[Prevention and treatment of venous thromboembolic complications in orthopedic patients]. / Kompleksnaya profilaktika i lechenie venoznykh tromboembolicheskikh oslozhnenii u patsientov ortopedicheskogo profilya.

OBJECTIVE: To analyze the comprehensive program for prevention of thromboembolic complications in orthopedic patients. MATERIAL AND METHODS: We have analyzed thromboembolic complications in orthopedic patients after surgeries on large joints over the past 5 years (2018-2022). CONCLUSION: A comprehensive approach to prevention and treatment of thromboembolic complications including ultrasound, early surgical prevention of pulmonary embolism can significantly improve postoperative outcomes after joint replacement surgery. Vacuum aspiration retrograde thrombectomy is effective, feasible and safe for acute ilio-femoral venous thrombosis reducing hospital-stay (p=0.0124) and restoring vein patency. Widespread thromboembolic complications, especially for pulmonary embolism in 2022, are likely due to a new coronavirus infection and require careful screening of patients with risk factors with appropriate preventive antithrombotic therapy.

Using experience during the COVID-19 pandemic to ensure the quality of PCR studies.

The issues of laboratory diagnostics have been relevant since the first days of the SARS-CoV-2 pandemic and play a key role in the fight against the spread of a new coronavirus infection. A direct method for the etiological diagnosis of the causative agent of COVID-19 is the detection of SARS-CoV-2 RNA using the nucleic acid amplification method. In the context of a pandemic and the mass appeal of patients for medical care, the issues of ensuring the quality of ongoing molecular biological studies at all stages (preanalytical, analytical, postanalytical) become the most relevant. the results and timing of the study not only affect the diagnosis and treatment tactics of a particular patient, but are also the basis for the introduction of anti-epidemic measures, the adoption of organizational measures. The study is to summarize the experience in creating an effective and reliable system for managing the quality of molecular biological research in a pandemic using the example of a federal budgetary healthcare institution. The experience of the laboratory of a federal healthcare institution in the context of the COVID-19 pandemic was analyzed, errors were analyzed at the preanalytical, analytical and postanalytical stages of PCR studies with the identification of quality criteria, the impact on which significantly leads to quality improvement. The quality control system for PCR studies is based on the development of regulatory documents and instructions for the patient and laboratory staff, registration of all documents in a single information system with access to information from all structural divisions, with the possibility of uploading data to the patient's personal account on the institution's website. Quality indicators of all stages of PCR studies and measures that significantly affect the quality of laboratory studies were identified; Measures have been identified to reduce the turnaround time of a PCR test: distribution of biomaterial flows, optimization of operators' work, purchase of additional equipment, a patient feedback system, and an infection control information system. The obtained results make it possible to create a reliable quality control system, minimize the risk of obtaining erroneous research results, optimizing the work of the clinical diagnostic laboratory and increasing its productivity.

[The opinion of personnel of medical organizations concerning effectiveness of systems of quality management and international certification].

The sociological study was carried out concerning effectiveness of systems of quality management. The technique of questionnaire survey was implemented in medical organizations with functioning systems of quality management and internationally certified systems. The evaluation by medical personnel impact of system of quality management on their activities based on results of using the given management sub-system was selected as a study object. At that, opinion ofpersonnel concerning time dynamics of indices of activity was served as a study subject. The involvement of personnel, alterations in activities of organization, remuneration of labor, effectiveness of treatment from point of view of organizations' staff members were considered. The conclusion was made that personnel of considered organizations has favorable opinion concerning effectiveness of the given systems. Among particular characteristics ofmedical care, 67% of respondents marked improvement of organization of functioning and 36% out of them marked significant improvement. The most of respondents (69%) felt positive dynamics of activities. At that, personnel of organizations mark no increasing of income in 68% of all cases and only 24% of respondents indicated salary increasing. Among negative outcomes of implementation of system of quality management, the respondents focused on increasing of workload. This trend was marked by 53% of personnel and 30% out of them indicated significant increasing of workload. The absence of alterations was marked by 38% of respondents and decreasing of workload was confirmed only by 9% of respondents.

[The quality management in clinical diagnostic laboratory in conditions of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary)].

The article presents experience of clinical diagnostic laboratory of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary) in the area of quality management of medical laboratory services on the basis of evaluation of efficacy and effectiveness of processes. The factors effecting quality of functioning of clinical diagnostic laboratory are indicated. The criteria and indicators of efficacy of work of employees of clinical diagnostic laboratory are presented.