervisory service based on the results of the inspection may consist of issuing an order to correct all identified inconsistencies, imposing a fine, as well as temporarily suspending the activities of the organization or individual entrepreneur for the period required to eliminate the violations. If a mass disease or its threat is detected, the sanitary-epidemiological service has the right to file a judicial application - this depends on the scale of the outbreak.

If the violations are not of such a global nature, but only non-compliance with sanitary standards is identified, the fine will be less - from 5 to 10 minimum wages. It can be replaced by suspension of the enterprise's activities for a period of three months for the purpose of correction. If there are errors in the condition of the premises or operating standards, such a fine will range from 10 to 20 minimum wages. Gross violations, in addition, are also fraught with imprisonment by court decision.

The size of the fine depends on who is found guilty. If this is a legal entity, its amount will be a larger amount than from an individual (seller, individual entrepreneur, representative of an institution).

What kind of violations are detected by Rospotrebnadzor and where?

Let's consider the list of the most common inconsistencies identified by the SES. Inspection of different types of institutions and organizations has its own characteristics. In hairdressing and beauty salons, the area occupied by the premises may not meet sanitary standards; there may be a lack of bactericidal ultraviolet light irradiators used for air disinfection. Perhaps the establishment does not have a special room for storing waste, hair, or there is no place for washing clothes. The rules for storing fluorescent lamps may be violated; the required triple set of tools or a foot bath in the pedicure room may be missing. It is considered a violation to perform pedicure and manicure procedures in the same room. Sanctions are also subject to poor sanitary conditions or the lack of a medical examination for workers, as well as a sign at the entrance to the building.

Checking in a medical facility

What violations can be detected in a SES medical institution? Checks in them often concern documents - it is possible that contracts for paid services (for example, dental) were drawn up incorrectly. They sometimes lack a lot of necessary information regarding the timing of such services, guarantees, etc. The clinic’s information stand must contain detailed information about the qualifications of the medical staff. The absence of such information is also fraught with punishment.

They are also fined for violating the rules of a special regime during epidemics, insufficiently thorough cleaning of equipment and sterilization of instruments, or incorrect concentration of disinfectants. A fine will be imposed for anything - for example, for the lack of necessary conditions for the personal hygiene of workers. Inspecting authorities may also find fault with non-compliance with the dimensions of premises that do not comply with the standards of the medical institution, incorrect registration of price tags for the sale of related medical drugs, and the lack of official training of employees before carrying out special work (for example, with radioactive radiation sources).

Check at the pharmacy

What can the SES fine a pharmacy for? Inspections most often concern violations of temperature and humidity conditions, improper washing of work clothes and linen, and lack of timely medical examinations of personnel.

A pharmacy establishment also faces a fine if the terms of sale of drugs, the conditions or the permissible temperature for their storage are violated, or if there is no necessary information for customers about each drug available for sale, its price, composition, indications and side effects.

SES check in a grocery store

The SES pays the closest attention to catering establishments and those that sell food. This is understandable - after all, the products consumed by the population must be at least safe for health. The most common errors identified at catering enterprises include malfunctions in the ventilation systems, disruption of technological processes (intersection of finished product flows with semi-finished products and raw materials), lack of medical examination of workers or the necessary equipment or personnel to maintain cleanliness.

This also includes violations in food technologies (such as re-freezing fish or meat products), the presence of expired semi-finished products, and the receipt and sale of goods without documents or labeling. A grocery store will be fined for discrepancies between the sanitary and technical characteristics of the premises occupied and the approved standards, lack of measuring instruments to control humidity and temperature conditions, storage of food products outside a special warehouse, sale and storage of goods with incorrect labeling or missing Russian-language information.

In addition, the SES actively inspects schools, kindergartens (especially private ones), gas stations, car washes, regardless of their legal form.

What's the result?

Based on the results of each inspection, a sanitary and epidemiological conclusion from the SES is issued. This is a mandatory document confirming the compliance of a product or product with all required sanitary standards. In addition, an inspection report is drawn up. All violations and inconsistencies found must be recorded in a protocol, which is certified by SES employees. One copy of the inspection report remains at the enterprise or individual entrepreneur, the other is intended for inspectors. Each of these events is recorded in a special control log.

About verification rules

In its inspections, Rospotrebnadzor is obliged to follow the regulations, which prescribe when carrying out this procedure to remain within its own competence, not to conduct scheduled on-site inspections in the absence of the organization’s management, and not to request information that is not relevant to the case.

He is prohibited from carrying out an examination or taking samples without recording each of the actions, divulging information about the results of the inspection, which is a state secret, and also violating the deadlines established for the event.

How to prepare for inspections

What can you advise those individual entrepreneurs or heads of organizations who are afraid of inspections? How best to prepare for them? The most reliable means is to constantly maintain cleanliness, comply with all necessary sanitary standards, have scrupulously completed documents for SES inspection and carry out all sanitary and hygienic measures on time. If you are not sure about the need for certain actions, you can get advice from the SES authorities.

When the inspectors arrive, check that they have permits. If they are missing or are issued in violation, you have the right to refuse admission to the inspection. We remind you once again that only the manager or a specially authorized person whose rights are confirmed by a power of attorney has the right to represent the organization during such inspections. For example, inspectors do not have the right to act in the presence of only a seller at a retail outlet who is not authorized to receive them.

To ensure security, the rights and responsibilities of each employee should be clearly stated in advance in their job description. Ordinary employees do not have the right to sign any documents.

Informal moments

Communication with the commission should be conducted in a calm business tone. The best course of action is open communication, but without providing unnecessary (excessive) information that could provoke unnecessary questions. You should not give inspectors reasons for additional sanctions.

Be prepared in advance that the commission will conduct its work quite scrupulously. If disputes arise, do not try to incite conflict. If your rights are violated, you should defend them in a confident, calm tone, relying on legal information.

The imposition of a fine must be reasoned and reflected in the protocol. Without documentary evidence, handing over a fine turns into a banal bribe. Each enterprise must have a logbook for recording inspections, in which all information about each such event is recorded in detail, including the received conclusion of the SES.

ON OCTOBER 1, new Sanitary and Hygienic requirements for dental medical organizations, developed by Rospotrebnadzor, come into force. They relate, in particular, to the placement of dental clinics, the decoration of their premises, equipment, microclimate and lighting. For violations, clinics will be fined or even closed altogether.

The document caused a mixed reaction among dentists: sharply negative among those engaged in private practice, and favorable among those who took part in the development of these requirements.

The most pressing issue in the dental business is premises. We quote the requirements: “Dental medical organizations can be located in separate buildings, in adapted premises, built-in (built-in and attached) to residential and public buildings, subject to the requirements of sanitary rules and regulations. In dental offices, the area for the main dental unit should not be less than 14 sq. m, for an additional installation - 10 sq. m (for a dental chair without a drill - 7 sq. m), the height of the offices is at least 2.6 m. The minimum set of premises for the work of a dental medical organization includes: a lobby group ( minimum 10 sq. m), dentist's office (minimum 14 sq. m), staff room (minimum 6 sq. m), toilet (minimum 3 sq. m) and storage room (minimum 3 sq. m). Total - 36 sq. meters.

“Most private dental offices meet the stipulated standards of the new SanPiN,” assures Georgy Bezvestny, chairman of the private dentistry section of the Russian Dental Association. “It is unlikely that anyone will need re-equipment; the costs of bringing their work into compliance with the new SanPiN will be minimal.”

Boris Kashko, head of the Committee on Security and Business Protection of the Association of Private Dental Clinics, has the opposite opinion. He believes that those who are just starting their own business will be the first to face the problem: rented premises in 100% of cases will not meet all the requirements of the new Sanitary Regulations and Regulations. “True, the rules presuppose the possibility of remodeling the premises,” he says. “A forced reason for repairs can be either the receipt of a new license or any other documents in the form of conclusions, confirmations, permits, etc. for the implementation of additional services. Redevelopment (for example , raising the ceiling height to 2.6 m on the first floor of a multi-story residential building in Moscow) is only possible theoretically: it will be cheaper to build a new one- or two-story building with the required space, I don’t know how much it costs to build a house in Moscow. that this is beyond the capabilities of either small or medium-sized businesses. Given the existence of private property in the country, the requirements are based on the administrative and material resources of the state. According to the new requirements, a private entrepreneur must have the same material capabilities for design, construction, and operation as the state. such opportunities, there is a need to enter into paid contracts with third-party organizations for design, coordination, measurement, issuance of an opinion, drawing up a protocol, examination, etc. Control, according to the document, falls on the dental company. There is a need to create a special service in the office to carry out a new function or conclude external contracts (of course, with payment for services).”

But Georgy Bezvestny has a different opinion. He says that the main objective of Rospotrebnadzor’s requirements is to create conditions to eliminate the possibility of infection of staff and patients with nosocomial infections, create conditions for comfortable, ergonomic work of medical personnel, and ensure compliance with the requirements of medical technologies. “At the dawn of private dentistry, there were attempts to present additional requirements to private owners. For example, in the Moscow region “Requirements for private dental offices” were published. We are glad that those days are over and that both legislators and inspectors have an understanding that private and public medicine should not differ in the quality of medical care. Both sanitary rules and norms correspond to this principle - they are the same for everyone.”

But the new requirements of Rospotrebnadzor threaten not only the infringement of the interests of small and medium-sized dental businesses. Their unquestioning observance, according to experts, will become an obstacle to the development of dentistry and will leave part of the population without timely dental care, and residents of remote settlements, especially in the North, may be left without teeth at all. Including because the document obliges dental clinics to have natural light. You might think that teeth don’t hurt on polar nights.

“Requirements in this form hinder not only the development of new areas in dentistry, but also the development of the very structure of dental care in the Russian Federation and create the possibility of legal and illegal siphoning of money from the medical business,” says Boris Kashko. “The rules do not even envisage the emergence of new construction projects in the future.” materials, technologies for medicine, hinder the introduction and dissemination of new medical technologies, become an obstacle to the development of the structural organization of dental care in the Russian Federation (development of mobile dental offices, non-stationary deployment of dental departments of hospitals (Moscow Ministry, Ministry of Emergency Situations, etc.), dental offices at sea courts, both public and private) etc."

The only thing in which the opinions of Kashko and Besvestny are similar is that the new document opens up new opportunities for officials to take bribes. Moreover, it contains not only requirements, but also recommendations (for example, regarding the sterilization of instruments, lighting), as well as “allowed” and mysterious “if possible”.

“Each inspector reads documents in his own way, mainly between the lines. By the way, when working on the document, the main task was to avoid double interpretation of the wording. We thought that we had succeeded. But during the discussion of the project, we held a seminar with representatives of Rospotrebnadzor. And Imagine our surprise when a completely simple proposal was presented to us “in a new light.” And to our question: “Where is this written?” - the answer was: “It’s implied.” We should write some kind of SanPiN or regulations for the inspectors. “they didn’t mean it,” but simply fulfilled their duties,” dreams Georgy Bezvestny.

Boris Kashko is more categorical. “A wave of inspections can be caused by any mandatory recommendation on the need for the office to present a new conclusion, certificate, compliance, etc. Moreover, each scheduled inspection must end with a conclusion that the object does not comply with the new requirements. The further fate of the office is known only to the Authorized Official. These rules do not answer this question,” he laments. “Such inspections will directly affect the existence of the business: the inspector issued a document - the office continues to work, the inspector did not issue a conclusion - medical activities are stopped.”

LIST OF DOCUMENTS
TO PREPARATE A MEDICAL ORGANIZATION FOR INSPECTION BY ROSPOTREBNADZOR

1. Documents for the head of a medical organization(legal representative of a legal entity): order of appointment to a position, employment contract, job description

2. Charter of a legal entity

3. TIN certificate

4. OGRN certificate

5. Codes OKVED

6. Bank details.

7. Documents, confirming that the medical organization has its own on the right of ownership (documents of ownership) or other legal basis (premises rental agreement) buildings, structures, structures and (or) premises in which licensed types of activities are carried out.

8. Staffing for the current year: with a mandatory indication of occupied and vacant positions, additionally - information about employees not listed in the staffing table, regulations on structural divisions, job descriptions of personnel.

9. Licenses for medical and pharmaceutical activities

10. Sanitary and epidemiological conclusions: for medical activities, for work with sources of ionizing radiation (IRS), for work with pathogenic biological agents (pathogenic biological agents) of 3-4 pathogenicity groups.

11. Floor plans of each building(in accordance with the building description, each room must be signed, the number of beds in each ward must be indicated).

12. Disinfection and cleaning of the exhaust ventilation system: contract for the performance of work (including in the catering department ─ with a laboratory test report), a log of disinfection and cleaning of the exhaust ventilation system (general for a medical organization), passports of ventilation systems, a technical report on the operation of ventilation systems (evaluation of its effectiveness).

13. Production control program: an order appointing someone responsible for conducting CPD, an agreement to carry out CPD with a license, certificate and scope of accreditation of the organization performing laboratory and instrumental research under the PC program, the latest research protocols.

14. Organization of medical waste management: an order for the appointment of responsible persons, a diagram and instructions for the management of medical waste, a log of briefings (preliminary upon hiring and periodic), technological logs for the accounting of medical waste by department and for the institution as a whole, an agreement for the removal of medical waste with delivery certificates -reception and coupons for waste disposal at landfills.

In the presence of medical waste management site in a medical organization: all of the above documents with the exception of the contract for the removal of medical waste.

15. Agreement for the removal of solid waste, food waste, class G waste(disposal of mercury-containing waste, including fluorescent and ultraviolet bactericidal lamps; expired disinfectants; expired medicines).

16. Agreement for deratization and disinsection of synanthropic arthropods(from flies, cockroaches, mice, if necessary - seasonal treatment of the territory of a medical organization from ticks) with certificates of work performed.

17. Agreement for washing the workwear of medical employees and linen of a medical organization.

18. Final acts on periodic medical examinations employees of a medical organization with an explanation according to the staffing schedule. Information on medical examinations external part-time workers(if available in the state).

19. Availability of medical records for catering staff, barmaids and employees associated with food distribution.

20. Data on the completion of the annual fluorographic examination employees of a medical organization; a list of employees subject to fluorographic examination this year, agreed with Rospotrebnadzor.

21 . Information on vaccinations employees of a medical organization against measles, rubella, diphtheria, hepatitis B. For employees involved in food distribution : against hepatitis A And Sonne dysentery(in medical institutions of the Moscow Department of Health). Availability of vaccination certificates.

22. Documents on the organization of therapeutic nutrition: invoices, invoices for the current month (as of the date of inspection) for all products. Documents confirming the quality of food products sold (certificates, declarations, EAC certificates). Documents confirming the use of specialized transport for transporting this type of food product, temperature sheet of conditions for transporting food products.

23. Agreement for medical device maintenance(equipment, apparatus, devices, tools) , certificates of work performed on the maintenance of medical devices.

24. Instructions for processing (disinfection, sterilization) of medical devices.

25. List of medical equipment, containing sources of ultrasound, ultraviolet radiation (ultraviolet bactericidal irradiator, bactericidal chamber for storing sterilized medical products, etc.), laser radiation, microwave, ionizing radiation, a list of endoscopic, disinfection and sterilization equipment (autoclaves, air sterilizer, ultrasonic washer, air chamber - steam formalin disinfection, etc.).

26. Documentation for medical devices: passport, instruction manual, registration certificate, certificate of conformity.

27. Endoscopic equipment: administrative document of the organization on the persons responsible for organizing and carrying out anti-epidemic measures during endoscopic manipulations, including the quality of processing of endoscopic equipment; documents on advanced training of medical workers directly related to endoscopic interventions and processing of endoscopic equipment (doctors and nurses); work instructions for reprocessing endoscopes; journals for monitoring the processing of endoscopes for non-sterile interventions.

28. Accounting documentation quality control of sterilization and disinfection of medical products: logbook for recording the quality of pre-sterilization treatment of medical products (form No. 366/u), logbook for monitoring the operation of air and steam (autoclave) sterilizers (form No. 257/u).

29. Logbook for recording and monitoring the operation of a bactericidal installation.

30. Calculation of the need for disinfectants.

31. Help about quantity of disinfectants, available as of the current month (as of the date of inspection).

32. Logbook for monitoring the concentration of working solutions of disinfectants.

33. General cleaning journal.

34. Journal of infectious diseases (form No. 060/у).

35. Commission on the prevention of HCAI: order on the work of the commission on the prevention of HCAI, the work plan of the commission on the prevention of HAI, minutes for the current and previous years of meetings of the commission on the prevention of HAI.

36. Comprehensive plan for the prevention of infectious diseases in a medical organization.

─ methodological folders developed on the basis of regulatory legal acts and organizational and administrative documents in the emergency department (operative folder), pathology department and in each medical department, as well as from the management of a medical organization. Each methodological folder contains:

1) order “On ensuring measures to prevent the introduction and spread of diseases requiring measures for sanitary protection of the territory”,

2) notification scheme,

3) functional responsibilities of officials, specifically for employees of each department,

5) general information about the clinical and epidemiological characteristics of diseases,

6) an operational plan for localizing the outbreak if a patient is identified with diseases,

7) plan of preventive measures,

8) the procedure for putting on and taking off personal protective equipment, their disinfection,

9) measures and means of personal prevention of medical personnel,

10) rules for collecting biological material for cholera,

11) a plan for conducting a training exercise with medical workers with the introduction of a conditional patient (with a protocol and registration of those present at the exercise).

38. Log of examination for pediculosis in the emergency department.

39. Medical documentation of patients.

40. Acts of reconciliation with the branch of the Federal Budgetary Healthcare Institution “Center for Hygiene and Epidemiology”.

41. Data microbiological monitoring from environmental objects and from patients for the current year (general for the hospital, breakdown by department, prevailing flora, antibiotic resistance). 5 case histories with purulent-septic complications after operations performed in the current and previous year.

42. Clinical diagnostic laboratory of 3-4 pathogenicity groups: order to create a commission on the safety of working with microorganisms of pathogenicity groups 3-4, an examination report of a clinical diagnostic laboratory of pathogenicity groups 3-4, documents on the professional training of medical personnel of the laboratory.