Laboratory work. Advanced training and professional retraining in laboratory science What is included in laboratory science

LABORATORY- methodological, technical, organizational support and practical implementation of laboratory research: a) human biological fluids for the purpose of preventing, diagnosing diseases and monitoring the results of treatment; b) objects environment to determine the degree of their contamination with biological, chemical agents, as well as the impact of physical factors. L. d. - the sphere of prof. activity of workers of laboratories to lay down. - the prof. and dignity. - epidemiological, institutions. The form of the organization of L. d. in to lay down. - the prof, establishments is a lab. clinical diagnostic service, i.e. a system of clinical diagnostic laboratories to lay down. - prof, institutions of various profiles and capacities, united by a single scientific and methodological guide and a common task - the most rational and effective use of scientific concepts and practical advice laboratory diagnostics (see) in order to optimize the diagnostic and medical processes. The form of the organization of L. d. in sanitation and hygiene is the system a dignity. - a gigabyte. and bacterial, SES laboratories of various levels, united by common tasks - environmental protection, ensuring optimal dignity. working conditions, education, life, human nutrition, prevention of acute diseases (see Bacteriological laboratory, Virological laboratory, Radiological laboratories, Sanitary-hygienic laboratory).

A large role in the development and implementation of the principles of the organization of the lab. services at the first stages of the development of Soviet health care were played by P. P. Averyanov, A. A. Bogomolets, O. I. Bronstein, E. A. Kost, E. G. Mineeva, E. D. Ravich-Birger, V. N. Toparskaya, R. L. Ulanovskaya, T. N. Feldman, T. V. Khitrovo-Goreva, and others. were marked by a transition to a higher stage of L. d., which corresponds to the further development of specialized medical care and the enlargement to lay down. - professional, institutions. In these conditions, they began to create joint laboratories in large medical institutions, institutions and centralized laboratories capable of providing the most complex species analyzes a number of institutions of the city or district. The Decree of the Central Committee of the CPSU and the Council of Ministers of the USSR "On measures to further improve public health" (1977) provides for the strengthening of work on the centralization of the lab. services, organizing centralized clinical diagnostic laboratories in republican, regional and regional centers, concentrating basic research for health care institutions and equipping them with modern apparatus, instruments and reagents.

In order to improve the organization of labor and improve the quality of work, the SES laboratories are being consolidated and centralized: a) merging into a single centralized laboratory on the basis of the regional SES with the inclusion of personnel from the laboratories of the city and district (in the city) SES; b) association of laboratories of the city and district SES on the basis of one of them; c) enlargement of the laboratories of the city SES by merging with it the laboratories of rural districts adjacent to the city; d) creation of inter-district laboratories on the basis of large SES of rural districts.

There is also a trend towards an increase in the number of gigabytes. and bacterial, researches in SES. In 1974, compared with 1970, the number of these analyzes increased by 13%.

The structure of the main types of research in clinical diagnostic laboratories for 1970-1975. presented in table 2.

Nomenclature of the main types of lab. analyzes represents the maximum range a lab. tests that can be implemented at this stage of development of the lab. diagnostics. Technical, economic and honey. factors dictate the limitation of its limits. The doctor is not interested in increasing the number of labs. indicators, but in increasing their informativeness and diagnostic value. Requirements of laboratories in quantity and quality of laboratory equipment (see), chemical. reagents and biol, the preparations growing according to expansion of a range a lab. tests and the complication of their analytical basis, should be commensurate with the possibilities of the economy. M3 USSR approved lists of mandatory minimum lab. tests for 47 types of institutions in accordance with their profile, capacity, significance in the healthcare system. The unity of research in the laboratories of hospitals and polyclinics is provided, which makes it possible to implement the preclinical laboratory to a greater extent in the required volume. examination of patients subject to hospitalization, and thereby reduce the diagnostic period of the patient's stay in bed. Mandatory minimum of various lab. researches in the main groups to lay down. - prof, institutions are presented according to the specified list in tab. 3. As can be seen from the table, the largest range of laboratory tests is presented in the laboratories of republican, regional and regional hospitals, which are organizational and methodological and advisory centers for all clinical diagnostic laboratories in the given territory, as well as in centralized clinical diagnostic laboratories, which allows to ensure the maximum range of studies.

Provides for the use of carefully selected unified techniques, common for all medical professionals, institutions of the country, which will provide a single degree of accuracy of research and compare the results of analyzes made to the same patient in different institutions.

Methods used for clinical and diagnostic purposes should have high analytical reliability and diagnostic value, ease of use in examining people, wide technical availability and cost-effectiveness. According to these requirements, when selecting unified methods, the criteria of analytical, clinical, diagnostic, technical and economic suitability are applied. By 1977, 168 methods for 121 indicators were unified in the USSR, which, in accordance with guidelines M3 of the USSR are used in all clinical diagnostic laboratories of the country. At the same time, they are developed and mastered in well-equipped - the so-called. reference laboratories reference research methods, which are selected on the basis of a single criterion - their high analytical reliability. They serve as a benchmark for assessing uniform methods and the quality of studies in ordinary laboratories.

Along with the quality of the method, the reliability of research results also depends on random and systematic errors of an intralaboratory nature. To identify and eliminate these errors in the lab. the service carries out quality control of research. The technical equipment of laboratories is determined by an approximate list approved by the M3 of the USSR for various kinds laboratories depending on their purpose and capacity.

The supply of equipment and its repair are carried out by Soyuzmedtekhnika institutions, the supply of reagents is carried out through local pharmacy departments and directly through the Soyuzreaktiv supply and trade organizations of the USSR Ministry of Chemical Industry. M3 of the USSR regulates the mandatory assortment minimum of chemical products. reagents for a lab. research in healthcare institutions.

The basis of the personnel of the laboratories is made up of workers with special honey. education: laboratory doctors, paramedical laboratory assistants, honey. laboratory assistants (see. Laboratory assistant). Training of laboratory assistants is carried out at the workplace in large laboratories through primary specialization and at the departments of clinical laboratory. diagnostics (see) and f-tov of improvement and specialization of doctors honey. in-t, advanced training - at the indicated departments. The wedge, residency is the highest form of training of laboratory doctors (see Clinical Residency). Training of medical assistants-laboratory assistants is carried out on a lab. medical departments. schools; advanced training - at workplaces in laboratories and in schools to improve the skills of workers with secondary medical education. education. Laboratory doctors, laboratory assistants and medical assistants. laboratory assistants are periodically certified. Laboratory doctors are assigned the second, first and highest qualification categories, laboratory assistants and medical assistants. laboratory assistants - the first qualification category. Biologists who graduated from high fur boots, chemists, pharmacists are allowed to work in laboratories as laboratory assistants with higher education, as honey. laboratory assistants - pharmacists with secondary education. They can improve their skills together with health workers. IN official duties laboratory doctors include performing research, mastering new methods, monitoring the work of laboratory assistants with secondary education, communication with clinicians, organizational and methodological work, the duties of laboratory assistants with secondary education are performing tests, preparatory work, and paperwork.

The organization of labor in laboratories largely depends on their type and capacity. In large laboratories, it is possible to divide labor, create teams according to the types of research, work with large series of analyzes, and use mechanization and automation tools. All laboratories use rational forms of workplace organization, accounting documentation, coding of samples, rapid tests, etc.

Along with the intralaboratory organization of labor, all greater value acquires the organization of relationships between laboratories with a wedge, departments, the use of technical means of communication, streamlining the appointments of analyzes based on agreed lab. tests, differential diagnostic programs, holding clinical and laboratory conferences, etc.

Lab. the analysis is performed, as a rule, in accordance with the appointment of a doctor (on duty or attending), drawn up on a form of the established form. The result of the study is sent to the department of the clinic or clinic that ordered the study for the patient, on a form approved by the M3 USSR sample or, in some cases, established in this institution, signed by the employee who performed the analysis, or the head. laboratory (when transmitting by teletype, the name of the employee responsible for the correct transmission of information is indicated). To ensure the correct interpretation of the results of the study, the standards of the studied parameters are indicated on the form (as directed by the health authority in departments of BC, polyclinics may instead have instructions indicating standards). The research results should be expressed in units corresponding to the International System of Units and GOST "Units physical quantities» (see Units of measurement). The order of their application and other units in the lab. practice is established guidelines M3 USSR.

With increase in volume a lab. information and consolidation of laboratories becomes rational use of the COMPUTER for management of laboratories and communication with a wedge, divisions.

Lab growth. researches raises a problem of preparation of the corresponding shots of both average, and the top link, and also accurate planning of development of L. d. in medical institutions of the country.

The methodical management of the laboratories is carried out by the main (freelance) specialists in the lab. case M3 of the USSR, Ministry of Health of the Allied and autonomous republics, administrations and departments of health care, the All-Union Scientific, Methodological and Control Center for Laboratory Affairs and organizational, methodological and control centers in the field. The main direction of their activity is determined by a comprehensive program of standardization and quality management lab. research. An important role in improvement of activity of laboratories is played by All-Union scientific about-in doctors-laborators created in 1952. The congresses spent by it, plenums of board, meetings of local departments promote introduction of achievements honey. science, unified methodological guidelines, best practices of laboratories.

The press organ of the All-Union Scientific Society of Laboratory Physicians is the journal "Laboratory Business", published since 1955. It covers the theoretical and practical issues of the wedge, laboratory diagnostics - methods of the lab. researches and results of their application in diagnostics, problems of scientific and technical progress in L. d., questions of the organization lab. service, scientific organization of labor and best practices of laboratories. Besides, some questions of L. are covered also in other honey. magazines.

tables

Table 1. GROWTH OF CLINICAL AND DIAGNOSTIC STUDIES IN THE USSR, 1970-1976

Table 2. STRUCTURE OF THE MAIN TYPES OF RESEARCH IN CLINICAL AND DIAGNOSTIC LABORATORIES OF THE USSR, 1970-1975*

Research types	As a percentage of the total number of analyzes
	all in hospitals and clinics		in hospital		in the clinic
General clinical
Hematological
Biochemical
Immunological
Microbiological
Cytological
* With an annual absolute increase in the total number of studies (approx. 8%), a relative increase in biochemical and immunological studies is visible.

Table 3. MANDATORY MINIMUM OF VARIOUS LABORATORY STUDIES IN THE MAIN GROUPS OF MEDICAL AND PREVENTIVE INSTITUTIONS ON THE LIST 197 5 (in the number of tests)

Types of institutions	Research types
	Clinical-chemical	hematological	cytological	biochemical	serological and immunological	microbiological
Regional hospitals and outpatient clinics						Not held
District, central district and city hospitals and polyclinics
Republican, regional, regional hospitals
Centralized clinical diagnostic laboratories	Not held	Not held

Bibliography: Kost E.A. and others. All-Union Scientific Society of Laboratory Doctors, in the book: Nauch. honey. islands of the USSR, ed. M. V. Volkova, p. 389, Moscow, 1972; Luchina K. I. and others. Organization of the sanitary and epidemiological service, M., 1977, bibliogr.; Materials on the state and prospects for the development of laboratory clinical and diagnostic services in the country, M., 1977; Menshikov V. V. et al. Indicators and trends in the development of clinical laboratory diagnostics at the present stage, Laborat, case, No. 9, p. 515, 1977; Broom to A. I. To the history of laboratory work in domestic medicine, in the same place, No. 12, p. 753, 1974; Ravi h - B and rg e p E. D. On the history of the organization of laboratory work in the USSR, ibid., No. 9, p. 520, 1977; Sh and t to and I. V. N. and V. V. Menshikov. Laboratory diagnostic service in the system of the Soviet health care, in the same place, No. 10, p. 579, 1977.

V.V. Menshikov.

Bacteriology 144 hours:
– Education Requirements
Training in residency in the specialty "Bacteriology".
– Positions held

Virology 144 hours:
– Education Requirements: Higher education– specialist in one of the specialties: “Medicine”, “Pediatrics”, “Medical and preventive work”, “Medical biochemistry”, “Medical biophysics”, “Medical cybernetics”
Training in residency in the specialty "Virology".
– Positions held

Clinical laboratory diagnostics 144 hours:
– Education Requirements
Training in internship / residency in the specialty “Clinical laboratory diagnostics”.
Positions held

Laboratory genetics 144 hours:
– Education Requirements: Higher education - a specialist in one of the specialties: “Medicine”, “Pediatrics”, “Dentistry”, “Medical and preventive work”, “Medical biochemistry”, “Medical biophysics”, “Medical cybernetics”
Training in residency in the specialty "Laboratory genetics".
– Positions held


– Education Requirements: Higher education - specialty in the specialty "Medical and preventive work." Training in residency in the specialty “Sanitary and hygienic laboratory research”.
– Positions held

Professional retraining

Bacteriology 576 hours:
- Education Requirements: Professional retraining in the specialty "Bacteriology" in the presence of training in internship / residency in one of the specialties: "Virology", "Infectious Diseases", "Clinical Laboratory Diagnostics", "Laboratory Mycology", "Epidemiology" or specialists who have a break in work experience in in the field for over five years.
– Positions held: Bacteriologist; manager (head) structural unit(department, department, laboratory, office, detachment, etc.) of a medical organization - a bacteriologist.

Virology 576 hours:
– Education requirements: Professional retraining in the specialty "Virology" in the presence of training in internship / residency in one of the specialties: "Bacteriology", "Infectious Diseases", "Clinical Laboratory Diagnostics", "Epidemiology" or specialists who have a break in work experience in this specialty for more than five years .
– Positions held: Virologist; head (head) of a structural subdivision (department, department, laboratory, office, detachment, etc.) of a medical organization - a virologist.

Clinical laboratory diagnostics 576 hours:
– Education requirements: Professional retraining in the specialty "Clinical Laboratory Diagnostics" in the presence of training in internship / residency in one of the specialties of the enlarged groups of specialties "Clinical Medicine" or "Health Sciences and Preventive Medicine" or specialists who have a break in work experience in this specialty for more than five years.
Positions held: Doctor of clinical laboratory diagnostics; head (head) of a structural subdivision (department, department, laboratory, office, detachment, etc.) of a medical organization - a doctor of clinical laboratory diagnostics.

Laboratory genetics 576 hours:
– Education requirements: Professional retraining in the specialty "Laboratory genetics" in the presence of training in internship / residency in one of the specialties: "Genetics", "Clinical laboratory diagnostics" or specialists with a break in work experience in this specialty for more than five years.
– Positions held: Doctor - laboratory geneticist; head (head) of a structural subdivision (department, department, laboratory, office, detachment, etc.) of a medical organization - laboratory geneticist.

Sanitary and hygienic laboratory tests 144 hours:
– Education requirements: Professional retraining in the specialty "Sanitary and hygienic laboratory research" in the presence of training in internship / residency in the specialty "General Hygiene" or specialists with a break in work experience in this specialty for more than five years.
– Positions held: Doctor for sanitary and hygienic laboratory research; head (head) of a structural subdivision (department, department, laboratory, office, detachment, etc.) of a medical organization - a doctor for sanitary and hygienic laboratory research.

1. General Provisions

1.1. TO professional activity as a specialist in the field of laboratory science, persons who have received a secondary medical education, diploma in the specialties "Medical and preventive business", " Laboratory diagnostics”, and a certificate in the specialty “Laboratory business”.

1.2. A specialist in the field of laboratory work is used in positions corresponding to the specialty "Laboratory work", is appointed and dismissed from his positions in accordance with applicable law.

1.3. In his work he is guided by the Constitution Russian Federation, the Law of the Russian Federation "On the sanitary and epidemiological well-being of the population", other Federal laws, Decrees and orders of the President of the Russian Federation, Decrees of the Government of the Russian Federation, other regulatory legal acts Russian Federation, orders and instructions of the Ministry of Health of the Russian Federation, these Regulations.

2. Responsibilities

2.1. Workplace organization.

2.2. Verification of the suitability of the material received for the study, the correctness of the execution of the accompanying documentation.

2.3. Carrying out registration of samples for research and analysis results.

2.4. Taking samples on analytical and technical scales for sanitary-chemical and microbiological studies.

2.5. Construction and verification of calibration graphs.

2.6. Sampling of air, water, soil, food products, swabs from the skin of the worker, from working surfaces.

2.7. Preparation of samples of water, air, soil, food products and other materials for sanitary-chemical and microbiological studies.

2.8. Preparation of standard and working solutions for calibrating instruments, nutrient media, reagents, paints and disinfectants.

2.9. Work on a photoelectric colorimeter, pH meter and other measuring instruments.

2.10. If there is a vivarium in the laboratory - work with laboratory animals under the guidance of a specialist with higher education.

2.11. Conducting studies of adverse factors in the production and environment (noise, vibration, illumination, electromagnetic fields) using instrumental methods.

2.12. Preparation of solutions, absorbing devices, electric aspirators and other equipment for conducting research on the atmospheric air of industrial enterprises, in foci of infectious diseases and food poisoning, in medical institutions, etc.

2.13. Fulfillment of instructions on safety and industrial sanitation, fire safety, the mode of operation with pathogens of 1-4 pathogenicity groups, the activities of a medical institution in extreme conditions.

2.14. Compliance with the internal regulations of the institution, job descriptions.

2.15. Providing first aid in emergency situations.

2.16. Regular professional development.

3. Rights

3.1. Freely visit industrial, municipal, food and other facilities and take samples.

3.2. Obtain information necessary for the quality performance of functional duties.

3.3. Make suggestions to the management on improving the organization and conduct of laboratory research.

3.4. Improve your qualifications, pass certification for the assignment of a qualification category.

3.5. Participate in conferences, meetings, professional medical associations.

4. Responsibility

A specialist for non-fulfillment of his professional duties shall be liable under the current legislation.

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