Active Edition from 28.03.2003
| Document name | Order of the Ministry of Health of the Russian Federation of 03.28.2003 N 127 "On approval of the instructions for the destruction of narcotic drugs and psychotropic substances included in the lists of the II and III list of narcotic drugs, psychotropic substances and their precursors to be controlled in the Russian Federation, the further use of which is recognized in medical practice. UNPARTICULAR" |
| Type of document | order, instruction |
| Host body | Ministry of Health of the Russian Federation |
| Document Number | 127 |
| Acceptance date | 01.01.1970 |
| Revision date | 28.03.2003 |
| Registration number in the Ministry of Justice | 4484 |
| Date of registration in the Ministry of Justice | 05.05.2003 |
| Status | valid |
| Publication |
|
| Navigator | Notes |
Order of the Ministry of Health of the Russian Federation of 03.28.2003 N 127 "On approval of the instructions for the destruction of narcotic drugs and psychotropic substances included in the lists of the II and III list of narcotic drugs, psychotropic substances and their precursors to be controlled in the Russian Federation, the further use of which is recognized in medical practice. UNPARTICULAR"
Order
In accordance with Decree of the Government of the Russian Federation of June 18, 1999 N 647 "On the procedure for the further use or destruction of narcotic drugs, psychotropic substances and their precursors, as well as tools and equipment that were confiscated or withdrawn from illicit circulation or whose further use was deemed inappropriate "(Collected Legislation of the Russian Federation, 1999, N 27, Art. 3360) I order:
1. Approve the "Instruction for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the List of narcotic drugs, psychotropic substances and their precursors, subject to control in the Russian Federation, the further use of which in medical practice is recognized as inappropriate" (Appendix).
2. To impose control over the implementation of this Order on the Deputy Minister A.V. Katlinsky.
Minister
Yu.L.SHEVCHENKO
Application
APPROVED
by order
Ministry of Health
Russian Federation
No. 127 dated March 28, 2003
1.1. This Instruction determines the procedure for the destruction of narcotic drugs and psychotropic substances included in the lists and III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation (hereinafter referred to as narcotic drugs and psychotropic substances), the further use of which in medical practice is recognized as inappropriate.
1.2. The destruction of narcotic drugs and psychotropic substances is carried out in cases where:
The expiration date has expired;
The narcotic drug or psychotropic substance was subjected to chemical or physical influence, which resulted in its unsuitability, excluding the possibility of restoration or processing;
Unused drugs are accepted from relatives of deceased patients;
It is difficult to determine whether a drug is a narcotic drug or a psychotropic substance;
A narcotic drug or psychotropic substance confiscated from illegal circulation may not be used for medical, scientific or other purposes.
1.3. Narcotic drugs and psychotropic substances, the further use of which is recognized as inappropriate by the authorities exercising their seizure or confiscation, are subject to destruction in full, except for cases when these authorities, on the basis of the conclusions of the Ministry of Health of Russia and the Ministry of Economic Development of Russia or commissions consisting of representatives of these ministries in the field and the body that carried out the seizure or confiscation, a decision will be made to turn them into state revenue and transfer them for use for the purposes provided for by the legislation of the Russian Federation.
1.4. The basis for the destruction of narcotic drugs and psychotropic substances confiscated or seized from illicit circulation is a court decision, a decision of an investigator or an employee of an inquiry agency to terminate a criminal case or to refuse to initiate a criminal case, as well as a decision of a body or official to impose an administrative penalty or to terminate proceeding on the case of an administrative offense<*>.
<*>dated July 24, 2002 N 557 "On making additions to the Decree of the Government of the Russian Federation dated June 18, 1999 N 647" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, July 29, 2002, N 30, art. 3057).
1.5. Destruction of narcotic drugs and psychotropic substances, the further use of which is recognized as inappropriate, including those confiscated or withdrawn from illegal circulation, is carried out by state unitary enterprises or state institutions if they have a license for activities related to the circulation of narcotic drugs and psychotropic substances, indicating the right to destroy them<*>.
<*>Decree of the Government of the Russian Federation of June 21, 2002 N 454 "On licensing activities related to the circulation of narcotic drugs and psychotropic substances" (Collected Legislation of the Russian Federation, 01.07.2002, N 26, art. 2597; 10.14.2002, N 41, art. . 3983).
1.6. For the destruction of narcotic drugs and psychotropic substances in state unitary enterprises or state institutions that have licenses for activities related to the circulation of narcotic drugs and psychotropic substances with the right to destroy them, commissions are created, consisting of representatives of internal affairs bodies, health authorities and security bodies. environment.
Legal entities that do not have licenses for activities related to the circulation of narcotic drugs and psychotropic substances with the right to destroy them, but carry out activities related to the circulation of narcotic drugs and psychotropic substances, conclude agreements with state unitary enterprises or state institutions that have such licenses, and transfer to them narcotic drugs and psychotropic substances to be destroyed with the execution of an acceptance certificate.
As narcotic drugs and psychotropic substances are accumulated by a legal entity, no later than the 30th day of each month, they are written off with subsequent destruction within a period not later than five days.
1.7. The need for the destruction of narcotic drugs and psychotropic substances, with the exception of those confiscated or seized from illegal circulation, is justified by the responsible person appointed by order of the head of the healthcare institution, pharmacy institution (organization).
At the same time, an order is issued on the write-off of narcotic drugs and psychotropic substances and their subsequent destruction, which indicates:
The name of narcotic drugs and psychotropic substances, indicating their dosage forms, dosages, packaging and batch numbers;
Net and gross weight of narcotic drugs and psychotropic substances to be written off and destroyed;
Reasons for decommissioning and destruction;
The person responsible for write-off and destruction;
Place and method of destruction.
Institutions and organizations that do not have a license for activities related to the circulation of narcotic drugs and psychotropic substances with the right to destroy them indicate the number of the contract and the date of its conclusion with a state unitary enterprise or a state institution that has such licenses.
Copies of the order are sent to:
To the health management body of the constituent entity of the Russian Federation;
To the internal affairs body of the constituent entity of the Russian Federation;
To the environmental protection authority of the constituent entity of the Russian Federation.
2. PROCEDURE FOR THE DESTRUCTION OF NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES2.1. The destruction of narcotic drugs and psychotropic substances is carried out at specially equipped sites (polygons) and (or) in specially prepared premises.
2.2. Personnel performing work on the destruction of narcotic drugs and psychotropic substances must have a permit to work with narcotic drugs and psychotropic substances, know the physicochemical and toxic properties of the substances being destroyed and the chemical reactions that occur during the neutralization and destruction of their chemical reactions.
2.3. Features of the destruction of narcotic drugs and psychotropic substances:
Liquid dosage forms (solutions for injection in ampoules and vials, medicines, drops) are destroyed by crushing (ampoules), followed by dilution of the contents of ampoules and vials with water in a ratio of 1:100 and draining the resulting solution into the sewer; the remains of ampoules and vials are taken out in the usual manner, as industrial or household waste;
Solid dosage forms (powders, tablets, capsules) containing water-soluble substances of narcotic drugs and psychotropic substances, after crushing to a powdery state, are diluted with water in a ratio of 1:100 and the resulting suspension (or solution) is drained into the sewer;
Solid dosage forms (powders, tablets, capsules) containing substances of narcotic drugs and psychotropic substances that are insoluble in water, soft dosage forms (ointments, suppositories), transdermal forms of narcotic drugs, including those already used, as well as pharmaceutical substances are destroyed by burning .
Medicines to be burned are wrapped in waste paper, abundantly moistened with an accessible combustible liquid, placed in a baking sheet and burned under draft (if the destruction is carried out indoors) or at the stake (if the destruction is carried out at the landfill). Ash is taken out or buried in the usual manner as a substance of the 4th hazard class in the prescribed manner.
2.4. When destroying narcotic drugs and psychotropic substances, the commission draws up an act, which indicates:
Date and place of drawing up the act;
Place of work, position, surname, name, patronymic of persons participating in the destruction;
Reason for destruction;
Information about the name (indicating the type of dosage form, dosage, unit of measure, series) and the amount of the destroyed narcotic drug, psychotropic substance, as well as the container or packaging in which they were stored;
Destruction method.
The number of copies of the act is determined by the number of parties involved in the destruction of narcotic drugs and psychotropic substances.
2.5. The transfer for further use of narcotic drugs and psychotropic substances in respect of which a decision has been made to destroy them is prohibited.
2.6. The head of the legal entity is personally responsible for exercising control over activities related to the circulation of narcotic drugs and psychotropic substances.<*>.
<*>Federal Law No. 3-FZ of January 8, 1998 "On Narcotic Drugs and Psychotropic Substances" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 1998, No. 2, Art. 219).
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On the site "Zakonbase" you will find an order from the Ministry of Health of the Russian Federation of 03.28.2003 N 127 "On approval of the instructions for the destruction of narcotic drugs and psychotropic substances included in lists of the II and III list of drugs, psychotropic substances and their precursors subject to control in the Russian Federation, THE FURTHER USE OF WHICH IN MEDICAL PRACTICE IS RECOGNIZED INAPPROPRIATE" in a fresh and complete version, in which all changes and amendments have been made. This guarantees the relevance and reliability of the information.
At the same time, download the order of the Ministry of Health of the Russian Federation of 03.28.2003 N 127 "On approval of the instructions for the destruction of narcotic drugs and psychotropic substances included in the lists of the II and III list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, the further use of which in IN MEDICAL PRACTICE RECOGNIZED INAPPROPRIATE" can be completely free, both in full and in separate chapters.
Footnote. Has become invalid by the order of the Minister of Health of the Republic of Kazakhstan dated May 31, 2017 No. 357 (shall be enforced after twenty-one calendar days after the day of its first official publication).
5. When designing, a land plot is not allocated for construction in territories previously used for landfills, sewage disposal fields, cattle burial grounds, cemeteries with soil contamination of an organic, chemical, radiation nature.
6. Health care facilities are located in residential areas, green or suburban areas at a distance from industrial and civil facilities in accordance with the requirements of these Sanitary Rules.
7. Specialized healthcare facilities for patients with a special regime of stay (psychiatric, tuberculosis, narcological) and complexes with a capacity of over 1000 beds for patients to stay for a long time are located in a suburban area or outlying areas, in green areas, observing gaps from the residential area not less than 500 meters (hereinafter - m).
8. It is not allowed to pass the main engineering communications (water supply, sewerage, heat supply, electricity supply) through the territory of healthcare facilities.
9. The set and areas of the main and auxiliary premises of healthcare facilities are determined by the design assignment and in accordance with the current building codes and rules of "Treatment and Preventive Institutions".
10. The structure, layout and equipment of the premises ensure the flow of technological processes and exclude the possibility of crossing flows with various epidemiological hazards.
11. In rural areas, it is planned to place medical outpatient clinics, feldsher-obstetric stations, medical stations in residential and public buildings, taking into account the service of one or several settlements. When placed in residential buildings, it is necessary to provide a separate entrance from the street.
12. Organizations providing outpatient care with a capacity of no more than 150 visits per shift, including those with day hospitals, outpatient surgery centers (with patients staying no more than 5 days) with the exception of those intended for servicing infectious patients and persons suffering from alcohol and drug addiction.
14. The room for magnetic resonance imaging is not located adjacent (horizontally and vertically) to the wards for pregnant women, children and cardiological patients.
15. Reception and ward departments for patients, electro-phototherapy rooms, maternity, operating rooms, dressing rooms, procedural, manipulation, central sterilization departments, workshops, warehouses of poisonous, potent, flammable and combustible liquids are not located in the basement and basement floors of buildings.
It is not allowed to place X-ray rooms directly under the ward and living quarters.
16. Dental facilities are not located in the basement and basement floors of public and residential buildings.
17. Buildings with a height of more than two floors are equipped with elevators. At the same time, elevators should be defined as "conditionally dirty" and "conditionally clean" to prevent the intersection of "dirty" and "clean" flows, transportation of patients, visitors, delivery of food to patients.
18. Infectious diseases, psychiatric, dermatovenerological, anti-tuberculosis departments, which are part of multidisciplinary hospitals, are located in separate buildings.
19. In infectious and anti-tuberculosis departments, a separate entrance (entrance) and a platform for transport disinfection are provided.
20. Buildings of objects are connected to centralized systems of cold, hot water supply and sewerage.
21. In the absence of a centralized water supply system in a settlement, imported water or water from the device of a local system is used, which meets the sanitary and epidemiological requirements for the safety of water bodies.
22. In wards, offices, toilets, procedural, dressing rooms, auxiliary rooms of healthcare facilities, sinks with hot and cold water supply through mixers are installed. In the cabinets where the processing of tools is carried out, a separate sink for washing hands and a sink for processing tools are provided.
23. Preoperative, dressing, delivery rooms, resuscitation rooms, treatment rooms, nurses' posts at the neonatal wards, surgical, gynecological rooms, locks of boxes, semi-boxes, laboratories are equipped with sinks with hot and cold water supply, for objects with centralized water supply with the installation of elbow taps, as well as elbow dispensers with liquid antiseptic soap and antiseptic solutions.
24. In organizations for the protection of motherhood and childhood, surgical and infectious diseases hospitals, at the entrance to each department, elbow dispensers with an antiseptic for hand treatment are installed.
In addition, medical personnel use individual dispensers with an antiseptic for hand treatment.
25. In the wards of newborns, sinks with a wide bowl and hot and cold water supply through faucets for washing children are installed.
26. In the absence of centralized hot water supply in sanitary checkpoints, preoperative and delivery rooms, treatment rooms, dressing rooms, vaccination rooms, sterilization rooms, departments for newborns and children under one year old, sanitary rooms, washing rooms, buffets, dispensing rooms, catering units, laundries, continuous water heaters are installed. actions.
27. When placing an object in non-sewered and partially sewered settlements, a local sewerage system and an export cleaning system are provided. A waterproof container (pit) for receiving wastewater is equipped with a lid, placed in the utility area and cleaned as it fills up to two-thirds of its volume.
28. Cleaning and disinfection of wastewater from facilities is carried out at citywide sewerage treatment facilities. In infectious diseases and anti-tuberculosis hospitals (departments), local treatment facilities are provided.
29. In infectious diseases, tuberculosis, dermatological and venereological departments, washbasins with elbow or contactless taps are installed in locks of boxes, semi-boxes and toilets for staff, and pedal descents for flushing tanks are provided in all toilets.
30. Descent of sewage from the premises of mud procedures and the mud kitchen of the mud bath is carried out through special ladders into the mud sump. In rooms for the preparation of gypsum, a gypsum sedimentation tank is equipped under the washbasin. In rooms for the preparation of gypsum, installation of gypsum sedimentation tanks with a capacity of 0.1 cubic meters (hereinafter - m 3) should be provided under the washbasin.
31. Grease traps are installed at the facilities for the treatment of industrial wastewater from the catering unit.
32. Ladder for sewage in the floor are equipped with a slope in the premises for washing and disinfection of ships, for processing cleaning equipment, the main shops of catering and laundries.
33. Pipes of water supply and sewerage systems are closed with casings along their entire length and are made of a material that is resistant to detergents and disinfectants.
34. Natural lighting is provided in the premises of the facilities.
35. Windows oriented to the southern points of the horizon are equipped with sun protection devices (visors, blinds).
36. Artificial lighting is provided in all rooms.
37. Lighting fixtures placed on the ceilings are equipped with solid (closed) shades.
38. To illuminate the wards (except for children's and psychiatric departments), combined wall lamps (general and local lighting) are used, installed at each bed at a height of 1.7 m from the floor level.
39. Lighting with a second light or only artificial lighting is allowed in the premises of pantries, sanitary facilities, enemas, personal hygiene rooms, showers and wardrobes for staff, thermostatic, microbiological boxes, preoperative and operating rooms, hardware, anesthesia, photo laboratories, rooms, operating rules in which are not natural light required.
40. In the corridors of ward sections (departments), natural lighting is provided through windows in the end walls of buildings and in light pockets (halls). The distance between the light pockets does not exceed 24.0 m and up to the pocket no more than 36.0 m. The corridors of the medical diagnostic and auxiliary units are equipped with end or side lighting.
41. Natural and artificial illumination of the premises of healthcare facilities is determined by the parameters in accordance with Appendix 1
42. Optimal microclimate and air conditions in the premises of healthcare facilities are provided by ventilation, air conditioning and heating systems. Supply and exhaust ventilation systems serve groups of premises in accordance with the cleanliness class.
43. Preventive inspection, repair of ventilation and air conditioning systems of air ducts, cleaning and disinfection of mechanical supply and exhaust ventilation and air conditioning systems is carried out in accordance with the approved schedule of the institution.
44. Buildings are equipped with forced-air and exhaust ventilation systems with artificial induction. In infectious hospitals (departments), including anti-tuberculosis, in each box and semi-box in the ward section, a separate exhaust ventilation system with gravitational induction is installed. In the absence of supply and exhaust ventilation with artificial induction in the infectious departments, natural ventilation is equipped with each box and semi-box equipped with a recirculation-type air disinfection device.
45. In healthcare facilities, by order of the head, a person is appointed responsible for the operation of ventilation and air conditioning systems, the implementation of the schedule for scheduled preventive maintenance of ventilation systems.
46. In all rooms, except for operating rooms, in addition to supply and exhaust ventilation with mechanical stimulation, natural ventilation is provided.
47. Outside air intake for ventilation and air conditioning systems of anti-tuberculosis organizations is carried out from a clean zone at a height of at least 3 m from the ground, emission of at least 2 m.
48. The air supplied to operating rooms, anesthesia, delivery, resuscitation, postoperative wards, intensive care wards, wards for patients with skin burns and oncohematological patients with immunodeficiency is disinfected using bactericidal air filters with a high degree of purification (at least 95 percent ( Further - %).
49. In operating rooms, intensive care wards, resuscitation, maternity, procedural, laboratories, rooms in which the operation of medical equipment is accompanied by the release of harmful substances into the air, provision is made for the installation of local exhausts or the installation of fume hoods. Biosafety cabinets are installed in laboratories that use complex techniques for different staining of preparations.
50. Massage rooms are provided with supply and exhaust ventilation with five air changes per hour.
51. Air conditioning is provided in operating rooms, anesthesia, delivery, postoperative wards, intensive care wards, oncohematological patients, patients with acquired immunodeficiency syndrome, with skin burns, resuscitation rooms, in wards for newborns, infants, premature, injured children. Not available in wards fully equipped with incubators.
52. The use of split systems in rooms requiring compliance with a special anti-epidemic regime is allowed with high efficiency filters.
53. The frequency of air exchange is selected on the basis of calculations to ensure the specified purity and maintain the gas composition of the air. Relative air humidity is not more than 60%, air speed is not more than 0.15 meters per second (hereinafter - m/s).
54. Air ducts, grilles, ventilation chambers are kept clean, without mechanical damage, corrosion, or leaks. The inner surface of the air ducts for supply and exhaust ventilation (air conditioning) excludes the removal of particles of the air duct material and protective coating into the premises. The inner coating is made of a material that does not have sorbent properties. Cleaning and disinfection of ventilation systems is carried out in accordance with the established schedule of the medical institution.
55. General exchange air handling units and local exhaust units are switched on five minutes before the start of work and switched off five minutes after work is completed.
56. In all rooms, air is supplied to the upper zone, to sterile rooms by laminar or slightly turbulent jets at a speed of not more than 0.15 m / s.
57. Equipment for ventilation systems is located in special rooms, separate for supply and exhaust systems, not adjacent vertically and horizontally to doctors' offices, operating rooms, wards, and premises for permanent residence of people.
58. In rooms for exhaust systems, exhaust ventilation with a single air exchange per hour is installed, for supply systems, supply ventilation with a double air exchange.
59. In aseptic rooms, hidden laying of air ducts, pipelines, fittings is carried out.
60. Exhaust ventilation with artificial induction without an organized inflow device is equipped in autoclaves, showers, toilets, sanitary rooms, rooms for dirty linen, temporary storage of waste and pantries for disinfectants.
61. Independent supply and exhaust ventilation and air conditioning systems are provided for the premises: operating units, resuscitation rooms and intensive care wards (separately for septic and aseptic departments), delivery rooms (delivery wards), neonatal wards, oncohematological, dialysis, burn dressing departments, separate ward sections, x-ray rooms.
62. In TB hospitals (departments):
1) the ventilation system provides at least six air exchanges per hour in the wards and twelve in the rooms for performing aerosol-forming procedures (sputum collection room, bronchoscopy), preventing the occurrence of stagnant zones;
2) recuperators of rotary or plate type are not used;
3) exhaust units serving high-risk areas and class 1-2 biological safety cabinets are equipped with devices for air disinfection using HEPA filters or bactericidal ultraviolet irradiation of sufficient intensity;
4) it is not allowed to combine floor networks with one vertical collector;
5) equipment for supplying and removing air is located on opposite walls;
6) all doors of rooms and locks are equipped with devices for automatic closing, doors of wards and boxes (in the lower part of the canvas) with ventilation grilles for air inflow;
7) exhaust ventilation from departments for patients with multidrug resistance of mycobacteria is arranged separately from each ward with gravitational inducement and with the installation of a deflector. Supply ventilation in these compartments is provided with mechanical stimulation and air supply to the corridor;
8) the exhaust air consumption is at least 80 cubic meters per hour (hereinafter - m 3 / hour) per bed. Chambers for patients who do not excrete bacteria are equipped with supply and exhaust ventilation with a supply air flow rate of 80% of the volume of exhaust air;
9) stairwells, elevator shafts, elevator shafts, are equipped with autonomous supply and exhaust ventilation with a predominance of exhaust.
63. Objects are connected to a centralized heating system, or their own heat source is used.
64. Temperature, air exchange rate, cleanliness category in the premises, including the day hospital of healthcare facilities, correspond to the parameters established in Annex 2 to these Sanitary Rules.
65. Permissible levels of bacterial contamination of the indoor air, depending on their functional purpose and cleanliness class of healthcare facilities, correspond to the parameters established in Annex 3 to these Sanitary Rules.
Each department for the treatment of patients with bacterial excretion is zoned in accordance with the epidemiological status. Patients with bacillary excretion with unknown drug-susceptibility status are kept in single rooms until the results of the drug-susceptibility test are available.
122. In the wards, beds are installed in strict accordance with the area.
123. Separate hospitalization of patients with tuberculosis is ensured in the compulsory treatment department, depending on drug susceptibility.
124. Patients with chronic forms of tuberculosis with constant bacillus excretion, who need symptomatic treatment, are subject to isolation in specialized organizations or departments at anti-tuberculosis organizations until the period of abacillation.
125. Separate rooms are allocated in anti-tuberculosis dispensaries for outpatient admission of patients excreting multi- (poly-) resistant strains.
126. In anti-tuberculosis hospitals, the ward filling cycle is observed within fourteen calendar days.
127. Each department of anti-tuberculosis hospitals is divided into "clean" and "dirty" zones, with a lock between them, equipped with air disinfection devices, and a sink for washing hands.
128. Sealed doors are placed around the entire perimeter of the lock, with opening towards the "dirty" zone and equipped with self-closing mechanisms.
129. In each department of the anti-tuberculosis organization, in primary health care institutions, organizations providing outpatient and inpatient care, a room with an area of at least 6 m2 is allocated for collecting sputum, part of which, used for direct collection of sputum, is separated to the entire height of the room by a partition, made of material resistant to detergents and disinfectants.
130. The sputum collection room is equipped with bactericidal shielded irradiators, a handwashing sink with a dispenser with antiseptic soap and an antiseptic solution, containers with a disinfectant solution, containers for clean containers and containers with sputum (bixes, metal boxes with galvanized or stainless steel handles), it is equipped with a local ventilation system with a room air exchange rate of at least 6-12 volumes per hour.
131. In the bacteriological laboratory of anti-tuberculosis dispensaries (departments), three separate sections are provided for performing bacterioscopic examinations:
1) for the preparation and staining of smears;
2) for bacterioscopy;
3) for registration and storage of drugs.
132. Visits to inpatient TB organizations are not allowed.
133. Food intake of patients with the release of mycobacterium tuberculosis is carried out in the wards.
134. Sleeping quarters in rehabilitation centers for children consist of isolated ward sections. The compositions of the sections are additionally equipped with: a playroom, a bedroom, a dressing room with drying cabinets, a pantry room.
The capacity of wards-bedrooms for children does not exceed five places. Two sections are provided with a room for ironing and cleaning clothes, a room for storing things for children.
135. Provide for single and double bedrooms in the rehabilitation center for adults. In the residential building of the center, there will be a treatment room, separate pantries for clean and dirty linen, a utility room, a room for staff on duty and a room for storing cleaning equipment, detergents and disinfectants.
136. The area of therapeutic, orthopedic, surgical, orthodontic dental offices is determined at the rate of 14 m 2 for the main dental chair and 7 m 2 for each additional one. If an additional chair has a universal dental unit, the area increases to 10 m 2 .
137. Dental organizations are located in separate, built-in (built-in-attached) premises located on the ground floors of residential and public buildings with a separate entrance, subject to the requirements of these Sanitary Rules.
138. In dental laboratories, the workplace of a dental technician in the main room is equipped with a special dental table and an electric grinder with local dust extraction. The area of the dental laboratory is not less than 7.0 m 2 , per workplace is not less than 4.0 m 2 . Fume hoods with mechanical impulse are equipped in sterilization and soldering rooms; local dust extraction at the workplaces of dental technicians in the main rooms and at each polishing machine - in the polishing rooms, exhaust hoods in the foundry above the centrifugal casting furnace, above the gas stove - in the soldering room, above the work table in the polymerization room.
139. The area of cabins in the departments (rooms) of electrotherapy, phototherapy and ultrasound therapy shall be equipped at the rate of at least 6 m 2 per one stationary device.
140. The electric sleep cabinet is located in an impassable area, taking into account the orientation of the windows to a quiet area, in soundproof conditions. At the office, a control room with a viewing window for observation is provided.
141. The room for group inhalation is isolated from other rooms.
142. Departments of physiotherapy are subdivided into a "dry" zone (rooms for electro-, light-, heat therapy) and a "wet" zone (hydrotherapy, mud therapy). For procedures for each type of treatment, separate rooms are equipped. It is allowed to place equipment for electrotherapy and phototherapy in the same room.
143. The department of acupuncture provides for: a doctor's office, a treatment room, a rest room for patients and sanitary facilities.
144. For contrast baths, two adjacent pools with dimensions of 1.75 m x 1.75 m and a depth of 1.2 (1.3) m are provided. The transition from one pool to another is carried out by stairs between the pools.
145. Mud treatment hall consists of separate cabins with adjoining shower cabins and two cabins for undressing patients. The entrance for patients is located only through the changing rooms and showers.
146. Electric mud procedures are carried out in a separate isolated room, which is part of the mud treatment rooms.
147. The dimensions of the water surface of therapeutic swimming pools are taken at the rate of 6.0 m 2 per student.
148. The office of hirudotherapy provides the following premises: for waiting for an appointment, a room for dispensing medical procedures, sanitary facilities (a bathroom, a room for storing cleaning equipment). A certificate of conformity is provided for each batch of leeches. Leeches are used once, not re-used. After application, leeches are placed in trays with salt at the end of regurgitation of blood, then they are dumped into a plastic bag, subjected to disinfection, followed by collection in accordance with the accepted medical waste management scheme.
149. A centralized sterilization department is provided for at the facilities.
The premises of the CSO are divided into three zones:
1) dirty (reception of dirty material, sorting, laying in a disinfection-washing machine);
2) clean (unloading the cleaned, disinfected and dried material from the disinfection-washing machine, packing, placing it in the sterilizer). A separate room is provided for the packaging of medical linen;
3) sterile (receipt of sterile material from sterilizers and its storage).
150. Entrance to the premises of clean and sterile zones is carried out through a sanitary checkpoint.
151. Additional premises: expedition (issuance of sterile material), sanitary units and amenity premises for medical personnel.
152. In independently organized medical and dental offices, provide for a washing and sterilization area of at least 6.0 m 2 for up to three workplaces, at least 8.0 m 2 for four or more workplaces.
Sterilizing equipment is installed in accordance with its operating instructions directly at the workplace.
153. When designing a laundry, its productivity is taken at the rate of washing 2.3 kilograms (hereinafter referred to as kg) of dry linen per day per bed in a hospital and 0.4 kg of dry linen per day per visit to an outpatient organization.
154. At health facilities of small capacity, a mini-laundry room (for washing overalls, towels, napkins) is provided, consisting of two rooms (one for collection and washing, the other for drying and ironing).
155. In hospitals, a disinfection department is provided (the composition and areas are determined by the capacity of the hospital). In the absence of their own disinfection department, disinfection of bedding is carried out in organizations that have disinfection chambers.
156. There are three entrances and exits in the pathoanatomical department and the mortuary, two for the separate reception and delivery of corpses, and the third for the use of personnel.
157. The following rooms are provided in the morgue: reception and storage of corpses, sectional (at least two), including a small sectional room for opening and issuing the corpses of people who died from infectious diseases with separate external entrances and access roads, a hall for ritual procedures and the issuance of corpses , storage of fixed material, clothing, coffins and other property, amenity premises for staff.
158. Premises associated with the transportation of corpses inside the building, autopsy, processing and storage of non-fixed sectional material are separated by a vestibule or corridor from the histological laboratory, rooms for doctors and attendants, the museum and amenity rooms.
159. The layout of the doorways and the design of the doors in the premises for storing corpses, the pre-sectional, sectional, room for dressing the corpses and in the mourning hall ensure the free passage of stretchers and the passage of gurneys.
160. In the centers of forensic medical examination, the department for the examination of living persons is located in an isolated compartment, with an independent entrance.
161. A room for storing corpses shall be equipped with refrigeration units providing a temperature of +2 o C - +4 o C, mechanization means for transporting corpses, racks, shelves or special safes. Storage of corpses on the floor is not allowed. When storing corpses on different floors, an elevator is equipped.
162. Cold and hot water is supplied to sectional tables. The sectional table is equipped with a container for collecting and disinfecting wastewater before draining into the sewer. The workplace at the sectional table is equipped with a wooden grate.
163. Sectional tables, wheelchairs, stretchers and other devices for transporting corpses shall be covered with a waterproof material resistant to detergents and disinfectants.
164. The floor is washed daily with hot water and detergents, wall panels, doors are washed as they become dirty, but at least once a week.
165. At least once a month and after the autopsy of corpses that died from infectious diseases, general cleaning is carried out in the premises, using detergents and disinfectants.
166. Work with sectional material is carried out using personal protective equipment (gown, gloves, aprons, glasses). In cases that do not exclude tuberculosis, high-protection masks and respirators are used.
3. Sanitary and epidemiological requirements for the content and
operation of premises and equipment of healthcare facilities
167. Wet cleaning (floor, furniture, equipment, window sills, doors) is carried out at least twice a day (in operating rooms between operations), using detergents and disinfectants approved for use in the Republic of Kazakhstan.
168. Cleaning equipment is marked with an indication of the premises and types of cleaning work, is used strictly for its intended purpose, and is disinfected after use.
169. The outer and inner surface of medical furniture is made of smooth materials resistant to detergents and disinfectants.
170. All technological, sanitary, engineering and other equipment available in the hospital is in good condition.
171. General cleaning of the premises of ward departments, functional rooms and offices with the use of detergents and disinfectants permitted for use in the Republic of Kazakhstan is carried out once a month and according to epidemiological indications, with the treatment of walls, floors, equipment, inventory, lamps.
172. For general cleaning, personnel are provided with overalls, personal protective equipment, marked cleaning equipment and clean rags.
173. After discharge, transfer, death of the patient, in the vacant ward, cleaning is carried out according to the type of final disinfection, bedding (mattresses, pillows, blankets) is subjected to chamber disinfection or treatment with disinfectant solutions.
174. General cleaning of the premises of the operating unit, dressing rooms, delivery rooms, treatment rooms, manipulation rooms, sterilization rooms, intensive care wards, rooms with aseptic regime is carried out once a week with the processing and disinfection of equipment, furniture, inventory.
175. In operating rooms, dressing rooms, delivery rooms, resuscitation wards, wards for newborns, premature babies and children under one year old, treatment rooms, infectious boxes, rooms with aseptic regime after each current cleaning for thirty minutes, after general cleaning for 2 hours, ultraviolet irradiators are turned on . When using other installations for air disinfection, the calculation is carried out in accordance with the operating instructions. Accounting for the hours worked of bactericidal irradiators is recorded in the log in the form, in accordance with Appendix 5 to these Sanitary Rules.
176. Unshielded mobile bactericidal irradiators are installed at the rate of 2.0-2.5 watts (hereinafter - W) per cubic meter of the room. Shielded bactericidal irradiators at the rate of 1.0 W per 1 m 3 of the room are installed at a height of 1.8-2.0 m from the floor, provided that the radiation is not directed at people in the room. In rooms with intense continuous load, ultraviolet recirculators are installed.
177. The switch for the lamps is placed in front of the entrance to the room and is blocked with a light board "Do not enter, the bactericidal irradiator is on!" in the state and Russian languages.
178. The following technologies are used to reduce air contamination to a safe level:
1) exposure to ultraviolet radiation using open and combined bactericidal irradiators used in the absence of people, and closed irradiators, including recirculators, which allow air disinfection in the presence of people;
2) application of bacterial filters.
Irradiators and filters are used in accordance with the instruction manual.
179. Change of linen for patients is carried out once every seven days and as it gets dirty.
Patients with tuberculosis who are on inpatient treatment are provided with clothing for an anti-tuberculosis hospital.
180. Change of bed linen for puerperas is carried out every three days and as it gets dirty.
181. Sterile or disposable underwear is used in operating rooms, delivery rooms, rooms with aseptic regime.
182. Collection of used linen is carried out in a dense special container (oilcloth, polyethylene bags, equipped linen carts). Dismantling of dirty linen in the departments is not carried out.
183. Temporary storage (no more than twelve hours) of dirty linen in departments is carried out in sanitary rooms, specially designated for this purpose premises in closed containers (metal, plastic tanks), which are easily washed and disinfected. To work with dirty linen, personnel are provided with replaceable sanitary clothing.
184. Clean linen is stored in specially allocated rooms on racks, in cabinets on shelves.
185. Washing of linen is carried out in laundries of all forms of ownership, subject to the allocation of special technological lines that exclude the possibility of contact of linen with non-hospital linen. The linen of infectious, purulent-surgical and pathoanatomical departments is disinfected before washing.
186. Transportation of clean and dirty linen is carried out in packaged form in closed labeled containers ("clean", "dirty" linen).
4. Requirements for the collection of medical waste
187. Collection, temporary storage and removal of medical waste is carried out in accordance with the waste management scheme adopted in the healthcare facility, which provides for:
1) qualitative and quantitative composition of generated waste;
2) the procedure for collecting waste;
3) applied methods of disinfection (neutralization) and waste disposal;
4) hygienic training of personnel in the rules of epidemic safety in waste management.
188. In order to organize the system for handling medical waste, the order of the head of the healthcare facility shall appoint:
1) a person who organizes waste management and monitors compliance with the requirements of these sanitary rules, sanitary and epidemiological legislation, waste legislation, who undergoes periodic training on waste management at advanced training courses;
2) persons responsible for waste management in each structural unit, who are instructed in the management of medical waste. Instruction on the handling of medical waste is carried out by the person indicated in the previous paragraph of these sanitary rules.
189. Personnel undergo preliminary and periodic medical examinations. Persons under the age of 18 are not allowed to work with waste.
190. Personnel are provided with overalls and personal protective equipment (dressing gowns, overalls, gloves, masks, respirators, special footwear, aprons, sleeves).
191. Disposable, waterproof bags, bags, metal and plastic containers, containers for collection and safe disposal are used to collect waste.
To collect each class of waste, bags, bags of various colors are used (class A waste - white, B - yellow, C - red, D - black), containers, containers - marking. Metal and plastic containers, containers for collecting hazardous waste are tightly closed.
192. Class A waste is collected in reusable containers and disposable bags.
Disposable bags are placed on special trolleys or inside reusable containers. Waste collection containers and trolleys are marked.
Food waste, in the absence of special dedicated refrigeration equipment, is temporarily stored for no more than twenty-four hours.
193. Class B waste is collected in disposable soft (bags) or hard (non-puncture) containers of yellow color or with yellow marking.
194. Stinging and sharp objects are collected separately from other types of medical waste in non-puncture and waterproof KBSU without prior analysis and disinfection.
If there are special devices for cutting off needles (needle removers, needle destructors, needle cutters, etc.), it is allowed to jointly collect used syringes without needles in disposable soft (bags) with other class B waste that are destroyed at special facilities.
195. To collect organic, liquid waste of class B, disposable moisture-resistant containers with a lid to ensure their sealing are used. Liquid waste is subject to mandatory decontamination (disinfection), after which it is drained into the drainage system.
196. KBSU are filled no more than three fourths of the volume.
Upon filling, the KBSU is tightly closed with a lid and sent to a temporary storage room for medical waste, where it is stored for no more than three days.
197. When organizing waste decontamination using special decontamination facilities, the collection, temporary storage, and transportation of class B waste is carried out without prior decontamination at the places of generation, provided that epidemiological safety is ensured.
198. Class B pathological and organic operational waste (organs, tissues, and so on) are subject to cremation (burning) or burial in cemeteries in a special designated area of the cemetery. Preliminary disinfection of such waste is not required, with the exception of waste from infectious patients.
199. Class B waste is subject to mandatory decontamination (disinfection) by physical methods (thermal, microwave, radiation, and others) at a healthcare facility. The use of chemical methods of disinfection is allowed only for the disinfection of food waste and excretions of patients, as well as in the organization of primary anti-epidemic measures in outbreaks. Export of non-disinfected class B waste outside the territory of the organization is not allowed.
Class B waste is collected in disposable soft packaging (bags) or solid (non-puncture) containers of red color or having a red marking. Used disposable piercing (cutting) instruments and other medical devices (hereinafter referred to as medical devices) are placed in solid (non-piercing) moisture-resistant sealed containers. Class B liquid biological waste after disinfection (disinfection) is discharged into the sewerage system.
200. During the final packaging of wastes of classes B and C for their removal from the unit, disposable containers (bags, KBSU) are marked with the appropriate inscriptions "Waste. Class B / Class B (respectively). Name of the organization, unit, date and surname of the person responsible for the unit for waste collection.
201. Used fluorescent lamps, mercury-containing devices and equipment are collected in labeled containers with tight-fitting black lids. After filling, the containers are tightly closed and stored in a temporary storage room for medical waste. As they accumulate, they are taken out and disposed of by specialized organizations.
Destruction of medicines that are not suitable for use is carried out in accordance with Article 79 of the Code of the Republic of Kazakhstan dated September 18, 2009 "On the health of the people and the healthcare system" (hereinafter referred to as the Code).
202. Class D radioactive medical waste with a short life cycle (solid, liquid and gaseous forms) is stored in appropriate storage facilities until it decays, then it is disposed of as class A medical waste. special polygons (burial grounds).
203. The responsible person of the medical organization keeps a daily record of medical waste in a log in the form, in accordance with Appendix 6 to these Sanitary Rules.
5. Requirements for the temporary storage of medical waste at
healthcare facilities
204. For temporary storage of medical waste of class B, C, D, a separate room is allocated at the healthcare facility.
205. Storage of more than twenty-four hours of food waste, class B non-disinfected waste, is carried out in refrigerators and freezers.
In medical organizations (health centers, offices, medical centers), class B and C wastes are stored in containers temporarily in utility rooms (refrigeration equipment is used for storage for more than 24 hours).
206. Class A waste containers are stored in a special area.
207. Containers are located no closer than 25 m from the healthcare facility. The platform for such containers is fenced on three sides to a height of 1.5 m.
208. A medical waste storage room shall be equipped with exhaust ventilation, refrigeration equipment for biological waste storage, racks, containers for collecting medical waste bags, a sink with hot and cold water supply, and a bactericidal lamp.
209. Class A, B, C wastes are stored at the place of generation for no more than one day (with the exception of KBSU with sharp objects, which are removed as they are filled by three fourths of the volume), in containers on special sites or in rooms for temporary storage of containers with waste no more than three days. Class B biological waste is stored at a temperature not exceeding +5 ° C.
210. After loading medical waste from temporary storage premises onto a vehicle, the premises, used inventory and equipment are disinfected.
211. A room for temporary storage of medical waste is located in close proximity to the exit from the building of the healthcare facility and with access roads for removal.
6. Requirements for the transportation of medical waste
212. When transporting class A medical waste, a motor vehicle designed for the transport of municipal solid waste is used.
213. Discharge of liquid medical waste of classes B and C without neutralization into the sewer network is not allowed.
214. Residues from pathogenic biological agents, used utensils, solid medical waste from the "infectious" zone of laboratories are collected in containers and neutralized in autoclaves or disinfectants.
215. Transportation of class B and C hazardous medical waste is carried out in accordance with the sanitary and epidemiological standardization documents approved by the state body in the field of sanitary and epidemiological welfare of the population in accordance with paragraph 6 of Article 144 of the Code (hereinafter referred to as standardization documents).
216. A vehicle that has a positive sanitary and epidemiological conclusion issued by an agency in the field of sanitary and epidemiological welfare of the population is allowed to transport medical waste.
A motor vehicle for the transportation of medical waste is equipped with a waterproof closed body that is easily disinfected. This vehicle is not used for other purposes.
7. Requirements for the disposal of medical waste
217. Incineration of medical waste of class B, C on the territories of healthcare organizations outside of specialized installations is prohibited.
218. Thermal treatment of waste is carried out by thermal treatment of medical waste at a temperature not lower than +800 - +1500 ° C, or according to the operating temperature of a special installation for the disposal of medical waste.
Incineration of medical waste is provided for in special installations (non-disinfected medical waste of class "B" and all medical waste of class "C"), located taking into account the size of the sanitary protection zone in accordance with the rationing documents.
219. To accommodate the installation, it is provided: a temporary waste storage room with an area of at least 10 m 2, a room for placing the installation with an area of at least 20 m 2 (unless otherwise provided by the manufacturer), equipped with supply and exhaust ventilation with a predominance of exhaust over inflow, with a drain into the system water disposal and water supply, utility rooms (staff room, bathroom, shower room).
For interior decoration, materials are used in accordance with the functional purpose of the premises.
220. Class A waste from the places of generation is delivered to a container located on the territory of a healthcare facility and taken to municipal solid waste landfills as the containers are filled, at least once every three days.
221. The end products of waste disposal are disposed of at landfills for municipal solid waste.
8. Sanitary and epidemiological requirements for the organization
nutrition of patients, to the working conditions of medical personnel at
healthcare facilities
222. The catering facility of a healthcare facility is located in a separate building connected to the main building and other buildings, convenient ground and underground passages, with the exception of infectious diseases departments.
223. When preparing dishes, the flow of the production process is strictly observed. Counter flows of raw materials and finished products are not allowed. Raw materials, food products are stored in compliance with the rules of the commodity neighborhood. Storage of perishable food products in the absence of refrigeration equipment is not allowed.
224. When drawing up the weekly menu layout, the approved nutritional standards are taken into account.
225. When replacing products and dishes, a weekly calculation of the chemical composition and nutritional value (calorie content) of diets is carried out.
226. A daily sample of prepared dishes is left at the catering department. For a daily sample, half a serving of first courses is left, portioned second courses are taken as a whole in an amount of at least 100 grams (hereinafter - gr.), third courses are taken in an amount of at least 200 grams.
Daily samples are stored in lidded labeled (1, 2, 3 dishes) jars at a temperature of +2 o C - +6 o C in a specially designated place in the refrigerator for storing ready-made food. After 24 hours, the daily sample is thrown into food waste. Vessels for storing a daily sample (containers, lids) are boiled for five minutes.
227. For the delivery of prepared food to the buffet departments of the hospital, labeled (for food) thermoses or dishes with closing lids are used. Transportation is carried out using special carts.
228. The distribution of prepared food is carried out by barmaids and nurses on duty of the department in dressing gowns marked "for distributing food." The head nurse controls the distribution of food in accordance with the prescribed diets.
229. When serving, first courses and hot drinks have a temperature not lower than + 75 ° C, second dishes - not lower than +65 ° C, cold dishes and drinks - from +7 ° C to +14 ° C. Until the moment of distribution, the first and second courses are on a hot plate up to two hours from the moment of preparation. It is not allowed to mix food with leftovers from the previous day and food made earlier on the same day.
230. Two rooms are provided in the canteens: for distributing food and washing dishes with the installation of a three-cavity bath.
231. In canteens, backup water heaters are installed with water supply to washing bathtubs, in canteens for infectious diseases, dermatovenerological, anti-tuberculosis departments - sterilizers for processing tableware.
232. Processing of dishes is carried out in the following sequence: mechanical removal of food and washing in the first wash with degreasing agents, rinsing with hot water in the second wash and drying dishes on special shelves, grates.
233. In buffet infectious diseases, dermatovenerological, anti-tuberculosis hospitals (departments), according to epidemiological indications in departments of a different profile:
1) after eating, the dishes are collected in the pantry on a separate table, freed from food debris, disinfected, washed and dried. Disinfection is carried out chemically (solutions of disinfectants, including in a washing machine) or thermally (by boiling, processing in an air sterilizer);
2) food remains are dumped into a special marked tank with a lid and disinfected according to the modes for the corresponding infections by falling asleep with a dry disinfectant in the ratio of one to five (one hour exposure). The table for used dishes, brushes, ruffs are disinfected after each use. Rags for tables and dishes are disinfected by immersion in a disinfectant solution, rinsed and dried.
234. Transfers for patients are transferred in plastic bags indicating the last name, first name of the patient, date of transfer. Lists of permitted (with indication of their quantity) and prohibited products for transfer are posted at the places of reception of transfers, in departments.
235. When providing medical assistance to children under the age of one year, the children's department provides for a room for the preparation and bottling of infant formula. Powdered milk mixtures after opening the package are marked with the date and time of opening and stored under the conditions and terms indicated on the package "storage after opening the package". Dilution of mixtures is carried out using sterile dishes. Ready milk mixtures are transported, applied, stored and distributed according to the manufacturer's documents.
236. Amenity premises for personnel are equipped according to the type of sanitary checkpoint and include: dressing rooms, showers, washrooms, a toilet, a room for storing special clothing and personal protective equipment. Dressing rooms are equipped with separate wardrobes for storing special and personal clothing.
237. To provide food for the staff, it is necessary to provide canteens or buffets; in all departments, a staff room of 12.0 m 2 is allocated, equipped with a refrigerator, devices for heating water and food, and sinks for washing hands. Food is not accepted at the workplace.
238. Medical personnel are provided with three sets of replaceable work clothes: gowns, caps (scarves), and replaceable shoes. Sanitary clothing is changed daily and as it gets dirty. Washing of sanitary clothes is carried out centrally, separately from the linen of patients.
239. Medical personnel providing advisory assistance, technical, administrative and economic personnel performing temporary work in departments of hospitals are provided with a change of clothes and shoes.
9. Sanitary and epidemiological requirements for conditions
sterilization and disinfection of medical devices
appointments at healthcare facilities
240. Disposable medical instruments without prior disinfection are subject to disposal.
241. Reusable medical devices after use are subjected to disinfection, pre-sterilization cleaning, drying, packaging and sterilization.
242. Disinfection of instruments is carried out at the places of use by various methods (boiling, steam, air, chemical).
243. For disinfection of medical devices, two containers are used. In the first container, the instrumentation is washed from the remnants of blood, mucus, and drugs, then it is immersed in the second container for exposure. Detachable products are processed in disassembled form.
When using a disinfectant that has a fixing effect on biological fluids, the instruments are preliminarily washed in a separate container with water, followed by its disinfection.
244. Disinfectant solutions are used in accordance with the terms specified in the instructions (guidelines) for the use of disinfectants approved for use in the Republic of Kazakhstan.
245. Pre-sterilization cleaning of medical devices is carried out manually or mechanically (ultrasound). When the disinfectant contains a detergent component, pre-sterilization cleaning is combined with disinfection.
246. The quality of pre-sterilization treatment is assessed by the absence of positive samples (azopyramic, phenolphthalein) for the residual amount of blood and alkaline components of synthetic detergents. At least 1% of medical devices of each name (at least 3-5 units) of each batch is subject to control.
247. Pre-sterilization cleaning and sterilization of medical devices is carried out in a centralized sterilization department, in the absence of it, in a specially allocated place of health facilities units.
Sterile material is delivered to departments in closed transport containers, special bags, transport elevator.
248. Sterilization of medical devices is carried out by physical (steam, air, infrared, glassperlen), chemical (chemical solutions, gas, plasma) methods, using appropriate sterilizing agents and equipment.
249. Sterilization is carried out according to the modes specified in the instructions for use of a particular agent, in the sterilizer operating manual.
250. Control of the operation of sterilizing equipment is carried out using physical methods (instruments), chemical (thermochemical indicators), biological tests.
251. Persons over eighteen years of age who have passed a medical examination, coursework and have a certificate of passing the technical minimum are allowed to work with sterilizers.
252. In children's departments, toys are washed daily at the end of the working day using a 2% soap and soda solution, rinsed with running water, and dried. Doll clothes are washed and ironed once a week. Soft toys are not used.
253. Bactericidal chambers equipped with ultraviolet lamps are used only for the storage of sterile instruments.
10. Sanitary and epidemiological requirements for the organization and
conducting sanitary and anti-epidemic
(preventive) activities at healthcare facilities
254. In the admissions department, a throat examination, temperature measurement, examination for pediculosis, scabies, and dermatomycosis of incoming patients are carried out, with a note in the medical history. Biological material is being selected according to epidemiological indications for laboratory research.
255. If an infectious disease is suspected, the patient is isolated in the diagnostic ward at the admission department (box) before being transferred to the infectious diseases department (hospital).
256. Sanitary treatment of patients is carried out upon admission to the hospital and a set of clean underwear, pajamas, slippers is issued. Patients in home clothes are allowed to stay in the hospital, with the exception of patients who are being treated in anti-tuberculosis organizations.
257. Sanitary treatment of a woman in labor is carried out after examination according to indications or at the request of a woman.
258. Observe the cyclical filling of wards during hospitalization of patients (within three days).
259. Patients with purulent-septic infection should be hospitalized in the department of purulent surgery, in its absence - in a separate isolated ward.
260. Dressings for patients with purulent discharge are carried out in a septic dressing room, in its absence in an aseptic dressing room, after dressing patients who do not have purulent discharge.
261. Cleaning equipment after use shall be disinfected, dried and further stored in a specially designated place.
262. Laboratory and instrumental studies at healthcare facilities are carried out in accordance with Appendix 7 to these Sanitary Rules.
Natural and artificial lighting of premises
healthcare facilities
Table 1
Premises | work surface and normalization plane of the coefficient of natural light (KEO) and illumination (H-horizontal, V-vertical) and the height of the plane above the floor | Discharge and sub-discharge of visual work |
|
operating room | |||
Preoperative | |||
dressing room | |||
Blood storage room | |||
Gypsum storage and preparation room | |||
Reception rooms for surgeons, obstetricians-gynecologists, traumatologists, pediatricians, infectious disease specialists, dermatologists, allergists, dentists, examination rooms | |||
Reception rooms for other specialists | |||
Dark rooms of ophthalmologists | |||
Functional diagnostic rooms, endoscopic rooms | |||
Fotaria, physiotherapy, physiotherapy, massage rooms | |||
Cabinets: hydrotherapy, therapeutic baths, shower rooms | |||
occupational therapy | |||
For sleep therapy | |||
Rooms for the preparation of paraffin, ozocerite, processing of gaskets, mud regeneration | |||
Day care wards | |||
Premises for storing medicines and dressings | |||
Storage facilities for disinfectants | |||
procedural, manipulative | |||
Offices, posts of nurses | |||
Day care facilities for patients | |||
Dining rooms | |||
Control rooms (control panels), washing, sterilization, sorting and storage rooms, linen | |||
Registry | |||
corridors | |||
Storage rooms for portable equipment | |||
Sanitary facilities: Washrooms, latrines; Smoking; Showers, dressing rooms streetwear |
table 2
natural lighting | Combined lighting | artificial lighting |
||||
KEO, e 11 , % | KEO, e 11 , % | Illumination, lx, at general lighting | Index discomfort M no more | Coefficient ripple - illumination K p,%, no more |
||
At the top or combined lighting | With lateral lighting | At the top or combined lighting | With lateral lighting |
|||
Temperature, air exchange rate, cleanliness category in
premises, including day hospital facilities
health care
Name premises | Estimated air temperature, | multiplicity air exchange in 1 hour |
premises | multiplicity hoods at natural air exchange |
||
Chambers for adult patients, premises for mothers of children branches, premises hypothermia | 80 m 3 /h for 1 bed | |||||
Chambers for tuberculosis patients (adults, children) | 80 m 3 /h for 1 bed | |||||
Chambers for patients with hypothyroidism | 80 m 3 /h for 1 bed | |||||
Chambers for patients with thyrotoxicosis | ||||||
post-op rooms, resuscitation halls, chambers intensive therapy, childbirth boxes, operating rooms, anesthesia rooms, wards for 1-2 beds for burn patients Pressure chambers | By calculation, but not less than ten times | Not allowed |
||||
|
aseptic (20% anesthesia, sterilization) septic |
||||||
Postpartum | Not allowed |
|||||
Chambers for 2-4 beds for burn patients, wards for children | Not allowed |
|||||
Chambers for premature, newborns and injured | calculated, but not | Not allowed |
||||
|
aseptic 100% septic |
||||||
Boxes, semi-boxes, box filters, preboxes |
(submission from corridor | |||||
Chamber sections infectious branches |
for 1 bed | 80 m 3 / h per | ||||
prenatal filters, reception and viewing boxes, viewing dressings, manipulation preoperative rooms for feeding children under the age of 1 year, room for vaccinations | ||||||
Sterilization during operating | 3 - septic branches 3- aseptic branches | |||||
small operating rooms including in daytime hospitals | ||||||
Doctor's offices, offices reflexology day room stay | inflow from corridor | |||||
|
working out in the hall | ||||||
Functional rooms diagnostics, sigmoidoscopy | ||||||
Medical office physical education, mechanotherapy, offices sounding | ||||||
Vestibules, rooms for eating, compressor inhalers, underwear and pantries premises | ||||||
Microwave cabinets and ultrahigh frequency therapy, offices thermotherapy, treatment rooms ultrasound | Not allowed |
|||||
Pantry storage dirty linen, cleaning items disinfectants | ||||||
Permissible levels of bacterial contamination of air
environment of premises depending on their functional purpose
and class of cleanliness of healthcare facilities
Table 1
Cleanliness class | Name of premises | Sanitary and microbiological indicators |
||||||
the total number of microorganisms in 1 m 3 of air (colony forming units (CFU / m 3) | the number of Staphylococcus aureus colonies in 1 m 3 of air (colony forming units (CFU / m 3) | the number of molds and yeasts in 1 dm 3 of air |
||||||
Before work | During work | Before work | During work | Before work | During work |
|||
Extra clean (A) | Operating rooms, maternity rooms, dialysis rooms, aseptic boxes for hematological, burn patients, wards for premature babies, aseptic block of pharmacies, sterilization (clean half), bacteriological laboratory boxes | no more than 200 | No more than 500 | Must not be | Must not be | Must not be | Must not be |
|
Net (B) | Procedural, dressing, preoperative, resuscitation wards and rooms, children's wards, breast milk collection and pasteurization rooms, assistant and filling pharmacies, premises of bacteriological and clinical laboratories intended for research, surgical and dental reception rooms | No more than 500 | No more than 750 | Must not be | Must not be | Must not be | Must not be |
|
Conditionally clean (B) | Chambers of surgical departments, corridors adjacent to operating rooms, delivery rooms, examination rooms, boxes and wards of infectious diseases departments, staff rooms, material rooms, pantries of clean linen | No more than 750 | No more than 1000 | Must not be | No more than 2 | Must not be | Must not be |
|
Permissible levels of infrasound and low-frequency noise
in the premises of healthcare facilities
Table 1
Purpose of premises or territories | Times of Day | Sound pressure levels, dB in octave bands with geometric mean frequencies, hertz (Hz) | Frequency-corrected sound pressure levels on the characteristic "lin" L, dB |
||||||
Chambers of hospitals and sanatoriums, operating hospitals | around the clock | ||||||||
Territories directly adjacent to the buildings of hospitals and sanatoriums | around the clock | ||||||||
Rest areas on the territory of hospitals and sanatoriums | From 7 o'clock to 23 o'clock | ||||||||
Territories directly adjacent to the buildings of polyclinics, outpatient clinics, dispensaries, | around the clock | ||||||||
Permissible levels of noise generated by individual types
medical equipment depending on operating modes (noise
characteristics at a distance of one meter from the equipment)
table 2
Name of products | Permissible sound level L A , dBA | Working mode |
|
Surgical equipment, equipment for artificial lung ventilation, anesthetic-respiratory | Continuous |
||
Laboratory equipment (for clinical, biochemical, bacteriological and other studies) | Continuous |
||
Sterilization and disinfection equipment | Continuous |
||
Physiotherapy, X-ray equipment, devices for functional diagnostics, similar equipment | Re-short-term |
||
Dental and laboratory equipment (centrifuges, thermostats, similar equipment) | Re-short-term |
||
Washing equipment | Re-short-term |
Journal of hours worked for bactericidal irradiators
Journal of daily record of medical waste
For 20___ year
(name of the healthcare facility)
Classes of medical waste | Name of the department of healthcare facilities | The volume of medical waste handed over to the temporary storage facility | Signature of the medical worker who accepted the medical waste | Delivery date | Sent for disposal (disposal) | Signature of person responsible for disposal |
|
Class B, kg | |||||||
Class B, kg | |||||||
|
Thermometers; Germicidal lamps; Fluorescent lamps b) cytostatics: Liquid, l; Solid, Mr. c) drugs: Liquid, l; Solid, Mr. | |||||||
scheduled inspections at healthcare facilities
Table 1
No. p / p | Research types | Research Frequency | |
Temperature, relative humidity, air exchange rate, illumination. | 1 time per year | Chambers for patients, post-operative wards, resuscitation rooms, intensive care wards, delivery boxes, operating and anesthesia rooms, hyperbaric chambers, postnatal wards, wards for premature babies, newborns, boxes, semi-boxes, preboxes, filters, examination, dressing, manipulation, procedural, sterilization , exercise therapy rooms, functional diagnostics rooms, patient reception rooms |
|
Noise level | 1 time per year | Sterilization rooms, laboratories, x-ray rooms, functional diagnostic rooms, dental rooms, physiotherapy rooms, resuscitation rooms, intensive care wards, operating rooms |
|
Electro-magnetic fields | 1 time per year | Laboratories, departments of functional diagnostics, magnetic resonance imaging room, physiotherapy rooms. |
|
2. Radiation control |
|||
Radiation dose rate measurements | at least once a year | At the workplaces of the staff, in the premises and on the territory adjacent to the treatment room |
|
Determining the effective dose of radiation exposure to a patient using an X-ray emitter radiation output meter | at least once a year | For each medical X-ray diagnostic apparatus not equipped with a dose-area product meter (over the entire range of operating values of the anode voltage of the X-ray tube) |
|
3. Sanitary and chemical control |
|||
1 time per year | Physiotherapy rooms |
||
1 time per year | Clinical diagnostic laboratories. |
||
1 time per year | |||
1 time per year | Preoperative, operating, sterilization, wards, procedural, resuscitation, postoperative, burn wards, functional diagnostics departments, clinical diagnostic laboratories, physiotherapy rooms, x-ray rooms |
||
1 time per year | X-ray rooms |
||
1 time per year | Wards, procedural, resuscitation, postoperative, burn wards, clinical diagnostic laboratories, pathoanatomical departments |
||
1 time per year | Resuscitation, postoperative, burn wards, physiotherapy rooms |
||
Preoperative, procedural, dressing, manipulation, clinical diagnostic laboratories, pathoanatomical departments, functional diagnostics departments, buffets - handouts (at least 2 types) |
|||
According to the established frequency of inspections | Centralized sterilization and according to indications |
||
4. Research on products, prepared meals and diets |
|||
1 time per year | Food processing units of organizations |
||
Heat Treatment Efficiency | According to the established frequency of inspections | Ready meals from meat and fish products on the distribution line |
|
Microbiological indicators of food safety | According to the established frequency of inspections | Catering units of organizations, buffet - distributing |
|
5. Water research |
|||
Water for bacteriological and sanitary-chemical indicators | According to indications | Water used for household and drinking purposes (from the distribution network and imported water) |
|
6. Sanitary and bacteriological indicators in assessing the sanitary condition of organizations |
|||
According to the established frequency of inspections | |||
According to the established frequency of inspections | |||
According to the established frequency of inspections | |||
According to the established frequency of inspections | |||
According to the established frequency of inspections | Children's hospitals, departments |
||
*Note: The content of harmful substances in the air of the LPO complies with the hygienic requirements for the air of the working area.
Laboratory and instrumental studies carried out at
production control (self-control) at the facilities
health care
table 2
No. p / p | Research types | Research Frequency | Place of measurement or sampling |
1. Control of physical factors |
|||
Air exchange rate | 1 time per year | Wards for patients, postoperative wards, resuscitation rooms, intensive care wards, delivery boxes, operating and anesthesia rooms, hyperbaric chambers, postnatal wards, wards for premature babies, infants, newborns, boxes, semi-boxes, preboxes, filters, examination, dressing, manipulation, procedural, sterilization rooms, exercise therapy rooms, functional diagnostics rooms, patient reception rooms, storage rooms for the main stock: medicines, dressings and medical products |
|
2. Sanitary and chemical control |
|||
Determination of the concentration of active substances in disinfectants, solutions | 1 time in 3 months | Preoperative, procedural, dressing, manipulation, clinical diagnostic laboratories, pathoanatomical departments, departments of functional diagnostics, buffets - handouts |
|
Quality control of pre-sterilization cleaning (azopyramic, phenolphthalein samples) | at least 1% of medical devices of each name (at least 3-5 units) | After pre-sterilization cleaning of medical devices |
|
3. Sanitary and bacteriological indicators in assessing the sanitary condition of organizations |
|||
Bacteriological examination of swabs from the external environment (for BGKP, pathogenic staphylococcus, opportunistic and pathogenic microflora) | 1 time in 3 months | Medical equipment and inventory, underwear, hands and overalls of personnel, inventory of catering units and distributing |
|
Bacteriological examination of the air environment | 1 time in 3 months | Operating, preoperative, maternity, intensive care wards and rooms, aseptic boxes, sterilization, dressing, manipulation, procedural, dental rooms, wards for premature babies, aseptic block of pharmacies, rooms for bacteriological and clinical laboratories |
|
Sterility test (washouts, material) | 1 time per month | Operating rooms, maternity rooms, resuscitation rooms, sterilization rooms, dressing rooms, manipulation rooms, dental rooms, treatment rooms, aseptic rooms |
|
Bacteriological control of disinfection and sterilization equipment | 1 time in 3 months | Sterilization, disinfection departments |
|
4. Physical and chemical control of equipment |
|||
Monitoring the operation of disinfection and sterilization equipment | Daily at every boot | Sterilization, disinfection departments |
|
On this page you can download for free current version normative legal act on labor protection: rules on labor protection when performing painting work.
More information about the document:
- Approved by order of the Ministry of Labor of Russia dated March 7, 2018 No. 127n (Order 127n)
- Order 127n was registered with the Ministry of Justice of the Russian Federation on 06/07/2018 under the number 51323
- Valid from 09.09.2018
Application area:
The rules on labor protection in the performance of painting work establish state regulatory requirements for labor protection in the organization and conduct of the main production processes and the performance of work on the preparation of painting materials and surfaces for painting, the application of paints and varnishes and powder polymer paints, drying and surface treatment of paint and varnish coatings (hereinafter - painting work).
The requirements of the labor protection rules when performing painting work are mandatory for employers - legal entities, regardless of their organizational and legal forms and individuals (with the exception of employers - individuals who are not individual entrepreneurs), when organizing and carrying out painting work.
MINISTRY OF LABOR AND SOCIAL PROTECTION OF THE RUSSIAN FEDERATION
ORDER
dated March 7, 2018 No. 127n
ABOUT THE APPROVAL OF THE RULES
ON LABOR SAFETY IN CARRYING OUT PAINTING WORKS
Below you can leave your comments (questions) regarding the application of this document in practice.
"On approval of the Instructions for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, the further use of which in medical practice is recognized as inappropriate"
Edition dated 05/07/2015 - Valid from 08/11/2015
Show changes
MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION
ORDER
dated March 28, 2003 N 127
On the approval of the instructions for the destruction of narcotic drugs and psychotropic substances included in the lists of the II and III list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, the further use of which in medical practice is recognized as inappropriate
(As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
In accordance with Decree of the Government of the Russian Federation of June 18, 1999 N 647 "On the procedure for the further use or destruction of narcotic drugs, psychotropic substances and their precursors, as well as tools and equipment that were confiscated or withdrawn from illicit circulation or whose further use was deemed inappropriate "(Collected Legislation of the Russian Federation, 1999, N 27, Art. 3360) I order:
1. Approve the "Instruction for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the List of narcotic drugs, psychotropic substances and their precursors, subject to control in the Russian Federation, the further use of which in medical practice is recognized as inappropriate" (Appendix).
2. To impose control over the implementation of this Order on the Deputy Minister A.V. Katlinsky.
Minister
Yu.L.SHEVCHENKO
INSTRUCTIONS
FOR THE DESTRUCTION OF NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES INCLUDED IN LISTS II AND III OF THE LIST OF NARCOTIC DRUGS, PSYCHOTROPIC SUBSTANCES AND THEIR PRECURSORS SUBJECT TO CONTROL IN THE RUSSIAN FEDERATION, THE FURTHER USE OF WHICH IN NON-INDUSTRIAL USE
(As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
1. GENERAL PROVISIONS
1.1. This Instruction determines the procedure for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation<1>(hereinafter respectively - narcotic drugs and psychotropic substances, the List), the further use of which in medical practice is recognized as inappropriate. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
<1>dated June 30, 1998 N 681 "On Approval of the List of Narcotic Drugs, Psychotropic Substances and Their Precursors Subject to Control in the Russian Federation" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 1998, N 27, Art. 3198; 2004, N 8, Art. 663 ; N 47, item 4666; 2006, N 29, item 3253; 2007, N 28, item 3439; 2009, N 26, item 3183; N 52, item 6752; 2010, N 3, item 314 ; N 17, item 2100; N 24, item 3035; N 28, item 3703; N 31, item 4271; N 45, item 5864; N 50, item 6696, 6720; 2011, N 10, 1390; N 12, item 1635; N 29, item 4466, 4473; N 42, item 5921; N 51, item 7534; 2012, N 10, item 1232; N 11, item 1295; N 19, item 2400; N 22, item 2864; N 37, item 5002; N 41, item 5625; N 48, item 6686; N 49, item 6861; 2013, N 6, item 558 ; N 9, item 953; N 25, item 3159; N 29, item 3962; N 37, item 4706; N 46, item 5943; N 51, item 6869; 2014, N 14, item 1626; N 23, item 2987; N 27, item 3763; N 44, item 6068; N 51, item 7430; 2015, N 1 item 1593). (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
1.2. The destruction of narcotic drugs and psychotropic substances is carried out in cases where:
The expiration date has expired;
A narcotic drug or psychotropic substance has been subjected to chemical or physical impact, which resulted in its unsuitability, excluding the possibility of recovery or processing (including the remains of incompletely used narcotic drugs and psychotropic substances in opened ampoules (vials), the presence of turbidity or discoloration of the solution due to for non-compliance with the storage regime, the presence of damage to the primary packaging); (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Unused drugs are accepted from relatives of deceased patients;
It is difficult to determine whether a drug is a narcotic drug or a psychotropic substance;
A narcotic drug or psychotropic substance confiscated or withdrawn from illegal circulation may not be used for medical, scientific or other purposes. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
1.3. Narcotic drugs and psychotropic substances, the further use of which is recognized as inappropriate by the authorities exercising their seizure or confiscation, are subject to destruction in full, except for cases when these authorities, on the basis of the conclusions of the Ministry of Health of Russia and the Ministry of Industry and Trade of Russia or commissions consisting of representatives of these ministries in the field and the body that carried out the seizure or confiscation, a decision will be made to turn them into state revenue and transfer them for use for the purposes provided for by the legislation of the Russian Federation. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
1.4. The basis for the destruction of narcotic drugs and psychotropic substances confiscated or seized from illicit circulation is a court decision, a decision of an investigator or an employee of an inquiry agency to terminate a criminal case or to refuse to initiate a criminal case, as well as a decision of a body or official to impose an administrative penalty or to terminate proceeding on the case of an administrative offense<*>.
<*>Decree of the Government of the Russian Federation of July 24, 2002 N 557 "On amendments to the Decree of the Government of the Russian Federation of June 18, 1999 N 647" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, July 29, 2002, N 30, art. 3057).
1.5. The destruction of narcotic drugs and psychotropic substances, the further use of which in medical practice is recognized as inappropriate, including those confiscated or withdrawn from illegal circulation, is carried out by state unitary enterprises and state institutions in the manner established by Federal Law of January 8, 1998 N 3-FZ " About narcotic drugs and psychotropic substances<2>and normative legal acts of the Russian Federation adopted in accordance with it. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
<2>Collection of Legislation of the Russian Federation, 1998, N 2, Art. 219; 2002, No. 30, art. 3033; 2003, N 2, art. 167; No. 27, Art. 2700; 2004, N 49, art. 4845; 2005, N 19, art. 1752; 2006, N 43, Art. 4412; No. 44, Art. 4535; 2007, N 30, Art. 3748; N 31, art. 4011; 2008, N 30, art. 3592; No. 48, art. 5515; No. 52, art. 6233; 2009, N 29, art. 3588, 3614; 2010, No. 21, Art. 2525; N 31, art. 4192; 2011, N 1, art. 16, 29; No. 15, Art. 2039; No. 25, Art. 3532; No. 49, art. 7019, 7061; 2012, N Yu, art. 1166; No. 53, art. 7630; 2013, N 23, Art. 2878; No. 30, art. 4057; No. 48, art. 6161.6165; 2014, N 23, art. 2930; 2015, N 6, Art. 885. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
The destruction of narcotic drugs and psychotropic substances (with the exception of the destruction of narcotic drugs and psychotropic substances confiscated or seized from illegal circulation) included in List II of the List may be carried out by municipal unitary enterprises and municipal institutions that are part of the municipal health care system in the manner established by Federal Law of 8 January 1998 N 3-FZ "On Narcotic Drugs and Psychotropic Substances" and the regulatory legal acts of the Russian Federation adopted in accordance with it, when providing medical care to citizens in the Russian Federation by medical organizations of the municipal health care system<3>. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
The destruction of narcotic drugs and psychotropic substances is carried out by the enterprises and institutions specified in paragraphs one and two of this paragraph, if they have a license for the activity of trafficking in narcotic drugs, psychotropic substances and their precursors, the cultivation of narcotic plants, indicating the work (service) for the destruction of narcotic drugs and psychotropic substances<4>. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
<4>Decree of the Government of the Russian Federation of December 22, 2011 N 1085 "On licensing activities for the circulation of narcotic drugs, psychotropic substances and their precursors, the cultivation of narcotic plants" (Sobranie zakonodatelstva Rossiyskoy Federatsii, 2012, N 1, art. 130; N 22, art. 2879; N 37, item 5002). (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
The transfer of narcotic drugs and psychotropic substances subject to destruction to these enterprises and institutions is carried out on the basis of an agreement and an acceptance certificate. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
1.6. For the destruction of narcotic drugs and psychotropic substances at the enterprises and institutions specified in paragraph 1.5 of this Instruction, commissions are created. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
In the event of the destruction of narcotic drugs and psychotropic substances confiscated or withdrawn from illegal circulation, the composition of the commission is formed taking into account the requirements of paragraph 9 of the Decree of the Government of the Russian Federation of June 18, 1999 N 647 "On the procedure for the further use or destruction of narcotic drugs, psychotropic substances and their precursors, plants containing narcotic drugs or psychotropic substances or their precursors, or parts thereof, containing narcotic drugs or psychotropic substances or their precursors, as well as tools and equipment that have been confiscated or withdrawn from illicit circulation or whose further use is deemed inappropriate"<5>. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
<5>Collection of Legislation of the Russian Federation, 1999, N 27, Art. 3360; 2002, No. 30, art. 3057; 2004, N 8, art. 663; No. 47, Art. 4666; 2009, No. 12, Art. 1429; 2011, N 46, art. 6519; No. 51, art. 7526; 2012, N 37, Art. 5002. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Write-off of narcotic drugs and psychotropic substances subject to destruction shall be made no later than the last working day of the calendar month. The destruction of narcotic drugs and psychotropic substances is carried out as they accumulate, but at least once a quarter. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
1.7. The need for the destruction of narcotic drugs and psychotropic substances, with the exception of those confiscated or seized from illegal circulation, is justified by the responsible person appointed by order of the head of the medical organization, pharmacy organization. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
At the same time, an order is issued on the write-off of narcotic drugs and psychotropic substances and their subsequent destruction, which indicates:
The name of narcotic drugs and psychotropic substances, indicating their dosage forms, dosages, packaging and batch numbers;
Net and gross weight of narcotic drugs and psychotropic substances to be written off and destroyed (for narcotic drugs and psychotropic substances registered as medicinal products - gross weight); (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Reasons for decommissioning and destruction;
The person responsible for write-off and destruction;
Place and method of destruction.
Date and number of the contract (in the case of the transfer of narcotic drugs and psychotropic substances for destruction to the enterprises and institutions specified in paragraph 1.5 of this Instruction). (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
1.8. If it is impossible to timely destroy the remains of incompletely used narcotic drugs and psychotropic substances, the tightness of ampoules (vials) is ensured using improvised material (for example, sealing wax, plasticine, wax, paraffin and other material), ampoules (vials) are placed in any packaging container and stored in safe on a separate shelf until destruction (transfer for destruction). (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
For subject-quantitative accounting, write-offs and destruction, the actual volume of residues of narcotic drugs and psychotropic substances in opened ampoules (vials) is calculated arithmetically without taking into account possible losses, including when typing into a syringe and preparing for an injection. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
2. PROCEDURE FOR THE DESTRUCTION OF NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES
2.1. The destruction of narcotic drugs and psychotropic substances is carried out at specially equipped sites (polygons) and (or) in specially prepared premises.
2.2. Personnel performing work on the destruction of narcotic drugs and psychotropic substances must have a permit to work with narcotic drugs and psychotropic substances, know the physicochemical and toxic properties of the substances being destroyed and the chemical reactions that occur during the neutralization and destruction of their chemical reactions.
2.3. Features of the destruction of narcotic drugs and psychotropic substances: (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Liquid dosage forms in glass ampoules, vials are destroyed by crushing the primary packaging, liquid dosage forms in plastic ampoules, syringe tubes are destroyed by crushing the primary packaging, followed by dilution of the resulting content with water in a ratio of 1:100 and draining the resulting solution into the sewer; (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Solid dosage forms containing water-soluble pharmaceutical substances of narcotic drugs and psychotropic substances, after crushing to a powdery state, are diluted with water in a ratio of 1:100 and the resulting suspension (solution) is drained into the sewer; (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Water-soluble pharmaceutical substances are destroyed by diluting with water in a ratio of 1:100 and draining the resulting solution into the sewer; (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Solid dosage forms containing water-insoluble pharmaceutical substances of narcotic drugs and psychotropic substances, soft dosage forms, transdermal dosage forms are destroyed by incineration; (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
Water-insoluble pharmaceutical substances are destroyed by incineration. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
The remains of crushed (crushed) primary packages of narcotic drugs and psychotropic substances are destroyed in accordance with the legislation of the Russian Federation on production and consumption waste<6>or in case of reference to medical waste - in the manner established by the legislation of the Russian Federation in the field of ensuring the sanitary and epidemiological welfare of the population<7>. (As amended by the Order of the Ministry of Health of the Russian Federation of 05/07/2015 N 228n)
2.4. When destroying narcotic drugs and psychotropic substances, the commission draws up an act, which indicates:
Date and place of drawing up the act;
Place of work, position, surname, name, patronymic of persons participating in the destruction;
Reason for destruction;
Information about the name (indicating the type of dosage form, dosage, unit of measure, series) and the amount of the destroyed narcotic drug, psychotropic substance, as well as the container or packaging in which they were stored;
The number of copies of the act is determined by the number of parties involved in the destruction of narcotic drugs and psychotropic substances.
2.5. The transfer for further use of narcotic drugs and psychotropic substances in respect of which a decision has been made to destroy them is prohibited.
| Document's name: | |
| Document Number: | 127 |
| Type of document: | Order of the Ministry of Health of Russia |
| Host body: | Russian Ministry of Health |
| Status: | current |
| Published: | New Pharmacy, N 8, 2003 |
| Acceptance date: | March 28, 2003 |
| Effective start date: | May 25, 2003 |
| Revision date: | 07 May 2015 |
On the approval of the Instructions for the destruction of narcotic drugs and psychotropic substances included in lists II and , further...
MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION
On Approval of the Instruction for the Destruction of Narcotic Drugs and Psychotropic Substances Included in Lists II and III of the List of Narcotic Drugs, Psychotropic Substances and Their Precursors Subject to Control in the Russian Federation
Document as amended by:
(Official Internet portal of legal information www.pravo.gov.ru, 07/31/2015, N 0001201507310005).
____________________________________________________________________
In accordance with the Decree of the Government of the Russian Federation of June 18, 1999 N 647 "On the procedure for the further use or destruction of narcotic drugs, psychotropic substances and their precursors, as well as tools and equipment that were confiscated or withdrawn from illicit circulation or whose further use was deemed inappropriate "(Collected Legislation of the Russian Federation, 1999, N 27, Art. 3360)
I order:
1. Approve the Instructions for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the List of narcotic drugs, psychotropic substances and their precursors, subject to control in the Russian Federation, the further use of which in medical practice is recognized as inappropriate (Appendix).
2. To impose control over the implementation of this order on the Deputy Minister A.V. Katlinsky.
Minister
Y. Shevchenko
Registered
at the Ministry of Justice
Russian Federation
May 5, 2003
registration N 4484
Application. Instructions for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, further use ...
Application
APPROVED
by order of the Ministry
health care
Russian Federation
dated March 28, 2003 N 127
INSTRUCTIONS
for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, the further use of which in medical practice is recognized as inappropriate
1. General Provisions
1.1. This Instruction determines the procedure for the destruction of narcotic drugs and psychotropic substances included in lists II and III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation (hereinafter respectively - narcotic drugs and psychotropic substances, the List), the further use of which in the medical practice is deemed inappropriate.
by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
________________
Decree of the Government of the Russian Federation of June 30, 1998 N 681 "On approval of the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 1998, N 27, art. 3198; 2004, N 8, 663; N 47, item 4666; 2006, N 29, item 3253; 2007, N 28, item 3439; 2009, N 26, item 3183; N 52, item 6752; 2010, N 3, 314; N 17, item 2100; N 24, item 3035; N 28, item 3703; N 31, item 4271; N 45, item 5864; N 50, item 6696, 6720; 2011, No. 10, item 1390; N 12, item 1635; N 29, item 4466, 4473; N 42, item 5921; N 51, item 7534; 2012, N 10, item 1232; N 11, item .1295; N 19, item 2400; N 22, item 2864; N 37, item 5002; N 41, item 5625; N 48, item 6686; N 49, item 6861; 2013, N 6, 558; N 9, art. 953; N 25, art. 3159; N 29, art. 3962; N 37, art. 4706; N 46, art. 5943; N 51, art. 6869; 2014, N 14 , item 1626; N 23, item 2987; N 27, item 3763; N 44, item 6068; N 51, item 7430; 2015, N 11, item 1593).
(The footnote was additionally included from August 11, 2015 by order of the Russian Ministry of Health of May 7, 2015 N 228n)
1.2. The destruction of narcotic drugs and psychotropic substances is carried out in cases where:
- the expiration date has expired;
- a narcotic drug or psychotropic substance has been subjected to chemical or physical impact, resulting in its unsuitability, excluding the possibility of recovery or processing (including the remains of incompletely used narcotic drugs and psychotropic substances in opened ampoules (vials), the presence of turbidity or discoloration of the solution from - for non-compliance with the storage regime, the presence of damage to the primary packaging);
by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
- unused drugs are accepted from relatives of deceased patients;
- it is difficult to determine whether the drug is a narcotic drug or a psychotropic substance;
- a narcotic drug or psychotropic substance confiscated or withdrawn from illegal circulation cannot be used for medical, scientific or other purposes.
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
1.3. Narcotic drugs and psychotropic substances, the further use of which is recognized as inappropriate by the authorities exercising their seizure or confiscation, are subject to destruction in full, except for cases when these authorities, on the basis of the conclusions of the Ministry of Health of Russia and the Ministry of Industry and Trade of Russia or commissions consisting of representatives of these ministries in the field and the body that carried out the seizure or confiscation, a decision will be made to turn them into state revenue and transfer them for use for the purposes provided for by the legislation of the Russian Federation.
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
1.4. The basis for the destruction of narcotic drugs and psychotropic substances confiscated or seized from illicit circulation is a court decision, a decision of an investigator or an employee of an inquiry agency to terminate a criminal case or to refuse to initiate a criminal case, as well as a decision of a body or official to impose an administrative penalty or to terminate proceedings in the case of an administrative offense *.
________________
* Decree of the Government of the Russian Federation of July 24, 2002 N 557 "On amendments to the Decree of the Government of the Russian Federation of June 18, 1999 N 647" (Collected Legislation of the Russian Federation, 2002, N 30, Art. 3057).
1.5. The destruction of narcotic drugs and psychotropic substances, the further use of which in medical practice is recognized as inappropriate, including those confiscated or withdrawn from illegal circulation, is carried out by state unitary enterprises and state institutions in the manner established and adopted in accordance with it by the regulatory legal acts of the Russian Federation.
________________
Collection of Legislation of the Russian Federation, 1998, N 2, Art. 219; 2002, N 30, art. 3033; 2003, N 2, article 167; N 27, art. 2700; 2004, N 49, art. 4845; 2005, N 19, article 1752; 2006, N 43, art. 4412; N 44, art. 4535; 2007, N 30, art. 3748; N 31, art. 4011; 2008, N 30, art. 3592; N 48, art. 5515; N 52, art. 6233; 2009, N 29, art. 3588, 3614; 2010, N 21, article 2525; N 31, art. 4192; 2011, N 1, art.16, 29; N 15, art. 2039; N 25, art. 3532; N 49, art. 7019, 7061; 2012, N 10, article 1166; N 53, art. 7630; 2013, N 23, article 2878; N 30, art. 4057; N 48, art. 6161, 6165; 2014, N 23, article 2930; 2015, N 6, article 885.
The destruction of narcotic drugs and psychotropic substances (with the exception of the destruction of narcotic drugs and psychotropic substances confiscated or seized from illegal circulation) included in List II of the List may be carried out by municipal unitary enterprises and municipal institutions that are part of the municipal health care system in the manner established by Federal Law dated 8 January 1998 N 3-FZ "On Narcotic Drugs and Psychotropic Substances" and the regulatory legal acts of the Russian Federation adopted in accordance with it, when providing medical care to citizens in the Russian Federation by medical organizations of the municipal health care system.
________________
Clause 4 of Article 5 of the Federal Law of January 8, 1998 N 3-FZ "On Narcotic Drugs and Psychotropic Substances".
The destruction of narcotic drugs and psychotropic substances is carried out by the enterprises and institutions specified in paragraphs one and two of this paragraph, if they have a license for the activity of trafficking in narcotic drugs, psychotropic substances and their precursors, the cultivation of narcotic plants, indicating the work (service) for the destruction of narcotic drugs and psychotropic substances.
________________
Decree of the Government of the Russian Federation of December 22, 2011 N 1085 "On licensing activities for the circulation of narcotic drugs, psychotropic substances and their precursors, the cultivation of narcotic plants" (Sobranie Zakonodatelstva Rossiyskoy Federatsii, 2012, N 1, art. 130; N 22, art. 2879; N 37, article 5002).
The transfer of narcotic drugs and psychotropic substances subject to destruction to these enterprises and institutions is carried out on the basis of an agreement and an acceptance certificate.
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
1.6. For the destruction of narcotic drugs and psychotropic substances at the enterprises and institutions specified in paragraph 1.5 of this Instruction, commissions are created.
In the event of the destruction of narcotic drugs and psychotropic substances confiscated or seized from illegal circulation, the composition of the commission is formed taking into account the requirements of paragraph 9 of the Decree of the Government of the Russian Federation of June 18, 1999 N 647 "On the procedure for the further use or destruction of narcotic drugs, psychotropic substances and their precursors, plants containing narcotic drugs or psychotropic substances or their precursors, or parts thereof, containing narcotic drugs or psychotropic substances or their precursors, as well as tools and equipment that have been confiscated or withdrawn from illicit circulation or whose further use is deemed inappropriate" .
________________
Collection of Legislation of the Russian Federation, 1999, N 27, Art. 3360; 2002, N 30, art. 3057; 2004, N 8, article 663; N 47, art. 4666; 2009, N 12, article 1429; 2011, N 46, article 6519; N 51, art. 7526; 2012, N 37, article 5002.
Write-off of narcotic drugs and psychotropic substances subject to destruction shall be made no later than the last working day of the calendar month. The destruction of narcotic drugs and psychotropic substances is carried out as they accumulate, but at least once a quarter.
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
1.7. The need for the destruction of narcotic drugs and psychotropic substances, with the exception of those confiscated or seized from illegal circulation, is justified by the responsible person appointed by order of the head of the medical organization, pharmacy organization.
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
At the same time, an order is issued on the write-off of narcotic drugs and psychotropic substances and their subsequent destruction, which indicates:
- the name of narcotic drugs and psychotropic substances, indicating their dosage forms, dosages, packaging and batch numbers;
- net and gross weight of narcotic drugs and psychotropic substances subject to write-off and destruction (for narcotic drugs and psychotropic substances registered as medicinal products - gross weight);
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
- reasons for decommissioning and destruction;
The person responsible for write-off and destruction;
- place and method of destruction;
- the date and number of the contract (in the case of the transfer of narcotic drugs and psychotropic substances for destruction to the enterprises and institutions specified in paragraph 1.5 of this Instruction).
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
.;
the paragraph became invalid on August 11, 2015 - order of the Ministry of Health of Russia dated May 7, 2015 N 228n;
the paragraph became invalid on August 11, 2015 - order of the Ministry of Health of Russia dated May 7, 2015 N 228n;
the paragraph became invalid on August 11, 2015 - order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
1.8. If it is impossible to timely destroy the remains of incompletely used narcotic drugs and psychotropic substances, the tightness of ampoules (vials) is ensured using improvised material (for example, sealing wax, plasticine, wax, paraffin and other material), ampoules (vials) are placed in any packaging container and stored in safe on a separate shelf until destruction (transfer for destruction).
For subject-quantitative accounting, write-offs and destruction, the actual volume of residues of narcotic drugs and psychotropic substances in opened ampoules (vials) is calculated arithmetically without taking into account possible losses, including when typing into a syringe and preparing for an injection.
(The paragraph is additionally included from August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n)
2. Procedure for the destruction of narcotic drugs and psychotropic substances
2.1. The destruction of narcotic drugs and psychotropic substances is carried out at specially equipped sites (polygons) and (or) in specially prepared premises.
2.2. Personnel performing work on the destruction of narcotic drugs and psychotropic substances must have a permit to work with narcotic drugs and psychotropic substances, know the physicochemical and toxic properties of the substances being destroyed and the chemical reactions that occur during the neutralization and destruction of their chemical reactions.
2.3. Features of the destruction of narcotic drugs and psychotropic substances:
- liquid dosage forms in glass ampoules, vials are destroyed by crushing the primary packaging, liquid dosage forms in plastic ampoules, syringe tubes are destroyed by crushing the primary packaging, followed by dilution of the resulting content with water in a ratio of 1:100 and draining the resulting solution into the sewer;
- solid dosage forms containing water-soluble pharmaceutical substances of narcotic drugs and psychotropic substances, after crushing to a powdery state, are diluted with water in a ratio of 1:100 and the resulting suspension (solution) is drained into the sewer;
- water-soluble pharmaceutical substances are destroyed by diluting with water in a ratio of 1:100 and draining the resulting solution into the sewer;
- solid dosage forms containing water-insoluble pharmaceutical substances of narcotic drugs and psychotropic substances, soft dosage forms, transdermal dosage forms are destroyed by incineration;
- water-insoluble pharmaceutical substances are destroyed by incineration.
The remains of crushed (crushed) primary packages of narcotic drugs and psychotropic substances are destroyed in accordance with the legislation of the Russian Federation on production and consumption waste, or in case of reference to medical waste - in the manner established by the legislation of the Russian Federation in the field of ensuring the sanitary and epidemiological welfare of the population.
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Federal Law No. 89-FZ of June 24, 1998 "On Production and Consumption Waste" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 1998, No. 26, Art. 3009; 2001, No. 1, Art. 21; 2003, No. 2, Art. 167 ; 2004, N 35, item 3607; 2005, N 19, item 1752; 2006, N 1, item 10; N 52, item 5498; 2007, N 46, item 5554; 2008, N 30, item .3616; N 45, article 5142; 2009, N 1, article 17; 2011, N 30, article 4590, 4596; N 45, article 6333; N 48, article 6732; 2012, N 26, article .3446; N 27, article 3587; N 31, article 4317; 2013, N 30, article 4059; N 43, article 5448; N 48, article 6165; 2014, N 30, article 4220, 4262 ; 2015, N 1, art. 11, 38).
(Collected Legislation of the Russian Federation, 2011, N 48, art. 6724; 2012, N 26, art. 3442, 3446; 2013, N 27, art. 3459, 3477; N 30, art. 4038; N 39, art. 4883 ; N 48, item 6165; N 52, item 6951; 2014, N 23, item 2930; N 30, item 4106, 4244, 4247, 4257; N 43, item 5798; N 49, item 6927 , 6928; 2015, N 1, art. 72, 85; N 10, art. 1425).
It is allowed to burn the dosage forms specified in the second and third paragraphs of this clause, and the pharmaceutical substances specified in the fourth paragraph of this clause.
The burning of pharmaceutical substances and dosage forms after dousing with a flammable liquid is carried out under draft (if destruction is carried out indoors), on a fire (if destruction is carried out at a landfill) or in special furnaces. Ash is removed or buried in the manner prescribed by the Federal Law of June 24, 1998 N 89-FZ "On Production and Consumption Waste".
(Paragraph as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.
2.4. When destroying narcotic drugs and psychotropic substances, the commission draws up an act, which indicates:
- date and place of drawing up the act;
Place of work, positions, last names, first names, patronymics of persons participating in the destruction;
- grounds for destruction;
- information about the name (indicating the type of dosage form, dosage, unit of measurement, series) and the amount of the destroyed narcotic drug, psychotropic substance, as well as the container or packaging in which they were stored;
- method of destruction.
The number of copies of the act is determined by the number of parties involved in the destruction of narcotic drugs and psychotropic substances.
2.5. The transfer for further use of narcotic drugs and psychotropic substances in respect of which a decision has been made to destroy them is prohibited.
2.6. The head of the legal entity* bears personal responsibility for exercising control over activities related to the circulation of narcotic drugs and psychotropic substances.
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* (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 1998, N 2, art. 219).
Revision of the document, taking into account
changes and additions prepared
JSC "Kodeks"
| Document's name: | |
| Document Number: | 127 |
| Type of document: | Order of the Ministry of Health of Russia |
| Host body: | Russian Ministry of Health |
| Status: | current |
| Published: | Russian newspaper, N 89, 05/14/2003 Supplement to Rossiyskaya Gazeta, N 27, 2003 Bulletin of normative acts of federal executive bodies, N 33, 18.08.2003 New Pharmacy, N 8, 2003 Healthcare, N 10, 2003 Babayan E.A., Gaevsky A.V., Bardin E.V. Legal aspects of the turnover of narcotic, psychotropic, potent, poisonous substances and their precursors: State and departmental acts. Part III. - M., 2003 |
| Acceptance date: | March 28, 2003 |
| Effective start date: | May 25, 2003 |
| Revision date: | 07 May 2015 |
