№ of payment order

Name of the requirement

Extent of violations

1.

Availability of the certificate of the specialist for the admission to clinical practice

rough

2.

Availability of the license and (or) appendix to the license

rough

3.

Compliance of the room or building on the property right or lease contracts, or agreements of free use by real estate (loan), either property trust management, or the agreement of public-private partnership to standards of the organization of delivery of health care of profile services for the rendered subspecies of medical activities, and also corresponding to the health regulations establishing sanitary and epidemiologic requirements to health care facilities

rough

4.

Availability of the functioning medical and (or) special equipment, the equipment and tools, devices, furniture, stock, transport and other means (if necessary) approved in standards of the organization of delivery of health care of profile services for the rendered subspecies of medical activities and the minimum standards of equipment of the organizations of health care by medical products

rough

5.

Availability of specialists in the rendered types of activity

rough

6.

Availability of specialization or enhancement and other types of advanced training for the last 5 (five) years on the rendered subspecies of medical activities (except for the graduates of internship, residency, average educational institution which completed training no later than 5 (five) years at the time of check).

rough

№ of payment order

Name of requirements

Extent of violations

For the objects of obstetric aid and (or) the stationary organizations incorporating delivery rooms and departments of pathology of newborns

1.

Availability of the conclusion about compliance of the subject of health care to provision of high-technology medical care under the organization of rendering high-technology services, including extracorporal fertilization (further – EKO)

rough

2.

Availability of the documentation confirming delivery of health care, entering the guaranteed amount of free medical care and (or) system of compulsory social medical insurance on free basis

rough

3.

Availability of the signed agreement of joint insurance of professional responsibility of health workers

rough

4.

Availability of written voluntary consent of the patient or his legal representative in case of invasive interventions and on holding medical and diagnostic actions

considerable

5.

Availability of the medical documentation ("The card of challenge of crew of emergency medical service" form No. 085/at, "The magazine of acceptance and refusals in hospitalization", "The medical record of the stationary patient" form No. 001/at) confirming stay of crew of SSMP in department SMP under the PHC organization or in the reception of hospital which is not exceeding 10 minutes (time for transfer of the patient to the doctor of reception) from the moment of its arrival in hospital, except as specified need of rendering emergency medical service for emergency situations

rough

6.

Availability of entry in the medical documentation confirming arrival of the patient in reception of hospital with carrying out primary assessment and carrying out medical sorting according to triazh-system (further - medical sorting) in certain group, proceeding from condition of the patient, its possible deterioration and first priority of rendering the emergency medical care.

Medical sorting is carried out continuously and preemstvenno. On completion of assessment, the patient is marked with color of one of categories of sorting, in the form of special color label or color tape. On medical sorting, allocate 3 groups of patients: the first group (red zone) – patients whose condition poses direct threat of life or deteriorations having high risk and requiring the emergency medical care; the second group (yellow zone) – patients whose condition poses potential hazard for health or can progress with development of the situation, the requiring emergency medical care; the third group (green zone) – patients whose condition does not pose direct threat for life and health and does not require hospitalization

rough

7.

Availability of the medical certificate issued by the doctor of reception with written reasons for refusal in the absence of indications for hospitalization in the organization of health care. Availability of the asset sent by the nurse of reception to the PHC organization for the place of attachment of the patient

rough

8.

Availability of entry in the medical documentation confirming indications for hospitalization: need of rendering pre-medical, qualified, specialized medical care, including using high-technology medical services, with the round-the-clock medical observation of patients:

1) in planned procedure – in the direction of specialists of PHC or other organization of health care;

2) according to the emergency indications (including days off and holidays) - regardless of direction availability

considerable

9.

Availability of entry in the medical documentation confirming carrying out survey of heavy patients by the manager of department in day of hospitalization in subsequent – daily. The patients who are in medium-weight condition are inspected at least once a week. Availability of the results of survey of the patient registered in the medical record with indication of recommendations about further tactics of maintaining the patient with obligatory identification of the health worker making records

rough

10.

Availability of entry in the medical documentation confirming carrying out daily survey by the attending physician of the patients who are in hospital except days off and holidays. Availability of the corresponding entries in the medical record in case of survey and appointment of additional diagnostic and medical manipulations as the doctor on duty

considerable

11.

Reasons availability in the medical record for dynamic assessment of condition of the patient under clinical protocols of diagnostics and treatment in case of identification of the fact of additional and repeated carrying out the researches conducted before hospitalization in the PHC organization or other organization of health care on medical indications

considerable

12.

Availability of the medical documentation confirming observance of requirements in case of issue of leaf and certificate of temporary disability for pregnancy and childbirth: - the sheet or the certificate of temporary disability on pregnancy and childbirth is issued by the health worker (the doctor the obstetrician-gynecologist), and in case of its absence - the doctor, together with the manager of department after the conclusion of the medical and consulting commission (further – VKK) since thirty weeks of pregnancy for the term of lasting hundred twenty six calendar days (seventy calendar days before childbirth and fifty six calendar days after the delivery) in case of normal childbirth. To the women living in the territories which were affected by nuclear testing, the sheet or the certificate of disability on pregnancy and childbirth is issued since twenty seven weeks lasting hundred seventy calendar days (ninety one calendar days before childbirth and seventy nine calendar days after the delivery) in case of normal childbirth;

2) to the women who temporarily left from the permanent residence within the Republic of Kazakhstan, the sheet or the certificate of temporary disability on pregnancy and childbirth is issued prolonged) in the medical organization where there was childbirth or in antenatal clinic (office) in the place of observation according to the statement (prenatal record) of the obstetrical organization

3) in case of the complicated childbirth, the birth of two and more children, the sheet or the certificate of temporary disability is prolonged in addition for fourteen calendar days by the health worker (the doctor the obstetrician-gynecologist), and in case of its absence - the doctor, together with the manager of department after the conclusion of VKK in the place of observation according to the statement of the obstetrical organization of health care. In these cases the general duration of prenatal and postnatal leaves constitutes hundred forty calendar days (seventy calendar days before childbirth and seventy calendar days after the delivery). To the women living in the territories which were affected by nuclear testing in case of the complicated childbirth, the birth of two and more children, the sheet or the certificate of temporary disability is prolonged in addition for fourteen calendar days, the general duration of prenatal and postnatal leaves constitutes hundred eighty four days (ninety one calendar days before childbirth and ninety three calendar days after the delivery);

4) in case of childbirth in case of term from twenty two to twenty nine weeks of pregnancy and the child's birth with body weight five hundred grams and more, lived more than seven days, are issued to the woman the sheet or the certificate of disability upon childbirth for seventy calendar days after the delivery. In case of childbirth in case of term from twenty two to twenty nine weeks of pregnancy and the birth of dead fruit or the child with body weight five hundred grams and more, died up to seven days of life, are issued to the woman the sheet or the certificate of temporary disability upon childbirth for fifty six calendar days after the delivery;

5) to the women living in the territories which were affected by nuclear testing, in case of childbirth in case of term from twenty two to twenty nine weeks of pregnancy and the child's birth with body weight five hundred grams and more, lived more than seven days, the sheet or the certificate of temporary disability is issued for ninety three calendar days after the delivery. To the women living in the territories which were affected by nuclear testing, in case of childbirth in case of term from twenty two to twenty nine weeks of pregnancy and the birth of dead fruit or the child with body weight five hundred grams and more, died up to seven days of life, the sheet or the certificate of temporary disability is issued for seventy nine calendar days after the delivery; 6) in case of the address of the woman during pregnancy behind leaf of temporary disability the maternity leave is estimated totally and is provided completely irrespective of number of the days which are actually used by it before childbirth. In case of the address of the woman to the period after the delivery behind leaf of temporary disability only leave after the delivery is granted by duration provided by this Item; 7) in case of approach of pregnancy during finding of the woman in paid annual labor leave or leave non-paid on child care before achievement of three years by it, the leaf about temporary disability is issued on all vacation days on pregnancy and childbirth, except as specified, provided by subitem part two

6) this Item;

8) in case of the death of mother in case of childbirth or in the postnatal period, the sheet or the certificate of temporary disability is issued to person performing care of the newborn;

9) in case of transaction on abortion, the sheet or the certificate of temporary disability is issued by the doctor together with the manager of department for the period of stay in hospital and out-patient and polyclinic level where transaction was made, and in case of complication - for the entire period of temporary disability. In case of spontaneous abortion (abortion) the sheet or the certificate of temporary disability for the entire period of temporary disability is issued;

10) when carrying out transaction of change of embryo the sheet or the certificate of temporary disability is issued by the medical organization performing operation from the date of replanting of embryo to the pregnancy establishment fact. To persons who adopted (adopted) newborn child(children), and also the natural mother in case of surrogacy it is direct from maternity hospital the sheet or the certificate of temporary disability is issued, from the date of adoption (adoption) and before the expiration of fifty six calendar days since the birth of the child

considerable

13.

Availability of entry in the medical documentation confirming observance of requirements when conducting examination of temporary disability, issue of leaf and certificate of temporary disability (form No. 001/at "The medical record of the stationary patient", form 052/at "The medical record of the ambulatory patient", roots of sheets of temporary disability of patients, form No. 025/at "The magazine for record of the conclusions of the medical and consulting commission", form No. 029/at "The book of registration of sheets about temporary disability", form No. 037/at "The reference No. ___ about temporary disability of the student, pupil of college, technical training college, about disease, quarantine and other causes of absence of the child attending school, the children's preschool organization (necessary to emphasize)", form No. 038/at "The reference No. ______ about temporary disability" and others):

1) availability of survey of person and data recording about its state of health in the medical record of the ambulatory (stationary) patient proving need of temporary release it from work;

2) issue of leaf and certificate of temporary disability in day of the statement of persons in case of hospitalization (including day hospitals, the rehabilitation centers) for the entire period of hospitalization;

3) closing of leaf and certificate of temporary disability with date of the statement from hospital if working capacity of persons is completely recovered;

4) prolongation to persons continuing to be temporarily disabled leaf and the certificate of temporary disability for term taking into account time necessary for its appearance to the health worker of polyclinic or challenge of the health worker on the house (but no more than for one calendar day). To persons receiving treatment outside the region of residence time necessary for arrival to the place of its permanent residence is considered (but no more than for four calendar days);

5) issue of the certificate of temporary disability in case of the injuries got the being able alcoholic or drug intoxication and also in case of sharp alcoholic or narcotic intoxication, for the entire period of temporary disability;

6) issue of leaf and certificate of temporary disability to persons suffering from mental diseases in case of the untimely appeal to the medical organization for last days for the conclusion of VKK of psychoneurological dispensary or the health worker (psychiatrist) together with the head of the medical organization;

7) issue of leaf and certificate of temporary disability to the persons sent by a court decision for medicolegal or forensic-psychiatric examination and recognized disabled from the date of revenues to examination;

8) issue at the same time leaf and the certificate of temporary disability to person combining training with work

considerable

14.

Availability of the informed written consent of the patient to blood transfusion and its components

rough

15.

Availability of entry in medical documentation (form No. 001/at "The medical record of the stationary patient") confirming inspection of the recipient before transfusion on markers of haemo transmissible infections (HIV, hepatitises B and C), and also recommendations in vypisny epicrisis of need of repeated inspection on HIV and hepatitises B and C in the PHC organization for the place of attachment through 1, 3, 6 months

considerable

16.

Availability at the medical organization of the contract for acquisition and delivery of blood and its components

rough

17.

Documentation availability (the internal document approved by the first head) confirming distribution of functions of the workers occupied at each stage of blood transfusion, its components

considerable

18.

Availability of entry in the medical documentation (result of research group on the AVO system and Rhesus factor of accessory, screening of irregular anti-erythrocytic antibodies in form 098/at or record electronically 001/at "The medical record of the stationary patient") confirming immunohematologic inspection of recipients for safety of transfusion therapy

rough

19.

Availability of entry in the medical documentation confirming establishment of indications to purpose of blood, its components based on clinical manifestations of deficit or dysfunction of the cellular, or other components of blood confirmed with laboratory data ("the Pretransfusion epicrisis" the loose leaf 6 to the medical record of the stationary patient form 001/at)

rough

20.

Documentation availability (the internal document approved by the first head) confirming continuous personnel training, participating in performing transfusion therapy and the admission to accomplishment of the transfusion help of medical personnel and medical personnel of average link

considerable

21.

Availability of the medical documentation confirming transfer of assets from hospital in PHC about the patients who transferred hemotransfusion

considerable

22.

Availability of the medical documentation ("Diary" the loose leaf 2 to the medical record of the stationary patient ф 001/at) confirming performance monitoring of blood transfusion and its components

considerable

23.

Maintaining forms of accounting documentation in the field of health care (form No. 003/at "Form of accounting of movement of blood, its components and diagnostic standards" on electronic and (or) paper; The Loose leaf 6 to the medical record of the stationary patient form 001/at "Pretransfusion epicrisis", "The protocol of transfusion of components", "Transfusion leaf", the Form No. 006/at "Form of accounting of blood transfusion, its components, medicines", the Form No. 007/at "Form of accounting of recipients of blood and its components") on electronic and (or) paper

rough

24.

Availability of the medical documentation confirming observance of actions when carrying out pathoanatomical opening:

1) carrying out pathoanatomical opening of corpses after ascertaining by doctors of biological death, after provision of the medical record of the stationary patient or the medical record of the ambulatory patient with the written order of the chief physician or his deputy for medical (medical) part of the organization of health care about the direction on pathoanatomical opening;

2) transfer of the medical record of the stationary patient or the medical record of the ambulatory patient with the pathoanatomical diagnosis introduced in it in medical archive of the organization of health care no later than ten working days after pathoanatomical opening;

3) carrying out kliniko-pathoanatomical analysis in cases of death of patients in the organizations of health care;

4) the organization by the chief physician and manager of pathoanatomical department of virologic (immunofluorescent) and bacteriological research of materials of opening of corpses in cases of suspicion of infectious diseases;

5) transfer to pathoanatomical bureaus, centralized pathoanatomical departments and pathoanatomical departments of medical records of stationary patients on all dead for prior days no later than 10 o'clock in the morning of the day following after factual determination of death

6) registration of results of pathoanatomical opening in the form of the pathoanatomical diagnosis (the pathoanatomical diagnosis includes: the main disease, complication of the main disease, associated disease, the combined main disease);

7) registration: - the health certificate on death (preliminary, final) the doctor in "pathological anatomy (adult, children's)" in day of carrying out pathoanatomical opening;

- the health certificate on perinatal death (preliminary, final) the doctor in "pathological anatomy (adult, children's)" in day of carrying out pathoanatomical opening;

8) registration of results of opening in the form of the protocol of pathoanatomical research;

9) availability of the written notice in judicial investigating bodies for the solution of question of transfer of corpse on forensic medical examination in case of detection of signs of violent death and the termination of carrying out pathoanatomical research of corpse;

10) availability of the notice in writing of the doctor in "pathological anatomy (adult, children's)" in case of primary detection during opening of signs of acute infectious disease, food or production poisoning, unusual reaction to inoculation, and also the emergency notice in bodies of the public sanitary and epidemiologic service, at once after their identification;

11) carrying out pathoanatomical research of placenta:

- in case of all diseases of the newborns revealed at the time of the birth;

- in cases, suspicious on hemolytic disease of newborns;

- in case of early otkhozhdeniye of waters and in case of dirty waters;

- in case of the diseases of mother proceeding with high temperature in the last trimester of pregnancy;

- in case of explicit anomaly of development or attachment of placenta;

- in case of suspicion on availability of congenital anomalies of development of fruit;

- in case of cases of preeclampsia, eclampsia

12) obligatory registration of fruit weighing less than 500 grams with anthropometrical data (weight, growth, head circle, thorax circle);

13) establishment of pathoanatomical opening depending on complexity on the following categories:

- first category;

- second category;

- third category;

- fourth category;

14) establishment by the doctor in "pathological anatomy (adult, children's)" categories of pathoanatomical opening and the reason of discrepancy of diagnoses in case of discrepancy of final clinical and pathoanatomical diagnoses;

15) availability of the detailed analysis with determination of profile and categories of yatrogeniya in all cases of iatrogenic pathology, revealed as a result of pathoanatomical opening

rough

25.

Availability of the medical documentation confirming observance of the following requirements under the organization of the obstetric and gynecologic help at the out-patient and polyclinic level:

1) ensuring early registration of pregnant women, in day of the appeal to the medical organization, without availability of the status of zastrakhovannost;

2) medical attendance at home pregnant women, women in childbirth, gynecologic patients and group of women of fertile age (further – ZhFV) social risk, universal (obligatory) patronage observation of the expectant mother in terms up to 12 weeks and 32 weeks of pregnancy

3) dispensary observation of pregnant women for the purpose of the prevention and early identification of complications of pregnancy, childbirth and the postnatal period with allocation of women "on risk factors";

4) carrying out prenatal screening - comprehensive examination of expectant mothers for the purpose of identification of risk group on chromosomal pathology and inborn malformations of pre-natal fruit;

5) identification of the pregnant women needing timely hospitalization in day hospitals, departments of pathology of pregnancy of the medical organizations of stationary level giving obstetric and gynecologic help, the profile medical organizations with ekstragenitalny pathology with respect for the principles of regionalization of the perinatal help;

6) the direction of pregnant women, women in labor and women in childbirth for receipt of the specialized help with medical observation, including using high-technology medical services in the medical organizations of republican level;

7) carrying out prenatal training of pregnant women in preparation for childbirth, including to partner childbirth, informing pregnant women on alarming signs, on effective perinatal technologies, the principles of safe motherhood, breastfeeding and perinatal leaving;

8) carrying out patronage of pregnant women and women in childbirth according to indications;

9) consultation and rendering services in questions of planning of family and protection of reproductive health;

10) prevention and detection of infections, sexually transmitted for the direction to profile specialists;

11) inspection of ZhFV with appointment, in need of profound inspection with use of additional methods and involvement of profile specialists for timely detection of ekstragenitalny, gynecologic pathology and their capture on dispensary accounting;

12) the organization and performing routine inspections of female population for the purpose of early detection of ekstragenitalny diseases;

13) inspection and treatment of gynecologic patients with use of modern medical technologies;

14) medical examinations of gynecologic patients, including rehabilitation and sanatorium treatment;

15) accomplishment of small gynecologic transactions with use of modern medical technologies;

16) conducting examination about temporary disability on pregnancy, childbirth and gynecologic diseases, determination of need and terms of temporary or permanent transfer of the worker for health reasons for other work, the directions for medico-social examination (further – MSE) women with signs of permanent disability;

17) twofold inspection during pregnancy on HIV infection with execution of the informed consent of the patient with fixation of data

rough

26.

Availability of written consent of both spouses for use of gametes, tissues of reproductive organs by the recipient who is married (consisting) (matrimony)

considerable

27.

Availability of documentation confirming the birth of 10 (ten) children from one donor who is the basis for the termination of use of this donor for recipients

considerable

28.

Availability of documentation confirming carrying out donorship of gametes, tissues of reproductive organs at the donor in case of observance of the following conditions:

1) the donor freely and consciously in writing expresses the informed consent on carrying out donorship of gametes, tissues of reproductive organs;

2) the donor of oocytes is informed in writing on complications for her health in connection with the forthcoming surgery;

3) the donor undergoes medico-genetic inspection and there is conclusion of the doctor-reproduktologa or doctor-uroandrologa about possibility of carrying out donorship of gametes, tissues of reproductive organs

considerable

29.

Availability of the written informed consent of the donor on carrying out induction of superovulation or in natural cycle with observance of requirements to donors of gametes, tissues of reproductive organs with passing of the donor of oocytes of medico-genetic inspection

considerable

30.

Availability of the medical documentation confirming carrying out EKO according to indications with use of donor oocytes:

1. The lack of oocytes caused by natural menopause.

2. Syndrome of premature depletion of ovaries, syndrome of resistant ovaries, condition after ovarioektomiya, radiotheraphy or chemotherapy.

3. Anomalies of development of genitals, lack of ovaries.

4. Functional inferiority of oocytes at women with the heritable diseases linked to floor.

5. Abortive repeated attempts of EKO in case of the insufficient response of ovaries to induction of superovulation, numerous receipt of low-quality embryos which transfer did not lead to pregnancy approach.

6. Rhesus factor conflict between the man and the woman.

7. Anomalies in karyotype at the woman.

8. Closely related (kinship) marriages with the birth of children with malformations.

9. Somatic diseases in case of which stimulation of ovaries is contraindicated

rough

31.

Availability of the medical documentation confirming carrying out by the doctor the obstetrician-gynecologist (reproduktology) of work with donors, medical examination of the donor before each procedure of intake of donor material, control of timeliness of carrying out and results of laboratory researches according to the schedule of inspection

considerable

32.

Availability of the medical documentation confirming carrying out donorship of oocytes on algorithm:

1) the choice of the donor of oocytes (on individual selection criteria and preferences of the recipient);

2) inspection of the donor and recipient;

3) synchronization of menstrual cycles at the donor and the recipient by means of medicines in case of transfer of embryos in cavity of uterus of the recipient in stimulated cycle of the donor;

4) the procedure of transfer of cryotinned embryos (synchronization of cycles is not carried out);

5) the procedure of fence of oocytes for use to recipients or cryopreservation for bank of gametes

considerable

33.

Availability of entry in the medical documentation confirming observance of requirements for refusal in EKO with use of donor oocytes in case of contraindications:

1. The somatic and mental diseases which are contraindications for incubation of pregnancy and childbirth.

2. Inborn malformations or the acquired deformations of cavity of uterus in case of which implantation of embryos or incubation of pregnancy is impossible.

3. Tumors of ovaries.

4. The benign tumors of uterus requiring operational treatment.

5. Sharp inflammatory diseases of any localization.

6. Malignant new growths (further - ZN) any localization

rough

34.

Availability of entry in the medical documentation confirming use of donor sperm when carrying out supplementary reproductive methods and technologies (further - VRT). Before delivery of sperm sexual abstinence within 3-5 days is required. Receipt of sperm is performed by masturbation. The ejaculate is collected in the special sterile, previously marked reservoir. This procedure is carried out in the special room having separate entrance, the corresponding interior, the bathroom with wash basin. In the absence of donor sperm in the medical organization, or at the request of the patient, donor sperm from other organizations having bank of donor sperm is used.

Only cryotinned donor sperm after obtaining repeated (in 6 months after cryopreservation) negative analysis results on HIV, syphilis and hepatitises B and C is applied.

Use of the cryotinned (defrozen) sperm provides:

1) holding actions for prevention of transfer of HIV, syphilis, hepatitis and other infections, sexually transmitted;

2) exception of possibility of meeting of the donor and recipient.

Requirements imposed to donor sperm:

1) amount of ejaculate of more 1,5 of milliliters (further - ml);

2) concentration of spermatozoa in 1 ml of ejaculate of 15 million and more; total quantity of spermatozoa in all ejaculate of 22,5 of million and more;

3) share of progressive and mobile forms (And + In) 32% and more;

4) share of morphological normal forms of 4% and more (by strict criteria of Kruger of 14% and more);

5) cryotolerant;

6) the test determining immunocompetent bodies of surface of spermatozoon (MAR-test) – according to indications

considerable

35.

Availability of the medical documentation confirming carrying out EKO with use of donor sperm according to indications:

1. Azoospermiya, oligoastenozoospermiya of heavy degree, nekrospermiya, akinozoospermiya, globulozoospermiya.

2. Condition after radiotheraphy or chemotherapy.

3. Anomalies of development of reproductive system.

4. Absence or functional inferiority of spermatozoa at men with the heritable diseases linked to floor.

5. Abortive repeated attempts of EKO in case of high index of fragmentation of DNA (deoxyribonucleic acid) of spermatozoa and numerous receipt of low-quality embryos which transfer did not lead to pregnancy approach.

6. Rhesus factor - the conflict between the man and the woman.

7. Anomalies in karyotype at the man

rough

36.

Availability of the individual donor card completed and coded by the doctor (the encoding scheme – free, the statement of the donor and his individual card are stored in the safe, as documents for office use)

considerable

37.

Availability of entry in the medical documentation confirming carrying out work with donors by the doctor-uroandrologom and embryologist. The doctor will organize performing medical examinations of the donor, exercises control of timeliness of carrying out and results of laboratory researches according to the schedule of inspection.

The embryologist makes cryopreservation and defrosting of sperm, estimates quality of sperm before and after cryopreservation, provides the necessary mode of storage of sperm, records material.

Registration of donor sperm is performed in the magazine of intake of donor sperm and in the card of receipt expense of sperm of the donor

considerable

38.

Availability of documentation confirming observance of requirements that donors of embryos are patients of the EKO procedure who have in bank unused cryotinned embryos. According to the free decision and the written informed consent of patients, these embryos are utilized, or donated to the medical organization. The embryos transferred to the medical organization are used for non-paid donation to infertile married couple, women (recipients) who are not married (matrimony).

Embryos for donation also receive as a result of fertilization of donor oocytes sperm of the donor.

Patients are informed that effectiveness of the procedure with use of the remained cryotinned embryos of patients of the EKO procedure is lower, than when using the embryos received from donor gametes. Provide to recipients phenotypical portrait of donors.

EKO with use of donor embryos is carried out according to indications:

1. Lack of oocytes.

2. Adverse medico-genetic forecast.

3. Numerous receipt (more than three times) of low-quality embryos which transfer did not lead to pregnancy approach.

4. Impossibility of obtaining or use of sperm, married (matrimony)

rough

39.

Availability of entry in the medical documentation confirming observance of requirements of carrying out supplementary reproductive methods and technologies

rough

40.

Availability of entry in the medical documentation confirming accomplishment of the following functions when rendering by average health workers (obstetricians, paramedics, medical sisters / brothers) of the pre-medical help to women in time and out of pregnancy:

1) independent acceptance and medical examination for the purpose of determination of the state of health of the patient, detection of diseases and complications of pregnancy

2) entering of data into subsystem "The register of pregnant women and women of fertile age" of the electronic portal "Registr Prikreplennogo Naseleniya" for the purpose of the automated maintaining groups of pregnant women and ZhFV and monitoring of indicators of the state of health of pregnant women and ZhFV;

3) rendering emergency and emergency pre-medical medical care to pregnant women, women in childbirth and ZhFV in case of conditions, life-threatening and to health of the woman under clinical protocols of diagnostics and treatment;

4) dynamic observation of pregnant women with chronic diseases together with district doctors and profile specialists;

5) accomplishment of appointments of the doctor obstetrician-gynecologist;

6) conducting physiological pregnancy and patronage of pregnant women and women in childbirth with timely provision of the directions and recommendations on the clinical protocol of diagnostics and treatment;

7) medical attendance at home pregnant women, women in childbirth, gynecologic patients and ZhFV group of social risk;

8) performing routine medical examination of women for the purpose of early detection of pretumoral and cancer diseases of female genitals and other localizations (skin, mammary glands);

9) carrying out medical sisterly examination of women of all age groupes which asked for medical care;

10) participation in performing screening and routine inspections for detection of diseases

rough

41.

Maintaining the Log in information systems (correction, amendment, removal of records), for the purpose of tracing of chronology of events of delivery of health care

considerable

42.

Availability of entry in the medical documentation confirming observance of requirements under the organization of rendering the obstetric and gynecologic help at the stationary level:

1) rendering the stationary consulting and diagnostic, treatment-and-prophylactic and rehabilitation help to pregnant women, women in labor, women in childbirth and newborns;

2) carrying out joint survey of the attending physician with the manager of department in case of arrival of expectant mothers up to 36 weeks of pregnancy having chronic diseases, needing treatment in specialized departments of multi-profile hospitals for assessment of weight of course of disease, the course of pregnancy and tactics of treatment.

3) scheduling of conducting pregnancy, childbirth and the postnatal period with accounting of individual approach;

4) conducting pregnancy, childbirth and the postnatal period under clinical protocols of diagnostics and treatment, and also according to the plan of maintaining;

5) carrying out consultation of pregnant women, women in labor and women in childbirth, control on observance of level of delivery of health care;

6) holding rehabilitation actions to mothers and newborns, including care of premature newborns;

7) consultations on delivery of health care to pregnant women, women in labor, women in childbirth and newborns with use of telecommunication systems;

8) implementation of examination about temporary disability, issues of leaf and the reference of temporary disability on pregnancy and childbirth, gynecologic patients;

9) rendering the resuscitation help and intensive therapy to mothers and newborns, including with low and extremely low body weight;

10) medico-psychological assistance implementation to women;

11) the notification of the medical organizations of higher level of regionalization of the perinatal help and local authorities of public administration by health care in case of identification during receipt or stay in hospital at the pregnant woman, the woman in labor, the woman in childbirth of critical condition;

12) observance of the scheme of the notification in case of critical situations at women;

13) transportation of pregnant women, women in childbirth, women in labor in critical condition on the third level of the perinatal help, in the regional and republican organizations of health care is performed according to the solution of consultation of doctors with participation of specialists of medical crew of medical aircraft after recovery of haemo dynamics and stabilization of the vital functions with the notification of the accepting medical organization;

14) in case of nontransportable condition of pregnant women, women in labor, women in childbirth implementation of challenge of qualified specialists "on", rendering complex of primary resuscitation help in case of medical emergencies, diagnostics of the menacing conditions at mother and fruit, the solution of question of delivery, performing the intensive and supporting therapy before transfer into higher level;

15) performing differential diagnostics in case of critical condition of pregnant women, women in labor, women in childbirth;

16) completeness of clinical inspections in case of critical condition of pregnant women, women in labor, women in childbirth;

17) for the purpose of establishment of the diagnosis, determination of tactics of treatment and the forecast of disease with participation at least three doctors timely creation of consultation in case of critical condition of pregnant women, women in labor, women in childbirth;

18) for pregnant women, women in labor needing operational abdominal delivery, need by specialists (obstetricians-gynecologists, intensivists, neonatology, doctors of emergency medical service, doctors of laboratory service, midwifes, anestezistka, nurses) to own operational technology of Cesarean section;

19) carrying out consultation of pregnant women, women in labor and women in childbirth by the anesthesiologist

rough

Delivery of health care by the newborn

43.

Availability of entry in the medical documentation confirming observance of requirements under the organization of delivery of health care by the newborn at the stationary level:

1) delivery of health care by the newborn on levels of regionalization of the perinatal help depending on indications;

2) availability in structure of the organizations of hospitals of the first level of regionalization of the perinatal help: individual maternity chambers, department for joint stay of mother and the child, inoculative office, chambers of intensive therapy for newborns and also provided by the staff list rate of the doctor in "Pediatrics (neonatology)" and the round-the-clock post of the neonatal nurse;

3) availability in hospitals of the second level of regionalization of chambers of resuscitation and intensive therapy of newborns with full range for resuscitation, medical ventilators with the different modes of ventilation (permanent positive pressure in airways), couveuses, kliniko-diagnostic laboratory, and also provided by the staff list the round-the-clock post (the doctor неонатолог and the children's nurse);

4) Observance in hospitals of the third level of regionalization of the perinatal help of the following requirements: availability of the round-the-clock neonatal post, clinical, biochemical and bacteriological laboratory, department of anesthesiology, resuscitation and intensive therapy (further – OARIT) for women and newborns, and also department of pathology of newborns and nursing premature joint stay with mother. availability of intensive care unit of newborns, departments of pathology of newborns and nursing premature, equipped with the modern medical and diagnostic equipment, medicines, the round-the-clock post (medical and sisterly), express laboratory.

5) Observance in hospitals of the first level to the sick newborn of the following requirements: primary resuscitation help; the intensive and supporting therapy; oxygenotherapy; invasive or noninvasive respiratory therapy; phototherapy; medical hypothermia; infusional therapy and/or parenteral food; treatment under clinical protocols of diagnostics and treatment. Observance in hospitals of the second level to the sick newborn of the following requirements: rendering primary resuscitation help to the newborn and stabilization of condition, nursing of premature children with gestation term more than 34 weeks; kateterization of the central veins and peripheral vessels; identification and treatment of inborn defects, delays of pre-natal development, hypoglycemia of newborns, hyperbilirubinemias, neonatal sepsis, damage of the central nervous system, respiratory distress syndrome, pheumothorax, necrotic enterokolit and other pathological conditions of the neonatal period; performing intensive therapy, the including correction of the vital functions (respiratory, cardiovascular, metabolic violations), invasive and noninvasive respiratory therapy, infusional therapy and parenteral food; in need of rendering the highly specialized help degree of readiness for transportation with mother in the organization of obstetric aid of the third level or organization of republican value is determined

rough

44.

Availability of entry in the medical documentation confirming observance of requirements of delivery of health care by the newborn in the medical organizations of the third level:

1) rendering primary resuscitation by the newborn and care of newborns

2) performing the intensive and supporting therapy: respiratory therapy, kateterization of the central veins and peripheral vessels, therapeutic hypothermia, parenteral food, nursing of premature children;

3) diagnostics and treatment of inborn defects, delays of pre-natal development of fruit (small weight to gestation term), hypoglycemia of newborns, neonatal sepsis, respiratory distress syndrome, hyperbilirubinemias, necrotic enterokolit, pheumothorax, bronchopulmonary dysplasia, persistent pulmonary hypertensia of newborn, perinatal damages of the central nervous system and other pathological conditions of the neonatal period;

4) performing the intensive and supporting therapy, therapeutic hypothermia, parenteral food;

5) performing invasive and not invasive respiratory therapy;

6) nursing of premature children;

7) rendering the round-the-clock advisory and medical and diagnostic help to specialists of the first and second level of regionalization, rendering emergency and emergency medical service with departure in the medical organization

rough

45.

Availability of entry in the medical documentation confirming observance of requirements for providing to the healthy newborn of basic care, including prevention of hypothermia with observance of "thermal chain", skin contact with mother or contact "skin - to - skin", early start of breastfeeding within the first hour (in the presence of signs of readiness of the baby), prevention of intrahospital infections

considerable

46.

Availability of entry in the medical documentation confirming observance of requirements of carrying out anthropometry of the healthy newborn, its complete survey and other actions in 2 hours after the delivery

considerable

47.

Availability of entry in the medical documentation confirming observance of requirements of rendering emergency medical service in case of identification of violations of condition of the newborn on indications transfer in chamber of intensive therapy or intensive care unit of newborns

rough

48.

Availability of entry in the medical documentation confirming observance of requirements for observation of mother and the healthy newborn in maternity chamber by the obstetrician within two hours after the birth:

1) measurement of body temperature at the newborn in 15 minutes after the birth, then – each 30 minutes;

2) observation at the newborn of the frequency of heartbeat and breath, nature of breath (identification of expiratory groan, assessment of extent of retraction of the lower departments of thorax), coloring of integuments, activity of sucking reflex, if necessary determines saturation pulsoksimetry

considerable

49.

Availability of entry in the medical documentation confirming observance of transfer in 2 hours after the birth of the healthy newborn with mother in department of joint stay of mother and child

considerable

50.

Availability of entry in the medical documentation confirming the round-the-clock observation by medical personnel and permanent participation of mother in implementation of child care, except as specified conditions of mother of average and heavy severity in postnatal department in chambers of joint stay of mother and child

considerable

51.

Availability of entry in the medical documentation confirming observance of requirements for dynamic observation of the newborn with timely identification of violations of condition of the newborn, carrying out necessary inspection, survey by the manager of department, the organization of consultation for refining of tactics of maintaining. Rendering according to indications of emergency medical service, timely transfer in chamber of intensive therapy or intensive care unit of newborns

rough

52.

Availability of entry in the medical documentation confirming observance of requirements by health workers in chambers of joint stay of mother and child:

1) about the held consultations, about breastfeeding benefits, about the equipment and frequency rate of decantation of breast milk by manual method, carrying out visual assessment of breastfeeding for provision of the practical help in the correct arrangement and applying of the child to mother's breast in order to avoid such conditions as cracks of nipples or лактостаз;

2) about training of mother (the parent or the legal representative) in alternative methods of feeding of children in the presence of contraindications to breastfeeding; consultations of women in childbirth how to support lactation in cases of separate stay of newborns

considerable

53.

Availability of entry in the medical documentation confirming daily survey of newborns by the doctor-neonatologom, consultations of mothers concerning leaving, prevention of hypothermia and vaccination

rough

54.

Availability of entry in the medical documentation confirming observance of requirements for the organization of consultation by profile specialists with holding medical and diagnostic actions and provision of mother of recommendations about inspection, treatment and rehabilitation with three and more microanomalies of development or detection of inborn pathology of newborns

rough

55.

Availability of entry in the medical documentation confirming observance of requirements of delivery of health care in case of medical emergencies at the newborn (asphyxia, respiratory distress syndrome and others) stabilization of its condition and determination of degree of readiness for transportation with mother in the organization of obstetric aid of the second or third levels

rough

56.

Availability of entry in the medical documentation confirming performing vaccination of newborns based on the voluntary informed consent of parents (mother, the father or legal representatives) on carrying out preventive inoculations in terms of carrying out preventive inoculations in the Republic of Kazakhstan

rough

57.

Availability of entry in the medical documentation confirming observance of requirements of carrying out by all newborn before the statement of neonatal screening for the purpose of identification of fenilketonuriya, inborn hypothyroidism and audiological screening

rough

58.

Availability of entry in the medical documentation confirming observance of requirements of carrying out by the doctor neonatology estimates of weight of condition, stabilization of condition, assessment of degree of readiness for transportation in case of medical emergencies at the newborn and the organization of its transfer with mother (in coordination with the obstetrician-gynecologist) in the medical organization of the second or third level

rough

59.

Availability of entry in the medical documentation confirming observance of requirements in case of suspicion and (or) identification at the newborn of sharp surgical pathology in the emergency procedure for carrying out consultation of the doctor in "Children's surgery (neonatal surgery)". After stabilization of indicators of vital functions the newborn transfer availability in surgical department of other medical organization (children's or multi-profile hospital) or in neonatal (or children's) surgical department in case of its availability in structure of the medical organization of obstetric aid for rendering the appropriate specialized medical care to it

rough

60.

Availability of entry in the medical documentation confirming observance of requirements for transfer in hospital of pediatric profile of the full-term newborns after achievement of age of 28 days or premature newborns after achievement of post-conceptual age 42 weeks needing further round-the-clock medical observation

considerable

61.

Availability of obligatory pathoanatomical research of fruit and placenta in case of termination of pregnancy on medical indications in case of suspicion on availability of congenital anomalies of development in fruit

rough

62.

Availability of entry in the medical documentation confirming carrying out kliniko-pathoanatomical analysis of all cases of maternal and infantile death after completion of all complex of pathoanatomical researches

rough

63.

Availability of the contract for rendering paid medical services in the organizations of health care. Availability of the documents determining the copayment fact

rough

64.

Availability of entry in the medical documentation confirming carrying out consultation of the children's cardiologist (heart surgeon) in case of detection of inborn malformation of cardiovascular system in the organizations of obstetric aid and in the presence of medical indications transfer of the newborn in profile hospital

rough

65.

Availability of entry in the medical documentation confirming use of opportunities of consultation with the profile republican organizations by means of telemedicine network in case of complexity in verification of the diagnosis of the child, determination of tactics of maintaining. If necessary implementation of transfer of the child in the profile republican organizations

rough

66.

Documentation availability (internal orders, provisions, protocols, questionnaires, research opinions) about carrying out clinical audit by support service of the patient and internal examination and its assessment by the following criteria:

1) quality of collection of the anamnesis which is estimated by the following criteria: lack of collection of the anamnesis; completeness of collection of the anamnesis; availability of data on the postponed, chronic and heritable diseases, the carried-out hemotransfusions, portability of medicines, the allergologichesky status; development of complications owing to the made tactical mistakes when holding medical and diagnostic actions because of low-quality collection of the anamnesis;

2) completeness and justification of conducting diagnostic testings which are estimated by the following criteria: lack of diagnostic actions; the wrong conclusion or lack of the conclusion by results of the conducted diagnostic researches which led to the wrong diagnosis and mistakes in treatment tactics; conducting the diagnostic testings provided by clinical protocols; conducting diagnostic testings with high, unjustified risk for the state of health of the patient, justification of conducting the diagnostic testings which did not enter in clinical the protocol; conducting diagnostic testings, not informative for statement of the correct diagnosis and the terms of treatment which led to unreasonable increase and rise in price of cost of treatment;

3) correctness, timeliness and justification of the exposed clinical diagnosis taking into account results of the conducted researches (in case of planned hospitalization the researches conducted and at pre-hospital stage are considered), which are estimated by the following criteria: the diagnosis is absent, incomplete or wrong, does not correspond to the international classification of diseases; the leading pathological syndrome determining weight of course of disease is not allocated, associated diseases and complications are not distinguished; the diagnosis is correct, but incomplete, the leading pathological syndrome in case of the allocated complications is not allocated, the associated diseases influencing outcome are not distinguished; the diagnosis of the main disease correct, but the associated diseases influencing result of treatment are not diagnosed. The objective reasons of the wrong and (or) untimely diagnostics (the atypical course of the main disease, the asymptomatic course of associated disease, seldom found complications and associated diseases) are reflected in results of examination. The impact assessment of the wrong and (or) untimely diagnosis on the subsequent stages of rendering medical services (help) is carried out;

4) timeliness and quality of consultations of profile specialists which are estimated by the following criteria: the lack of consultation which resulted in wrong interpretation of the symptoms and syndromes which negatively affected disease outcome; consultation is timely, rejection in attention of opinion of the consultant in case of diagnosis partially affected disease outcome; consultation is timely, the opinion of the consultant is considered in case of diagnosis, failure to carry out of the recommendation of the consultant for treatment partially affected disease outcome; the opinion of the consultant wrong also affected disease outcome.

Availability of documentation confirming evaluating objectivity of the reasons of untimely consultation and influence of untimely diagnosis on the subsequent stages of rendering medical services (help);

5) amount, quality and justification of holding medical actions which are estimated by the following criteria: lack of treatment in the presence of indications; purpose of treatment in the absence of indications; purpose of ineffective medical actions without features of course of disease, associated diseases and complications; accomplishment of medical actions not in full, without functional condition of bodies and systems, prescription of medicines without the proved clinical efficiency; unreasonable variation from requirements of clinical protocols, the polypragmasy availability which led to development of new pathological syndrome and deterioration in condition of the patient;

6) absence or development of complications after medical interventions, are estimated all arisen complications including caused by surgeries (overdue surgery, inadequate amount and method, technical defects) and diagnostic procedures;

7) the achieved result which is estimated by the following criteria: achievement of the expected clinical effect in case of respect for technology of rendering medical services (help); lack of clinical effect of medical and preventive actions owing to low-quality collection of the anamnesis and conducting diagnostic testings; lack of the expected clinical effect owing to holding ineffective medical, preventive actions without features of course of disease, associated diseases, complications, prescription of medicines without the proved clinical efficiency; the polypragmasy availability which caused development of undesirable effects;

8) quality of maintaining medical documentation which is estimated on availability, completeness and quality of entries in primary medical documentation intended for data recording about the state of health of the patients reflecting nature, amount and quality of the provided medical care

rough

67.

Maintaining forms of accounting documentation in the field of health care (form No. 048/at "Prenatal record of the pregnant woman and woman in childbirth", form No. 002/at "The protocol (card) of pathoanatomical research No. ____", form No. 077/at "The individual prenatal record and women in childbirth" and others) on electronic and (or) paper

insignificant

68.

Maintaining the Log in information systems (correction, amendment, removal of records), for the purpose of tracing of chronology of events of delivery of health care

considerable

Requirements for subjects (objects) giving stationary, hospital-replacing help

69.

Availability of the documentation confirming delivery of health care, entering the guaranteed amount of free medical care and (or) system of compulsory social medical insurance on free basis

rough

70.

Availability of the signed agreement of joint insurance of professional responsibility of health workers

rough

71.

Availability of the conclusion about compliance of the subject of health care to provision of high-technology medical care

rough

72.

Availability of written voluntary consent of the patient or his legal representative in case of invasive interventions and on holding medical and diagnostic actions

considerable

73.

Availability of entry in the medical documentation ("The card of challenge of crew of emergency medical service" form No. 085/at, "The magazine of acceptance and refusals in hospitalization", "The medical record of the stationary patient" form No. 001/at) confirming stay of crew of SSMP in department SMP under the PHC organization or in the reception of hospital which is not exceeding 10 minutes (time for transfer of the patient to the doctor of reception) from the moment of its arrival in hospital, except as specified need of rendering emergency medical service for emergency situations

considerable

74.

Availability of entry in the medical documentation confirming arrival of the patient in reception of hospital with carrying out primary assessment and carrying out medical sorting according to triazh-system (further - medical sorting) in certain group, proceeding from condition of the patient, its possible deterioration and first priority of rendering the emergency medical care.

Medical sorting is carried out continuously and preemstvenno. On completion of assessment, the patient is marked with color of one of categories of sorting, in the form of special color label or color tape. On medical sorting, allocate 3 groups of patients: the first group (red zone) – patients whose condition poses direct threat of life or deteriorations having high risk and requiring the emergency medical care; the second group (yellow zone) – patients whose condition poses potential hazard for health or can progress with development of the situation, the requiring emergency medical care; the third group (green zone) – patients whose condition does not pose direct threat for life and health and does not require hospitalization

rough

75.

Availability of medical documentation (form No. 001/at "The medical record of the stationary patient") of the heavy patient confirming hospitalization needing permanent monitoring of the vital functions on medical indications, according to the solution of consultation and the notification of heads of the organizations of health care with the subsequent transfer in other medical organization for disease profile for further inspection and treatment after stabilization of condition

considerable

76.

Availability of the medical documentation confirming the medical certificate of the doctor of reception with written reasons for refusal in the absence of indications for hospitalization in the organization of health care ("The magazine of acceptance and refusals in hospitalization" from medical information systems (further – MIS), the reference in form No. 027/at (refusals in hospitalization)). The nurse of reception the asset goes to the PHC organization for the place of attachment of the patient

rough

77.

Availability of entries in medical documentation ("The magazine of acceptance of patients and refusals in hospitalization" from MIS, coupons of planned hospitalization, "The medical record of the stationary patient" (form No. 001/at) of indications for hospitalization: 1) need of rendering pre-medical, qualified, specialized medical care, including using high-technology medical services, with the round-the-clock medical observation of patients; 2) in planned procedure – in the direction of specialists of PHC or other organization of health care; 3) according to the emergency indications (including days off and holidays) - regardless of direction availability

considerable

78.

Availability of entry in medical documentation (form No. 001/at "The medical record of the stationary patient") confirming carrying out survey by the manager of department of heavy patients in day of hospitalization in subsequent – daily. The patients who are in medium-weight condition are inspected at least once a week. Results of survey of the patient are registered in the medical record with indication of recommendations about further tactics of maintaining the patient with obligatory identification of the health worker making records

considerable

79.

Availability of the established clinical diagnosis together with the manager of department no later than three calendar days from the date of hospitalization of the patient in the organization of health care in the form of No. 001/at "The medical record of the stationary patient"

considerable

80.

Availability of entry in medical documentation (form No. 001/at "The medical record of the stationary patient") confirming carrying out daily survey of the attending physician of the patients who are in hospital except days off and holidays. In case of survey and appointment of additional diagnostic and medical manipulations as the doctor on duty the corresponding entries in the medical record are carried out. In case of deterioration in condition of the patient the doctor on duty notifies the manager of department and (or) the attending physician, approves modification of process of diagnostics and treatment, and makes entry in the medical record (paper and (or) electronic) option.

In electronic version of the medical record record is made no later than days from the moment of change of condition of the patient.

In case of medical emergencies frequency rate of records depends on dynamics of weight of condition. Records of the doctor of hospital reflect specific changes in condition of the patient and need of correction of appointments, reasons for the appointed inspection and treatments, assessment and interpretation of the received results and efficiency of the carried-out treatment. Frequency rate of survey in case of medical emergencies at least each 3 hours, with indication of time of rendering emergency aid on hours and minutes

considerable

81.

Availability of confirmatory medical documentation on observance of requirements in case of planned hospitalization:

1) direction availability on hospitalization in hospital and the coupon of planned hospitalization;

2) hospitalization of the patient according to the established date of planned hospitalization in the direction;

3) availability carried out kliniko-diagnostic (laboratory, tool and functional) researches and consultations of profile specialists according to the diagnosis of the statement from the medical record of the ambulatory patient form No. 052/at

considerable

82.

Availability of entry in medical documentation on carrying out consultations or consultation in case of difficulty in identification of the diagnosis, inefficiency of the carried-out treatment, and also in case of other indications

rough

83.

Availability of entry in medical documentation on respect for criteria in case of the statement, in particular:

1) the commonly accepted result of treatment (recovery, improvement, without changes, death, it is transferred to other medical organization);

2) the written application of the patient or his legal representative in the absence of direct danger to life of the patient or to people around;

3) cases of violation of internal rules and procedures of the organization of health care, and also creation of obstacles for medical and diagnostic process, infringement of the rights of other patients to receipt of appropriate medical care (in the absence of direct threat of his life) about what entry in the medical record is made

considerable

84.

Availability of entry in medical documentation on issue of vypisny epicrisis to the patient on hands in case of the statement with indication of the complete clinical diagnosis, the carried-out amount of diagnostic testings, medical actions and the recommendation about further observation and treatment. Data on the statement are entered in information systems to the day, with indication of the actual time of the statement

insignificant

85.

Availability of the informed written consent of the patient to blood transfusion and its components

rough

86.

Availability of entry in medical documentation (form No. 001/at "The medical record of the stationary patient") confirming inspection of the recipient before transfusion on markers of haemo transmissible infections (HIV, hepatitises B and C), and also recommendations in vypisny epicrisis of need of repeated inspection on HIV and hepatitises B and C in the PHC organization for the place of attachment through 1, 3, 6 months

considerable

87.

Availability at the medical organization of the contract for acquisition and delivery of blood and its components

rough

88.

Documentation availability (the internal document approved by the first head) confirming distribution of functions of the workers occupied at each stage of blood transfusion, its components

considerable

89.

Availability of entry in the medical documentation (result of research group on the AVO system and Rhesus factor of accessory, screening of irregular anti-erythrocytic antibodies in form 098/at or record electronically 001/at "The medical record of the stationary patient") confirming immunohematologic inspection of recipients for safety of transfusion therapy

rough

90.

Availability of entry in the medical documentation confirming establishment of indications to purpose of blood, its components based on clinical manifestations of deficit or dysfunction of the cellular, or other components of blood confirmed with laboratory data ("the Pretransfusion epicrisis" the loose leaf 6 to the medical record of the stationary patient form 001/at)

rough

91.

Documentation availability (the internal document approved by the first head) confirming continuous personnel training, participating in performing transfusion therapy and the admission to accomplishment of the transfusion help of medical personnel and medical personnel of average link

considerable

92.

Availability of the medical documentation confirming transfer of assets from hospital in PHC about the patients who transferred hemotransfusion

considerable

93.

Availability of the medical documentation ("Diary" the loose leaf 2 to the medical record of the stationary patient ф 001/at) confirming performance monitoring of blood transfusion and its components

considerable

94.

Maintaining forms of accounting documentation in the field of health care (form No. 003/at "Form of accounting of movement of blood, its components and diagnostic standards" on electronic and (or) paper; The Loose leaf 6 to the medical record of the stationary patient form 001/at "Pretransfusion epicrisis", "The protocol of transfusion of components", "Transfusion leaf", the Form No. 006/at "Form of accounting of blood transfusion, its components, medicines", the Form No. 007/at "Form of accounting of recipients of blood and its components") on electronic and (or) paper

rough

95.

Availability of confirmatory medical documentation on indications for hospitalization in day hospital under the out-patient and polyclinic organizations and in hospital at home:

1) exacerbation of the chronic diseases which are not requiring the round-the-clock medical observation;

2) active planned improvement of group of patients with the chronic diseases which are subject to dynamic observation;

3) the patient's aftercare next day after hospitalization rate on medical indications;

4) carrying out rates of medical rehabilitation of the second and third stage;

5) palliative care;

6) orphan diseases at the children integrated to high risk of infectious complications and requiring isolation in the period of seasonal viral diseases for receipt of regular replacement enzymatic and antibacterial therapy. Availability of indications for hospitalization in day hospital in case of the round-the-clock hospital are:

1) carrying out transactions and interventions with special preoperative preparation and resuscitation support;

2) conducting the difficult diagnostic testings requiring special preliminary preparation and also not available in the out-patient and polyclinic organizations of health care;

3) observation of patients whose treatment is connected with transfusion of medicines of blood, intravenous injections of krovezameshchayushchy liquids, the specific hyposensibilizing therapy, injections of strong medicines, intra joint introductions of medicines;

4) aftercare next day after hospitalization in the presence of indications to the early statement after operational treatment;

5) palliative care;

6) chemotherapy, radiation therapy, correction of the pathological conditions which arose after performing specialized treatment to oncological patients

considerable

96.

Availability of confirmatory medical documentation on inspection of persons on clinical indications on HIV infection in case of detection of the following diseases, syndromes and symptoms:

1) increase in two and more lymph nodes lasting more than 1 month, persistent, generalized limfadenopatiya;

2) fever of not clear etiology (permanent or recidivous lasting more than 1 month);

3) inexplicable heavy cachexia or the expressed violations of food which are badly giving in to standard treatment (at children), inexplicable loss of 10% of weight and more;

4) chronic diarrhea within 14 days and more (at children), inexplicable chronic diarrhea lasting more than month;

5) seborrheal dermatitis, pruritic papular rash (at children);

Angular heylit 6);

7) recidivous upper respiratory tract infections (sinusitis, average otitis, pharyngitis, tracheitis, bronchitis);

8) shingles;

9) any disseminated local mycosis, deep mycoses (кокцидиоидоз, extra pulmonary криптококкоз (kriptokokkovy meningitis), споротрихоз, aspergillomycosis, изоспороз, extra pulmonary histoplasmosis, стронгилоидоз, actinomycosis);

10) tuberculosis pulmonary and extra pulmonary, including the disseminated infection caused by atypical mycobacteria except tuberculosis of peripheral lymph nodes;

11) hairy leukoplakia of oral cavity, linear eritema of gums;

12) the heavy long recidivous pneumonia and chronic bronchitis which are not giving in to regular therapy (frequency rate two or more times within year), the asymptomatic and clinically expressed lymphoid intersticial pneumonia;

13) sepsis, long and recidivous it is purulent - bacterial diseases of internals (pneumonia, pleura empyema, meningitis, meningoentsefalita, infections of bones and joints, purulent miozit, salmonellezny septicaemia (except Salmonella typhi), stomatitises, gingivita, periodontitis);

14) pnevmotsistny pneumonia;

15) the infections caused by virus of simple herpes with damage of internals and chronic (lasting more than one month from the moment of disease) damage of skin and mucous membranes, including eyes;

16) cardiomyopathy;

17) nephropathy;

18) encephalopathy of not clear etiology;

19) the progressing multifocal leykoentsefalopatiya;

20) Kaposha's sarcoma;

21) new growths, including lymphoma (brain) or V-cellular lymphoma;

22) toxoplasmosis of the central nervous system;

23) candidiasis of gullet, bronchial tubes, tracheas, lungs, mucous membranes of oral cavity and nose;

24) the disseminated infection caused by atypical mycobacteria;

25) cachexia of not clear etiology;

26) the long recidivous piodermiya which are not giving in to regular therapy;

27) serious chronic inflammatory illness of female genital of not clear etiology;

28) invasive new growths of female genitals;

29) мононуклеоз in 3 months from the beginning of disease;

30) infections, sexually transmitted (syphilis, clamidiosis, trichomoniasis, gonorrhea, genital herpes, virus папилломатоз and others) with the established diagnosis;

31) viral hepatitises B and C, in case of confirmation of the diagnosis;

32) extensive drain condylomas;

33) contagious mollusk with extensive rashes, the huge disfiguring contagious mollusk;

34) primary weak-mindedness at earlier healthy faces;

35) the patients with hemophilia and other diseases who are systematically receiving blood transfusion and its components;

36) generalized Cytomegaloviral infection

rough

97.

Availability of the contract for rendering paid medical services in the organizations of health care. Availability of the documents determining the copayment fact

rough

98.

Availability of entry in the medical documentation confirming observance of requirements when conducting examination of temporary disability, issue of leaf and certificate of temporary disability (form No. 001/at "The medical record of the stationary patient", form 052/at "The medical record of the ambulatory patient", roots of sheets of temporary disability of patients, form No. 025/at "The magazine for record of the conclusions of the medical and consulting commission", form No. 029/at "The book of registration of sheets about temporary disability", form No. 037/at "The reference No. __________ about temporary disability of the student, pupil of college, technical training college, about disease, quarantine and other causes of absence of the child attending school, the children's preschool organization (necessary to emphasize)", form No. 038/at "The reference No. ______ about temporary disability" and others).:

1) availability of survey of person and data recording about its state of health in the medical record of the ambulatory (stationary) patient proving need of temporary release it from work;

2) issue of leaf and certificate of temporary disability in day of the statement of persons in case of hospitalization (including day hospitals, the rehabilitation centers) for the entire period of hospitalization;

3) closing of leaf and certificate of temporary disability with date of the statement from hospital if working capacity of persons is completely recovered;

4) prolongation to persons continuing to be temporarily disabled leaf and the certificate of temporary disability for term taking into account time necessary for its appearance to the health worker of polyclinic or challenge of the health worker on the house (but no more than for one calendar day). To persons receiving treatment outside the region of residence time necessary for arrival to the place of its permanent residence is considered (but no more than for four calendar days);

5) issue of the certificate of temporary disability in case of the injuries got the being able alcoholic or drug intoxication and also in case of sharp alcoholic or narcotic intoxication, for the entire period of temporary disability;

6) issue of leaf and certificate of temporary disability to persons suffering from mental diseases in case of the untimely appeal to the medical organization for last days for the conclusion of VKK of psychoneurological dispensary or the health worker (psychiatrist) together with the head of the medical organization;

7) issue of leaf and certificate of temporary disability to the persons sent by a court decision for medicolegal or forensic-psychiatric examination and recognized disabled from the date of revenues to examination;

8) issue at the same time leaf and the certificate of temporary disability to person combining training with work

considerable

99.

Documentation availability (internal orders, provisions, protocols, questionnaires, research opinions) about carrying out clinical audit by support service of the patient and internal examination and its assessment by the following criteria:

1) quality of collection of the anamnesis which is estimated by the following criteria: lack of collection of the anamnesis; completeness of collection of the anamnesis; availability of data on the postponed, chronic and heritable diseases, the carried-out hemotransfusions, portability of medicines, the allergologichesky status; development of complications owing to the made tactical mistakes when holding medical and diagnostic actions because of low-quality collection of the anamnesis;

2) completeness and justification of conducting diagnostic testings which are estimated by the following criteria: lack of diagnostic actions; the wrong conclusion or lack of the conclusion by results of the conducted diagnostic researches which led to the wrong diagnosis and mistakes in treatment tactics; conducting the diagnostic testings provided by clinical protocols; conducting diagnostic testings with high, unjustified risk for the state of health of the patient, justification of conducting the diagnostic testings which did not enter in clinical the protocol; conducting diagnostic testings, not informative for statement of the correct diagnosis and the terms of treatment which led to unreasonable increase and rise in price of cost of treatment;

3) correctness, timeliness and justification of the exposed clinical diagnosis taking into account results of the conducted researches (in case of planned hospitalization the researches conducted and at pre-hospital stage are considered), which are estimated by the following criteria: the diagnosis is absent, incomplete or wrong, does not correspond to the international classification of diseases; the leading pathological syndrome determining weight of course of disease is not allocated, associated diseases and complications are not distinguished; the diagnosis is correct, but incomplete, the leading pathological syndrome in case of the allocated complications is not allocated, the associated diseases influencing outcome are not distinguished; the diagnosis of the main disease correct, but the associated diseases influencing result of treatment are not diagnosed. The objective reasons of the wrong and (or) untimely diagnostics (the atypical course of the main disease, the asymptomatic course of associated disease, seldom found complications and associated diseases) are reflected in results of examination. The impact assessment of the wrong and (or) untimely diagnosis on the subsequent stages of rendering medical services (help) is carried out;

4) timeliness and quality of consultations of profile specialists which are estimated by the following criteria: the lack of consultation which resulted in wrong interpretation of the symptoms and syndromes which negatively affected disease outcome; consultation is timely, rejection in attention of opinion of the consultant in case of diagnosis partially affected disease outcome; consultation is timely, the opinion of the consultant is considered in case of diagnosis, failure to carry out of the recommendation of the consultant for treatment partially affected disease outcome; the opinion of the consultant wrong also affected disease outcome.

Availability of documentation confirming evaluating objectivity of the reasons of untimely consultation and influence of untimely diagnosis on the subsequent stages of rendering medical services (help);

5) amount, quality and justification of holding medical actions which are estimated by the following criteria: lack of treatment in the presence of indications; purpose of treatment in the absence of indications; purpose of ineffective medical actions without features of course of disease, associated diseases and complications; accomplishment of medical actions not in full, without functional condition of bodies and systems, prescription of medicines without the proved clinical efficiency; unreasonable variation from requirements of clinical protocols, the polypragmasy availability which led to development of new pathological syndrome and deterioration in condition of the patient;

6) absence or development of complications after medical interventions, are estimated all arisen complications including caused by surgeries (overdue surgery, inadequate amount and method, technical defects) and diagnostic procedures;

7) the achieved result which is estimated by the following criteria: achievement of the expected clinical effect in case of respect for technology of rendering medical services (help); lack of clinical effect of medical and preventive actions owing to low-quality collection of the anamnesis and conducting diagnostic testings; lack of the expected clinical effect owing to holding ineffective medical, preventive actions without features of course of disease, associated diseases, complications, prescription of medicines without the proved clinical efficiency; the polypragmasy availability which caused development of undesirable effects;

8) quality of maintaining medical documentation which is estimated on availability, completeness and quality of entries in primary medical documentation intended for data recording about the state of health of the patients reflecting nature, amount and quality of the provided medical care

considerable

100.

Availability of documentation confirming observance of actions when carrying out pathoanatomical opening:

1) carrying out pathoanatomical opening of corpses after ascertaining by doctors of biological death, after provision of the medical record of the stationary patient or the medical record of the ambulatory patient with the written order of the chief physician or his deputy for medical (medical) part of the organization of health care about the direction on pathoanatomical opening;

2) registration of results of pathoanatomical opening in the form of the pathoanatomical diagnosis (the pathoanatomical diagnosis includes: the main disease, complication of the main disease, associated disease, the combined main disease);

3) transfer of the medical record of the stationary patient or the medical record of the ambulatory patient with the pathoanatomical diagnosis introduced in it in medical archive of the organization of health care no later than ten working days after pathoanatomical opening;

4) carrying out kliniko-pathoanatomical analysis in cases of death of patients in the organizations of health care;

5) pathoanatomical opening in case of suspicions of sharp infectious, oncological diseases, pathology of children's age, lethal outcome in connection with medical manipulations for the purpose of establishment of cause of death and refining of the diagnosis of disease from the death;

6) the organization by the chief physician and manager of pathoanatomical department of virologic (immunofluorescent) and bacteriological research of materials of opening of corpses in cases of suspicion of infectious diseases;

7) transfer to pathoanatomical bureau, centralized pathoanatomical bureau and pathoanatomical department of medical records of stationary patients on all dead for prior days no later than 10 o'clock in the morning of the day following after factual determination of death;

8) registration: - the health certificate on death (preliminary, final) the doctor in "pathological anatomy (adult, children's)" in day of carrying out pathoanatomical opening; - the health certificate on perinatal death (preliminary, final) the doctor in "pathological anatomy (adult, children's)" in day of carrying out pathoanatomical opening;

9) registration of results of opening in the form of the protocol of pathoanatomical research;

10) availability of the written notice in judicial investigating bodies for the solution of question of transfer of corpse on forensic medical examination in case of detection of signs of violent death and the termination of carrying out pathoanatomical research of corpse;

11) availability of the notice in writing of the doctor in "pathological anatomy (adult, children's)" in case of primary detection during opening of signs of acute infectious disease, food or production poisoning, unusual reaction to inoculation, and also the emergency notice in bodies of the public sanitary and epidemiologic service, at once after their identification;

12) carrying out pathoanatomical research of placenta: - in case of still birth; - in case of all diseases of the newborns revealed at the time of the birth; - in cases, suspicious on hemolytic disease of newborns; - in case of early otkhozhdeniye of waters and in case of dirty waters; - in case of the diseases of mother proceeding with high temperature in the last trimester of pregnancy; - in case of explicit anomaly of development or attachment of placenta; - in case of suspicion on availability of congenital anomalies of development of fruit; - in case of cases of preeclampsia, eclampsia

13) obligatory registration of fruit weighing less than 500 grams with anthropometrical data (weight, growth, head circle, thorax circle);

14) establishment of pathoanatomical opening depending on complexity on the following categories: - first category; - second category; - third category; - fourth category;

15) establishment by the doctor in "pathological anatomy (adult, children's)" categories of pathoanatomical opening and the reason of discrepancy of diagnoses in case of discrepancy of final clinical and pathoanatomical diagnoses

16) availability of the detailed analysis with determination of profile and categories of yatrogeniya in all cases of iatrogenic pathology, revealed as a result of pathoanatomical opening

rough

101.

Availability of the written application of the spouse (spouse), close relatives or legal representatives of the dead or written declaration of will this by person in case of his life for issue of corpse without carrying out pathoanatomical opening in the absence of suspicion on violent death

considerable

102.

Availability of entry in medical documentation with the subsequent intake of biological materials on determination of content of psychoactive agent with entering of results in the medical record in case of detection of signs of the use of psychoactive agents during the address for medical care to the organization of health care without pronouncement of the Conclusion of medical examination for factual determination of the use of psychoactive agent and state of intoxication

insignificant

103.

Availability of confirmatory medical documentation on holding medical and diagnostic actions, provision of medicines, the organization of clinical nutrition and the corresponding leaving of the patient from the moment of receipt in the organization of health care ("The medical record of the stationary patient" form No. 001/at)

considerable

104.

Availability of entry in the medical documentation confirming use of opportunities of consultation with the profile republican organizations by means of telemedicine network in case of complexity in verification of the diagnosis of the child, determination of tactics of maintaining. If necessary transfer of the patient in the profile republican organizations is made

considerable

105.

Availability of entry in the medical documentation confirming ensuring the supporting leaving (support of adequate feeding, maintenance of water balance, control of pain, maintaining fever, kislorodoterapiya)

considerable

106.

Availability of entry in the medical documentation confirming carrying out daily survey of the patient by the doctor, survey of the manager (in case of receipt in the first days, repeatedly at least 1 time a week)

considerable

107.

Availability of entry in the medical documentation confirming observance of requirements of rendering the anesteziologichesky and reanimatologichesky help:

1) rendering specialized medical care to patients in the emergency and planned procedures, including high-technology medical services;

2) determination of method of anesthesia, implementation of medicamentous preoperative preparation and carrying out different techniques of anesthesia in case of different surgeries, childbirth, diagnostic and medical procedures;

3) observation of condition of patients in the postnarcotic period in probuzhdeniya chambers before recovery of consciousness and stabilization of function of vitals;

4) assessment of extent of dysfunction of vitals and systems and carrying out expanded complex of actions for resuscitation and intensive therapy in case of different critical situations, including methods of extracorporal detoxication, hyperbaric oxygenation, electrocardiostimulation;

5) intensive observation (express control of condition of life support systems, and also metabolism with use of methods of laboratory and functional diagnostics, monitoring of breath and blood circulation), full and purposeful correction of frustration;

6) carrying out resuscitation measures to patients (in the presence of indications) in other departments;

7) establishment of indications for further treatment of patients in the conditions of OARIT, and also transfer of patients from OARIT in profile departments after stabilization of function of vitals with recommendations about treatment and inspection for the next days;

8) consultation of doctors of other departments concerning practical anesthesiology and resuscitation;

9) efficiency analysis of work of department and quality of the provided medical care, development and holding actions for improvement of quality of delivery of health care and to decrease in lethality

considerable

108.

Availability of confirmatory medical documentation on carrying out medical rehabilitation on the main disease (form No. 001/at "The medical record of the stationary patient", form No. 047/at "Rehabilitation card"). Purpose of the first stage of rehabilitation after consultation of the doctor of reabilitolog for prevention of complications and acceleration of functional recovery within treatment of the main disease according to clinical protocols. Duration of rate of medical rehabilitation, the list and amount of services is determined based on the conclusion of the doctor-reabilitologa or multidisciplinary group (further – MDG) taking into account basic treatment of the main disease with registration of medical part of the individual program of rehabilitation of the patient

considerable

109.

Availability of entry in the medical documentation confirming carrying out survey by the manager of department in case of arrival of neurosurgical patients and in subsequent as necessary to disease ("The medical record of the stationary patient" form No. 001/at)

considerable

110.

Availability of entry in the medical documentation confirming observance of requirements of rendering the ophthalmologic help in stationary conditions:

1) rendering the emergency specialized ophthalmologic help;

2) rendering the highly skilled specialized, including high-technology ophthalmologic help in planned procedure;

3) medical and diagnostic (laboratory, tool and functional) actions, provision of medicines, organization of clinical nutrition and corresponding leaving;

4) the organization of consultation (survey of the patient by the specialist of higher qualification or other profile) and/or consultation (if necessary for the purpose of identification of the diagnosis, determination of tactics of treatment and the forecast of disease), including profile specialists of the organizations of republican level giving ophthalmologic help;

5) after completion of treatment in hospital provision to the patient of the statement from the medical record with results of the conducted examination, treatments and recommendations about further tactics of treatment of the patient;

6) monitoring and the analysis of accounting and reporting statistical forms, monitoring of the main medico-statistics of incidence, disability from disease of organs of vision;

7) ensuring medical and diagnostic process, succession and interrelation with the PHC organizations, with other medical organizations, ophthalmologic and other profile services at all stages of rendering the ophthalmologic help

rough

111.

Availability of entry in the medical documentation confirming observance of requirements of the organization of delivery of health care in case of sharp violation of brain blood circulation (further – ONMK) at the stationary level in the conditions of the insultny centers (IC):

In case of suspicion of stroke or the tranzitorny ischemic attack, patients in the emergency procedure are hospitalized in the nearest primary or regional insultny centers on territorial arrangement.

Staging of delivery of health care by the patient with ONMK is performed according to algorithm of rendering the pre-hospital, stationary, out-patient help to patients with stroke

rough

112.

Maintaining the Log in information systems (correction, amendment, removal of records), for the purpose of tracing chronology of events of delivery of health care

considerable

113.

Availability of the medical record of the stationary patient approved in the form No. 001/at "The medical record of the stationary patient" which is the main medical document of the medical organization which is filled in on each patient who arrived in hospital.

The medical record of the stationary patient contains all necessary data characterizing the patient's condition during the whole time of stay in hospital, the organization of its treatment, this objective and laboratory researches and appointments.

Data from the medical record of the stationary patient allow to control correctness of the organization of medical and diagnostic process and are used for provision of data

considerable

Requirements for subjects (objects) giving out-patient and polyclinic help (primary health care and the consulting and diagnostic help)

114.

Availability of the documentation confirming delivery of health care, entering the guaranteed amount of free medical care and (or) system of compulsory social medical insurance on free basis

rough

115.

Availability of the signed agreement of joint insurance of professional responsibility of health workers

rough

116.

Availability of written voluntary consent of the patient or his legal representative in case of invasive interventions and on holding medical and diagnostic actions

considerable

117.

Availability of the medical record of the ambulatory patient about compliance of the held medical and diagnostic events with recommendations of clinical protocols

considerable

118.

Availability of documentation confirming observance of requirements under the organization and carrying out VKK: 1) availability of the order of the head of the medical organization: - about creation of VKK;

- about structure, the number of members (at least three doctors), - about work and the schedule VKK;

2) availability of the conclusion of VKK

considerable

119.

Availability of confirmatory documentation on observance of requirements by the PHC organizations when performing routine medical examinations of target groups of the population:

1) availability of lists of target groups of persons which are subject to screening surveys;

2) ensuring succession with the profile medical organizations for carrying out these surveys;

3) informing population on need of passing of screening researches;

4) entering of data on passing of screening researches into MIS;

5) carrying out the monthly analysis of the conducted screening researches with provision of information in local authorities of public administration by health care to the 5th following the accounting period

considerable

120.

Availability of confirmatory documentation on compliance of levels of rendering medical rehabilitation to patients:

1) primary level – the PHC medical organizations having office/department of rehabilitation, day hospital in the structure and rendering medical rehabilitation to patients whose condition is estimated from 1 to 2 points on scale of rehabilitation routing (further – ShRM);

2) secondary level – the medical organizations having in the structure the specialized departments and (or) the centers performing medical rehabilitation in out-patient, hospital-replacing and stationary conditions, rendering medical rehabilitation to patients whose condition is estimated from 2nd to 4 points on ShRM;

3) tertiary level – the specialized medical organizations having in the structure departments and (or) the centers rendering medical rehabilitation including using high-technology medical services in out-patient, hospital-replacing and stationary conditions, to patients whose condition is estimated from 2nd to 4-ta points on ShRM

considerable

121.

Availability of documentation confirming compliance of rendering the ftiziopulmonologichesky help at the out-patient and polyclinic level to the following requirements:

1) carrying out information and explanatory work on prevention, early detection of tuberculosis;

2) planning (forming of lists of the subject persons, execution of the schedule), the organization and carrying out fluorographic inspection with registration in medical documentation of results of inspection;

3) planning (forming of lists of the subject persons, execution of the schedule), the organization and carrying out tuberkulinodiagnostika of children and teenagers with registration in medical documentation of results of inspection, carrying out additional examination of tuberkulinopolozhitelny children);

4) the direction on inspection of persons in case of suspicion of tuberculosis on diagnostic algorithm of inspection

5) the direction to the phthisiatrician of persons with positive results of fluorographic inspection, children and teenagers with for the first time the revealed positive and giperergichesky tuberkulinovy test, with increase of tuberkulinovy sensitivity on 6 mm and more, children with collateral reactions and complications to tuberculosis inoculation;

6) planning, organization and performing vaccination against tuberculosis;

7) controlled treatment of latent tuberculosis infection (further - LTI) to destination the phthisiatrician, including in the video observed mode;

8) inspection of contact;

9) out-patient direct and controlled or video observed treatment of TB patients;

10) diagnostics and treatment of collateral reactions to antitubercular medicines to destination phthisiatrician;

11) diagnostics and treatment of associated diseases;

12) maintaining medical records of the TB patients who are on out-patient treatment including tuberculosis with multiple and wide medicinal stability;

13) regular entering of data into the national registry of TB patients within competence

rough

122.

Availability of entry in the medical documentation confirming observance of requirements of rendering the oncological help in form of the out-patient and polyclinic help: forming of groups of persons with risk of development of oncological diseases; survey by the doctor for the purpose of determination of condition of the patient and establishment of the diagnosis; laboratory and tool inspection of the patient for the purpose of diagnosis; dynamic observation of oncological patients; selection and the direction on hospitalization of oncological patients for receipt of specialized medical care, including high-technology medical services; additional examination of persons with suspicion on ZN for the purpose of verification of the diagnosis; determination of tactics of maintaining and treatment of the patient; performing out-patient antineoplastic therapy

rough

123.

Availability of obligatory confidential physical examination on availability of HIV infection of persons according to clinical and epidemiological indications, including sexual partners of pregnant women, persons who addressed voluntarily and anonymously

considerable

124.

Availability of the confirming medical documentation on observance of requirements of holding actions by the doctor the obstetrician-gynecologist in case of primary address of the woman concerning pregnancy and in case of desire to keep it:

1) availability of collection of the anamnesis, availability at the pregnant woman and relatives of diseases (diabetes, arterial hypertension, tuberculosis, mental disturbances, oncological diseases and others), the birth of children with inborn malformations and heritable diseases;

2) mark availability about postponed in the childhood and at mature age of diseases (somatic and gynecologic), transactions, blood transfusion and its components;

3) availability of group of "risk" on inborn and heritable pathology for the direction to the doctor in "Medical genetics" (without ultrasonic screening and the analysis of maternal serumal markers) according to the following indications: the age of the expectant mother of 37 years is also more senior, availability in the anamnesis of cases of termination of pregnancy according to genetic indications (and/or) the child's births with inborn malformation or chromosomal pathology, availability in the anamnesis of cases of the birth of the child (or availability of relatives) with monogenic heritable disease, availability of family carriage of chromosomal or gene mutation, the burdened obstetric anamnesis (still birth, usual not incubation and others);

4) availability of result of blood sampling of expectant mothers for the analysis of maternal serumal markers in the first trimester of pregnancy and purpose of ultrasonic screening in the first, second and third trimesters of pregnancy;

5) availability of record of features of reproductive function;

6) availability of record about the state of health of the spouse, blood type and Rhesus factor accessory;

7) availability of record of nature of production where spouses, addictions work;

8) survey availability for early registration of pregnant women up to 12 weeks and registration in day of identification of pregnancy for timely inspection;

9) availability of contraindications to pregnancy incubation;

10) availability of the plan of maintaining taking into account the revealed factors

rough

125.

Availability of entry in the medical documentation confirming observance of requirements by the doctor the obstetrician-gynecologist on rendering and the organization of the obstetric and gynecologic help to women in case of pregnancy, after the delivery, provision of services on planning of family and protection of reproductive health and also prevention, diagnostics and treatment of gynecologic diseases of reproductive system:

1) availability of visits for dispensary observation of pregnant women for the purpose of the prevention and early identification of complications of pregnancy, childbirth and the postnatal period with allocation of women "on risk factors";

2) availability of results of the carried-out prenatal screening - comprehensive examination of expectant mothers for the purpose of identification of risk group on chromosomal pathology and inborn malformations of pre-natal fruit;

3) timely hospitalization of the pregnant women needing hospitalization in day hospitals, departments of pathology of pregnancy of the medical organizations of stationary level giving obstetric and gynecologic help, the profile medical organizations with ekstragenitalny pathology with respect for the principles of regionalization of the perinatal help;

4) the direction of pregnant women, women in labor and women in childbirth for receipt of the specialized help with medical observation, including using high-technology medical services in the medical organizations of republican level;

5) availability of records about carrying out prenatal training of pregnant women in preparation for childbirth, including to partner childbirth, availability of informing pregnant women on alarming signs, about effective perinatal technologies, the principles of safe motherhood, breastfeeding and perinatal leaving;

6) carrying out patronage of pregnant women and women in childbirth according to indications;

7) consultation and rendering services in questions of planning of family and protection of reproductive health;

8) detection of infections, sexually transmitted for the direction to profile specialists;

9) availability of inspection of ZhFV with appointment, in need of profound inspection with use of additional methods and involvement of profile specialists for timely detection of ekstragenitalny, gynecologic pathology and their capture on dispensary accounting;

10) by results of inspection inclusion in group of dynamic observation of ZhFV depending on condition of reproductive and somatic health for timely preparation for the planned pregnancy for the purpose of improvement of result of pregnancy for mother and the child;

11) availability of performing routine inspections of female population for the purpose of early detection of ekstragenitalny diseases;

12) availability of inspection and treatment of gynecologic patients with use of modern medical technologies;

13) availability of the revealed and inspected gynecologic patients for preparation for hospitalization in the specialized medical organizations;

14) results of medical examination of gynecologic patients, including rehabilitation and sanatorium treatment;

15) the number of the executed small gynecologic transactions with use of modern medical technologies;

16) lists of pregnant women, women in childbirth and gynecologic patients on ensuring succession of interaction in inspection and treatment;

17) availability of conducting examination of temporary disability on pregnancy, childbirth and gynecologic diseases, determination of need and terms of temporary or permanent transfer of the worker for health reasons for other work, the directions on MSE of women with signs of permanent disability

rough

126.

Availability of results and additional these subsequent surveys and researches in the form of No. 077/at "The individual prenatal record and women in childbirth No. ___" and in the form of No. 048/at "The prenatal record of the pregnant woman and woman in childbirth No. ___" in case of each visit of the pregnant doctor of the obstetrician-gynecologist

considerable

127.

Availability of entry in the medical documentation confirming carrying out patronage at home by the midwife or the patronage nurse of the expectant mothers who did not attend appointment within 3 days after the appointed date

rough

128.

Availability in medical documentation of the conclusion of VKK on possible incubation of pregnancy at women with contraindications to pregnancy on ekstragenitalny pathology

considerable

129.

Availability of the contract for rendering paid medical services in the organizations of health care. Availability of the documents determining the copayment fact

rough

130.

Availability of documentation confirming observance by the average health worker of medical aid station of the organization of formation of requirements:

1) availability of the single list of students in the organizations of education;

2) availability of the list of the studying (target groups) which are subject to screening surveys;

3) the organization and performing immunoprevention with the subsequent vaccine-challenged observation of vaccinated;

4) conducting control of adherence to deadlines of passing of obligatory medical examinations of all staff of school and employees of catering department;

5) maintaining forms of accounting documentation in the field of health care on electronic and (or) paper

considerable

131.

Availability of the medical documentation confirming observance of requirements when conducting examination of temporary disability, issue of leaf and certificate of temporary disability (form No. 001/at "The medical record of the stationary patient", form 052/at "The medical record of the ambulatory patient", roots of sheets of temporary disability of patients, form No. 025/at "The magazine for record of the conclusions of the medical and consulting commission", form No. 029/at "The book of registration of sheets about temporary disability", form No. 037/at "The reference No. ____ about temporary disability of the student, pupil of college, technical training college, about disease, quarantine and other causes of absence of the child attending school, the children's preschool organization (necessary to emphasize)", form No. 038/at "The reference No. ____ about temporary disability" and others):

1) availability of survey of person and data recording about its state of health in the medical record of the ambulatory (stationary) patient proving need of temporary release it from work;

2) issue of leaf and certificate of temporary disability in day of the statement of person in case of hospitalization (including day hospitals, the rehabilitation centers) for the entire period of hospitalization;

3) closing of leaf and certificate of temporary disability with date of the statement from hospital if working capacity of person is completely recovered;

4) prolongation to persons continuing to be temporarily disabled leaf and the certificate of temporary disability for term taking into account time necessary for its appearance to the health worker of polyclinic or challenge of the health worker on the house (but no more than for one calendar day). To persons receiving treatment outside the region of residence time necessary for arrival to the place of its permanent residence is considered (but no more than for four calendar days);

5) issue of the certificate of temporary disability in case of the injuries got the being able alcoholic or drug intoxication and also in case of sharp alcoholic or narcotic intoxication, for the entire period of temporary disability;

6) issue of leaf and certificate of temporary disability to persons suffering from mental diseases in case of the untimely appeal to the medical organization for last days for the conclusion of VKK of psychoneurological dispensary or the health worker (psychiatrist) together with the head of the medical organization;

7) issue of leaf and certificate of temporary disability to the persons sent by a court decision for medicolegal or forensic-psychiatric examination and recognized disabled from the date of revenues to examination;

8) issue at the same time leaf and the certificate of temporary disability to person combining training with work

considerable