MAIN SANITARY AND EPIDEMIOLOGICAL OFFICE
1. Purpose and scope.
1.1 The recommendations were developed in the development of the current "Sanitary norms and rules for working with equipment that creates ultrasound transmitted by contact to the hands of workers" No. 2282-80 in order to optimize and improve the working conditions of medical workers in ultrasound rooms.
2. Hygienic requirements for the equipment of ultrasound rooms
2.1 A set of rooms intended for equipping ultrasound rooms,
should include:
A room for conducting diagnostic studies at the rate of at least 20 m 2 per unit;
A room for undressing and dressing a patient with an area of at least 7m 2;
Premises for waiting for admission at the rate of 1.2 m 2 per patient, at least 10 m 2.
2.2 It is forbidden to place ultrasound rooms in the basement, semi-basement and basement rooms.
2.3 The room for ultrasound should have:
- natural and artificial lighting;
- sink with cold and hot water supply;
General exchange ventilation system with an exchange rate of 1:3, air conditioners BK-1500 are allowed.
2.4 The walls in the premises of the ultrasound room should be painted with light-colored oil paint. Wall tiling with ceramic tiles is prohibited.
2.5 Noise levels at workplaces are not more than 40 dB.
In order to reduce noise in the premises, it is recommended to line ceilings and walls with sound-absorbing materials /for example "Akmigran"/.
2.7 The couch /with adjustable height/ should be placed in the center of the room or some distance from the wall.
2.8 When conducting research, general lighting should be turned off, only a table lamp should be left, the windows in the classrooms should be darkened with curtains.
2.9 Electrical appliances that cause interference with the operation of ultrasound equipment should not be placed in the ultrasound room and near it.
3. Hygienic requirements for the organization and conduct of ultrasound.
To work with ultrasonic equipment, persons are allowed not younger than 18 years old, who have completed the appropriate training course and safety briefing.
Given that the duration of a diagnostic study varies widely, the number of patients examined by one health worker should not exceed 10-11 people.
For a complex of gymnastic exercises, physiotherapeutic procedures, etc. it is recommended that medical personnel working on ultrasound machines take two 10-minute breaks during a work shift.
To protect the hands of personnel from exposure to contact ultrasound, two pairs of gloves should be used: bottom cotton, top rubber.
Contact of unprotected hands with the scanning surface of a working ultrasonic sensor is not allowed.
When applying a contact lubricant to the area under study, care should be taken to ensure that it does not fall on the hands of the healthcare worker.
4. Therapeutic and preventive measures to prevent the adverse effects of high-frequency ultrasound and related factors.
4.1 The therapeutic and prophylactic complex of measures includes:
- medical examinations, clinical examination;
- physiotherapeutic procedures;
Special complex of industrial gymnastics;
Eye exercises;
Psychological relief.
4.2 Order of the Ministry of Health N 700 (dated 19.06.84).
DOCUMENTATION OF THE ULTRASONIC ROOM
The working documentation of the ultrasound diagnostics office is:
1. Journal of preliminary registration for the study. The purpose of the journal is to plan the scope of the office's work. In this case, patients are distributed among doctors according to their work schedule and by areas of study (abdominal cavity, kidneys, thyroid gland, mammary glands, etc.). Instead of this journal, separate sheets can be used, which are handed over to the registry in advance.
2. Journal of registration of research results. This journal should include:
Date of the study;
The serial number of the study;
Passport data of the patient (full name, year of birth);
Medical institution, department or surname of the doctor who sent the patient for research;
Preliminary clinical diagnosis (the basis for the diagnostic procedure);
The number of studies carried out (codes, ciphers, etc.);
The conclusion of the ultrasound examination (research results).
The last column briefly records the conclusion of the doctor who conducted the study, and a copy of the protocol with a detailed description of the ultrasound picture and the images taken should be stored in the archive of the department, so that they can be easily found if necessary.
3. Journal of analysis of identified pathology. It is most advisable to keep a journal according to the organ-nosological principle (organ - disease - the number of detected cases per month, quarter, half year, year). The most interesting cases can be recorded separately (with anamnesis, ultrasound results, surgery, section).
4. Archive (file cabinet). The archive organization system can be different and depends on the profile of the medical institution and the volume of research. In small departments (rooms) of ultrasound diagnostics, the second copies of the protocols can be filed, stored in folders or pasted in a notebook according to the dates of the examination.
It is also possible to create a card file in alphabetical order by year of work.
In large departments where diversified studies are carried out, it is advisable to keep an archive not only in chronological order, but also thematically (ie, by organs and diseases).
A copy of the ultrasound protocol and images of an adult patient should be kept 5 years (with identified pathology) and 1 year (in the absence of pathological changes) counting from the date of the last examination. The results of an ultrasound examination of children are archived for at least 5 years, regardless of the nature of the identified changes.
5. Ultrasound protocol. If a special form is not used for the protocol, the name and address of the medical institution, the date of the study and the name of the doctor who conducted the study must be indicated. The conclusion is a medical document only if there is a seal of a medical institution or a personal seal of a doctor.
Order of the Ministry of Health of the USSR N 581 of 06/21/1988.
STAFF STANDARDS FOR MEDICAL PERSONNEL OF DEPARTMENTS (OFFICES) OF ULTRASOUND DIAGNOSTICS OF MEDICAL INSTITUTIONS (Appendix 7).
1. Medical staff. The positions of ultrasound diagnostic doctors are established depending on the amount of work and the current estimated time standards for ultrasound examinations. These positions are established within the limits of the labor plan and wage allocations. The position of the head of the department is established if there are at least 3 positions of ultrasound diagnostic doctors in the state instead of 0.5 positions of a doctor.
2. Middle medical personnel. The position of a nurse is established in accordance with the positions of ultrasound diagnostic doctors, including the position of the head of the department. The position of a senior nurse is established according to the position of the head of the department instead of 0.5 of the position of a nurse.
3. Junior medical staff. The positions of nurses are established at the rate of 0.5 positions for 1 position of an ultrasound doctor, including the position of the head of the department, but not less than 1 position.
Note: engineering support for the functioning of units of departments (rooms) of ultrasound diagnostics is carried out by personnel whose positions are introduced in accordance with the standard staff of managers, specialists, employees and workers of healthcare institutions.
***MINISTRY OF HEALTH OF THE RSFSR ORDER No. 132, 02.08.91 ON THE IMPROVEMENT OF THE IMAGING SERVICE (excerpt) I ORDER: ...
to resolve the issue of organizing on the basis of medical institutions and clinics medical and
research institutes of departments (departments) of radiation diagnostics, including X-ray and radiological,
X-ray diagnostic departments (rooms), divisions of radionuclide, ultrasound, computer,
magnetic resonance and other types of diagnostics, taking into account local conditions, to organize their work in accordance
with the “Regulations on the Department (Department) of Radiation Diagnostics”, its divisions and personnel ... Appendix N 1 to the order of the Ministry of Health of the RSFSR of August 2, 1991 N 132 REGULATIONS ON THE DEPARTMENT (DEVICE) OF RADIATION DIAGNOSIS 1. General provisions 1.1. Department (department) of radiation diagnostics is organized on the basis of medical and preventive institutions, clinics of medical and research institutes and is their structural subdivision. REGULATIONS ON THE DEPARTMENT (OFFICE) OF ULTRASONIC DIAGNOSTICS 2. Management of the department (cabinet) of ultrasound diagnostics is carried out by the head. 3. The work of the department (office) of ultrasound diagnostics is organized in accordance with the Regulations on the Department of Radiation Diagnostics, these Regulations and other regulatory documents. 4. The main tasks of the department (office) are: 4.1. Providing patients with clinically sound highly qualified diagnostic and therapeutic care using ultrasound methods using additional special techniques. 4.2. Combining the results of work with other diagnostic and clinical departments in order to clarify the diagnosis and determine the amount of medical care. 5. Issuance of conclusions based on the results of an ultrasound examination no later than the next day after the study. Appendix N 18 to the order of the Ministry of Health of the RSFSR dated August 2, 1991 N 132 REGULATIONS ON THE DOCTOR OF THE DEPARTMENT (OFFICE) OF ULTRASOUND EXAMINATIONS OF THE DEPARTMENT (DEPARTMENT) OF RADIATION DIAGNOSTICS with special training in ultrasound diagnostics. 2. The doctor of ultrasound diagnostics is directly subordinate to the head of the department (department) of radiation diagnostics, in his absence - to the head of the institution or his deputy for medical work. 3. The doctor of ultrasound diagnostics in his work is guided by the Regulations on the department (office) of ultrasound diagnostics, the Regulations on the department (department) of radiation diagnostics, this Regulation and other regulatory documents. 4. In accordance with the tasks of the ultrasound diagnostic room, The doctor provides and implements: 4.1. Carrying out ultrasound diagnostic studies according to clearly formulated indications and making the final decision on its implementation, determining the required volume and rational research methodology, performing diagnostic and therapeutic-diagnostic invasive manipulations, including on-site visits. 4.2. Development and implementation of new diagnostic methods and equipment. 4.3. Consultative work on the use of ultrasound in diagnostics and its possibilities in medical practice. Participation in the analysis of complex cases and errors in diagnosis, identification and analysis of the reasons for the discrepancy between ultrasound data and pathological and operational data. 4.4. Maintenance of relevant medical and reporting documentation, analysis of quantitative and qualitative performance indicators. 4.5. Raising the qualifications of middle and junior medical personnel and monitoring their work, compliance with safety and labor protection rules. 4.6. Control over the safety and rational use of equipment and apparatus, their technically competent operation. 5 . The ultrasound doctor must: 5.1. Improve their skills in the prescribed manner, master new equipment and new methods for conducting ultrasound diagnostic studies. 6 . The doctor of ultrasound diagnostics has the right: 6.1. Give orders and instructions to the middle and junior medical staff. 6.2. Represent the administration of the institution of employees subordinate to him to encourage or impose a penalty. 6.3. Make proposals to the administration of the institution on improving the work of the office, organizing working conditions. 6.4. Participate in meetings, conferences, which discuss issues related to the work of the ultrasound diagnostic room. Appendix N 19 to the order of the Ministry of Health of the RSFSR dated August 2, 1991 N 132 REGULATIONS ON THE NURSE (DEPARTMENT) OF THE ULTRASOUND ROOM OF THE DEPARTMENT (DEPARTMENT) OF RADIATION DIAGNOSTICS diagnostic equipment and safety precautions. A nurse with experience in a surgical or intensive care unit is appointed to the position of a nurse in the office where invasive manipulations are performed under ultrasound or x-ray ultrasound control. 2. In her work, the nurse of the ultrasound diagnostics room is guided by the Regulations on the Department of Radiation Diagnostics, on the department (office) of ultrasound examinations, by this Regulation. 3. The main tasks of the nurse in the ultrasound diagnostic room are the preparation of wiping and lubricants, ultrasound equipment for the study, preparing the patient for an ultrasound diagnostic study and participating in other procedures, photographic recording of images during the study and registration of study data in the relevant accounting documents , regulating the flow of examined persons, maintaining a first-aid kit with drugs for emergency care, ensuring the safety of equipment, equipment, household equipment, observing the sanitary regime, participating in archiving and ensuring the safety of medical information. When performing invasive manipulations, her duties include maintaining a clean dressing room or operating room in the office, preparing sterile instruments, materials, gowns, as well as the necessary set of drugs, the patient for invasive manipulation and assisting the doctor during it. 4. A nurse in an ultrasound diagnostics room is obliged to improve their qualifications in the prescribed manner, strictly comply with safety regulations, internal labor regulations, monitor the technical condition of the equipment and maintain the necessary accounting and reporting documentation.
Appendix N 22 to the order of the Ministry of Health of the RSFSR
EXAMPLE ESTIMATED TIME RATES FOR ULTRASONIC EXAMINATIONS
Ultrasound examination of the organs of the hepatobiliary system:
Liver + gallbladder 20 min.
Gallbladder with function definition 60 min.
Pancreas 20 min.
Spleen 20 min.
Ultrasound examination of the organs of the genitourinary system:
Kidneys + adrenal glands 20 min.
Bladder with determination of residual urine 15 min.
Prostate gland + testicles 20 min.
Ultrasound examination of the female genital organs:
For gynecological diseases 25 min.
During pregnancy 30 min.
Ultrasound examination of the internal organs of the fetus:
in the II and III trimester of pregnancy 30 min.
Ultrasound examination of the organs of the newborn:
Brain 30 min.
Internal organs 30 min.
Ultrasonic examination of surface structures:
Thyroid gland 15 min.
Mammary gland 20 min.
Salivary glands 20 min.
Lymph nodes 20 min.
Peripheral vessels 20 min.
Dopplerometry of vessels with spectral analysis
in constant wave mode 50 min.
Vascular examination with color Doppler
mapping 60 min.
Soft tissues 20 min.
Ultrasound examination of the chest organs :
Mediastinum 20 min.
Pleural cavity 20 min.
Echocardiography with color mapping 60 min.
Echocardiography with Doppler analysis 60 min.
Doppler ultrasonography of blood vessels in pulsed
mode 40 min.
Therapeutic and diagnostic studies under ultrasound control:
Percutaneous diagnostic puncture 45 min.
Percutaneous diagnostic puncture with
express cytological examination 70 min.
Therapeutic and diagnostic puncture of abdominal cysts
cavity and retroperitoneal space 70 min.
Therapeutic and diagnostic puncture of the abdominal and pleural
cavities 90 min.
Percutaneous drainage of the gallbladder 120 min.
Percutaneous drainage of the bile ducts
ultrasonic and x-ray control 150 min.
Ultrasound hysterosalpingography
(echohydrotubation) 60 min.
Note:
Estimated workload for an ultrasound doctor
with a 6.5 hour working day - 33 conventional units.
A conventional unit is taken to be a work with a duration of 10
In combined studies of several organs, the calculated
the norms for each subsequent organ are reduced by 5 minutes.
In the study of children, the norm of time increases by 10%
Estimated time limit includes:
1. preparatory-final time
2. the time of the actual study
3. Time for documentation and work review.
Working hours of the ultrasound doctor
|
For medical workers, the law provides for reduced working hours. Article 350 of the Labor Code of the Russian Federation establishes that such duration should not exceed 39 hours per week. Depending on the position and (or) specialty, the duration of the working hours of medical workers is determined by the Government of the Russian Federation. Until recently, the Order of the Ministry of Health of the USSR dated 12/11/1940 was in force, the annexes to which contained lists of medical workers who had a working day of 6.5 and 5.5 hours, but with the proviso that with a six-day working week. In "Rossiyskaya Gazeta", the official publication, dated February 20, 2003 No. 33 (3147), a new Decree of the Government of the Russian Federation "On the working hours of medical workers depending on the position and (or) specialty" was published dated February 14, 2003 No. 101. The reduced working hours of medical workers, depending on their position and (or) specialty, is established: So, in Appendix No. 2 - a working week of 33 hours - I are indicated. Medical and preventive organizations, institutions (polyclinics, outpatient clinics, medical centers, stations, departments, offices), if the doctor conducts exclusively outpatient admission of patients. The main purpose of the estimated norms of time for functional studies is to use them when: Solving issues of improving the organization of the activities of offices (departments) of functional diagnostics; Planning and organizing the work of medical personnel of these units; Analysis of the labor costs of medical staff; Formation of staff standards for the medical staff of the relevant medical institutions. Working hours according to settlement norms cannot exceed 84.5% of your total working time. The fulfillment of settlement norms or overfulfillment ultimately affects your salary. If you are an outpatient, then your working week is 33 hours, and the working day, as a rule, is 6.5 hours, unworked hours can “accumulate” to 1 working Saturday per month. On the day you have a norm - 33 units, they are calculated using a special table. In principle, the usual polyclinic reception fully provides the amount of work to fulfill all this norm and even exceed it. You may also be paid compensation for working in hazardous working conditions. Order of the Russian Ministry of Health of October 15, 1999 No. 377 approved the Regulation on the remuneration of healthcare workers, which is used when determining the wages of employees of healthcare institutions of the system of the Ministry of Health of the Russian Federation. Healthcare institutions include medical and preventive, sanitary-epidemiological and other institutions included in the "Nomenclature of Healthcare Institutions", approved by the Ministry of Health of Russia. If you work in an institution included in this nomenclature, then you are entitled to a salary (rate) increase of 15% (Appendix No. 2 to the said Regulation, position 1.17 of the List of institutions, divisions and positions, work in which gives employees the right to increase salaries (rates) in connection with hazardous to health and especially difficult working conditions "Departments (offices): ultrasound diagnostics and endoscopic") |
Active Edition from 02.08.1991
ORDER of the Ministry of Health of the RSFSR of 02.08.91 N 132 "ON IMPROVING THE SERVICE OF RADIATION DIAGNOSIS"
APPROXIMATE ESTIMATED TIME RATES FOR RADIOLOGICAL AND ULTRASONIC EXAMINATIONS
X-ray examinations of the chest organs
| X-ray of the chest organs | 10 minutes. |
| Radiography (survey) of the chest in one projection | 10 minutes. |
| in two projections | 15 minutes. |
| Fluoroscopy and radiography of the heart with a contrasted esophagus | 20 minutes. |
| X-ray of the larynx | 10 minutes. |
| Radiography of the heart, diaphragm | 19 min. |
X-ray examinations of the abdominal organs (digestive organs)
| Pharyngography contrast | 20 minutes. |
| X-ray (survey) of the abdominal cavity | 10 minutes. |
| Radiography (survey) of the abdominal cavity | 16 min. |
| Fluoroscopy and radiography of the stomach according to the traditional method | 20 minutes. |
| Self x-ray and x-ray of the esophagus | 10 minutes. |
| Retrogradehy | 90 min. |
| Cholangiography intraoperative | 30 min. |
| Cholangiocholecystography intravenous | 30 min. |
| Oral cholecystography | 15 minutes. |
| Primary double contrast stomach | 30 min. |
| Duodenography probeless | 20 minutes. |
| probe | 30 min. |
| Irrigoscopy | 35 min. |
X-ray studies of the osteoarticular system
| Radiography of the peripheral parts of the skeleton and spine in one projection | 10 minutes. |
| in two projections | 15 minutes. |
| X-ray of the skull in two projections | 15 minutes. |
| X-ray of the paranasal sinuses | 10 minutes. |
| X-ray of the temporomandibular joint | 15 minutes. |
| X-ray of the lower jaw | 15 minutes. |
| X-ray of the bones of the nose | 10 minutes. |
| X-ray of teeth | 10 minutes. |
| X-ray of the temporal bone | 15 minutes. |
| X-ray of the clavicle | 10 minutes. |
| Radiography of the scapula in two projections | 15 minutes. |
| Radiography of the ribs with autocompression during breathing | 20 minutes. |
| X-ray of the sternum with compression during respiratory movements | 35 min. |
| X-ray of the thoracic spine with a compression belt during respiratory movements | 25 min. |
| Functional examination of the spine | 20 minutes. |
| Radiography of the pelvic bones | 10 minutes. |
| X-ray of soft tissues | 10 minutes. |
| For each additional shot in special projections, | 5 minutes. |
X-ray studies used in urology and gynecology
| Urography intravenous | 40 min. |
| Intravenous urography in a specialized institution with additional jobs (imaging table) provided by the relevant paramedical personnel - the time can be reduced to | 20 minutes. |
| Ascending pyelography | 40 min. |
| Ascending cystography | 15 minutes. |
| Ureterography | 30 min. |
| Hysterosalpingography | 30 min. |
| Pelvimetry | 20 minutes. |
| Pneumopelviography | 30 min. |
X-ray examination of the mammary glands
| Panoramic radiography of the mammary glands in frontal and oblique projections | 15 minutes. |
| Panoramic radiography of the breast in one projection | 10 minutes. |
| Targeted radiography of the breast | 10 minutes. |
| Targeted breast x-ray with direct magnification of the x-ray image | 10 minutes. |
| Radiography of the soft tissues of the axillary regions | 10 minutes. |
| Ductography | 40 min. |
| Double duct contrast | 45 min. |
| Pneumocystography of a palpable mass | 25 min. |
| Pneumocystography of a non-palpable mass | 45 min. |
| Targeted needle biopsy of a palpable mass | 25 min. |
| Targeted needle biopsy of a non-palpable mass | 45 min. |
| Interstitial marking of a non-palpable mass | 45 min. |
| Radiography of the removed sector of the breast | 15 minutes. |
Complex and time-consuming special X-ray studies associated with puncture, catheterization, probing of ducts, cavities, performed in specialized rooms
| Bronchography | 45 min. |
| Pneumomediastinography (percutaneous, transtracheal) | 60 min. |
| Aortography | 40 min. |
| cavography | 40 min. |
| Phlebography peripheral | 40 min. |
| Phlebography of the pelvis | 30 min. |
| Angiocardiography | 70 min. |
| Arteriography visceral | 55 min. |
| Coronary angiography | 90 min. |
| Cerebral angioarteriography (carotid) | 55 min. |
| Angioarteriography, peripheral | 55 min. |
| Lymphography | 90 min. |
| X-ray studies combined with surgical treatment procedures | 120-150 min. |
| Percutaneous drainage of kidney cysts | 60 min. |
| Loop stone removal | 60 min. |
| Bougienage of ureteral stricture | 40 min. |
| Bougienage of urethral stricture | 30 min. |
| Fistulography | 20 minutes. |
| X-ray endoscopic studies (depending on the complexity of the study) | 60-90 min. |
| Tomography in one projection | 30 min. |
| in two projections | 40 min. |
| X-ray computed tomography without intravenous amplification | 45 min. |
| with intravenous amplification | 60 min. |
| Correspondence consultation on the submitted radiographs with the execution of the protocol | 15 minutes. |
Note: With a separate study of both paired organs, the temporary norms increase by 50%. Time for tomography is added to the main study. The proposed time standards are designed for work on specialized tripods. Taking into account the specifics of studies of young children (up to 7 years), the severity of patients, the estimated time limits for one study increase by 20%. When working on universal-purpose devices that require preparing it for the transition to performing a tomographic examination, the time limits increase by 5 minutes. When working on devices in wards and operating rooms, the number of studies performed is limited by dosimetric control data at the workplace and timing. The average time for the study of one patient is 15 minutes. Pictures on ward devices when combining work in the X-ray room - 30 minutes.
Ultrasound examination of the organs of the hepatobiliary system
Ultrasound examination of the organs of the genitourinary system
Ultrasound examination of the female genital organs
Note:
The estimated load rate for an ultrasound doctor with a 6.5 hour working day is 33 conventional units.
A work of 10 minutes is taken as a conventional unit.
In combined studies of several organs, the calculated norms for each subsequent organ are reduced by 5 minutes.
In the study of children, the norm of time increases by 10%.
Boss
Main Directorate
medical care to the population
O.V. RUTKOVSKY
Boss
Main Directorate
maternal and child health
D.I.ZELINSKAYA
Appendix No. 23
to the order of the Ministry of Health of the RSFSR
dated August 2, 1991 N 132
To case No. 2-983/14
DECISION
In the name of the Russian Federation
Seversky District Court of the Krasnodar Territory consisting of:
Presiding Judge Maslak V.G.,
Under Secretary Chikova I.A.,
With the participation of: plaintiff Yu.I. Vasiliev, representative of the defendant E.V. Orlova,
Having considered in open court a civil case on the claim of Yury Ivanovich Vasiliev against the MBUZ MO SR "Severskaya CRH" on the obligation to restore the length of the working day, on changing the conditions of remuneration, on the recovery of underpaid amounts of wages, on compensation for damage caused to health, and on compensation for non-pecuniary damage,
INST A N O V&L:
plaintiff Vasilev Yew.AND. applied to the court with an application to the MBUZ MO SR "Severskaya CRH" on the obligation to restore the length of the working day, on changing the conditions of remuneration, on the recovery of unpaid amounts of wages, on compensation for damage to health, and on compensation for moral damage.
In substantiation of the stated claims, the plaintiff in his application stated the following:
He has been working in the Seversk Central District Hospital since 1984, since 2002 he has been working as a doctor in the functional diagnostics room.
In 2003, the administration of the Seversk Central District Hospital increased the duration of his work shift by 1 rate, by 1 hour 12 minutes.
In December 2013, he received a letter from the Ministry of Labor of the Russian Federation dated December 12, 2013 and the full text of the order of the Ministry of Health No. 283 dated November 30, 1993, which states that the working day of a doctor in the office (department) of functional diagnostics, with a five-day working week, is 6 hours 30 minutes. Of these, 84% (5 hours 30 minutes) of working time goes to functional studies (ECG interpretation). All other types of work are allocated 16% (60 minutes) of working time. The total work shift is 6 hours and 30 minutes.
The plaintiff worked daily for 1 hour 12 minutes for 11 years and received underpayment for ECG transcribed in excess of the norm by 1 rate.
In 2013, the salary for 1 rate, the work shift is 6085 rubles, 21 days = 289 rubles 76 kopecks. The cost of 1 ECG: 289.76:19.4 = 14.93 rubles. It turns out that for each deciphered ECG he should receive 14 rubles 93 kopecks, and not 10 rubles 91 kopecks, as the head physician of the Central District Hospital claims. Since 2003, he has received less than 480,000 rubles in salary.
Every year, the plaintiff was at the workplace for more than 266 hours over working hours by illegal order of the administration of the Seversk Central District Hospital, and since he worked at the initiative of the defendant, he should be paid these hours in double the amount, that is, 532 hours. Over 11 years of work, processing amounted to 5852 hours. The cost of 1 hour of work is more than 44 rubles, therefore, he should receive compensation in the amount of 257,488 rubles.
These processings led to the fact that he lost sight in one eye, received a retinal detachment. He estimates the damage caused to his health by the illegal increase in working hours at 2,000,000 rubles.
In connection with the foregoing, the plaintiff asks the court to restore the length of the working day in accordance with the order of the Ministry of Health No. 283 of November 30, 1993, with a five-day working week up to 6 hours 30 minutes, of which 5 hours 30 minutes for decoding the ECG, 60 minutes for other work; pay for labor in accordance with order No. 283, based on a shift load of 19.4 ECG per shift; to pay the money underpaid to him for decoding the ECG in excess of the rate for 11 years - 480,000 rubles; pay 5852 hours of processing in the amount of 257,488 rubles; pay him the damage caused to his health in the amount of 2,000,000 rubles; pay him moral damages in the amount of 2,000,000 rubles, and in total 4,737,488 rubles (case files 1-6).
At the hearing, the plaintiff insists on the claims set forth in the statement of claim, asks to satisfy them in full.
The representative of the defendant Orlova E.The. at the hearing the claims of the plaintiff did not recognize, submitted to the court an objection to the statement of claim Vasilyeva Yew.The. The representative of the defendant considers the claims of the plaintiff unfounded, far-fetched and not subject to satisfaction on the following grounds:
Vasiliev Yuri Ivanovich,<...>year of birth, has been working in the MBUZ MO SR "Severskaya CRH" since 10/08/1984, as a doctor of functional diagnostics since 06/28/2000 for one position on the terms of the employment contract No. 470 of 10/02/2006.
I DECIDED:
In a lawsuit against Yury Ivanovich Vasiliev against the MBUZ MO SR "Severskaya CRH" on the obligation to restore the length of the working day, on changing the conditions of remuneration, on the recovery of unpaid amounts of wages in the amount of 737,488 rubles, on payment of damage caused to health in the amount of 2,000,000 rubles and to refuse compensation for non-pecuniary damage in the amount of 2,000,000 rubles.
The decision can be appealed to the Krasnodar Regional Court through the Seversky District Court within a month from the date of the decision of the court in final form.
Judge Maslak The.G.
Court:
Seversky District Court (Krasnodar Territory)Judges of the case:
Maslak Vasily Grigorievich (judge)In accordance with the Decree of the Ministry of Health of 03.12.2012 No. 185 “On the approval of approximate staffing standards for medical and other employees of polyclinics and children's polyclinics (polyclinics) and the invalidation of some decisions of the Ministry of Health of the Republic of Belarus” (as amended by the Decree of the Ministry of Health of 20.01.2018 No. 10) the positions of ultrasound diagnostic doctors are established based on the volume of work and estimated time standards at the rate of 1 position per 10,400 conventional units of ultrasound examinations and treatment and diagnostic procedures under ultrasound control per year with a 38.5-hour working week.
For a specialist doctor, including the head of a structural unit engaged in ultrasound diagnostics and working in nursing homes for the elderly and disabled, in nursing care hospitals, in institutions, departments, wards for the provision of palliative care in special clinics for terminally ill people (hospice), in departments and wards for patients with acute cerebrovascular accident, damage to the spinal cord and spine (spinal patients), as well as their early medical rehabilitation, a 35-hour working week is established (see Decree of the Ministry of Labor and Social Protection dated 07.07.2014 No. 57 " On some issues of providing compensation for working conditions in the form of reduced working hours, ch. 34).
What normative legal act regulates the annual load rate on the ultrasound machine of 20,800 conventional units of ultrasound examinations and treatment and diagnostic procedures under ultrasound control?
The indicator of the annual load on the ultrasound machine was not introduced by the regulatory legal acts of the Ministry of Health. However, in order to ensure the availability of medical care, to exclude the downtime of expensive equipment, which includes ultrasound scanners, it is advisable to organize the work of ultrasound rooms in outpatient healthcare organizations based on the staffing of two positions of an ultrasound doctor.
Thus, the annual volume of work of an ultrasound room, in which one ultrasound scanner is installed and the staffing table implies the presence of two doctors, is determined based on the calculation of 1 position per 10,400 conventional units of ultrasound examinations and treatment and diagnostic procedures under ultrasound control per year at 38 .5-hour working week, which is 20,800 conventional units of ultrasound examinations and treatment and diagnostic procedures under ultrasound control per year.
How is the ultrasound doctor paid for the provision of paid medical services?
Remuneration of employees providing paid medical services, including ultrasound diagnostics, is carried out:
- when an employee is enrolled in a staffing position for extrabudgetary activities - for the hours actually worked under the conditions established for budgetary organizations by Decree of the Ministry of Labor of January 21, 2000 No. 6 “On measures to improve the conditions for remuneration of employees of budgetary organizations and other organizations receiving subsidies, who are equated in terms of wages with employees of budgetary organizations”;
- when performing paid medical services during their main working hours, the employee receives additional incentive payments (bonuses), financial assistance is provided in accordance with the provision on material incentives, which is developed in each healthcare institution and is an integral part of the collective agreement.
What regulatory legal act defines the concept of research in ultrasound diagnostics?
The definition of the term "research in ultrasound diagnostics" is given in the Decree of the Ministry of Health of November 28, 2007 No. 129 "On approval of uniform norms and standards for material and labor costs (time, consumption of basic and auxiliary materials) for paid medical services for instrumental diagnostics provided by legal entities of all forms of ownership and individual entrepreneurs in the prescribed manner. The specified term is used as a unit of measurement, taking into account, among other things, the norms of time for conducting a study. For example, ultrasound of the abdominal organs in accordance with the above-mentioned regulation is counted as one study.
All topics of the identified issues are considered in the most detailed way during the educational process at retraining courses in ultrasonic diagnostics and advanced training courses for ultrasound doctors with an analysis of the regulatory legal acts regulating the activities of the ultrasound diagnostic service, and analysis of specific examples.
Elena Krutova, Deputy Head of the Department of Economic Analysis and Health Development of the Ministry of Health,
Elena Latushkina, Chief Specialist of the Department of Organization of Medical Assistance of the Ministry of Health,
Alexey Chukanov, chief freelance specialist in ultrasound diagnostics of the Ministry of Health.
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