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Instructions on labor protection for a nurse in the intensive care unit and resuscitation department of anesthesiology and resuscitation. Full document

Occupational Safety and Health / Standard instructions for labor protection

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Safe Operation

1. General requirements for labor protection

1.1. A person is allowed to work in the department of anesthesiology and resuscitation as a nurse in the intensive care and resuscitation ward (hereinafter referred to as PITR):

• with completed secondary special education;
• certified for the specified position;
• who has undergone special training in labor protection in accordance with GOST 12.0.004-90;
• having group II approval for electrical safety;
• who do not have medical contraindications to work in the position.

1.2. The PITR nurse should be guided by:

• Instructions for the organization and implementation of sanitary and hygienic measures for the prevention of nosocomial infection (order of the Ministry of Health of the USSR dated July 31.07.78, 720 No. XNUMX);
• OST 24-21-2-85 Sterilization and disinfection of medical devices. Methods, means, modes;
• Order of the Ministry of Health of the Russian Federation of March 21.03.03, 109 No. XNUMX "On the improvement of anti-tuberculosis measures in the Russian Federation";
• By order of the Department of Health of the Krasnodar Territory dated July 5, 2001 No. 184-0D / 61-P "Standards for epidemiological surveillance of nosocomial infections for health care facilities of the region" and by order of the head of the department of anesthesiology and resuscitation No. 23/1 dated September 28.09.2004, XNUMX "On ensuring the epidemiological safety of personnel departments of anesthesiology and resuscitation";
• other regulatory documents related to the production process;
• this instruction.

1.3. In the process of performing the duties of a PIT nurse, the following dangerous and harmful production factors may affect her:

• an increase in the voltage value in the electrical network, the closure of which can occur through the human body;
• infection from patients with open forms of tuberculosis and (or) their secretions;
• infection with hepatitis B viruses, HIV when working with virus carriers;
• constant psycho-emotional stress associated with working with patients in an unconscious state or with altered forms of consciousness;
• inhalation of a gas-narcotic mixture when working with inhalation anesthetics.
• contact with open areas of the skin and (or) mucous membranes of drugs, disinfectants.

1.4. In order to minimize factors that worsen working conditions, the PITR nurse

a) must be provided with (and use during all working hours) the following certified protective equipment:

• special clothing and footwear;
• protective disposable medical masks (at least 3 pieces for a 6-hour shift), and when working with virus carriers - masks with a protective screen;
• disposable surgical gloves.

In all working premises, sanitary and hygienic standards for temperature and illumination must be observed.

b) must observe the rules of personal hygiene both to protect themselves from infection and to protect the patient from nosocomial infections. Before and after each manipulation or any other contact with the patient, wash hands with warm running water and liquid or disposable soap, then treat them with an available certified bactericidal agent for treating the skin;

c) without exception, all procedures and manipulations should be performed only with gloves on!;

d) if pathological material gets on the skin and mucous membranes during therapeutic, diagnostic manipulations and procedures (pathological material - blood, saliva, sputum, wound discharge (extravasate), urine, feces of the patient), it is necessary:

in case of skin contact:

• immediately treat the skin with 70 ° ethyl alcohol, then wash with running water and soap and re-disinfect with 70 ° alcohol solution.
• in case of contact with mucous membranes:
• immediately treat (without rubbing!) 0,05% solution of potassium permanganate (if the material gets into the mouth, rinse the mouth and throat 3-4 times with the same solution).

For injections and cuts:

• squeeze blood out of the wound and treat the wound with a 5% alcohol solution of iodine.

1.5. In order to prevent the occurrence of diseases, the PITR nurse must undergo medical examinations at least once a year (Order of the Ministry of Health of the Russian Federation of March 14.03.96, 90 No. XNUMX "On conducting preliminary medical examinations upon admission to work and periodic medical examinations").

1.6. The PITR nurse is obliged to comply with the internal regulations, the current labor protection rules. Eating (smoking) in a designated area

1.7. The victim or his eyewitness must immediately notify the immediate supervisor - the head of the department of anesthesiology and resuscitation of each accident at work.

1.8. Persons who have committed violations of this instruction are subject to disciplinary action in accordance with the internal regulations and an extraordinary examination of knowledge of labor protection issues.

2. Labor protection requirements before starting work

2.1. Before the start of the work shift, the PITR nurse must change into overalls;

2.2. Check the readiness for operation of equipment, instruments, apparatus and make sure that they are in good condition. In case of detection of defects, immediately inform the head nurse of the department;

2.3. Check the serviceability of lines with medical gases and their connecting elements. Verify the presence of medical gases. In case of detection of malfunctions, lack of medical gases, immediately inform the head nurse of the department;

2.4. Conduct a visual inspection of the fire extinguishing equipment available at the workplace;

2.5. Make sure that you have personal protective equipment (medical masks, gloves), if necessary, get them from the head nurse of the department

3. Labor protection requirements during work

3.1. Depending on the nature of the activity, the PITR nurse can work in a sitting or standing position. It is recommended to work while sitting no more than 60% of the working time, the rest of the time, standing or moving

3.2. During work, the PITR nurse must strictly observe the requirements of asepsis and antisepsis, and the rules of personal hygiene. Before and after each manipulation, the PITR nurse must wash their hands, followed by their treatment with one of the licensed bactericidal drugs;

3.3. To maintain the normal condition of the skin of the hands in the process of work, you should:

• wash hands with water not lower than room temperature;
• dry them with an individual towel;
• do not allow drugs to come into contact with the skin of the hands.

4. Labor protection requirements after the end of work

4.1. After the end of the work shift, the PITR nurse should:

• clean your workplace, make sure that devices and equipment that are not currently in use are disconnected from the mains, there are no leaks of medical gases;
• carry out the necessary sanitary and hygienic measures (if necessary, wash hands thoroughly again and treat them with a licensed bactericidal preparation), take a hygienic shower, change into normal clothes;
• place work clothes in a cabinet specially designated for them, separate from the cabinet in which ordinary clothes are stored.

4.2. The PITR nurse must report to the head nurse of the department about all detected malfunctions and shortcomings.

5. Labor protection requirements in emergency situations

5.1. In the event of an explosion or fire, the PITR nurse quickly and accurately follows the instructions of the anesthesiologist-resuscitator, and in his absence, the PITR nurse must:

• call the fire brigade by phone 01 or report a fire to the emergency department (via intercom);
• organize the evacuation of personnel and patients from the danger zone;
• de-energize the room;
• take measures to extinguish the fire with fire extinguishing equipment available at the workplace;
• provide first aid to the injured.

5.2. In the event of an electric shock, the PITR nurse should:

• release the victim from the action of electric current (disconnect faulty equipment from the electrical network, and if it is impossible, de-energize the entire room);
• provide the victim with first aid.

5.3. In the event of an emergency equipment failure, the PITR nurse should: