The trend of continuous growth in the number of patients with pathology of the maxillofacial region necessitates the optimization of the medical care service in the profile of maxillofacial surgery and the introduction of a patient-oriented approach to medical care. On the territory of the Penza Region, in order to improve the quality of medical care for patients with head and neck pathology, a Center for maxillofacial surgery was established on the basis of the State Budgetary Healthcare Institution "Penza Regional Clinical Hospital named after N.N. Burdenko" in 2020. The work of the Maxillofacial Surgery Center is based on the principles of continuity and complementarity of specialists of a medical organization in the process of providing medical care. For this purpose, new specialists and positions in the staffing table have been introduced into the structure of the Center. In the course of optimizing the medical care service in the profile of maxillofacial surgery, the role of the nursing staff has been revised in the direction of increasing its professional competence. Increasing the competence of nurses is one of the pressing issues of effective development of the healthcare system. The staff of the Maxillofacial Surgery Center has introduced a new form of organization of the work of nursing staff - a clinical (universal) nurse. A clinical nurse has been assigned the duties of a post, procedural and dressing nurse, but the number of patients under observation has been reduced. With the introduction of a new position, nurses have the opportunity to expand the potential of their professional duties, increase the level of personal development. Clinical nurses have become more independent in making decisions when providing medical care within their competencies, and have expanded the scope of professional knowledge. The expansion of the profile of the manipulations performed contributes to the development of nursing specialists, allowing them to become universal, which provides a higher level of qualification. In general, a more professional, patient-oriented approach to the provision of medical care in the Center of Maxillofacial Surgery to patients with pathology of the maxillofacial region in the Penza region has been provided.
This article presents the most well-known research methods that have been applied in practice, which make it possible to assess the state and indicators of public health and health care. The above methods contribute to obtaining the necessary data on the current activities of the subjects of the health care system and assessing the health and quality of life of the population. Modern medical science is characterized by an increase in the number of ongoing scientific research. Research is a necessary component of dissertation work, only they introduce new information into the health care system, allow one to acquire new skills, and contribute to the development of new technologies. The research results are certainly of interest to both healthcare professionals and patients. The requirements for the methodology of scientific research and the quality of the data provided by the researcher are becoming unambiguously more stringent. The implementation and implementation of scientific research in the field of medicine is associated with the need and obligation to comply with various standards and regulations. The published data must be scientifically new and presented in accordance with international standards. Undoubtedly, a certain role is played by the competent presentation of research and analysis methods, which allow the researcher and specialists studying the research data to correctly interpret the data obtained and put them into practice. Thus, selective planning of prospective research in the field of public health and health care, correct formulation of goals and objectives, concretization of research design, definition of modern research methodology and data analysis are the basis of its effectiveness. The use of a set of interacting medical and sociological research methods, focused on the result, contributes to the achievement of the set goals at the proper level.
The annual increase in patients and increased requirements for the quality of medical care lead to the reorganization of the work of various departments of medical hospitals. In order to improve the quality and accessibility of specialized medical care in the profile "maxillofacial surgery" in the territory of the Penza Region, in 2020, the structure of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko will be reorganized, which allows solving a number of existing problems. An important direction in the modernization of the Center was the structural and organizational restructuring. The purpose of the study: to analyze the quality and effectiveness of providing care to children with pathology of the maxillofacial region by doctors of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko. Materials and methods. A comprehensive assessment of the quality of care for children with maxillofacial pathology from 2018-2020 in the Penza region and in the period from November 2020 to July 2021 was carried out. Center of Maxillofacial Surgery of the N. N. Burdenko State Medical University. Results and discussion. Having analyzed the existing shortcomings and problems, established connections, the growth of patients in need of treatment by a maxillofacial surgeon contributed to the opening of the Maxillofacial Surgery Center in the N. N. Burdenko State Medical University, which included 10 specialized children's beds; 2 ultra-short stay beds; an outpatient office; a rehabilitation room; material and technical equipment, tools, medicines for children; maxillofacial surgeon, pediatrician, pediatric dentist, general dentist, clinical nurses, speech therapist. Conclusion. The opening of the Maxillofacial Surgery Center in the Penza region has shown high efficiency. The economic effect in obtaining specialized treatment due to the work of an outpatient office and a rehabilitation office based on a patient-oriented model is noted. In order to achieve maximum efficiency and fully meet the need for providing medical care to the children's population of the Penza region in the profile "maxillofacial surgery", it is necessary to open a department of pediatric maxillofacial surgery due to the projected workload of open beds.
Every year there is a significant increase in combined anomalies and deformities of the maxillofacial region, congenital pathologies, malignant tumors, severe inflammatory diseases of the face and neck. Almost every patient who underwent surgery on the maxillofacial region develops secondary deformities of the maxillofacial region, adentia of the teeth of the jaws, impaired occlusion and speech, skeletal anomalies, which requires a comprehensive interdisciplinary approach of doctors of different profiles. The aim of the work was to improve the provision of specialized care to patients with pathology of the maxillofacial region through the introduction of an interdisciplinary approach in the treatment of patients in the center of maxillofacial surgery at the N.N. Burdenko Penza Regional Clinical Hospital (N.N. Burdenko ). Material and methods. The study was carried out on the basis of the Center for Maxillofacial Surgery of the State Budgetary Healthcare Institution "Penza Regional Clinical Hospital named after V.I. NN Burdenko ". A retrospective analysis of outpatient patient records, case histories, electronic databases, regulatory and legal documentation from 2010-2020 was carried out. Results and its discussion. Until November 2020, in the Penza region, medical care for patients with diseases of the maxillofacial region was provided in the department of maxillofacial surgery of the N.N. Burdenko State Budgetary Clinical Hospital. When analyzing the reporting and regulatory documents, it was concluded that it is necessary to improve the quality of specialized care in the field of maxillofacial surgery. We propose to employ the following specialists on the staff of the department: dentist-therapist for adults and children, gnathologist, dentist-orthodontist, otorhinolaryngologist, speech therapist. Conclusion. The materials presented in the article reflect the need for an integrated approach and close interaction between the doctors of the center. This stage begins during the preoperative preparation and planning of the operation. Rehabilitation of patients with pathology of the maxillofacial region is aimed at maximum aesthetic and anatomical recovery and requires an individual approach. To solve this problem, it is necessary to introduce interdisciplinary interaction of specialists in the center of maxillofacial surgery.
The literature review focuses on the problems of the professional activities of paramedical personnel. The attention is given to the specific features of the nursing staff work. The review is based on scientific papers published on the relevant topic and regulatory documents of medical organizations.
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