«The organisation, carrying out and «The organisation, carrying out and monitoring monitoring screenings screenings programs»programs»

«The organisation, carrying out and «The organisation, carrying out and monitoring monitoring screenings screenings programs»programs»

Discipline: «the General medical Discipline: «the General medical practice»practice»

Speciality: 051301 «the General Speciality: 051301 «the General medicine»medicine»Course: Course: VV

The purpose: To acquaint students with carrying out bases screenings programs, as

one of the basic actions for preventive maintenance chronic noncommunicable.

The lecture plan:• The purposes and problems screenings

programs.• Technology of carrying out screenings

researches• The documentation on carrying out and

the reporting screenings inspections

Preventive medical inspections of target groups of the population

• Rules of carrying out of preventive medical inspections of target groups of the population the Order of MZ РК №165 from 11/10/2009 with changes

• Main objective of preventive medical inspections (screenings) – revealing of diseases at early stages and the prevention of development of diseases, the risk factors promoting occurrence of diseases, formation and strengthening of health of the population.

• Skriningovye surveys are spent within the limits of ГОБМП

Technology of carrying out of preventive medical inspections of separate categories of

adult population by selective (screenings) inspections

• Feature of carrying out of routine inspections by a way screenings inspections is survey of the population man's and female, city and agricultural population of the allocated target groups.

І. Responsibility for carrying out screenings researches;

• Experts of level of the primary medicosanitary help (ПМСП)

ІІ. Groups screenings supervision

• Skriningovye inspections of the persons who have reached of 18 years, and since 25 years till 60 years with an interval of 1 times in five years for the purpose of early revealing of the basic illnesses of system of blood circulation (an arterial hypertension, an ischemic heart trouble)

• Carrying out screenings inspections on revealing of a cancer of a neck of a uterus in age group of 35-60 years with an interval of 1 times in five years.

• Carrying out screenings inspections on revealing of a cancer of a mammary gland in age group of 50-60 years with an interval alternate years.

ІІІ. The carrying out scheme screenings researches:

1. To make family the list of the target group attached to a territorial site having broken of them on groups on year of birth.2. To make the schedule of continuation of routine inspections, dynamic supervision, improvement and prophylactic medical examination of target groups.3. The schedule of terms of carrying out of inspections – coverage of target groups by routine inspections by a way скрининговых inspections in a current of 10 months of year:• Dynamic supervision and improvement is spent in a current of 12 months• Population prophylactic medical examination under indicationsAt scheduling it is necessary to consider following terms:• Coverage of target groups by routine inspections by a way скрининговых inspections within 10 months of year;• Dynamic supervision and improvement within 12 months;• Population prophylactic medical examination under indications.

IV. The documentation:• The statistical card of the out-patient patient

(the form 025-08/у) is filled with the medical personnel of an average link and accompanied for the patient at all stages of inspection

• V. Population participation in скрининговых researches:

• The wide notification of the population in mass media about the purposes and problems of routine inspections, business hours of medical - preventive organisations

• To inform the population on conditions of carrying out of inspection (measurement of arterial pressure, cytologic research).

screenings surveys1. The basic illnesses of system of blood

circulation – АГ, ИБС and risk factors of their development among men and women

2. Diabetes among men and women3. Pretumoral, malignant new growths of a neck of

a uterus among women4. Pretumoral, malignant new growths of a

mammary gland among women5. Glaucomas among men and women6. Pretumoral, malignant new growths thick and a

rectum among men and women

Early diagnostics of illnesses of System of blood circulation

• Target groups are-chitsa 18; 25; 30; 35; 40; 45; 50; 55; 60; 65 years.

• The given target group is formed by the average medical personnel (the medical assistant, the local Staff nurse, the staff nurse of the general practice).

• The algorithm of inspection begins with medical aid station level (ФЛ, ФАП), a medical ambulance station, branch of the general medical practice / of local service of polyclinic.

Algorithm of inspection

• MeasurementThe arterialPressure (HELL)• Definition of an arterial hypertension• Superfluous alcohol intake – The daily single

daily use for men of 35-65 years: more than 0,5 l. Beer, or more than 250 ml. Fault, or more than 50 ml. Strong spirits;

For young men (31-34 years) women, persons at the age of more than 66 years the daily single daily use more than 285 ml. Beer, or more than 120 ml. Fault, or more than 25 ml. A hard liquor.

• Superfluous weight of a body – For adults it is calculated under the formula of Ketle: Weight (kg) / Growth (м2), at an indicator 25 admits the superfluous weight of a body.

2 stage• Medical examination, diagnostics with

carrying out of laboratory-diagnostic researches is spent: electrocardiogram removal, biochemical researches: measurements of level of cholesterol, триглицеридов. Measurement of sugar of blood is spent at patients of 35 years and is more senior.

• In norm the general cholesterol 5,2 mmol/l, triglycerides 0,5-2,1 mmol/l, glucose 3,88-5,55 mmol/l.

3 stage• It appears necessary highly skilled

and specialised copper the help needing with corresponding recommendations about the further improvement of the population.

Early diagnostics of a cancer of a neck of a uterus

Target groups are persons 35, 40. 45, 50, 55, 60 years with carrying out of the following The laboratory Researches:Skrinnngovoe inspection on earlier revealing of a cancer of a neck of a uterus consists of 3 stages.1 stage - filling with the medical personnel of an average link Statistical card of the out-patient patient (the form 025-08/у).2 stage - Profound inspection and the further tactics of treatment at district clinic level / city (female consultation).3 stage - Rendering of specialised medical aid at level of a city/regional oncological clinic.

Earlier revealing of a cancer of a mammary

glandThe target Group Women 50, are 52, 54, 56,> 58 60 years.• For revealing of a pathology of mammary glands me the personnel of an average link spends poll with filling of the Statistical card of the out-patient patient (the form 025-08/у).

The age groups which are subject скрининговому to inspection and

volume of inspections

AgeSurvey by

expertsLaboratory researches

18 years The therapist/vop

At the Direction on 2 stage of inspection for revealing of illnesses of system of blood

circulation:The electrocardiogram, biochemical researches:

cholesterol level, triglycerides

25 years The therapist/vop

At the Direction on 2 stage of inspection for revealing of illnesses of system of blood

circulation:The electrocardiogram, biochemical researches:

cholesterol level, triglycerides

30 year

s

The therapist/vop

At the Direction on 2 stage of inspection for revealing of illnesses of system of

blood circulation:The electrocardiogram, biochemical

researches: cholesterol level, triglycerides

35 year

s

The therapist/vop,The accoucheur /The gynecologist

At the Direction on 2 stage of inspection for revealing of illnesses of system of

blood circulation:The electrocardiogram, biochemical

researches: cholesterol level, triglycerides, sugar in blood.

Without fail for women: Pap- The test, expanded colposcopy, the test for presence

ВПЧ (Дigene- The test)

40 years

The therapist/vop, The accoucheur/gynecologist

At the Direction on 2 stage of inspection for revealing of illnesses of system of blood

circulation:The electrocardiogram, biochemical

researches: cholesterol level, triglycerides, sugar in blood.

Without fail for women: Pap- The test, expanded colposcopy, the test for presence

ВПЧ (Дigene- The test)

45 years

The therapist/vop,The accoucheur/gynecologist

At the Direction on 2 stage of inspection for revealing of illnesses of system of blood

circulation:The electrocardiogram, biochemical

researches: cholesterol level, triglycerides, sugar in blood.

Without fail for women: Pap- The test, expanded colposcopy, the test for presence

ВПЧ (Дigene- The test)

50 years

The therapist/vop,The accoucheur /Gynecologist Mammolog/The oncologist

At the Direction on 2 stage of inspection for revealing of illnesses of system of blood

circulation:The electrocardiogram, biochemical

researches: cholesterol level, triglycerides, sugar in blood.

Without fail for women: Pap- The test, expanded colposcopy, the test for presence

ВПЧ (Дigene- The test)

52 years

Mammolog/The oncologist

Without fail for women:mammography

54 years

Mammolog/The oncologist

Without fail for women:mammography

55 years

The therapist/vop, the Accoucheur/gynecologist

At the Direction On 2 Stage Inspections for Revealings of illnesses

Blood circulation systems: The electrocardiogram, biochemical

researches: cholesterol level, триглицеридов, sugar in blood.

Without fail for women: Pap- The test, expanded кольпоскопия, the test for

presence ВПЧ (Дigene- The test)

56 years

Mammolog/The oncologist

Without fail for women:маммография

58 years Mammolog/The oncologist

Without fail for women:маммография

60 years The therapist/vop, the Accoucheur /The gynecologist

At a direction on 2 stage of inspection for revealing of illnesses of system of blood

circulation:The electrocardiogram, biochemical researches:

cholesterol level, триглицеридов, sugar in blood. Without fail for women: Pap- The test, expanded

кольпоскопия, the test for presence ВПЧ (Дigene- The test), маммография

65 years The therapist/vop

At a direction on 2 stage of inspection for revealing of illnesses of system of blood

circulation:The electrocardiogram, biochemical researches:

cholesterol level, триглицеридов, sugar in blood.

Skriningovye surveys of adult population

Groups of the dynamic population

1. Healthy without risk factors – the persons who are not showing any complaints and at which in the anamnesis and during survey chronic diseases, risk factors илим infringements of functions of separate bodies and systems – диспансерная group are not revealed IAND (D - I

2. Healthy with risk factors – persons with the revealed risk factors, "the boundary" conditions, needing supervision and preventive intervention (persons at whom insignificant deviations from the established borders of norm in sizes the HELL and the other physiological characteristics, not influencing functional activity оргшанизма) dispancer group are revealed I(D - I

3. Almost healthy – the persons having in the anamnesis sharp and chronic disease without aggravations within last several years, dispensary group II (D -II)

4. Patients – the persons needing treatment, - dispensary group III (D - III)

The literature• The order of MZ РК № 607 from 10/15/2007 «About

perfection of routine inspections of separate categories of adult population».

• Management on the primary medicosanitary help + WithD/ under the editorship of A.A.Baranova, I.N.Denisova, А.Г Chuchalina. – М, 2006. – 1584 with.

• Rules of carrying out of preventive medical inspections of target groups of the population the Order of MZ РК №165 from 11/10/2009 with changes

• Polyclinic therapy / Under the editorship of V.A.Galkin. – М: Medicine, 2000.–256 with. Storozhakov G. I, Chukaeva I.I., Alexanders A.A.polyclinic therapy: the textbook. – М, 2007. – 704 with.

Control questions• Problem screenings inspections of separate

groups of the population.• Age groups screenings researches on

preventive maintenance of the basic cardiovascular diseases.

• Carrying out stages screenings inspections.• The statistical documentation of screening.• The reporting of results screenings

researches.