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Положение о деятельности противотуберкулезных организаций

08.02.2020 by Администратор326
Утверждено

приказом Министра здравоохранения

Республики Казахстан

от « 14 » марта 2011 года

№  131

 

 

Положение о деятельности

противотуберкулезных организаций

 

 

  1. Общие положения

 

  1. Настоящее Положение о деятельности противотуберкулезных организаций (далее — Положение) разработано в соответствии с подпунктом 1) пункта 3 статьи 32 Кодекса Республики Казахстан «О здоровье народа и системе здравоохранения» и определяет статус и полномочия противотуберкулезных организаций.
  2. К  противотуберкулезным организациям (далее – ПТО) относятся следующие организаций здравоохранения:

1) Республиканское государственное казенное предприятие «Национальный центр проблем туберкулеза Республики Казахстан» Министерства здравоохранения Республики Казахстан (далее – НЦПТ РК);

2)    областные, городские и районные (межрайонные) противотуберкулезные диспансеры (больницы);

3)    специализированные противотуберкулезные санатории;

4)    фтизиатрические кабинеты.

  1. Деятельность ПТО Республики Казахстан направлена на организацию противотуберкулезной помощи больным туберкулезом и профилактику, снижение заболеваемости, распространенности, инвалидности и смертности от туберкулеза.
  2. ПТО в своей деятельности руководствуются Кодексом Республики Казахстан «О здоровье народа и системе здравоохранения», отраслевыми нормативными правовыми актами, Уставом организации, настоящим Положением и осуществляют свою деятельность на основании государственной лицензии на медицинскую деятельность.
  3. ПТО осуществляют:

1) совместно с государственными органами санитарно-эпидемиологической службы организационно-методическое руководство по профилактике туберкулеза (вакцинация и ревакцинация БЦЖ, профилактические осмотры населения);

2) санитарно-противоэпидемические (профилактические) мероприятия в очагах туберкулезной инфекции, химиопрофилактику, наблюдение за контингентом больных активным туберкулезом, состоящим на диспансерном учете, и санитарно-просветительную работу;

3) диагностику туберкулеза, основанную на стандартных исследованиях (бактериологических: микроскопия, посев и тест на лекарственную чувствительность (далее – ТЛЧ), клинико-рентгенологических и постановке туберкулиновых проб Манту 2 ТЕ, а также дополнительных методах (инструментальных и радиологических);

4) химиотерапию больных туберкулезом под непосредственным наблюдением медицинского работника на стационарном и амбулаторном этапах лечения;

5) проведение поддерживающей фазы лечения и реабилитацию больных туберкулезом в условиях специализированных противотуберкулезных санаториев;

6) направление материалов в судебные органы на больных туберкулезом с бактериовыделением, уклоняющихся от лечения, для принудительной изоляции.

  1. Республиканское государственное казенное предприятие «Национальный центр проблем туберкулеза Республики Казахстан»Министерства здравоохранения Республики Казахстан

 

  1. НЦПТ РК осуществляет организационно-методическую, образовательную, научную, лечебно-диагностическую, консультативную работу и высокоспециализированную противотуберкулезную помощь населению Казахстана.
  2. НЦПТ РК является клинической базой для кафедр фтизиатрии средних и высших медицинских учебных заведений (последипломное обучение).
  3. При НЦПТ РК создается Республиканская централизованная врачебно-консультативная комиссия (далее – РЦВКК).
  4. НЦПТ РК осуществляет функции:

1) оказания консультативной, практической и организационно-методической помощи ПТО областного, городского и районного уровней, организациям первичной медико-санитарной помощи (далее – ПМСП), а также медицинским службам ведомств Министерства юстиции Республики Казахстан (далее – МЮ РК), Министерства обороны Республики Казахстан (далее – МО РК), Министерства внутренних дел Республики Казахстан (далее – МВД РК) и учебным заведениям Министерства образования и науки Республики Казахстан (далее — МОН РК), Министерству труда и социальной защиты Республики Казахстан (МТиСЗ РК);

2) оказания противотуберкулезной помощи больным туберкулезом, направленным ПТО областей, города республиканского значения и столицы;

3) ведения научно-исследовательской работы, апробации и внедрения в практику новых и усовершенствованных технологий;

4) регулярного эпидемиологического надзора за туберкулезом в Республике Казахстан, в том числе на основании систематического сбора, мониторинга и анализа данных Национального регистра больных туберкулезом;

5) диагностики туберкулеза, основанной на стандартных исследованиях (бактериологических: микроскопия, посев и ТЛЧ), клинико-рентгенологических и постановке туберкулиновых проб Манту 2 ТЕ, а также дополнительных методах (инструментальных и радиологических);

6) химиотерапии больных в стандартных и индивидуальных режимах лечения под непосредственным контролем медицинского работника;

7) диагностики и лечения сопутствующих патологий с привлечением профильных специалистов;

8) диагностики и проведения мероприятий по снижению и своевременному устранению побочных реакций противотуберкулезных препаратов (далее – ПТП);

9) учета в соответствии с формами первичной медицинской документации, утвержденными приказом и.о. Министра здравоохранения Республики Казахстан от 23 ноября 2010 года № 907 (далее – формы первичной медицинской документации) (зарегистрирован в Реестре государственной регистрации нормативных правовых актов за № 6697);

10) отчетности в соответствии с отчетными формами, утвержденными приказом Министра здравоохранения Республики Казахстан от 22 сентября 2010 года    № 742 (далее – отчетные формы) (зарегистрирован в Реестре государственной регистрации нормативных правовых актов за № 6586);

11) определения потребности в ПТП для лечения и профилактики туберкулеза в Республике Казахстан, контроля за расходованием и правильным хранением их в ПТО и организациях ПМСП;

12) мониторинга и оценки реализации противотуберкулезных мероприятий в регионах, с привлечением медицинских работников МЮ РК, МВД РК, и региональных Департаментов государственного санитарно-эпидемиологического надзора (далее – ДГСЭН)  и Комитетов контроля медицинской и фармацевтической деятельности Министерства здравоохранения Республики Казахстан;

13) организации и проведения тренингов, семинаров, конференций для медицинских работников фтизиатрической службы гражданского и пенитенциарного сектора, а также организаций ПМСП по вопросам борьбы с туберкулезом и мер инфекционного контроля;

14) работы с неправительственными организациями, в том числе общественными и международными;

15) участия в региональных, республиканских и международных форумах, съездах, семинарах и конференциях, совещаниях и тренингах;

16) санитарно-просветительной работы, в том числе совместно с РГКП «Национальный центр проблем формирования здорового образа жизни»;

17) межведомственного взаимодействия для повышения эффективности противотуберкулезных мероприятий и обеспечения преемственности между ПТО, организациями ПМСП и медицинскими службами ведомств Республики Казахстан.

 

  1. Областной, городской противотуберкулезный диспансер (больница)

 

  1. Областной, городской (города республиканского значения и столицы) противотуберкулезный диспансер (больница) (далее – ОПТД/ГПТД) является специализированной диагностической и лечебно-профилактической организацией здравоохранения, координирующей деятельность противотуберкулезной службы в области, оказывающей организационно-методическую, практическую и консультативную противотуберкулезную помощь медицинским организациям и населению области.
  2. При ОПТД/ГПТД создается областная/городская ЦВКК (далее – ОЦВКК/ГЦВКК).
  3. ОПТД/ГПТД осуществляет функции:

1) организационно-методического руководства ПТО и организаций ПМСП области/города по вопросам оказания противотуберкулезной помощи населению;

2) консультативной, практической и организационно-методической помощи медицинским организациям и медицинским службам ведомств МЮ РК, МО РК и МВД РК, а также учебным заведениям МОН РК области по проведению противотуберкулезных мероприятий;

3) диагностики туберкулеза, основанной на стандартных исследованиях (бактериологических: микроскопия, посев и ТЛЧ), клинико-рентгенологических и постановке туберкулиновых проб Манту 2 ТЕ, а также дополнительных методах (инструментальных и радиологических);

4) химиотерапии больных в стандартных и индивидуальных режимах лечения под непосредственным контролем медицинского работника;

5) лечения больных туберкулезом с лекарственно-чувствительными и лекарственно-устойчивыми формами;

6) изоляции больных с заразной формой туберкулеза, уклоняющихся от лечения, и хронической формой туберкулеза;

7) диагностики и лечения сопутствующих патологий с привлечением профильных специалистов;

8) диагностики и проведения мероприятий по снижению и своевременному устранению побочных реакций на противотуберкулезные препараты;

9) проведения совместно с ДГСЭН области мониторинга за:

вакцинацией БЦЖ новорожденных, ревакцинацией детей в возрасте 6 лет (1 класс);

планированием ежегодных дифференцированных флюорографических осмотров на туберкулез и постановке туберкулиновой пробы Манту 2 ТЕ детскому населению групп «риска»;

10) учета в соответствии с формами первичной медицинской документации;

11) отчетности в соответствии с отчетными формами;

12) диспансерным наблюдением за больными активным туберкулезом в области;

13) определением потребности в ПТП для лечения и профилактики туберкулеза, контролем за расходованием и правильным хранением их в ПТО и организациях ПМСП;

14) направлением больных в специализированные противотуберкулезные санатории на поддерживающую фазу лечения, а также детей в детские дошкольные и школьные учреждения санаторного типа;

15) выполнением противотуберкулезных мероприятий на основе стандартных индикаторов на областном уровне;

16) проведением мероприятий по экспертизе трудоспособности больных туберкулезом и направлением на медико-социальную экспертную комиссию (далее — МСЭК);

17) внедрением в практику современных методов диагностики, лечения и профилактики туберкулеза;

18) участием в региональных, республиканских и международных форумах, съездах, семинарах и конференциях, совещаниях и тренингах;

19) вынесением проблемных вопросов на рассмотрение местных исполнительных органов (областные координационные советы по туберкулезу);

20) санитарно-просветительной работой, в том числе совместно с центром формирования здорового образа жизни (далее – ЦФЗОЖ);

21) межведомственным взаимодействием для повышения эффективности противотуберкулезных мероприятий и обеспечения преемственности между ПТО, организациями ПМСП и ведомственными медицинскими службами области;

22) отбором больных для оказания социальной помощи.

  1. При ОПТД/ГПТД создается стационар (отделение, палата) дневного пребывания (далее — СДП).
  2. СДП предназначены для:

1)      госпитализации больных I, II категории без бактериовыделения, III категории, состояние которых не требует круглосуточного наблюдения и лечения, но которым необходимо проведение контролируемого курса химиотерапии;

2)      дифференциальной диагностики туберкулеза от других легочных заболеваний.

  1. Для проведения обследования больным из СДП используются лечебно-диагностические службы ПТО, в составе которого он организован.
  2. Финансирование СДП предусматривается в смете ПТО, в составе которой он организован.

  1. Специализированный противотуберкулезный санаторий

  1. Специализированный противотуберкулезный санаторий (далее — Санаторий) осуществляет лечебно-профилактическую и реабилитационную противотуберкулезную помощь населению Казахстана.
  2. Санаторий осуществляет функции:

1) химиотерапии больных туберкулезом в поддерживающей фазе, в стандартных и индивидуальных режимах лечения, под непосредственным контролем медицинского работника, направленных из НЦПТ РК, ПТО областного, городского и районного уровней;

2) внедрения в практику новых и усовершенствованных технологий в лечении и реабилитации больных туберкулезом;

3) диагностики и проведения мероприятий по снижению и своевременному устранению побочных реакций ПТП;

4) учета в соответствии с формами первичной медицинской документации;

5) отчетности в соответствии с отчетными формами;

6) участия в региональных, республиканских и международных форумах, съездах, семинарах и конференциях, совещаниях и тренингах;

7) санитарно-просветительной работы по профилактике туберкулеза.

  1. Городской противотуберкулезный диспансер (больница)

  1. Городской противотуберкулезный диспансер (больница) (далее – ГПТД) является специализированной диагностической и лечебно-профилактической организацией здравоохранения, координирующей деятельность противотуберкулезной службы в городе, оказывающей организационно-методическую, практическую и консультативную противотуберкулезную помощь медицинским организациям и населению города.
  2. ГПТД осуществляет свою деятельность под организационно-методическим руководством ОПТД.
  3. ГПТД осуществляет функции:

1) организационно-методической помощи медицинским организациям города, в том числе организациям ПМСП и медицинским службам ведомств МЮ РК, МО РК, МВД РК по проведению противотуберкулезных мероприятий;

2) диагностики туберкулеза, основанной на стандартных исследованиях (бактериологических: микроскопия, посев и ТЛЧ), клинико-рентгенологических и постановке туберкулиновых проб Манту 2 ТЕ, а также дополнительных методах (инструментальных и радиологических);

3) лечения больных туберкулезом с лекарственно-чувствительными и лекарственно-устойчивыми формами;

4) изоляции больных с заразной формой туберкулеза, уклоняющихся от лечения, и хронической формой туберкулеза;

5) химиотерапии больных в стандартных и индивидуальных режимах под непосредственным контролем медицинского работника;

6) диагностики и лечения сопутствующих патологий с привлечением профильных специалистов;

7) диагностики и проведения мероприятий по снижению и своевременному устранению побочных реакций ПТП;

8) проведения совместно с УГСЭН города мониторинга за:

вакцинацией БЦЖ новорожденных, ревакцинацией детей в возрасте 6 лет (1 класс),

планированием ежегодных дифференцированных флюорографических осмотров в соответствии с перечнем лиц группы «риска», подлежащих ежегодному обязательному флюорографическому обследованию на туберкулез и постановке туберкулиновой пробы Манту 2 ТЕ детскому населению групп «риска»;

9) формированием групп «риска» по туберкулезу, обследованием лиц с подозрением на туберкулез методом микроскопии, совместно с организациями ПМСП и УГСЭН;

10) диспансерным наблюдением за больными активным туберкулезом в городе;

11) определением потребности в ПТП для лечения и профилактики туберкулеза, контролем за расходованием и правильным хранением их в ПТО и организациях ПМСП;

12) направлением материалов в судебные органы на больных туберкулезом с бактериовыделением, уклоняющихся от лечения, для принудительной изоляции;

13) выполнением противотуберкулезных мероприятий, на основе стандартных индикаторов на городском уровне;

14) проведением мероприятий по экспертизе трудоспособности больных туберкулезом и направлением на МСЭК;

15) внедрением в практику современных методов диагностики, лечения и профилактики туберкулеза;

16) представлением медицинской документации больных туберкулезом на ЦВКК ОПТД для верификации диагноза, определения типа и группы диспансерного учета, коррекции лечения и отбора на хирургическое лечение.

17) участием в региональных, республиканских и международных форумах, съездах, семинарах и конференциях, совещаниях и тренингах;

18) проведением санитарно-просветительной работы, в том числе совместно с ЦФЗОЖ.

  1. При ГПТД создается СДП в порядке, определяемом в пунктах 13 — 16 настоящего Положения.

  1. Районный противотуберкулезный диспансер (больница)

  1. Районный противотуберкулезный диспансер (больница) (далее – РПТД) является специализированной медицинской организацией здравоохранения района.
  2. РПТД осуществляет свою деятельность под организационно-методическим руководством ОПТД/ГПТД.
  3. РПТД осуществляет функции:

1)      диагностики туберкулеза, основанной на стандартных исследованиях (бактериологических: микроскопия, посев и ТЛЧ), клинико-рентгенологических и постановке туберкулиновых проб Манту 2 ТЕ, а также дополнительных

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