Form of emergency notification in ses. Emergency notification of infectious disease

Registration, accounting and reporting on infectious diseases are regulated by Order of the USSR Ministry of Health dated December 29, 1978 No. 1282. It is this document that contains a list of infectious disorders that are subject to registration in healthcare institutions, regardless of the place of infection of the patient. This list consists of more than 40 items, including:

• plague, cholera, smallpox and fever, leprosy (quarantine);
• skin and venereal diseases (syphilis, gonorrhea, favus);
• tuberculosis;
• salmonella (for example, typhoid fever);
• various foodborne infections caused by bacterial pathogens;
• whooping cough, measles, rubella, diphtheria, chickenpox;
• rabies, foot and mouth disease;
• tropical diseases;
• animal bites and wounds from them;
• atypical reactions to vaccinations, etc.

If they are found or suspected, it is necessary to immediately notify the Sanepidnadzor service. To do this, a doctor or nursing staff fills out an emergency notification of an infectious disease in the form 058y. Also, this document must be compiled by a medical worker of the enterprise, who, during a medical examination or examination of an employee, revealed in him:

• infection with an infection;
• food poisoning;
• acute occupational poisoning;
• suspicion of these diagnoses.

The Ministry of Health also specifies that emergency notifications of dangerous diseases are filled out by doctors who have identified or suspected a source of infection in:

• polyclinics (at a doctor's appointment or when calling at home);
• hospitals;
• maternity hospitals;
• kindergartens, schools and any other educational institutions;
• sanatoriums.

Sample Form 058y (Emergency Notice)

When do I need to send a notice to the SES

After filling out an emergency notification of an infectious disease, it must be sent to the territorial sanitary and epidemiological station within 12 hours, while the place of registration of the outbreak is important, and not the place of residence of the patient.

The resulting data is used by health oversight bodies to:

• preventing the spread of infection and isolating patients;
• control over the development of the disease and the organization of vaccinations;
• improving existing prevention programs;
• statistical accounting.

How to fill out an Infectious Disease Notice

A unified form can be found in Appendix No. 1 to the Order, according to which the following must be indicated in the form:

• diagnosis;
• Full name, passport data of the patient, his age, address and place of work;
• information on anti-epidemic measures taken with the patient and contact persons;
• date and place of hospitalization;
• date and time of the initial notification of the Center for State Sanitary and Epidemiological Surveillance (TSGSEN);
• a list of people in contact with the patient, their contacts;
• FULL NAME. and the signature of the healthcare professional who issued the notice.

Then the message is urgently sent to the Central State Sanitary and Epidemiological Service no later than 12 hours from the moment an infectious disease is detected or suspected. At the same time, it is worth duplicating all the information by phone in order to speed up the process as much as possible. After the work done, it is necessary to register a notification in the journal of infectious patients of registration form No. 60.

Since many diseases have similar symptoms, it is not uncommon for the initial diagnosis to be incorrect. If such an error is found, the doctor must send a second notification with a changed diagnosis, indicating in the first paragraph:

• changed diagnosis;
• the date of its establishment;
• initial diagnosis.

The same rule applies to cases where the diagnosis is specified. For example, if as a result of the analyzes received, new details of the disease and the causes of its occurrence were discovered.

3.4. Take measures to introduce modern methods of laboratory diagnostics in medical organizations.

3.5. Ensure the personal responsibility of officials of medical organizations when carrying out anti-epidemic measures: medical examination and medical observation of persons at risk of infection, when prescribing and observing post-exposure (emergency) prevention schemes, in compliance with the rules for discharge of infectious patients from a hospital and conducting dispensary observation.

3.6. Ensure compliance with the anti-epidemic regime in medical organizations.

Information about changes:

By order of the Ministry of Health of Russia and Rospotrebnadzor dated November 10, 2016 N 857n / 1147, paragraph 3 was supplemented with subparagraph 3.9

Information about changes:

By order of the Ministry of Health of Russia and Rospotrebnadzor dated November 10, 2016 N 857n / 1147, the order was supplemented with paragraph 4

on the organization of preventive measures (including immunization and other specific prevention).

Information about changes:

by order

5. Heads of departments of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the constituent entities of the Russian Federation, railway transport:

5.2. In accordance with the established procedure, inform the Federal Service for Surveillance in the Sphere of Consumer Rights Protection and Human Welfare about emergency situations of a sanitary and epidemiological nature.

5.3. As part of the epidemiological investigation, ensure interaction with interested government authorities.

5.5. To take part in the planned training of specialists of medical organizations on the issues of medical observation, post-exposure (emergency) prevention in epidemic foci, rules for discharge of infectious patients from hospitals, organization of dispensary observation.

5.6. To ensure the participation of specialists exercising epidemiological surveillance in medical consultations to establish final diagnoses in epidemic foci.

5.4. Take timely measures to equip laboratories with modern equipment and introduce new research methods in order to improve the quality of work in the epidemic focus.

Information about changes:

By order of the Ministry of Health of Russia and Rospotrebnadzor dated November 10, 2016 N 857n / 1147, the order was supplemented with paragraph 6

6. The Federal Service for Supervision of Consumer Rights Protection and Human Welfare ensures that the Ministry of Health of the Russian Federation is informed of:

Information about changes:

By order of the Ministry of Health of Russia and Rospotrebnadzor dated November 10, 2016 N 857n / 1147, the paragraph numbering was changed

Health workers of the Minsk Infectious Diseases Clinical Hospital and the City Children's Infectious Diseases Clinical Hospital, as well as polyclinics, must report by phone about an infectious disease (except for chickenpox, rubella, mumps), food poisoning, complications after vaccination to the city center for disinfection and sterilization, where does this information come from 3 times a day are transferred to the district TsGiE. Information about chicken pox, rubella, mumps is transmitted immediately to the district TsGiE. Emergency notices with primary and final diagnoses from infectious diseases hospitals are first delivered by courier to the city center for health and safety, from where they are picked up by employees of the district center for health and safety. Emergency notifications from polyclinics are immediately delivered to the district TsGiE.

An emergency notification number is assigned immediately by phone at the City Center for Disinfection and Sterilization or at the district TsGiE.

When filling out an emergency notice, the patient's last name, first name, patronymic, gender, date of birth, address of the patient's actual residence, name and address of work, study, service, office phone number, date of appearance of the first clinical signs of an infectious disease, food poisoning, complications after vaccination, date of initial request for medical care, date of establishment of the primary/final diagnosis, date of the last visit to the place of work, service, study, date of admission to the health care organization to which health care organization he was hospitalized, diagnosis of the disease primary/final, disease code according to ICD-10 (international classification diseases), the diagnosis was confirmed by laboratory: yes/no.

In addition, the estimated place and date of infection (food poisoning), potential transmission factors, an epidemiological survey is indicated (the intended product is indicated, the date and place of its purchase, storage conditions when this product was consumed), information about the patient's immunization (for diseases, controlled immunologically). The latest information is filled in in organizations that provide outpatient care, have a card of preventive vaccinations for the patient in the form 063 / y. Primary anti-epidemic measures are noted (final disinfection by the employees of the disinfection and sterilization center or residents) and additional information (are there any persons who were in the outbreak and communicated with patients with acute intestinal infections, viral hepatitis and are subject to epidemiological surveillance: 1 persons belonging to the contingents of workers food enterprises and persons equated to them "2 children attending preschool institutions, schools, boarding schools, children's health groups: 3 unorganized children under 2 years old), date and time of transmission by telephone of information about an infectious disease, food poisoning , complications after vaccination in the sanitary-epidemiological organization. From the feldsher-obstetric point, the latest information is additionally transmitted to the healthcare organization, in whose subordination it is. Information about the person who transmitted by telephone information about an infectious disease, food poisoning, complication after vaccination, indicating the position, initials and surname, information about the person who received the above information at the sanitary and epidemiological organization by telephone, indicating the position, initials and surnames.

The emergency notification number matches the registration number assigned after information about an infectious disease, food poisoning, complications after vaccination in the "Journal of infectious diseases, food poisoning, complications after vaccination" in the form No. 060 / y in the sanitary and epidemiological organization (form No. 060 /y is given in Appendix 2 to the order of the Ministry of Health of the Republic of Belarus dated December 22, 2006 No. 976). The registration number is recorded in the emergency notice. The date of posting of this emergency notice and the person who filled out the notice indicating the position and initials, surname and signature are indicated.

Emergency notification of an infectious disease, food poisoning, complications after vaccination and the order of the Ministry of Health of the Republic of Belarus dated 12/22/2006. No. 976 "On approval of the forms of primary medical documentation for the registration of infectious diseases" are attached.

The spread of acute infectious diseases poses a significant threat to the population. In order for preventive measures to be taken in a timely manner, it is necessary to notify the sanitary and epidemiological control authorities as soon as possible. The notification procedure involves filling out an emergency notification of an infectious disease. The article tells who, in what form and in what time frame should draw up this document.

What is provided and in what cases it is filled

The procedure for maintaining documentation for the registration, recording and reporting of infectious diseases is determined by Order of the Ministry of Health of the USSR dated 12/29/1978 N 1282 and is valid to this day. This normative act contains a list of 37 diseases subject to mandatory registration. Their discovery (or suspicion of them) is subject to urgent reporting to the sanitary and epidemiological supervision services. In this case, an emergency notification of an infectious disease is filled out by a doctor or paramedical personnel. The exceptions are acute infections of the upper respiratory tract and influenza.

The need to fill out the document applies to all cases of food and acute occupational poisoning.

Notification form

"Emergency notification of an infectious disease, food, acute, occupational poisoning, unusual reaction to vaccination" is filled out in accordance with the form No.

It should include the following information about the patient:

1. Diagnosis and laboratory confirmation mark (mandatory in case of bacillary dysentery, parapertussis, intestinal coli infection).
2. Age.
3. Residence address.
4. Address of the place of work/study/children's institution.
5. Dates of the disease, initial treatment, diagnosis, subsequent visit to the children's institution of hospitalization.
6. Place of hospitalization.
7. Information about poisoning.
8. Primary anti-epidemic measures.
9. Date and time of the primary alarm in the SES.
10. The date and time the notification was sent.

When filling out the form, special attention should be paid to the description of the anti-epidemic measures taken.

Procedure for filling and sending

The notification is issued by a medical worker of any department, regardless of the situation in which the disease was detected. Form No. 058 / y is also available to medical workers of children's institutions: nurseries, kindergartens, schools, boarding schools, orphanages, orphanages. The drawn up notice is subject to registration in a special journal (recording form No. 60 / y). The established term for sending the document to the territorial center for sanitary and epidemiological control does not exceed 12 hours. Sending a notice does not replace the need for immediate transfer of patient information over the phone. In case of a change in the diagnosis, an emergency notification is sent to the SES again. In this case, paragraph 1 indicates the amended diagnosis, the date of its statement and the initial diagnosis.

Project dossier

Explanatory note

In accordance with subparagraph 11 of part 2 of article 14, parts 2-3 of article 97 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, N 48, art. 6724; 2013, N 48, item 6165; 2014, N 30, item 4257; N 49, item 6927; 2015, N 10, item 1425; N 29, item 4397; 2016, N 1, item 9; N 15, item 2055; N 18, item 2488; N 27, item 4219; 2017, N 15, item 2136) and subparagraphs 5.2.197 and 5.2.199 of the Regulation on the Ministry of Health of the Russian Federation, approved Decree of the Government of the Russian Federation of June 19, 2012 N 608 (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2012, N 26, Art. 3526; 2013, N 16, Art. 1970; N 20, Art. 2477; N 22, Art. 2812; No. 33, article 4386; No. 45, article 5822; 2014, No. 12, article 1296; No. 26, article 3577; No. 30, article 4307; No. 37, article 4969; 2015, No. 2, article 491; N 12, item 1763; N 23, item 3333; 2016, N 2, item 325; N 9, item 1268; N 27, item 4497; N 28, item 4741; N 34, Article 5255, N 49, Article 6922; 2017, N 15, art. 2136), I order:

1. Approve:

2. Recommend the heads of the executive authorities of the constituent entities of the Russian Federation in the field of healthcare, the Federal Medical and Biological Agency, federal state budgetary and state institutions subordinate to the Ministry of Health of the Russian Federation, to ensure:

3. Recognize invalid the order of the Ministry of Health of the USSR of October 4, 1980 N 1030 "On approval of the forms of primary medical documentation of health care institutions" in terms of approval of the forms of primary medical documentation of health care institutions N 058u "Emergency notification of an infectious disease, food, acute occupational poisoning, unusual reaction to vaccination", N 060y "Journal of Infectious Diseases".

4. To impose control over the execution of this order on the Deputy Minister of Health of the Russian Federation S.A. Regional.

Application No. 1

1. Date of completion of the notice: __.__.____. Time __.__.

2. Notification: primary - 1, repeated - 2.

3. Surname, name, patronymic _____________________________________________

____________

4. Gender: male. - 1, female - 2.

5. Date of birth: __.__.____.

6. Address of actual residence: subject of the Russian Federation __________

district ______________ city ____________ town _________________

street ______________ building _______ apartment _______ tel. ___________________

7. Terrain: urban - 1, rural - 2.

8. Place of work (study, children's institution) _____________________________,

8.1. Date of last visit __.__.____.

9. Clinical diagnosis:

The main disease ________________________________________________ ICD-10 code _______.

External cause ________________________________ ICD-10 code _______.

10. The diagnosis was confirmed by laboratory: yes - 1, no - 2.

10.1. The result of the laboratory examination ________________________________

11. Dates: diseases __.__.____.,

initial treatment (identification) __.__.____,

establishing a diagnosis __.__.____,

hospitalization __.__.____.

12. Place of hospitalization ______________________________________________,

12.1. Left at home (reason) _______________________________________________.

13. Outcome of the disease: recovery - 1, improvement - 2, death - 3.

14. Anti-epidemic (preventive) measures taken

_________________________________________________________

__________________________________________________________

__________________________________________________________

____________________________________

15. Reported:

15.1 to the executive authority of the subject of the Russian Federation in the field of healthcare: __.__.____. Time __.__.

15.2. to the department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the constituent entity of the Russian Federation:

Time __.__.

16. Full name of the person who filled out the notice _________________________________.

Application No. 2
to the order of the Ministry of Health of the Russian Federation
dated "___" _____________ 2017 No. ____

3. In paragraph 1 indicate the date and time of filling out the Notice.

4. If the diagnosis or suspicion of it is established for the first time, in paragraph 2 the “primary” mark is made, when the final diagnosis is established, a new Notice is filled in, which is marked as “repeated”.

5. In paragraphs 3-7 indicate the last name, first name, patronymic, gender, date of birth, address of actual residence of the patient (s), locality.

6. In paragraph 8 indicate the place of work, study, children's institution, the date of their last visit.

7. Clinical diagnosis - preliminary or final underlying disease (or suspicion of it) is indicated in paragraph 9 with the ICD-10 code. In the presence of occupational poisoning, an adverse reaction associated with immunization, or exposure to living mechanical forces, in addition to recording the wording and code of the underlying disease or injury, it is mandatory to indicate the wording of the external cause and its code according to ICD-10.

8. In paragraph 10, the presence or absence of laboratory confirmation of the diagnosis is noted; the result of a laboratory examination.

9. In paragraphs 11-12 indicate the dates of the disease, initial treatment (detection), diagnosis, hospitalization, place of hospitalization, or in case of staying at home, the reason is indicated.

10. In paragraph 13 indicate the outcome of the disease, occupational poisoning, adverse reaction associated with immunization, or exposure to living mechanical forces at the end of the episode of medical care.

11. Paragraph 14 includes information on the anti-epidemic (preventive) measures taken.

12. Paragraph 15 includes information (date and time) on the communication of information on the Notice to:

the executive authority of the constituent entity of the Russian Federation in the field of health care within 1 hour by phone, within 10 hours - by e-mail system in compliance with the confidentiality of the transmitted information;

department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the constituent entity of the Russian Federation within 2 hours by phone, within 12 hours - in writing and / or by e-mail system, observing the confidentiality of the transmitted information.

Phones and e-mail addresses are brought to the performers in the prescribed manner.

13. In clause 16 indicate the full name of the person who filled out the Notice.

Application No. 3
to the order of the Ministry of Health of the Russian Federation
dated "___" _____________ 2017 No. ____

Started on "____" ____________ 20 Finished on "______" ____________ 20

f. No. 058-1/u

etc. to the bottom of the page

reversal f. No. 058-1/u

etc. to the bottom of the page

3. In column 2 indicate the date of completion of the Notice.

4. In columns 3-6, the passport data of the patient (s), the address of actual residence are noted.

5. In column 7 indicate the place of work (study, children's institution).

6. In column 8 make a mark "primary" or "repeated" Notice.

7. In columns 9 and 10 indicate the diagnosis of a preliminary or underlying disease and its ICD-10 code. If the diagnosis code is in column 10 of classes I - XVIII, then dashes are placed in columns 11 and 12. If the diagnosis code is in column 10 of the XIX class, then in columns 11 and 12 the wording of the external cause and its code from the XX class of the ICD-10 should be indicated.

8. In column 13, the presence or absence of laboratory confirmation, the result of a laboratory examination, is noted.

9. Columns 14-17 indicate the dates of the disease, initial treatment (detection), diagnosis, hospitalization.

10. In column 18, a note is made about the hospitalization of the patient (s) (place of hospitalization). In the case of leaving the patient (s) at home, the reason is indicated.

11. The column indicates the final diagnosis, the date of its establishment, the outcome of the disease (recovery, improvement, death).

12. In columns 20-23 indicate the date and time of the message to the executive authority of the constituent entity of the Russian Federation in the field of healthcare and the department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the constituent entity of the Russian Federation.

13. In column 24, the surname and initials of the responsible person who filled out the Notice are noted.

14. Box 25 for notes.

Document overview

It is planned to improve the accounting system for primary medical records.

The order in which they are filled in is determined.

An emergency notice is sent to the regional executive authority in the field of healthcare and the Rospotrebnadzor Office for the subject of the Federation.