Trường trung cấp ktkt dược Tuệ Tĩnh

Trng trung cp ktkt dc Tu Tnh

Li cm nQua qu trnh hc tp ti trng v thi gian thc t ti trm y t x Ho Thch tip xc, tm hiu, hc hi cc kin thc c bn hon thin bn bo co ny l nh s quan tm gip ch o nhit tnh ca cc thy c trng, cng ton th cn b nhn vin trm y t x Ho Thch lun khch l, gp , b xung kin thc, kinh nghim, cung cp s liu, s sch, to iu kin cho em tip xc a bn dn c d iu tra cc vn sc kho. Trong khun kh hn hp v thi gian v cn t kinh nghim v thc t chuyn mn nn bn thu hoch ny cn nhiu thiu st. V vy, em knh mong c s ng gp ca cc thy c gio cng cn b nhn vin trm y t x Ho Thch. ng thi, em knh mong cc thy c chm trc, b qua nhng khuyt im ca em. Vi tm long bit n su sc, em xin chn thnh cm n qu thy c, cng tp th cn b nhn vin trm y t x Ho Thch tn tnh gip em hon thnh bn bo co ny. Em xin chn thnh cm n! H ni, ngy 30 thng 3 nm 2012 Sinh vin thc tp Nguyn Th Minh (8/12/92) Lp dc 3D3

Nguyn Th Minh(8/12/92)3D3[Type text]

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M uNgy nay, khi t nc ngy cng pht trin, ngnh y t c ng v nh nc, t chc y t th gii WHO quan tm t trung ng n a phng. Cng tc chm sc sc kho cho ngi dn ngy cng c nng cao. Trm y t x, phng l mt t chc y t c s trong mng li h thng chm sc sc kho quc gia. l ni thc hin chm sc sc kho ban u cho nhn dn. Trm y t x Ha Thch l mt t chc y t c s di s lnh o ca u ban nhn dn x Ho Thch, t lu tr thnh a ch y t tin cy trong long nhn dn a phng. Cng tc chm sc sc kho cho cng ng lun c x cao, ch trng, quan tm hng u. vi i ng cn b tr, nhit tnh, lun t sc kho ca ngi dn ln trn. Trong tri tim mi cn b y t x lun khc ghi li bc dy: lng y phi nh t mu phc v ht mnh v sc kho ca nhn dn. Nh s quan tm, chm sc ca cn b nhn vin trm y t x Ha Thch, thc hin tt cng tc truyn thng gio dc sc kho m dn hiu v chm sc sc kho ca mnh tt hn. Cng tc chm sc sc kho ca nhn dn lun c m bo, pht hin v cha tr kp thi nn y li, khng dch bnh ly lan pht trin. chnh v th, trm y t lun nhn c s quan tm, khen ngi ca cp trn. Vi c m theo hc ngnh y dc chm sc cho bn thn, gia nh v cng ng, em theo hc ngnh dc s ti trng trung cp kinh t k thut dc Tu Tnh. Em c trng gii thiu thc tp y t c s ti Trm y t x Ha Thch. Trong thi gian thc tp ti trm em c hc tp kin thc, kinh nghim thc t chuyn mn. Qua thi gian tm hiu, thc tp ti trm, cng s gip , hng dn ca thy c trong trng v cn b nhn vin trm, em hon thnh qu trnh thc tp v vit bi thu hoch. Bi thu hoch ca em gm c 7 phn: 1. Phn 1: Tm hiu chc nng, nhim v ca trm y t x, t chc b my trm y t x Ho Thch, nhim v ca tng nhn vin y t. 2. Phn 2: chun on cng ng, tm hiu cc vn sc kho, m hnh bnh tt, thc t s dng thuc ca ngi dn trong x.Nguyn Th Minh(8/12/92)3D3[Type text] Page 2


3. Phn 3: k hoch hot ng, t chc hot ng ca trm y t x Ho Thch. 4. Phn 4: Cng tc dc tai trm y t, danh mc thuc. 5. Phn 5: tm hiu m hnh vn thuc nam ti trm v mt s bi thuc y hc c truyn c s dng ti a phng cha cc bnh thng thng. 6. Phn 6: mt s biu mu, ti liu ca trm y t x. 7. Phn 7: kt lun


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Phn 1: tm hiu chc nng, nhim v ca trm y t x, t chc b my ca Trm y t x Ha Thch v nhim v ca tng nhn vin y t. Vit Nam cng nh tn th gii, ngnh y dc lun c vai tr quan trng trong vic bo v v chm sc sc kho con ngi. con ngi l ti nguyn quan trng nht quyt nh s pht trin ca t nc. Sc kho l ti nguyn vn qu nht ca con ngi v ton x hi. Chnh v vy, u t cho sc kho chnh l u t cho s pht trin ca x hi, ca t nc. Chm sc tt cho sc kho con ngi l nng cao cht lng cuc sng cho mi c nhn, mi gia nh v ton x hi. Trong thi k hi nhp, t nc ang xy dng cng nghip ho hin i ho, t nc ta ang pht trin nh hin nay th vic chm sc sc kho cho con ngi ngy cng c ch trng,n tr thnh nhim v quan trng hng u cho ngnh y dc nc nh. I, Khi qut v chc nng v nhim v ca ngnh y-dc. 1, Chc nng. - Thc hin cng tc chuyn mn dc, nghin cu k thut y-dc. Tham gia tp hun, bi dng cn b. - Qun l thuc, ho cht, y c v ch chuyn mn v dc tai trm. - Tng hp kin thc v xut cc vn cng tc y-dc theo phng hng ca ngnh. 2, Nhim v. - Cn c vo chc nng ca ngnh v da trn c s khoa hc chun mn, v lp k hoch pht trin cng tc dc, lp k hoch v nhu cu d tr thuc, ho cht, dng c y t iu tr: - Bo qun t thuc, y c trong trm. - Chp hnh nghim chnh ch chuyn mn v dc. - Hng dn ngi dn s dng thuc, thc hin hng dn, chm sc sc kho, tham gia kin khoa hc k thut v dc theo yu cu iu tr. - Gp phn xy dng cc tiu chun, ch chuyn mn chuyn ngnh.


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- Hng dn tuyn truyn, chm sc sc kho v k hoach ho gia nh cho ton dn theo nh k trong nm. - Nhp thuc v cp pht thuc cho nhn dn. II, Khi qut tnh hnh a l, dn s, t chc b my ca Trm y t x Ha Thch, nhim v ca tng nhn vin y t. 1, S lc a bn thc tp X Ho Thch l mt trong nhng x trung du min ni, nm pha ty huyn Quc Oai, H Ni, gip vi tnh Ho Bnh. Nm bm ng 21A- ng Cu-Ba, do Cu-Ba gip Vit Nam xy dng t nhng nm 70 ca th k trc_ nay l ng H Ch Minh. X c nhiu cng ty, x nghip, nh my, c quan n v ng qun trn a bn nh: c c s ca tng cng ty ch Vit Nam l cng ty ch Long Ph, 2 m khai thc Thng u, nh my sn xut phn vi sinh, c s ch bin thc phm, doanh tri qun i s on 58,..v..v..X Ho Thch gm c 5 thn l Bch Thch, Ho Trc, Thng u, long Ph, Ho Ph. Sau khi sp nhp v H Ni, v tr ca x kh thun li c th quy hoch, pht trin th theo trc ng H Ch Minh sut t Ho Lc ko di 13km ti Xun Mai (huyn Chng M), hai u l hai trng ai hc ln l i hc Quc Gia H Ni v i hc Lm Nghip Vit Nam. Chnh v c v tr a l thun li m nn kinh t ca x ang phat trin, i sng nhn dn ngy cng c nng cao. Vi din tch 18,34 km2, tng dn s 11304, ngh nghip chinh ca ngi dn trong x l nng nghip. Cng tc chm sc sc khe cho nhn dn c m bo, hot ng khm cha bnh t kt qu cao. Trm y t x Ha Thch_ t chc y t c s di s lnh o ca y ban nhn dn x, ni chm sc sc khe ban u cho nhn dn. Trm nm trung tm x, trn tuyn ng lin huyn, ni tp trung ng dn c. Trm c thnh lp nm 1955 vi 3 dy nh cp bn, c s vt cht cn s khai, thiu thn, ngho nn. n 1963 c xy dng li, cc phng chc nng, i ng nhn vin y t c b sung. c s quan tm, u t ca cc cp chnh quyn, nm 2010 trm c xy dng mi vi din tch khun vin 1155 m2 vi hai dy nh hai tng c din tchNguyn Th Minh(8/12/92)3D3[Type text] Page 5


350m2 , 19 phng chc nng: tng 1 c phng trc n h sinh, phng truyn thng gio dc sc khe, phng tiu phu, phng khm ph khoa, phng k hoch ha gia nh, phng sau , phng ch , phng khm, phng tim, phng bnh nhn, phng sn, phng dc; tng 2 c phng trc y bc s, hi trng, hai phng bnh nhn, phng ph trm, phng trng trm, phng dn s. Cc dng c, trang thit b c ti trm:DANH MC TRANG THIT B Y T TRM Y T X (C bc s)

S TT I 1 2 3 4 5 6 7 8 9 10 11 12 13

Tn trang thit b

n v

Slng

KHM IU TR CHUNG Ging bnh T u ging Bn khm bnh n bn khm bnh Huyt p k ng nghe bnh Nhit k y hc 42Oc My in tim 1 hoc 3 knh My chm cu My siu m chn on loi xch tay My kh dung My ht in My ht p chn ci ci ci ci ci ci ci ci ci ci ci ci ci 10 5 2 3 4 4 10 1 2 1 1 1 1Page 6



S TT 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33

Tn trang thit b Knh hin vi Ba th phn x Bp bng ngi ln Bp bng tr em Bn tiu phu B dng c tiu phu B dng c ra d dy Cn trng lng 120kg c thc o chiu cao li thp khng g Bn dng c Cng tay Cng y Xe y cp pht thuc T ng thuc v dng c Khay qu u 825mlthp khng g Khay qu u 475mlthp khng g Khay ng dng c nng Khay ng dng c su Hp hp bng gc hnh trng 24cm Hp hp dng c c np

n v ci ci ci ci ci b b ci ci ci ci ci ci ci ci ci ci ci ci ci

Slng 1 1 2 2 1 2 1 1 8 2 1 1 1 2 2 2 4 4 4 4Page 7



S TT 34 35 36 37

Tn trang thit b Bt ng dung dch 600ml, thp khng g Thng nhm ng nc c vi Cc ng dng dch 500ml c chia Bm tim dng mt ln 2 ml (c s ban u) - dng theo nhu cu Bm tim dng mt ln 5 ml (c s ban u) - dng theo nhu cu Bm tim dng mt ln 10 ml(c s ban u) - dng theo nhu cu Bm tim dng mt ln 20 ml(c s ban u) - dng theo nhu cu Kp phu tch 1x2 rng, di 200mm Kp phu tch khng mu, 140mm Kp Korcher c mu v kho hm Kp phu tch thng kiu Mayo Ko thng, nhn 145mm

n v ci ci ci ci

Slng 2 2 2 50

38

ci

100

39

ci

100

40 41 42 43 44 45

ci ci ci ci ci ci

50 2 4 2 4 4Page 8



S TT 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67

Tn trang thit b Ko thng t 145mm Ko cong nhn/nhn 145mm Ko thng nhn/t 145mm Ko cong t 145mm Ko ct bng gc Kp kim Mayo 200mm Cn dao s 4 Li dao m s 21 - hp 5 li n Clar Gi treo dch truyn n pin B trn Vt i n Vt i nam Thng tiu nam, n cc loi Bc tho tht, dy dn Ti chm nng lnh Gh u quay Cc thu tinh chia Cc b np chn, tay Garo cho tim truyn v garo cm mu ... Bng y t

n v ci ci ci ci ci ci ci ci b

Slng 2 3 3 3 3 2 2 2 1

ci ci ci ci ci ci ci ci ci b ci gi

2 2 2 2 20 1 2 2 2 5 10 10Page 9



S TT 68 69 II 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 III

Tn trang thit b Bng vt thng y t Xoong luc dng c

n v cun ci

Slng 10 4

CHUYN KHOA TMH - RHM - MT B khm ng quan + n treo trn Kp ly d vt tai Loa soi tai Kp ly d vt mi Km khm mi Gh rng n gin Km nh rng tr em Km nh rng ngi ln By rng thng By rng cong B ly cao rng bng tay Bm tim nha khoa B khm (khay qu u, gng, gp) B dng c hn rng su ng n gin Bng th th lc Knh lp 2 mt Kp ly d vt trong mt ci ci b 3 cI ci ci ci ci ci ci ci b ci b b ci ci ci 1 1 1 2 1 1 2 2 5 5 2 1 2 2 1 1 2

XT NGHIMPage 10



S TT 87 88 89 90 91 92 IV 93 94 95 96 97 98 99 100 101 102 103 104

Tn trang thit b My xt nghim sinh ho (n gin) My xt nghim huyt hc (n gin) My xt nghim nc tiu (n gin) T lnh 150 lt My ly tm nc tiu My ly tm

n v ci ci ci ci ci ci

Slng 1 1 1 1 1 1

KHM IU TR SN PH KHOA - Bn khm ph khoa M vt c nh, thp khng g M vt c va, thp khng g Van m o cc c Kp gp bng gc thng 200mm Kp cm mu thng, thp khng g Ko cong 160mm thp khng g Khay qu u, thp khng g Thc o t cung Thc o khung chu Kim khu 3 cnh, 3/7 vng Gng m c 6,5 v 7 ci ci ci ci ci ci ci ci ci ci ci 1 2 2 2 2 2 2 1 1 1 2 30Page 11



S TT 105 106 107 108 109 110 111 112 113 114 115 116

Tn trang thit b Thng nhm c vi, 20 lt Bm tim dng mt ln 2 ml Bm tim dng mt ln 5 ml Kp ly vng Kp c t cung 2 rng, 280mm, thp khng g B dng c ht thai 1 van + ng ht s 4, 5, 6 Chu tm tr em 25 lt Bng huyt p k tr em Qu bp tho tht Bu nh git Bng ht nht mi tr s sinh + ng ht nht Kp cm mu thng loi Korcher-Ochner, thp khng g 160mm Bn thp khng g Thc dy 1,5 mt Thc o khung chu ng nghe tim thai Bm ht sa bng tay Ko ct tng sinh mn 200mm Kim khu c t cung

n v ci ci ci ci ci ci ci ci ci ci ci ci

Slng 1 20 50 2 2 5 1 2 1 1 2 4

117 118 119 120 121 122 123

ci ci ci ci ci ci ci

1 1 1 1 1 2 2


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S TT 124 125 126 127 V 128 129 130 131 132 133 134 135 136 VI 137 138 139 140 141 142

Tn trang thit b Ch khu loi khng tiu Balon xy hoc Bnh xy xch tay c ng h Ch Catgut No. 2 Cn tr s sinh 15kg

n v gi ci gi ci

Slng 10 2 5 1

DNG C DIT KHUN Ni hp p lc 18 lt in than Ni luc dng c in Xoong luc dng c Ni luc dng c un du T sy in c nh Kp dng c sy hp Chu thp khng g - dung tch 6 lt Chu nha 10 n 20 lt X ng 12 n 15 lt ci ci ci ci ci ci ci ci ci 1 1 4 1 1 2 1 4 4

THIT B THNG DNG My bm nc in Loa phng thanh cm tay My vi tnh + My in My thu hnh (Tivi) in thoi Bn lm vic ci ci b ci ci ci 1 1 1 1 1 4Page 13



S TT 143 144 145 146 Gh

Tn trang thit b

n v ci ci ci ci

Slng 20 3 4 2

Gh bng T ng ti liu Bng en

Trm c t thuc thit yu, t thuc cp pht. Cc t thuc u l t knh c kha cn thn. Vi t thuc c, thuc hng thn, t thuc c ring, ghi r v kha chc chn. C cc gi k xp cc dng c y t c xp ng trnh t, ngn np, d thy, d ly. Xung quanh nh trm y t c vng thuc nam v trng cy xanh to khng kh trong lnh,mt m. y ban nhn dn x lun ch trng chm sc sc khe cho nhn dn, u t xy dng trm khang trang, rng ri, sch s, c s vt cht, dng c y thit b y t y . i ng cn b cng nhn vin ng , trnh chuyn mn, nng lc cao, lun ht lng phc v, chm sc sc khe cho nhn dn. Tri qua qu trnh pht trin lu di, vi s c gng phn u ca nhn dn, cc cp chnh quyn, y ban nhn dn x cng i ng cn b trm, trm y t x pht trin c v cht v lng, c s vt cht khang trang, cc hot ng chm sc sc khe t kt qu cao. Chnh v vy m Trm y t x Ha Thch dt chun trm y t t chun quc gia t nm 2006 v lun nhn c s quan tm v khen ngi ca cp trn. H thng mng li y t x su rng, cht ch. Ngoi cn b y t ca trm cn c i ng y t thn qua o to v cc cng tc vin chng trnh ti cc thn xm, lun theo di chm sc, nm r tnh hnh dch bnh ti mi thn xm nn cng tc chm sc sc khe ngi dn lun t kt qu cao. 2, Chc nng, nhim v ca trm y t x


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Trm y t x l n v k thut u tin, l t chc y t c s trong mng li chm sc sc khe quc gia, chu s qun l, lnh o ca cc c quan nh nc teo quy nh ca php lut_y ban nhn dn x. Trm y t x c chc nng qun l nh nc v y t v trc tip chm sc sc khe ban u cho nhn dn trn a bn vi nhim v nh sau: 1. Lp k hoach v la chn chng trnh u tin v chuyn mn y t trnh ln y ban nhn dn x, bo co vi phng y t v t chc trin khai thc hin. 2. Pht hin v bo co kp thi cc dch bnh ln tuyn trn. Gip chnh quyn a phng thc hin cc bin php v cng tc v sinh, phng chng dch bnh. Gi gn v sinh cng ng, ng lng, ng xm, tuyn truyn thc sc khe cho mi i tng ti cng ng. 3. Tuyn truyn, trin khai thc hin cc bin php chuyn mn v bo v sc khe ngi m, tr em, k hoch ha gia nh, bo m vic qun l thai, khm thai v thng cho sn ph. 4. T chc s cu ban u, khm cha bnh thng thng cho nhn dn ti trm y t v m rng n h gia nh. 5. T chc khm sc khe v qun l sc khe cho i tng trong khu vc mnh ph trch, tham gia khm tuyn ngha v qun s. 6. Xy dng t thuc, hng dn s dng thuc an ton,hp l, c k hoch qun l cc ngun thuc. Xy dng pht trin thuc nam, kt hp ng dng y hc dn tc trong phng v cha bnh. 7. Qun l cc ch s sc khe v tng hp bo co, cung cp thng tin kp thi, chnh xc ln tuyn trn theo quy nh ca n v mnh ph trch. 8. Bi dng kin thc chuyn mn, k thut cho cn b y t thn xm v nhn vin y t cng ng. 9. Tham mu cho chnh quyn x v trng phng y t huyn, ch o cc ni dung chm sc sc khe ban u v t chc thc hin nhng ni dung chuyn mn thuc cc chng trnh trng im y t ti a phng.


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10.Pht hin bo co y ban nhn dn x v cc c quan y t cp trn cc hnh vi, hot ng y t phm php trn a bn, kp thi ngn chn x l. 11.Kt hp cht ch vi cc on th qun chng, cc c quan ban ngnh trong x tuyn truyn v cng t chc thc hin cc ni dung chm sc sc khe cho nhn dn. 3, Chc trch ngi thy thuc ti tuyn y t x. a Nhim v chung - Lun ch n cng tc v sinh phng bnh, tuyn truyn, gio dc nhn dn thc hin v sinh phng bnh, nng cao trnh hiu bit v y hc thng thc cho nhn dn. - Khi trong x c dch bnh xy ra phi c k hoch bao vy, dp tt dch bnh, bo co kp thi ln cp trn. - Y s cng n h sinh t k hoch bo v BMTE trong x theo ch o ca cp trn. - Y s phi c trch nhim trong cng tc thng k c ti liu phc v cng tc nghin cu, bo co ln trn chnh xc v lu tr ti x. - Y s phi ch n cng tc dc, c th l: t k hoch duy tr t thuc v t thuc cp cu ti trm, hng dn v ng vin nhn dn trong x s dng thuc an ton hp l. - Y s phi nghin cu cc k hoch phng h cho nhn dn lao ng. ng gp kin vic bo v sc khe hc sinh cho cc trng hc trong x v bit s dng hc sinh vo vic tuyn truyn v sinh phng bnh. - C trch nhim n c kim tra v gip k hoch cho cc cn b chuyn trch khc (y t thn, cng tc vin dn s, cng tc vin phng chng xut huyt). b Nhim v iu tr - Chu trch nhim chnh trong cng tc khm bnh, thm khm thai, cho nhn dn. - Pht hin sm, x l s b v kp thi cc trng hp cp cu. Sau ty theo tnh hnh c th gi li iu tr hoc chuyn ln tuyn trn.Nguyn Th Minh(8/12/92)3D3[Type text] Page 16


- iu tra, nm bt tnh hnh dch bnh ti x. - Pht hin c k hoch iu tra cc bnh truyn nhim x hi. - Hng dn cho nhn dn cch dng cc thuc thng thng, cch trng, thu hi, s dng thuc nam. - Khi cha bnh phi kt hp c thuc tn dc v ng dc. - Nu l trm trng th phi lm nhim v lnh o trm y t. 4, T chc b my trm v nhim v ca nhn vin y t Trm y t x Ha Thch chu s qun l ch o gim st ca trung tm y t huyn Quc Oai v chuyn mn nghip v, kinh ph, nhn lc y t v chu s qun l ca y ban nhn dn x Ha Thch trong cng tc chm sc bo v sc khe cho nhn dn. Trm trng trm y t x Ha Thch c b phiu tn nhim, sau gim c s y t H Ni k quyt nh b nhim. Trm y t x Ha Thch c 10 cn b nhn vin trm, cng nm cn b y t thn trong c 10 cn b bin chc v 5 cn b hp ng bao gm cc chc danh chuyn mn v ngi ph trch tng cng vic cu th nh sau: 1. Trm trng: bc s Phng Vn Vin. Ngi lnh o trm y t, chu trch nhim trc cp trn, thc hin cc nhim v sau: - Lp k hoach hot ng ca trm y t x, trnh cp c thm quyn ph duyt v t chc trin khai, thc hin k hoch c ph duyt, tng kt nh gi, rt kinh nghim hng nm. - Tham gia ch o chm sc sc khe ban u, lm ph ban thng trc ch o, ch tr cng tc truyn thng gio dc sc khe cho nhn dn trn a bn. - Xy dng quy ch hot ngca trm y t x theo hng dn ca gim c trung tm y t d phng huyn, qun l nhn lc v hot ng ca trm theo quy ch, theo chc trch c nhn v thc hin cc ch , chnh sch theo quy nh ca nh nc i vi cn b y t thuc quyn qun l. - Trc tip thc hin nhim v chuyn mn v t chc trin khai thc hin cc quy ch chuyn mn ti trm y t.Nguyn Th Minh(8/12/92)3D3[Type text] Page 17


- Phn cng cc nhn vin y t thuc trm qun l, thc hin cc chng trnh mc tiu Quc Gia ph hp vi chuyn mn tng ngi, t hiu qu: chng trnh v sinh phng chng dch bnh, v sinh mi trng. An ton v sinh thc phm, y t, trng hc, khm cha bnh v phc hi chc nng, y hc c truyn, chm sc sc khe tr em, chm sc sc khe sinh sn v cc chng trnh y t quc gia khc - Qun l ch o y t thn xm hot ng chuyn mn, t chc giao ban hng thng, phi hp hot ng v cng tc Dn s - K hoch ha gia nh vi cn b chuyn trch x v cng tc vin thn xm. - Hun luyn, bi dng chuyn mn nghip v cho y t thn xm. - T chc phong tro thi ua, khen thng phi hp vi cc t chc on th ti trm theo ni dung s y t quy nh. - Bo m qun l v t chc cung ng thuc thit yu v s dng thuc an ton , hp l cha bnh ti trm cho nhn dn v cc i tng chnh sch khc theo quy nh, quy ch hin hnh. - Tham mu cho y ban nhn dn x qun l hnh ngh y dc t nhn trn ton x. - Qun l c s vt cht, ti sn, y dng c, thuc cha bnhca trm y t - Qun l ti chnh thu, chi ca trm theo quy nh. - Tip nhn, qun l cng vn ti liu. - Thc hin ch thng k bo co theo quy nh v khi c dch trn a bn qun l phi bo co kp thi, ng quy nh. - Tham gia cc cuc hp v cc cng vic khc khi c giao. 2. Ph trng trm: y s a khoa Ngc Ln c nhim v v ph trch chng trnh y t Quc Gia nm 2012: - Ph trch ch o chung trm y t. - Ph trch chng trnh phng chng HIV/AIDS - Ph trch truyn thng gio dc sc khe. - Ph trch duy tr chun quc gia v y t x - Nng cao cht lng y t c s - Ph trch chun I 3. Y s sn nhi: Bi Th Dung c nhim v:Nguyn Th Minh(8/12/92)3D3[Type text] Page 18


- Khm cha bnh, thng trc cp cu theo phn cp, c trm trng giao. - Tham gia khm thai, thng, theo di qun ly thai sn, lm cc th thut chuyn mn c phn cp. - Qun l theo di, thc hin chm sc chng trnh chm sc sc khe b m tr em nh sc khe sinh sn, phng chng suy dinh dng, phng chng tiu chy,tim chng m rng. - Tham gia truyn thng bo v sc khe cng ng. - Thc hin dich v k hoch ha gia nh c phn cp. - Ghi chp thng k s liu theo biu mu nhng vic c giao bo co trng trm tng hp. - Ph trch chng trnh phng chng dch, an ton v sin thc phm. - Phng chng st xut huyt, st rt - Ph trch thn Long Ph, chun II, chun III. 4. Y s a khoa: Nguyn Vn C c nhim v: - Ph trch dc, cung ng thuc, s dng thuc an ton hp l. - Ph trch xt nghim, cn lm sang. - Ph trch cc ri lon do thiu iod - Ph trch kt hp qun dn phng chng thm ha, thin tai - T trng cng on - Ph trch gim st dch nm 2012 G Da, Bc, Bng Rui thn Bch Thch. 5. N h sinh trung hc: V Th Ngha c phn cng nhim v: - Khm cha bnh, thng trc cp cu theo phn cp, c trm trng giao. - Tham gia khm thai, thng, theo di qun ly thai sn, lm cc th thut chuyn mn c phn cp. - Qun l theo di, thc hin chm sc chng trnh chm sc sc khe b m tr em nh sc khe sinh sn, phng chng suy dinh dng, phng chng tiu chy,tim chng m rng. - Tham gia truyn thng bo v sc khe cng ng. - Thc hin dich v k hoch ha gia nh c phn cp. - Phng chng cc bnh ly qua ng tinh dc.Nguyn Th Minh(8/12/92)3D3[Type text] Page 19


- Phng chng ri lon do thiu vitamin A - P trch thu chi ti chnh ca trm. - Ph trch lng vn ha sc khe - Ph trch thn Thng u, chun V, chun VI. - Gim st dch thn Thng u. 6. N h sinh trung hc: ng Th Long ph trch: - Khm cha bnh, thng trc cp cu theo phn cp, c trm trng giao. - Tham gia khm thai, thng, theo di qun ly thai sn, lm cc th thut chuyn mn c phn cp. - Qun l theo di, thc hin chm sc chng trnh chm sc sc khe b m tr em nh sc khe sinh sn, phng chng suy dinh dng, phng chng tiu chy,tim chng m rng. - Tham gia truyn thng bo v sc khe cng ng. - Thc hin dich v k hoch ha gia nh c phn cp. - Phng chng cc bnh ly qua ng tinh dc. - Ph trch y t hc ng, y t lao ng, mi trng. - Phng chng bnh di, da liu, m la - Khi phc vn thuc nam, a y hc c truyn dn tc cng ng. - Tng hp bo co chung ca trm. - Ph trch thn Ha Ph, chun IV, chun IX. - Ph trch gim st dch xm 3,4 thn Ha Ph. 7. iu dng trung hc: Nguyn Vn Dng c nhim v: - Thc hin mnh lnh ca y, bc s v chm sc bnh nhn ti trm - Thc hin quy trnh v sinh chng nhim khun ti trm. - Tham gia tuyn truyn gio dc sc khe cng ng. - Ghi chp thng k biu mu nhng vic c giao bo co trng trm tng hp. - Ph trch chng trnh tim chng m rng. - Ph trch chng trnh bo v sc khe tm thn cng ng - Ph trch phc hi chc nng ua vo cng ng - Chm sc ngi cao tui - Ph trch thn Ha Ph, chun VIII.Nguyn Th Minh(8/12/92)3D3[Type text] Page 20


- Gim st dch t i 1 n i 5 thn Bch Thch. 8. Y s a khoa: Nguyn Quang Huy( cn b hp ng TTYT) - Ph trch cng tc khm cha bnh cng ng ch Dung. - Ph trch nng cao cht lng chm sc sc khe ngi bnh. - Phng chng tai nn thng tch. - Phng chng bnh tiu ng, cao huyt p, bnh K. - Phng chng tiu chy, nhim khun h hp cp tnh. - Gim st dch i 4 ln so_Thng u. 9. Bi Th Hi: cn b hp ng x: gim st dch t i 6 n i 8 thn Bch Thch. 10.Phng Th Hng: y t thn Bch Thch, gim st dch oi 9,10 xm mi thn Bch Thch. 11.Phng Thanh Lun: cn b hp ng x: gim st dch t xm 1 n xm 3 thn Ha Trc. 12.Phng Th Minh: cn b hp ng x: ph trch gim st dch xm 46 thn Ha Trc. 13.L Th Thng: y t thn Ha Ph: ph trch gim st dch xom 1,2 thn Ha Trc. 14.V Th Ngc: y t thn Long Ph: ph trch gim st dch xom 1-3 thn Long Ph. 15. Vn Trng:cn b hp ng x, ph trch gim st dch t xm 4-6 thn Long ph.


Page 21


Phn II: Chun on cng ng, tm hiu cc vn sc khe, m hnh bnh tt, thc t s dng thuc ca ngi dn trong xX Ha Thch l vng bn sn a, giao thng thun tin, nhiu tuyn ng giao thng quan trng huyt mch bc qua a bn x c bit l ng H Ch Minh. Ni c nhiu c quan n v ng qun trn a bn, l x tp trung nhiu cng ty, x nghip, m hnh trang tri chn nui,..v..v.V vy x chu s nhim t nc thi, khi bi t cc nh my,nht l vo ma nng, khi b t cc phng tin vn ti, cc cht thi sinh hot v sn xut. Hn na hot ng thng mi,giao lu trao i,bun bn kh si ni. l cc yu t thun li cho nhiu dch bnh xy ra, c nguy c gy ra cc dch bnh pht sinh v ly lan nhanh chng. Tuy nhin, c s quan tm ca trm y t x, chnh quyn a phng cng s tham gia tch cc ca cng ng nn trong nhng nm qua dch bnh c dp tt, khng ly lan,pht trin. Qua tham kho s sch ti trm v s ng gp kin ca cn b y t trm, em chn thn Thng u tm hiu cng ng, thu thp thng tin, la chn cc vn sc khe cn gii quyt v tin hnh cc hot ng truyn thng gio dc sc khe ngi dn. I, S lc v thn Thng u Thng u l thn nm pha ty x Ha Thch, l a bn gip danh vi a hnh i ni, c c s ca m khai thc , nh my sn xut phn vi sinh, nhiu trang tri chn nui ln,..v..v.nn hot ng giao lu bun bn, thng mi nhn nhp, hn na li nm cnh tuyn ng H Ch Minh nn tnh hnh giao thng tp np, lu lng xe qua li ln. Tng dn s ton thn 2151 ngi, tng s h 486 h, s tr em di 5 tui l 279 chu. II, Tm hiu cng ng thu thp ch s 1, thi gian thc tp 6/3-30/3/2012 2, i tng tm hiu: tm hiu ngu nhin 10 h gia nh trong thn v v sinh thn xm. 3, phng thc thc hinNguyn Th Minh(8/12/92)3D3[Type text] Page 22


o Thu thp cc thng tin t s sch, bo co v thng tin t nhn vin y t o Quan st h gia nh: nh , ngun nc sinh hot, nh v sinh, x l rc thi sinh hot m hnh VAC. o Phng vn h gia nh: ni dung ch yu vo cc vn v sinh n ung, v sinh thc phm, x l rc thi, tim chng cho tr em di 5 tui, s dng thuc an ton hp l, p dng bin php k hoch ha gia nh, tnh hnh dch bnh v mt s vn khc. 4,kt qu: qua quan st tm hiu em thu c mt s vn sau: - Nh : nhn chung v sinh nh ca ca cc h iu tra l tt - Ngun nc sinh hot cc h u c ging khi, c b lc hp v sinh t 100% - Nh v sinh hp v sinh:qua kho st 10 h gia nh th c 8 h c nh v sinh t hoi, s cn li cha c iu kin xy t hoi. - X l rc thi: c 4 h co h rc, cc h cn li thu gom vo bao sau vt ra khu t trng, bi tp kt rc. - V sinh n ung: trong 10 h c tm hiu c 2 h s dng nc ng bnh ung, cc h cn li ung nc ging un si. Ra tay trc khi n v chun b nu n, i din 8 h tr li l khng. - Tim chng m rng c 19 tr em trong tng s 10 h u c tim chng y . - Tnh hnh dch bnh: do mng li y t thn x lm tt cng tc phng chng dch bnh nn mc d c im ca a phng (gip i ni l ni d xy ra dch st rt, ri nhiu nh my x nghip, c s sn xut kinh doanh, trang tri chn nui, hot ong gaio thng tp np,) c nhiu diu kin thun li, tim n nguy c cao dch bnh bng pht nhng do cng tc phng chng dch tt nn t u nm ti nay trong thn khng pht hin dich bnh no ly lan, pht trin. Ngy 16/3/2012 ton th nhn vin trm y t tin hnh chin dch tm mn, ly mu xt nghim k sinh trng st rt ti a bn thn nhng khng pht hin trng hp no c k sinh trng st rt.Nguyn Th Minh(8/12/92)3D3[Type text] Page 23


- S dng thuc an ton hp l: qua phng vn 20 ngi dn trong cc h, tm hiu v vic dng thuc khi au bnh (cm st, au u, nhc mi,) c 12 ngi tr li ch ung theo n khm bnh, s cn li mua thuc ti tim thuc ty v ung, ch i khm khi ung thuc 2-3 ngy m cha ht bnh. - Vn dn s, k hoch ha gia nh: qua kho st 10 h th c 8 h co b m thc hin bin php t vng, 1 b m dng thuc trnh thai, v mt b m khng s dng bin php trnh thai no. Hn na t l sinh con th 3 thn x cn kh cao. 5, Ch s thu thp Stt 1 2 3 4 5 6 7 Ch s thu thp S dng ngun nc ging c b lc 10/10 h S h khng c nh v sinh t hoi 2/10 h X l rc thi chua t tiu chun 6/10 h V sinh n ung, khng ra tay trc khi n 8/10 h Tim chng m rng y 19/19 tr S dng thuc khng theo n p dng bin php trnh thai T l 100% 20% 60% 80% 100% 40% 90%

6, bng xc dnh vn sc khe im 3: im rt r rng 2: im r rng 1: c thc khng r lm Tiu chun xc nh vn sc khe Phng chng dch X l rc thi Dn s V sinh k hoach n ha gia ung,ra nh tay trc khi n 3 2 3 2Page 24

Cc chi s biu hin vn Cng ng bit tn v c

3 3

2 2



phn ng c hot ng ca nhiu ban ngnh on th Ngoi cn b y t c mt nhm ngi thng tho vn Tng cng Tiu chun xt u tin

3 2

3 2

3 2

2 2

11

9

11

8

7, T cc vn sc khe trn, em la chn cc vn sc khe u tin Phng chng dch X Dn s V sinh l k n rc hoch ung,ra thi ha gia tay nh trc khi n 3 3 3 3 2 2 2 2 2 3 3 2 2 2 15 3 2 13 2 2 13

Mc ph bin ca vn Gy tc hi ln nh hng n lp ngi kh khn c k thut, phng php gii quyt Kinh ph ph hp Cng ng sn sng tham gia gii quyt Tng cng

3 3 3 3 3 3 18

nh gi: u tin 1: phng chng dch bnh u tin 2: dn s, k hoch ha gia nh u tin 3: x l rc thi u tin 4: v sinh n ung, ra tay trc khi n III, Tm hiu m hnh bnh tt Sau thi gian thc tp ti trm y t x Ha Thch, em c tip xc vi nhiu bnh nhn khc nhau. Tnh hnh bnh tt ca bnh nhn ph


Page 25


thuc rt nhiu vo cng tc chm sc sc khe, iu kin mi trng, kinh t, vn ha x hi, chnh tr, tp qun, - Vic xc nh m hnh bnh tt l c s koa hc gip cho cng tc phng bnh, xy dng k hoach cp cu v iu tr gip h thp ti a tn sut mc bnh v t l t vong. - i tng tm hiu: tt c bnh nhn n khm v iu tr ti trm y t x t nm 2011 n 2/2012. - Phng php nghin cu: hi cu tt c h s bnh n ca trm t nm 2011 n thng 2/2012 - Tng s bnh nhn: 4897 Nhm bnh Bnh dch Tn bnh St rt St xut huyt del Tay chn ming St pht ban Vim amidal (chu yu tr em) Vim phi Tiu chy Bnh da liu: l nga, m ay,.. Chn thng do tai nn giao thng, lao ng, sinh hot,.. Hi chng c, vai tay,.. Hi chng tht lng hng Hi chng suy nhc thn kinh suy nhc c th Hi chng ri lon tin nh au mt S ca 3 5 5 9 1273 1034 498 107 276 T l 0,06% 0,1% 0,1% 1,8% 39% 21% 10% 2,2% 5,6%

Bnh ni khoa

-

Bnh ngoi khoa

Bnh v thn kinh

-

45 51 375 39

0,92% 1% 7,7% 0,8%

Bnh v chuyn -

15

0,03%Page 26



khoa rng hm mt, tai mi hng Bnh ph khoa

- Vim kt mc - Vim chn rng, vim li - Vim nhim ng sinh dc - Ri lon kinh nguyt

67 262 769 64

1,4% 5,4% 15,7% 1,3%


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Phn III: k hoch hot ng, t chc hot ng ca trm y t x Ha ThchI, k hoch phng bnh nm 2012 - Chng trnh phng chng HIV/AIDS - Truyn thng phng chng HIV/AIDS cho ph n mang thai, ph n c nguy c cao v ph n tui sinh . - Trin khai l pht ng thng phng chng HIV/AIDS. - Chng trnh dinh dng: cn o tr em di 5 tui b suy dinh dng hng thng ( thng 1, 2, 4, 5, 7, 8, 10, 11), cn o tr em di 2 tui hng qu ( I, III, IV). - Chng trnh y t hc ng: khm sc khe cho hc sinh trng mm non, tiu hc, trung hc c s nm hc 2012-2013 (1500 hc sinh) thng 10. - Chng trnh phng chng m la thng 3. - Khi phc vn thuc nam: 12 thng. - Chng trnh v sinh an ton thc phm: truyn thng kim tra, gim st: thng 1, 4, 9. - Chng trnh truyn thng gio dc sc khe: thng 4, 11. - Chng trnh phng chng ri lon do thiu iod: thng 10. - Phng chng st rt: thng 3. K hoch cng tc thng 1 nm 2012 ca trm y t x Ha Thch. Tun Tun 1 ngy 2-8 Ni dung cng vic t - Ch ng gim st cht ch dch bnh ma ng xun cc thn ( nh t, tay chn ming, cm AH5N,..) - Ch ng lp k hoch kim tra, gim st v sinh an ton thc phm trong dp tt nguyn n v ma l hi 100% c s sn xut kinh doanh. - Ch ng lp k hoch phc v sc khe nhn dn trong dp tt nguyn n (trc 2/24h, y c sPage 28



Tun 2 t 915

-

Tun 3 t 1622 Tun 4 -

-

-

thuc, trang thit b. T chc tim chng m rng thng xuyn cho tr em v ph n c thai thng 1/2012 T chc tim chng dch v cho i tng np tin. Vit bi truyn thng v v sinh an ton thc phm, phng chng dch gi v i truyn thanh ca x pht trc trong v sau tt nguyn n. T chc tng kt y t, dn s nm 2011 (y ban nhn dn x t chc ch o). Chun b kinh ph mua qu tt v cp ch tt cho cn b, cng nhn vin chc trm y t. T chc on th kim tra v sinh an ton thc phm trn a bn. Phn cng cn b trc tt nguyn n mi kp 2 ngi trc 24/24h. T chc tng v sinh mi trng trm y t trc khi ngh tt. Cn b ph trch dc trong dip tt hng ngy kim thuc v bn giao cc kp trc, b sung thuc hng ngy. T chc tt trng cy: mi cn b trm y t v y t thn trng cc loi cy lm thuc vo vn thuc nam ti trm. Cc ng ch ph trch cc chng trnh tng hp bo co trong thng gi v trung tm y t theo quy nh.

II, Cc hot ng y t ca trm y t x Ha Thch 1, t chc hot ng chuyn mn c s quan tm ch o ca trung tm y t huyn Quc Oai, s h tr v chuyn mn ca cc trung tm chuyn khoa, cng s on kt


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thng nht ca n v quyt tm hon thnh cc ch tiu, k hoch chuyn mn do cp trn giao. Tp th n v lun c gng hon thnh cng tc, chp hnh mi ch trng, chnh sch ca ng v nh nc ra, gng mu chp hnh s phn cng ca cp trn, ni quy, quy ch ca n v v ngnh, thc hnh tit kim chng lng ph. C tinh thn hc tp chuyn mn, nghip v, chnh tr, tham gia y cc t thc tp chuyn mn, nghip v nng cao trnh nng lc p ng yu cu nhim v ngy cng cao. 2, T chc hot ng cc chng trnh mc tiu y t quc gia, v chng trnh khc. Trm y t x l n v u tin tip xc vi ngi dn trong x, gi vai tr quan trng trong cng tc chm sc sc khe nhn dn. Trong nhng nm qua trm t chc tt cc hot ng y t ti a phng v hon thnh k hoch, ch tiu cp trn giao. 2.1, hot ng khm cha bnh: trm t chc khm cha bnh ti trm cho ngi dn trong x ch yu l cc i tng c th bo him y t tr em di 6 tui, cc i tng khm dch v c cht lng v hiu qu. Nm 2011 t 4236 ca, 3 thng u nm 2012 t 661 ca. 2.2, Hot ng chm sc sc khe sinh sn Chm sc sc khe sinh sn l mt chin lc Quc gia m hin nay ang c ng v Nh nc rt quan tm v ch trng. c bit cn quan tm n sc khe sinh sn ca ngi ph n la tui sinh v thin chc cao qu nht ca ngi ph n m to ha ban tng l mang thai v sinh con. Tuy nhin lm tt thin chc ca mnh ngoi trch nhim thing ling ca tnh mu t ngi ph n cn phi c nhng kin thc c bn v chm sc sc khe sinh sn cho bn thn mnh. Lm th no sinh cho mnh, cho gia nh, cho x hi mt a con thng minh khe mnh th ngay t khi bt u c thai, i khm thai l vic lm cn thit ngi m bit c sc khe ca m c m bo ttNguyn Th Minh(8/12/92)3D3[Type text] Page 30


cho s pht trin ca con hay khng, bit cch t chm sc bn thn v sc khe c cc can thip kp thi khi cn thit. Trong qu trnh mang thai, ph n c thai nn i khm thai nhiu ln, ti thiu phi c khm 03 ln trn 03 k thai nghn. Quan trng nht l khm thai trong ba thng u, giai on ny c nh hng quyt nh n cuc i a tr v l giai on hnh thnh thai nhi. Th nhng khng phi b m no cng nhn thc c nh vy nn vic i ng k qun l thai sm trong ba thng u l rt t, hu nh khi c thai c 04 n 05 thng thm ch 06 n 07 thng mi n trm y t khm thai v tim phng un vn cho m v con. y l tnh trng khin cn b Trm Y t x lun trn tr. Cc thn u c mt cn b y t thn ph trch, l iu kin thun li cho Trm Y t trong vic thc hin nhim v c giao. lm tt cng tc chm sc sc khe sinh sn,ngay t u nm, Trm Y t ch ng lp k hoch, ln danh sch i tng ph n trong tui sinh , i tng no mi kt hn, i tng no mi c mt con vn cn tip tc sinh ca tng thn giao cho y t thn ph trch. ng thi lp k hoch c th cho hng tun, hng thng, hng qu v truyn thng t vn v bi dng kin thc k nng t vn cho y t thn. T chc giao ban vi y t thn, trin khai k hoch kim tra sc khe, tuyn truyn v chm sc sc khe sinh sn ti h gia nh kt hp iu tra i tng ph n c thai, vn ng h i ng k qun l thai sm trong ba thng u. C th nm 2011, vit c 18 bi tuyn truyn v pht trn h thng truyn thanh ca x mi tun pht mt ln; t chc truyn thng t vn ph n c thai c 03 bui ti Trm Y t vi tng s 172 lt ngi tham gia; Phi kt hp vi cc ban ngnh on th, thn xm t vn truyn thng lng ghp c 12 bui cho 620 lt ngi nghe v kin thc chm sc SKSS; 100% ph n c thai c ti c s y t do cn b c chuyn mn , khng sy ra tai bin g do sai st v chuyn mn; c bit l cng tc qun l thai sm trong ba thng u th tng r rt nm 2012 vi 99 ph n c thai th c 76 ph n c qun l thai sm trong ba thng u t 76,8% tng 25,2% so vi nm 2011Nguyn Th Minh(8/12/92)3D3[Type text] Page 31


Kt qu trn nh du mt bc thay i v hnh vi nhn thc ca ch em ph n trong tui sinh v cng l c mt qu trnh vn ng ca i ng lm cng tc y t x Ha Thch. duy tr v lm tt hn na cng tc chm sc sc khe sinh sn ni chung v qun l thai nghn trong ba thng u ni ring cho nhng nm tip theo, Trm Y t x Ha Thch s lm tt cng tc chuyn mn nghip v, nng lc qun l, k nng truyn thng, t vn. Phi kt hp cht ch vi cc ban ngnh on th, a dng ha cc loi hnh truyn thng c hiu qu a cng tc chm sc sc khe sinh sn c bit l cng tc qun l thai sm trong ba thng u ca x Ha Thch ngy mt tt hn. 2.3, sinh k hoch Nm 2011, Ban dn s k hoch ha gia nh t chc khm ph khoa cho 362 lt ngi; t vng trnh thai cho 78 lt ngi/93 ch tiu t 84%k hoch c giao; Bao cao su 89/86 = 103% k hoch; Thuc ung trnh thai: 100/92 = 109% k hoch; Tim thuc trnh thai 6/5 = 120% k hoch; 3 thng u nm 2012 trm thc hin t vng 10 ca. 2.4, Tim chng m rng - tr em MD v PNCT c phng un vn s sinh t 100% nm 2011, tr em c tim chng 3 thng u nm 2012 y t 35%, tim chng BCG t 375, UV2 t 42%. - T chc tim chng dch v cc loi rubella, quai b, si, vim gan b. - Trm m bo cung ng vacxin y , khng c tai bin xy ra, khng pht hin tr em mc cc bnh trong chng trnh TCMR. 2.5, Hot ng phng chng suy dinh dng cho tr em di 5 tui - ton x c 1346 tr

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