Thực hành cộng đồng 1 phần 1

HOC Y KHOA THAI NGUYEN

H iii
NHA XUAT BAN Y HOC



TR U O N G DAI HOC Y KHOA THAI NGUYEN

THI/C HflNH CONG DONG 1
■

■

NHA XU AT BAN Y HOC
HA NOI - 2007


CHU BIEN:
PGS. TS. Dam Khai Hoan

BAN BIEN SOAN:
PGS.TS. Dam Khai Hoan
ThS. Nguyen Phifdng Lan
ThS. Nguyen Ngoc Diep
ThS. Nguyen Thu Hien
ThS. Nguyen To Uyen
ThS. Nguyen Van Thoa
ThS. Pham My Hoai
BS. Le Thj Bay
Ths. Ha Huy Phtfdng

LOI Gldl THIEU
Dap ling yeu cau cham soc siic khoe cho nhan dan trong giai doan
hien nay ngiibi bac si khong nhiing co kien thiic toan dien, kha nang
nghien cHu ma ho can nhiing ky nang lam viec trong dieu kien thiic te
cua cong dong. Cong dong 1 la mon hoc trong chiidng trinh dao tao bac
si da khoa he chinh quy cua Triibng Dai hoc Y khoa Thai Nguyen danh
cho sinh vien nam thti nam, nham gop phan dat dtftic yeu cau do. Mon
hoc nay tao ra nhiing cd hoi cho sinh vien thi/c hanh cac kien thiic da hoc
dittfc ti( nam thii nhat den nam thii nam tai y te tuyen huyen va xa.
Dita tren nhu cau thiic te va chiictng trinh giao due diia vao cong
dong ban hanh theo quyet dinh so 272/YK-QD ngay 15 thang 7 nam
2005 cua Triicfng Dai hoc Y Khoa Thai Nguyen - Tap the giang vien
Triibng da bien soan cuon tai lieu hoc tap mon hoc cong dong 1 danh cho
sinh vien.
Trong qua trinh bien soan cuon tai lieu nay ch in g toi da nhan
diidc sii ho trcj cua Chiictng trinh Hop tac Y te Viet Nam-Thuy Dien, Vu
Khoa hoc- Dao tao Bo Y te, y kien dong gop cua cac chuyen gia trong va
ngoai niibc cung nhii cong dong dao tao Dong Hy va Phi. LitOng. Chung
toi tran trong cam On nhiing y kien dong gop quy bau do.
Tuy nhien Ian dau bien soan se khong tranh khoi nhiing khiem
khuyet, rat mong cac dong nghiep va cac ban sinh vien gop y de Ian
xuat ban sau hoan chinh hefn.

c h Ci b i £ n

PGS. TS. Dam Khai Hoan

3

MUC LUC
Hi/dng dan sir dung tai lieu

6

Mon hoc thiic hanh cong dong 1

7

Hifdng dan thi/c hanh cong dong

9

To chifc hoat dong cua TTYT du phong huyen

16

To chifc va quan ly cac chUdng trinh muc tieu y te quoc gia
tai TTYT dir phong huyen

19

To chifc va hoat dong cua khoa DUdc, khoa Xet nghiem,
phong Ke hoach tong hdp tai benh vien huyen.

22

Tang huyet ap

29

Dai thao dudng

33

Hen phe quan

40

Lap so theo doi sifc khoe ba me tai nha

48

Giao due silfc khoe va tu" van cho nguoi mang thai

56

Kham phu khoa

60

Benh tieu chay

67

Nhiem khuan ho hap cap

73

To chirc hoat dong cua tram y te xa

79

Phan ti'ch he thong so sach bao cao tai tram y te xa

88

Thi/c hien cac chuong trinh Sot ret va tiem chung mo rang tai tuyen y te xa

92

Chan doan cong dong

96

Lap ke hoach Truyen thong-Giao due si/c khoe

106

Thi/c hanh Truyen thong - Giao due sifc khoe

114

To c h u t chuyen tuyen trong san phu khoa

120

Hirdng d in sinh vien tif hoc, tii nghien ciru va van dung thirc te mon hoc

126

Hi/dng dan danh gia mon hoc

127

Phu luc

129
5


HlfONG

d An

Sir DUNG
TAI LIEU
•
•

Cuon tai lieu mon hoc cong dong 1 la cuon tai lieu hudng d&n sinh vien thuc
hanh tai cO sd y te. Bo" cuc tai lieu dUdc chia lam hai phan chinh:
Phan 1: Hudng dan thuc hanh cong dong
Phan nay cung cap nhflng thong tin din thiet cho sinh vien de chu&n bi triidc
khi di hoc tai cong dong. Sinh vien doc lan ltfdt cac chu de de on tap lai ly thuyet co
lien quan den mon hoc theo sU hudng dan, chuan bi cac tai lieu va trang thiet bi can
thiet de san sang hoc tai cong dong mot cach chu dong theo ke hoach hudng dan.

Phan 2. Cac bai thuc hanh tai cong dong
Sinh vien nghien ciiu muc tieu bai hoc dtfdc gidi thieu phan dau cua moi bai
de dinh hudng noi dung va phiidng phap nen ap dung cho moi chu de. Doc phan noi
dung se hudng dan tifng btfdc cac hoat dong sinh vien nen lam de dat dtfdc muc tieu
hoc tap. Sau khi hoc xong bai hoc, nhom sinh vien nen thao luan de tra ldi cho cac
cau hoi lUdng gia. Khi co mong muon tU hoc, tu nghien cCfu va van dung thuc te
nhiing kien thiic va ky nang da dat dUdc sinh vien co the tham khao phan hudng
dan cuoi moi bai.
Phan 3: Phu luc
Sinh vien sU dung cac loai tai lieu trong phu luc de thuc hien cac yeu cau dieu
tra va hoan thanh cac loai san pham lien quan den thuc hanh cong dong.
Khi can tim kiem tai lieu tham khao cho mon hoc sinh vien co the xem danh
muc cac tai lieu tham khao d phan cuoi cua tai lieu. Cac loai tai lieu nay co san d
thu vien cua TrUdng va cd sd y te.
Nghien ciiu cuon tai lieu mot cach tong the triidc khi thUc hanh tai cong dong
se giup sinh vien co cach nhin tong quat ve mon hoc va chu dong trong hoc tap. Vi
vav sinh vien nen nghien cilu ky va lap ke hoach chi tiet trUdc khi di thiic hanh tai
y te tuyen huyen va xa.

6


MON HOC
THI/C
HANH CONG
DONG 1
■
■
■
So DVHT:

So tiet

:

4
0/180

Ly thuyet: 0
Ly thuyet: 0

Thiic hanh: 4
Thiic hanh: 180

So Ian thi: 1
Thdi gian thiic hien: Nam thii 5 (Hoc ky IX & X)

MUC TIEU

Sau khi ket thuc mon hoc, sinh vien co kha nang:
1. Mo ta diictc chiic nang, nhiem vu va cac hoat dong cua TTYT dii phong huyen
2. Kham va xii tri diictc mot so benh thiibng gap tai benh vien huyen
3. Phan tich diic/c cac hoat dong chuyen mon cua mot so khoa phong cua benh
vien huyen va TTYT dii phong huyen.
4. Mo ta diictc cac chiictng trinh y te Quoc gia dang thiic hien tai huyen va phan
tich chi tiet hoat dong cua 1 chiictng trinh muc tieu co hieu qua nhat tai huyen.
5. Mo ta diictc nhiem vu va qui trinh quan ly tram y te xa.
6. Mo ta diic/c cach thiic hien chiictng trinh y te Quoc gia tai xa va phan tich chi
tiet viec thiic hien 2 chiiOng trinh muc tieu co hieu qua nhat tai xa.
7. Phan tich dittfc he thong so sach, so lieu va he thong bao cao tai tram y te xa.
8. Phan tich hoat dong va cach dieu hanh y te thon ban tai xa.

9. Tien hanh chan doan cong dong va liia chon diidc van de siic khoe liu tien.
10. Xay di/ng ke hoach va to chiic thiic hien diictc mot buoi TT - GDSK tai cong dong
11. Xii tri diidc cac benh thiibng gap tai tram y te xa.

7


NOI DUNG
So tiet
TT

Ten bai hpc

1

Tap huan cac van de lien quan thuc hanh cong dong 1:

Ly .
thuyet

Thirc
hanh

Muc tieu, noi dung va cac yeu cau hpc tap cua mon hpc
thuc hanh cong dong.

1

0

1

Phifdng phap thi/c hanh ve to chut quan ly va hoat dong
cCia TTYT di/ phong huyen va cac chi tieu hpc tap.

1

0

1

Phifdng phap thirc hanh lam sang tai benh vien huyen va
cac chi tieu hpc tap.

1

0

1

Phifdng phap thuc hanh tai TYT xa va chi tieu hpc tap.

1

0

1

Phifdng phap thuc hanh tai CD va cac chi tieu hpc tap.

1

0

1

Phifdng phap viet bao cao thu hoach.

1

0

1

To chifc hoat dong cCia TTYT dif phong huyen

9

0

9

To chifc va quan ly cac chifdng trinh y te quoc gia tai huyen

9

0

9

To chiic va thuc hien kham va giai quyet cac benh thifdng
gap tai phong kham benh vien huyen

14

0

14

To chifc va thirc hien kham va giai quyet cac benh thifdng
gap tai khoa Noi Nhi Lay

30

0

30

To chirc va thi/c hien kham va giai quyet cac benh thirdng
gap tai khoa Ngoai San

18

0

18

To chirc va hoat dong cua khoa Di/dc, xet nghiem, phong
ke hoach tong hdp.

12

0

12

To chifc hoat dong cua tram y te xa

9

0

9

Giao ban tai tram y te.

6

0

6

Quan ly hoat dong mang lifdi y te thon ban.

6

0

6

Phan tich he thong sd sach bao cao tai tram y te xa

9

0

9

Thuc hien cac chifdng trinh Tiem chung md rong, Sot ret va
Bifdu co tai TYT xa

6

0

6

Chan doan cong dong

27

0

27

Lap ke hoach GDSK de giai quyet 1 van de Stic khoe ifu
tien d cong dong

10

0

10

Tien hanh GDSK de giai quyet 1 van de sifc khoe ifu tien d
cong dong

15

0

15

To chifc chuyen tuyen trong san phu khoa

6

0

6

180

6

Thuc hanh tai TTYT duphdng huyen va BV huyen (2 tuan)

2

•

3

Tong
sd

Thuc hanh tai xa (2 tuan)

Tong cong

8

;

174


HUONG DAN THUC HANH CONG DONG

MUC T liu

Sau khi hoc xong bai nay sinh vien co kha nang:
1. Trinh bay diidc muc tieu, noi dung hoc tap tai cong dong
2. Mo ta diidc cac yeu cau cua deft hoc tap tai cong dong

1. Gidi thieu mon hoc
ThUc hanh cong dong 1 la mon hoc danh cho sinh vien nam thii nam thuc
hanh cac kien thiic va ky nang da tich luy dUdc trong suot qua trinh tu nam thii
nhat den nam thii nam. Muc dich cua mon hoc nay nham tao ra cd hoi cho sinh
vien thuc hanh cac ky nang trong dieu kien thuc te cua y te tuyen huyen va xa.

Ngoai viec thuc hanh cac ky nang c&n thiet day la cd hoi tot cho sinh vien hoc hoi,
quan sat cac van de siic khoe dang xay ra trong thuc te cong dong va cac yeu to" moi
trUdng tu nhien. moi trUdng xa hoi anh hudng den viec cung cap va sii dung cac
dich vu y te cua cong dong.

2. Muc tieu va chu de hoc tap
Muc tieu va noi dung cua mon hoc dUdc chia lam 2 phan chinh: hoc tap ve to
chiic, hoat dong cua y te tuyen huyen; hoc tap ve to chiic, cac hoat dong cua tram y
te xa va cac van de siic khoe xay ra trong cong dong (ph&n nay sinh vien doc phan
chUdng trinh chi tiet mon hoc).

3. Ke hoach thirc hanh tai tuyen huyen
3.1. Lich hoc
Lich hoc cu the cua tiing ngay se do giao vien chu nhiem tai tuyen huyen
thong bao cho nhom sinh vien. Noi dung va thdi lUdng cac chu de nhu sau:
TT
1
2
3
4

Noi dung
To chiic hoat dong cua trung tarn y te du phong huyen
To chirc va quan ly cac chuong trinh muc tieu y te
quoc gia tai huyen
To chiic hoat dong khoa di/dc, Khoa xet nghiem,
phong ke hoach tong hdp benh vien huyen
Thi/c hien kham va giai quyet cac benh thi/dng gap tai
Phong kham benh vien huyen

Thdi gian
(tiet)
9
9
12
14

Can bo
Lanh dao TTYT
du phong huyen
Can bo trung tam
y te di/ phong huyen
Lanh dao benh
vien huyen
Bac si
phong kham

9


5

Thuc hien kham, giai quyet cac benh thi/dng gap khoa
Noi Nhi Lay

30

Bac sT khoa No*
hoac Nhi

6

Thuc hien kham, giai quyet cac benh thtrdng gap khoa
Ngoai San
------—■
Tl/ hoc theo chi tieu

18

Bac sT khoa Ngoai
hoac San

7

CB phong ke
hoach (quan ly ldp)

3.2. Huang dan hoc tai trung tarn y te di/phdng huyen
- To chiic hoat dong trung tarn y te du phong huyen: sinh vien dUdc nghe
lanh dao cua trung tam y te du phong huyen gidi thieu ve to chiic nhan sii, cac
nhiem vu cu the trong nam va cac hoat dong tien hanh thifdng quy. Ket hdp giiia
phan gidi thieu cua lanh dao trung tam, quan sat cac hoat dong dien ra trong thdi
gian thuc hanh va doi chieu vdi ly thuyet da hoc sinh vien tU rut ra nhan xet ve to
chiic va hoat dong cua trung tam den thuc hanh. De hoc tot phan nay tai cong
dong sinh vien can on tap ph&n ly thuyet to chiic hoat dong cua trung tam y te du
phong huyen.
- To chiic va quan ly cac chUdng trinh muc tieu y te quoc gia tai huyen: can
bo phu trach tiing chUdng trinh se gidi thieu vdi sinh vien ve muc tieu, giai phap,
cach chi dao tuyen xa hoat dong va quan ly cac chUdng trinh y te do. De dat diidc
muc tieu khi hoc chu de nay sinh vien can on tap ph&n ly thuyet cua mon hoc cac

chUdng trinh y te quoc gia.

3.3. Huang dan hoc tai benh vien tuyen huyen
- To chiic hoat dong benh vien huyen va cac khoa phong: sinh vien dUdc
nghe lanh dao benh vien gidi thieu ve to chiic nhan sii, cau true cac khoa phong cua
benh vien tuyen huyen, chiic nang va nhiem vu cua benh vien. Ket hdp giiia phan
gidi thieu cua lanh dao benh vien, quan sat cac hoat dong dien ra trong thdi gian
thuc hanh va doi chieu vdi ly thuyet da hoc, sinh vien tu rut ra nhan xet ve to chiic
va hoat dong cua benh vien den thuc hanh. De hoc tot ph&n nay tai cong dong sinh
vien can on tap ph&n ly thuyet to chiic hoat dong benh vien tuyen huyen.
-

Thuc hanh tai cac khoa: giao vien phu trach ldp se chia sinh vien thanh
nhom nho de thuc hanh luan khoa. Tai cac khoa sinh vien se chu dong hoc tap dudi
sU gnip dd cua cac bac si trong tiing khoa. Khi thuc hanh tai cac khoa sinh vien can
hoc ve cac to chiic mot khoa phong (bao gom: Phan cong cong viec cho tiing can bo,
sfip xep khoa phong, trang thiet bi); tham gia kham chiia benh va tu van siic khoe
cho benh nhan; tham gia trUc tai benh vien; nhan xet ve mo hinh benh tat va cach
xii tri tai benh vien huyen trong thdi gian thuc hanh. De dat dUdc muc tieu hoc tap
phan nay sinh vien c&n on tap kien thiic lam sang cua cac chuyen khoa da hoc.

4. Ke hoach thirc hanh tai tram y te xa (TYTX)
4.1. Lich hoc
Lich hoc cu the cua tdng ngay se do tram trUdng (hoac ngUdi dUdc uy quyen)
cua tram y te xa thong bao cho nhom sinh vien. Noi dung va thdi liidng cac chu de
nhu sau:

10

TT
1

Noi dung
To chiic hoat dong cua tram y te xa
Thi/c hien chUdng trinh sot ret, tiem chung md rong
tai tuyen y te xa
He thong sd sach, bao cao tai TYTX
Chan doan cong dong
Lap ke hoach cho mot buoi Truyen thong - Giao due
sifc khoe tai cong dong
Thi/c hanh Truyen thong - Giao due sifc khoe tai
cong dong
To chifc chuyen tuyen trong san phu khoa
Tif hoc theo cac chi tieu

2
3
4
5
6
7

Thdi gian (tiet)
9

Can bo
Can bo TYT X

6

Can bo TYT X

9
27

Can bo TYT X
Can bo TYT X

10

Can bo TYT X

15

Can bo TYT X

6

Can bo TYT X
Tram trudng (quan
ly sinh vien)

4.2. Hudng dan hoc tai tram y te xa
4.2.1. Bifdc 1: gidi thieu va lam quen
Hoat dong gidi thieu va lam quen giiia nhom sinh vien, can bo tram, y te thon
ban va Uy ban nhan dan xa dUdc tien hanh ngay tu: buoi dau tien sinh vien co mat
tai tram y te. Nhom trUdng lien he vdi tram trUdng de gidi thieu ve nhom. Tram
trUdng tram y te se chu tri buoi gidi thieu cac thanh phan lien quan den qua trinh
hoc tap cua sinh vien tai cong dong va cac nguyen tac sinh vien can thuc hien trong

hai tuan lam viec va sinh hoat tai xa.
4.2.2. Bifdc 2: trinh bay ke hoach hoc tap cua nhom vdi tram y te xa
d&n,
thuc
hoat
tiing

Dua tren chUdng trinh thuc hanh da dUdc bo mon Y hoc Cong dong hudng
nhom trUdng nhom sinh vien trinh bay ve muc tieu hoc tap va cac noi dung
hanh tai tram. Tren cd sd thao luan giiia tram y te va nhom sinh vien ve cac
dong can tien hanh, tram trUdng tram y te lap ke hoach day hoc chi tiet cho
ngay trong toan bo ddt thuc te.

4.2.3. Bifdc 3: lam viec, tham gia true tai tram v te va hoc cac noi dung theo yeu cau
-

ThUc hien cac hoat dong theo lich dUdc phan cong.

-

Chu dong hoc tap theo cac noi dung yeu cau

-

Lfing nghe sii trinh bay/gicli thieu cua can bo TYTX

- Thu thap cac thong tin can thiet b&ng cac phUdng phap va cac kenh thong
tin khac nhau.
-

So sanh giiia phan ly thuyet da dUdc hoc va thiic trang cua TYTX

-

Thao luan nhom cac van de theo hUdng dan cua tiing chu de

- Trinh bay vdi giao vien nhiing diem chUa ro de dUdc giai dap (phUdng phap
va noi dung cu the tham khao phan hu6ng dan hoc chi tiet tiing chu de)
-

Van dung nhiing kien thiic, ky nang da cd vao tiing hoan canh cu the tai

tram y te

11


- Tham gia vao cac hoat dong cua Tram: trong thdi gian lam viec tai tram
hoac tham gia trUc, sinh vien pho'i hdp cung cac can bo y te xvt tri cac trUdng hdp
den kham va dieu tri. Moi nguyen tic kham chQa benh phai theo quy dinh cua
tram y te xa.
+ Cong tac kham chCta benh:
.

Kham benh, chan doan, ke ddn

.

Kham thai, kham benh phu khoa

.

Tieu phau ddn gian

.

Sd, cap ctiu vet thUdng

.

Chuyen tuyen

+ Tham gia cac chUdng trinh y te trien khai tai tram
+ Cong tac dUdc:
• Cap phat thuoc
.

Du tru, mua ban thuoc

• Bao quan thuoc
+ Cac chUdng trinh y te trien khai trong xa
.

Tham gia vao chUdng trinh tiem chung mci rong.

.

Tham gia chUOng trinh IMCI

.

Tham gia vao cac chUdng trinh y te khac trien khai tai cong dong

+ Cong tac hanh chinh:
.

Ghi chep so sach, phieu kham ...

.

Thong ke so' lieu de bao cao dinh ky

.

Giao ban cung tram y te

+ Cong tac ngoai tram:
• Dieu tra
.

Giao due siic khoe

.

Kham, theo ddi benh nhan tai cong dong

4.2.4. Bifdc 4: hoan thanh bao cao, cac loai giay td va thu tuc lien quan.

12

-

Phieu dieu tra tai tram y te.

-

Cac phieu dieu tra ho gia dinh (moi ngUdi 15 phieu), dien ket qua vao bang.

-

Bang ke hoach giao due siic khoe va ket qua

-

Bai tuyen truyen giao due siic khoe

-

Bao cao ket qua ddt thuc te


4.3. Hudng dan hoc tai cong dong
4.3.1. Thu thap thong tin tif cong dong
Sinh vien sii dung cong cu dieu tra do bo mon hudng dan de thu thap thong
tin c&n thiet tut ho gia dinh. Sinh vien trinh bay cach chon mau vdi can bo y te cua
TYTX, can bo tram se hudng dan sinh vien cach tiep can vdi ho gia dinh. Viec lam
sach so lieu can dUdc thiic hien ngay tai cong dong.
Ngoai viec thu thap nhiing thong tin can thiet theo cong cu da hudng dan,
sinh vien can tim hieu cac phong tuc tap quan, cac yeu to cd anh hudng den siic
khoe cua cong dong nh&m cd day du thong tin can thiet cho xac dinh van de siic

khoe va lua chon van de siic khoe Uu tien.
4.3.2. Truyen thong giao due sifc khoe
Theo ke hoach hoc tap moi nhom sinh vien c&n to chiic mot buoi truyen thong
giao due siic khoe cho cong dong. Chu de truyen thong la van de Uu tien c&n giai
quyet d cong dong. Sinh vien can chu dong lien he vdi cong dong de to chiic buoi
truyen thong, bao gom: lien he vdi ban nganh doan the cd lien quan vdi chu de
truyen thong, mdi doi tUdng dich, lien he dia diem, chuan bi cd sd vat chat can
thiet...(sinh vien nghien ciiu bai ke hoach truyen thong giao due siic khoe).
4.3.3. Tham gia vao cac hoat dong cua dia phi/ong
Khi thuc hanh tai cong dong, ngoai viec thiic hien cac nhiem vu chuyen mon
sinh vien nen tham gia vao cac hoat dong cua dia phUdng nham tao moi quan he
v6i cong dong va tim kiem cd hoi de hieu phong tuc tap quan cua dia phUdng.

5. Noi quy hpc tai cong dong
Sinh vien TrUdng Dai hoc Y khoa Thai Nguyen thuc hanh tai cong dong phai
tuan theo cac quy dinh sau:
1. Sinh vien phai thiic hien tot moi noi quy, quy dinh cua dia phUdng va cd sd
thiic hanh.
2. Sinh vien phai khiem ton hoc tap, le do trong quan he vdi can bo, nhan vien
y te va nhan dan dia phUdng.
3. Sinh vien phai ton trong phong tuc tap quan cua dia phUdng.
4. Nghiem cam sinh vien tham gia hoat dong cac te nan xa hoi.
5. Sinh vien phai chiu sii quan ly cua can bo y te cd sd.
6. Sinh vien khong dUdc vang mat trong cac ddt thiic hanh, moi sii vang mat
phai cd giay phep va dUdc sii dong y cua can bo y te cd sd.
7. Ket thuc ddt hoc tap, moi sinh vien phai hoan thanh cac chi tieu va ban bao
cao ket qua ddt hoc tap theo quy dinh cua nha trUdng.
8. Moi sinh vien phai co trach nhiem thiic hien tot ban noi quy nay

13

6. Chuan bj
6.1. Kien thiic lien quan
Sinh vien c&n nghien ciiu lai cac tai lieu co lien quan den nhiing noi dung sau:
-

Nhiem vu cua tram y te xa/ phUdng

-

Quan ly y te

-

Lap ke hoach y te

-

Giam sat hoat dong y te

-

Danh gia hoat dong y te

-

Quan ly nhan luc y te

-

Quan cd sd vat chat va trang thiet bi y te

-

Nguon kinh phi y te

-

Quan ly thong tin y te

-

Cac chUdng trinh y te quoc gia: muc tieu, giai phap.

-

Quan ly thong tin y te

- Quy che ve thong ke y te (ban hanh kern theo quyet dinh cua Bo trUdng Bo
Y Te so 379/2002/QD-BYT ngay 8/2/2002)
-

Nhiem vu y te thon ban

-

Ky nang giao tiep

- On tap cac phan ly thuyet lam sang co lien quan den kham, dieu tri va xii

tri benh nhan tai tuyen y te cd sd.

6.2. Phwong tien di lai
Viec di chuyen tCf trUdng den cd sd y te do TrUdng to chiic, sinh vien can chu
dong trong viec chuan bi phUdng tien di chuyen tii cd sd y te den nha dan.

6.3. Vat dung ca nhan can thiet
Quan ao, tu trang, do dung ca nhan...

7. Cac loai tai lieu can nop cho bo mon sau khi ket thuc dot thirc hanh
7.1. Tap the nhom

14

-

Phieu dieu tra tai tram y te xa

-

Phieu dieu tra 10 chuan y te xa

-

Cac phieu dieu tra ho gia dinh (moi ngUdi 10 phieu), cung cac bang trong.

-

Ban ke hoach Truyen thong- Giao due siic khoe

-

Bai Truyen thong- Giao due siic khoe

-

Bao cao thu hoach cua nhom theo mau hu6ng dan


7.2. Ca nhan
-

Bang cham diem cho ca nhan cua Trung tam y te

-

Bang cham diem cho ca nhan cua can bo Tram y te

8. Nhumg diem can liru y
Trong qua trinh thuc hanh tai tram y te, sinh vien tham khao phan phan
cong trach nhiem cua tting ben lien quan den qua trinh thuc hanh (Y te tuyen
huyen, tram y te. Uy ban nhan dan, Y te thon ban, giao vien TrUdng dai hoc Y
khoa) de phoi hop co hieu qua. Nhiem vu cua cac ben lien quan nhu sau:
-

Can bo trung tam y te huyen va tram y te xa.

+ Quan ly sinh vien
+ Hudng dan sinh vien thuc hanh theo ke hoach cua trUdng
+ LUdng gia qua trinh thuc hanh.

-

Can bo giang bo mon Y hoc cong dong, Y hoc xa hoi va Dich te.

+ Chuan bi cong dong, xay dung ke hoach.
+ Tap huan cho sinh vien.
+ Giam sat trong qua trinh hoc tap.
+ LUdng gia khi ket thuc ddt thuc hanh cong dong
-

Can bo cac bo mon lam sang:

+ Giao chi tieu thuc hanh
+ Tap huan cho sinh vien.
+ Giam sat trong qua trinh hoc tap.
Phu luc kem theo:
1. Phieu dieu tra 10 chuan quoc gia y te xa
2. Phieu dieu tra tai tram y te xa
3. Phieu dieu tra ho gia dinh
4. Bang trong
5. M&u bao cao
6. Phieu cham diem cua y te tuyen huyen
7. Phieu cham diem cua tram y te xa

15


TO CHUTC HOAT DONG CUA TRUNG TAM Y TE DU PHONG HUYEN

MUC TIEU

Sau khi hoc xong bai nay, sinh vien co kha nang:
1. Nhan xet diidc thiic trang to chiic hoat dong cua Trung tam Y te dii phong
huyen ncfi sinh vien den thiic tap.

1. Bifdc 1: Gidi thieu Trung tam Y te dii phong huyen ndi sinh vien thiic te
-

Vi tri cua trung tam: la ddn vi sii nghiep triic thuoc Sd y te, chiu sii quan ly

toan dien cua Giam doc Sd Y te, sii quan ly nha nUdc cua Uy ban nhan dan huyen
va sii chi dao ve chuyen mon, ky thuat cua cac Trung tam thuoc he dii phong, cac
Trung tam chuyen nganh tinh.
-

Cd cau to chiic cua Trung tam Y te dii phong huyen:

+ Bo may lanh dao: Giam doc, Pho Giam doc. Chiic trach nhiem vu cu the
cua cac can bo lanh dao Trung tam.
+ Bo may giup viec Giam doc trung tam: cac phong chiic nang, giup viec.
+ Cac khoa chuyen mon cua trung tam.
-

Chile nang, nhiem vu va hoat dong cua Trung tam Y te dii phong huyen:

+ Xay diing ke hoach trien khai thiic hien cac nhiem vu chuyen mon ky thuat
tren dia ban huyen.
+ To chiic trien khai thiic hien cac hoat dong chuyen mon, ky thuat ve phong,
chong dich benh, HIV/AIDS, cac benh xa hoi, dinh dudng cong dong, an
toan ve sinh thiic pham, truyen thong giao due siic khoe,...

+ Hudng dan va giam sat chuyen mon, ky thuat ve cac hoat dong thuoc linh
viic phu trach doi vdi cac tram y te xa/phUdng, thi tran, cac cd sd y te tren
dia ban.
+ Tham gia dao tao, dao tao lai, tap huan, boi diidng kien thiic ve chuyen
mon nghiep vu cho can bo y te xa, nhan vien y te thon ban,...
+ Quan ly va to chiic trien khai thiic hien cac dii an thuoc chUdng trinh muc
tieu y te quoc gia.
+ Quan ly can bo , che do chinh sach, quan ly tai chinh, tai san v.v..

16


2. Bifdc 2: tham quan Trung tam Y te du phong huyen
Cac phong lam viec cua Ban Giam doc;
Cac phong chiic nang giup viec cho Ban Giam doc: phong hanh chinh tong
hdp, phong truyen thong giao due siic khoe;
Cac khoa chuyen mon nhU:
-

Khoa Y te cong cong;

-

Khoa Cham soc siic khoe sinh san;

-

Khoa Kiem soat dich, benh, HIV/AIDS;

-

Khoa An toan ve sinh thiic pham;

-

Khoa xet nghiem, v.v...

Sinh vien can chu y tim hieu ve cO cau to chiic, hoat dong cu the cua cac
phong ban nhU:
-

Co sd vat chat: so" phong lam viec, cac trang thiet bi,...

-

Nguon nhan luc cd bao nhieu ngUdi, du hay thieu?

-

Chiic nang nhiem vu cu the cua tiing thanh vien?

- Ai phu trach chUdng trinh/hoat dong y te nao? Chiu sii dieu hanh, giam sat
cua ai?
- Tinh hinh thiic hien nhiem vu? Nhiing kho khan thuan ldi khi thiic hien
nhiem vu dUdc giao? Cach khac phuc kho khan de hoan thanh nhiem vu?
- Sinh vien xem, doc cac so sach, bieu mau bao cao thong ke va quan sat
cach ghi chep, lam bao cao so sach.
Trong khi can bo trung tam hudng dan, sinh vien can chu y quan sat, Mng
nghe, ghi chep lai de cd dUdc nhiing thong tin can thiet.

3. Bifdc 3: thao luan nhom
Sinh vien thao luan nhom theo 2 noi dung sau:
1. Thiic trang cO cau to chiic cua Trung tam y te dii phong huyen.
2. Hoat dong cua Trung tam Y te dii phong huyen.
Sinh vien thao luan, so sanh giiia ly thuyet va thiic te de dua ra nhiing nhan
xet cua minh ve thiic trang cd cau to chiic, sii phan cong cong viec, viec thiic hien
cac nhiem vu va hoat dong cua Trung tam Y te dii phong huyen. Tim ra nhiing Uu
diem can phat huy, nhiing bat cap can khac phuc de thiic hien tot cong tac du
phong tai tuyen y te huyen trong cham soc va bao ve siic khoe nhan dan.

TL/Ll/ONG GIA
1.

Cong cu ludng gia

1.
Thiic trang cd cau to chiic cua Trung tam y te du phong huyen co phu hdp
vdi quy dinh cua he thong To chiic y te Viet Nam khong?

17


2. Su phan cong cong viec cho cac thanh vien d cac phong ban. khoa co phu
hdp vdi chuc nang va nhiem vu cua ho khong? Tai sao?
3. Trung tam y te dii phong huyen co hoan thanh tot nhiem vu khong? Nhiing
nhiem vu nao chua hoan thanh?
4. Nhung kho khan va thuan ldi trong qua trinh thiic hien nhiem vu cua
Trung tam y te du phong huyen? Cach k h ic phuc kho khan de hoan thanh nhiem
vu diidc giao?

2. Hirdng dan sinh vien tir lifdng gia
Qua ket qua thao luan nhom . cac y kien thao luan dUdc thong nhat ngay
sau buoi hoc chinh la phan dap an cho cac cau hoi tu ludng gia cua sinh vien.
Trinh bay nhiing diem chua r5, con thac mac vdi can bo Trung tam hoac giao
vien de dUdc giai dap.

HUCING DAN TU HOC, TU NGHIEN CLfU, VAN DUNG THUC TE
1. PhUdng phap hoc
Sinh vien doc tai lieu phan ly thuyet cd lien quan den cac noi dung hoc tap
trong bai giang. danh dau nhiing diem con kho hieu hoac chua ro de thao luan vdi
cac ban sinh vien khac trong khi hoc hoac hoi giao vien de dUdc giai dap.
Sinh vien chu dong hoc hoi va de nghi vdi can bo Trung tam giup dd khi din thiet.

2. Van dung thuc te
Qua thuc hanh tai Trung tam y te dii phong huyen, sinh vien tham quan tim
hieu ve thuc trang to chiic hoat dong cua Trung tam dii phong huyen, tii dd sinh
vien cd kha nang doi chieu so sanh giiia nhiing kien thiic dUdc hoc trong bai ly
thuyet vdi thiic te dUdc chiing kien. dua ra nhiing nhan xet ve thiic trang cd cau to
chiic, chiic nang. nhiem vu va hoat dong cua Trung tam y te dii phong huyen co phu
hdp hay khong phu hdp vdi he thong y te Viet Nam hien nay.

3. Tai lieu tham khao
1. Bo Y te - UNICEF. Quan ly cham soc siic khoe ban d&u d tuyen y te cd sd.
Nha xuat ban y hoc. Ha Noi. 2000.
2. Bo Y te - To chiic Y te The gidi. Du an phat trien he thong y te - Quan ly y
te. Nha xuat ban y hoc. Ha Noi. 2001.
3. Bo mon Y xa hoi hoc. To chiic va quan ly y te. TrUdng Dai hoc Y khoa Thai
Nguyen. 2006.
4. TrUdng Dai hoc Y khoa Thai Nguyen. Tai lieu day/hoc mon hoc Thiic hanh
cong dong 1. 2006.

18


TO CHljrc VA QUAN LY CAC CHUtfNG TRINH MUC TIEU
Y TE QUOC GIA TAI TRUNG TAM Y TE DU PHONG HUYEN

MUC TIEU
Sau khi hoc xong bai nay, sinh vien co kha nang:
1. Liet ke dittic ten cac chitting trinh muc tieu y te quoc gia dang trien khai tai
Trung tam Y te dtf phong huyen ntii sinh vien den thiic tap.
2. Nhan xet dittic thiic trang to chiic chi dao, quan ly mot chitting trinh muc tieu
y te quoc gia cu the tai Trung tam Y te dii phong huyen.

1. Bifdc 1: gidi thieu ve to chiic va quan ly cac chUdng trinh muc tieu y te quoc gia
tai Trung tam Y te dii phong huyen:
- Cac chiidng trinh muc tieu y te quoc gia hien dang dUdc trien khai tai
Trung tam Y te dii phong huyen ndi sinh vien dang thiic tap.
- Sii phan cong can bo phu trach cac chifdng trinh cu the, chiic nang nhiem
vu cua cac can bo y te trong viec to chiic trien khai va quan ly cac chiidng trinh muc
tieu y te quoc gia.

2. Bifdc 2: kien tap thiic hanh to chiic va quan ly cac chiidng trinh muc tieu y te
quoc gia tai cac khoa chuyen mon cua Trung tam.
-

Chiidng trinh phong chong sot ret.

-

Chiidng trinh phong chong cac roi loan do thieu iot.

-

Chiidng trinh tiem chung md rong.

-

Chiidng trinh phong chong phong.

-

Chiidng trinh phong chong lao.

-

Chifdng trinh bao ve siic khoe tam than cong dong.

-

Chiidng trinh phong chong suy dinh diidng tre em.

-

Chiidng trinh bao dam chat lifdng, ve sinh an toan thiic ph&m.

-

Chiidng trinh phong chong HIV/AIDS.

-

Chu'dng trinh phong chong sot xuat huyet.

Chu y tim hieu thiic te cac biidc to chiic chi dao hoat dong va cong tac quan ly
dac biet la cong tac giam sat, danh gia cac chifdng trinh muc tieu y te quoc gia cua
tuyen v te huyen doi vdi tuyen y te xa.

19


Tuy theo tiing chiidng trinh y te cu the ma co cac noi dung chi tiet, thong
thifdng de to chiic chi dao thiic hien va quan ly mot chiidng trinh y te quoc gia tai
tuyen y te huyen can thiic hien tot mot so" noi dung chinh sau:
+ Xay diing ke hoach, thanh lap Ban chi dao chiidng trinh, hop ban chi dao,
tap huan ve chuyen mon ky thuat.
+ To chiic thiic hien ke hoach.
+ Quan ly nhan liic phuc vu cho chiidng trinh.
+ Quan ly thuoc, hoa chat, vacxin,...
+ Quan ly phiidng tien, vat tii va kinh phi lien quan den chiidng trinh.
+ Quan ly ky thuat chuyen mon thiic hien chiidng trinh.
+ Hiidng d in giam sat chuyen mon, ky thuat va danh gia chiidng trinh doi
vdi cac tram y te xa/phiidng.
+ Tong hdp bao cao thong ke theo quy dinh cua tiing chiidng trinh v.v..
Trong khi can bo Trung tam hiidng dan, sinh vien can chu y quan sat, lang
nghe, ghi chep lai nhiing thong tin can thiet.
Khi can bo trung tam gi6i thieu, hii6ng dan cho sinh vien cac loai so sach,
cach ghi chep va cach lam cac bieu mau bao cao thong ke. Sinh vien nen xem chi tiet
cu the cac bien ban ve cach thiic to chiic chi dao trien khai chiidng trinh, tham khao
cach ghi chep cac so sach, bieu mau bao cao ve cac chiidng trinh muc tieu y te quoc gia.

3. BlTdc 3: thao luan nhom
Sinh vien thao luan nhom theo 2 noi dung sau:
1. Hien cd bao nhieu chiidng trinh muc tieu y te quoc gia dang diidc trien khai
tai Trung tam Y te dii phong huyen?
2. Cac biidc to chifc chi dao hoat dong va cong tac quan ly cac chtfdng trinh
muc tieu y te quoc gia tai Trung tam Y te dii phong huyen?
Sinh vien thao luan nhom diidi sii hiidng dan, giam sat cua can bo Trung
tam, sinh vien can so sanh giiia ly thuyet va thiic te de diia ra nhiing nhan xet
cua minh ve thiic trang to chiic chi dao, quan ly cac chiidng trinh muc tieu y te
quoc gia tai Trung tam Y te dii phong huyen. Til dd tim ra nhiing ifu diem can
phat huy, nhiing bat cap c&n kh&c phuc de thiic hien tot cac chifdng trinh y te
quoc gia tai tuyen y te huyen.

TU LUONG GIA
1.

Cau hoi luong gia

1. Hien co bao nhieu chifdng trinh muc tieu y te quoc gia dang diidc trien khai
tai Trung tam Y te dii phong huyen? Dd la nhiing chifdng trinh nao?
2. Cac bifdc de trien khai thiic hien 1 chifdng trinh muc tieu y te quoc gia cu
the bao gom nhiing bifdc nao? Noi dung cua cac bifdc dd?
3. So sanh gnla thiic te va ly thuyet ve viec trien khai thiic hien chifdng trinh9

20


4.
Ban co nhan xet gi ve cach ghi chep cac bien ban. so sach. bieu mau thong

ke lien quan tdi cac chiidng trinh? Tii do rut ra nhiing kinh nghiem de co the giup
cho viec to chiic va quan ly cac chiidng trinh y te quoc gia tai tuyen y te huyen diidc
tot hdn.

2. Hudng dan sinh vien tir ludng gia
Qua ket qua thao luan nhom. cac y kien thao luan diidc thong nhat ngay sau
buoi hoc chinh la phan dap an cho cac cau hoi tu lifdng gia cua sinh vien. Trinh
bay nhiing diem chiia ro, con thac mac v6i can bo Trung tam hoac giao vien de
diidc giai dap.

HlfCfNG DAN TU HOC, TU NGHIEN ClRJ, VAN DUNG THI/C TE
1. Phifdng phap hoc
Sinh vien doc tai lieu phan ly thuyet co lien quan den cac noi dung hoc tap
trong bai giang bao gom:
-

Muc tieu dinh hudng cua chiidng trinh.

-

Cac giai phap chuyen mon ky thuat de thiic hien chiidng trinh.

-

Cac biidc trien khai chiidng trinh muc tieu y te quoc gia.

Trong khi doc tai lieu din danh dau nhiing diem con kho hieu hoac chiia r5 de
thao luan vdi cac ban sinh vien khac trong khi hoc hoac hoi giao vien de diidc giai dap.
Sinh vien chu dong hoc hoi va de nghi vdi can bo Trung tam giup dd khi can thiet.

2. Van dung thirc te
Qua thiic hanh tai Trung tam Y te dii phong huyen, sinh vien tham quan kien
tap tim hieu ve thiic trang to chiic va quan ly cac chUdng trinh muc tieu y te quoc
gia dang diidc trien khai tai Trung tam Y te dii phong huyen, tii do sinh vien co kha
nang doi chieu so sanh giiia nhiing kien thiic dtfdc hoc trong bai ly thuyet vdi thiic
te diidc chiing kien. diia ra nhiing nhan xet ve thiic trang viec thiic hien cac chiidng
trinh muc tieu y te qudc gia, van dung diidc nhiing kinh nghiem thiic te de c6 the
giup cho viec to chiic chi dao va quan ly chu'dng trinh y te quoc gia tai tuyen y te cd
sd diidc tot hdn.

3. Tai lieu tham khao
1. Bo Y te - UNICEF. Quan ly cham soc siic khoe ban dau d tuyen y te cd sd.
Nha xuat ban Y hoc. Ha Noi, 2000.
2. Bo Y te. Quan ly va hoat dong giam sat cua Trung tam Y te huyen. Trung
tam nhan liic y te. Nha xuat ban Y hoc. Ha Noi, 1994.
3. Bo Y te. Quan ly cac chiidng trinh y te d tuven y te cd sd. Nha xuat ban Y
hoc, 1990.
4. Bo mon Y xa hoi hoc. To chiic va quan ly y te. Triidng Dai hoc Y khoa Thai
Nguyen. 2006.
5. Triidng Dai hoc Y khoa Thai Nguyen. Tai lieu day/hoc mon hoc cong dong
1. 2006.
21


TO CHUfC HOAT DONG KHOA DUDC, KHOA XET NGHIEM,
PHONG KE HOACH TONG HOP TAI BENH VIEN TUYEN HUYEN

MUC TIEU
Sau khi hoc xong bai nay, sinh vien co kha nang:
3. Nhan xet dittic to chiic, hoat dong cua khoa dittic, khoa xet nghiem.

4. Mo ta to chiic hoat dong phong ke hoach tong htip tai benh vien tuyen huyen.

1. Cong tac quan ly duoc tai benh vien huyen
1.1. Btfdc 1: so sanh thiic trang to chiic hoat dong cua khoa diidc benh vien tuyen
huyen v6i quy djnh
Noi dung

TT
To c h u t
1

Xay dung dam bao ve sinh, sach se,

2

Xay dung dam bao cao rao, an toan va phu hop vdi ti'nh chat cong viec.

3

Khoa difdc bo tri 6 dja diem thuan tien

Hoat dong
1

Cong tac diitru mua, van chuyen, kiem nhap thuoc

2

Lap ke hoach thuoc, hoa chat , vat dung y te tieu hao hang nam dung
quy djnh.

3

Lap ke hoach thuoc, hoa chat, vat dung y te tieu hao hang nam theo
dung djnh mCfc.

4

Mua thuoc dam bao so lifdng

5

Mua thuoc dam bao chat lifdng theo ke hoach

6

Thifc hien dung cac quy dinh ve mua sam

7

Thuoc phai bao quan theo dung yeu cau ky thuat

8

Van chuyen thuoc theo quy djnh

9

Kiem nhap thuoc theo quy djnh

Quan ly thuoc, hoa chat va vat dung tieu hao y te tai cac khoa
Thuoc ITnh ve phai dung trong ngay
Thifdng trifc cap phat thuoc 24 h trong ngay
Phieu Unh thuoc phai theo dung quy dinh..

22

Co

Khong


Cap phat thuoc, hoa chat theo cfung quy djnh
Co lap sd sach, thanh toan theo quy djnh
Thong ke bao cao ban giao theo quy djnh
Cac khoa phong ban thuoc trong benh vien.
Kiem ke thuoc, hoa chat dung cu tieu hao
1

Kiem ke theo djnh ky

2

Thanh lap hoi dong kiem ke theo quy djnh

3

Noi dung kiem ke: doi chieu sd xuat, sd nhap vdi chUng til

4

Doi chieu thuoc, hoa chat ghi trong sd sach v6i hien cd ve sd lupng va
chat li/png..

Kho va cong tac bao quan, cap phat
1

Thiet ke theo quy djnh, an toan, sach se

2

Du phuong tien.

3

Du anh sang

4

Sap xep trong kho ngSn n£p

5

Kho cd du gia, ke

6

Cac thuoc va hoa chat trong kho dupe xep theo chung loai de lay, de thay

7

Tri/dc khi giao thuoc dirpc si thuc hien 3 kiem tra, 3 doi chieu

8

Thuc hien 5 chong: nham Ian, qua han, mdi mot, trom cap, tham hoa

9

To chUc chia thanh kho chinh va kho cap phat le

10

Khoa trang bj phuong tien cho phu hpp

Cong tac dutru mua, van chuyen, kiem nhap thuoc
1

Lap ke hoach thuoc, hoa chat, vat dung y te tieu hao hang nSm dung
quy dinh.

2

Lap ke hoach thuoc, hoa chat, vat dung y te tieu hao hang nSm theo
dung djnh mUc.

3

Mua thuoc dam bao sd lupng

4

Mua thuoc dam bao chat lupng theo ke hoach

5

Thuc hien cac dung cac quy djnh ve mua sam

6

Thuoc phai bao quan theo dung yeu cau ky thuat

7

Van chuyen thuoc theo quy djnh

8

Kiem nhap thuoc theo quy dinh

1.2. BWO'C 2 : sinh vien thao luan nhom theo cac cau hoi sau.

Cau hoi 1: to chiic cua khoa nhif the nao, co phu hdp khong? tai sao?
Cau hoi 2: cong tac da tru mua, van chuyen, kiem nhap thuoc cua benh vien
co dung theo quy dinh khong?
23