{"id":10898,"date":"2023-11-03T16:15:37","date_gmt":"2023-11-03T16:15:37","guid":{"rendered":"http:\/\/www.sanatateafemeii.md\/?page_id=812"},"modified":"2023-11-09T12:53:45","modified_gmt":"2023-11-09T09:53:45","slug":"","status":"publish","type":"page","link":"https:\/\/cidsr.md\/en\/portofolio\/proiecte\/proiectul-cresterea-calitatii-serviciilor-de-avort-integrate-in-cadrul-serviciilor-de-sanatate-reproductive-in-transnistria-saaf\/al-doilea-training-in-servicii-de-avort-integrate-in-cadrul-serviciilor-de-sanatate-reproductiva-in-transnistria\/","title":{"rendered":"","raw":""},"content":{"rendered":"","protected":false,"raw":""},"excerpt":{"rendered":"","protected":false,"raw":""},"author":4,"featured_media":0,"parent":10894,"menu_order":999,"comment_status":"closed","ping_status":"closed","template":"page-text.php","meta":{"_acf_changed":false,"_ru_post_content":"","_ru_post_name":"","_ru_post_excerpt":"","_ru_post_title":"","_en_post_content":"","_en_post_name":"","_en_post_excerpt":"","_en_post_title":"","_ro_post_content":"![\"20150702_131442\"](\"http:\/\/www.avort.md\/wp-content\/uploads\/2015\/06\/20150702_131442-736x1024.jpg\")
\u00cen perioada 29.06.15 \u2013 03.07.15 \u00een incinta Centrului de S\u0103n\u0103tate Reproductiv\u0103 de pe ling\u0103 Centrul Republican al Mamei \u0219i Copilului<\/a>, or. Tiraspol a avut\u00a0loc cel de-al doilea training de instruire \u00een servicii de avort integrate \u00een cadrul serviciilor de s\u0103n\u0103tate reproductiv\u0103 \u00een Transnistria: avortul medicamentos (AM)<\/a> \u0219i vacuum aspiratia manuala (VAM)<\/a>.\r\n\r\nAceast\u0103 activitate face parte din cadrul proiectului SAAF \u201cCre\u0219terea calit\u0103\u021bii serviciilor de avort integrate \u00een cadrul serviciilor de s\u0103n\u0103tate reproductive in Transnistria\u201d<\/a>.\r\n\r\n\u00cen cadrul acestui training au\u00a0fost instrui\u021bi 22 de medici obstetricieni ginecologi din toat\u0103 regiunea Transnistria.\r\n\r\nScopul trainingului: instruirea lucr\u0103torilor \u2013 cadrelor medicale din institu\u021biile medico-sanitare din regiunea Transnistriei \u00een efectuarea \u00eentreruperilor de sarcin\u0103 \u00een condi\u021bii de siguran\u021b\u0103: AM<\/a> \u0219i VAM<\/a>.\r\n\r\nTrainingul a fost\u00a0organizat de c\u0103tre Centrul de Instruire in Domeniul Sanatatii Reproductive (CIDSR)<\/a> or. Chi\u0219in\u0103u \u00een colaborare cu d-na Natalia Slepuha \u2013 medic \u0219ef al Centrului Republican al Mamei \u0219i copilului, d-na Oxana Ceban, \u0219efa Centrului de S\u0103n\u0103tate Reproductiv\u0103 or. Tiraspol \u0219i cu acordul \u0219i sus\u021binerea Ministerului S\u0103n\u0103t\u0103\u021bii din Transnistria<\/a>.\r\n\r\nParticipan\u021bii au\u00a0fost instrui\u021bi de c\u0103tre:\r\n\r\n\t- Dr. Rodica Comendant, medic obstetrician-ginecolog, doctor \u00een \u0219tiin\u021be medicale, expert al OMS<\/a> \u00een \u00eentreruperi de sarcin\u0103 \u00een siguran\u021b\u0103, director CIDSR<\/a>.<\/li>\r\n\t
- Dr. Stelian Hodorogea \u2013 medic obstetrician-ginecolog, doctor \u00een \u0219tiin\u021be medicale, expert al OMS<\/a> \u00een tehnologii perinatale.<\/li>\r\n<\/ul>\r\n\u00cen prima zi a seminarului s-a vorbit despre proiectul\u00a0SAAF<\/a>, care sunt scopurile \u0219i obiectivele proiectului \u0219i ce urmeaz\u0103 s\u0103 se realizeze pe parcursul perioadei (2015-2016) de desf\u0103\u0219urare a proiectului.\r\n\r\nOxana Ceban a f\u0103cut o retrospectiv\u0103 asupra tuturor activit\u0103\u021bilor care s-au desf\u0103\u0219urat pe parcursul anului 2014 \u00een cadrul proiectul\u00a0SAAF<\/a>, care au fost realiz\u0103rile precum \u0219i ce a\u0219tept\u0103ri sunt p\u00e2n\u0103 la finalul anului 2017. Deasemeni \u00een linii generale s-a prezentat situa\u021bia din sfera \u00eentreruperilor de sarcin\u0103 din Transnistria , principalele probleme precum \u0219i urm\u0103torii pa\u0219i ai proiectului SAAF<\/a>.\r\n\r\nPentru \u00eenceput participan\u021bii au fost supu\u0219i unei test\u0103ri cu scopul de a determina a\u0219tept\u0103rile \u00een urma desf\u0103\u0219ur\u0103rii acestui training, care sunt \u00eentreb\u0103rile cu care s-au confruntat \u00een practica de zi cu zi \u0219i la care nu au g\u0103sit r\u0103spunsuri. Alte subiecte abordate \u00een prima zi a trainingului au fost:\r\n
\r\n\t- Securitatea \u0219i eficien\u021ba\u00a0VAM<\/a>;<\/li>\r\n\t
- Determinarea sarcinii \u0219i perioadei de gesta\u021bie;<\/li>\r\n\t
- Selectarea pacien\u021bilor \u0219i studiul acestora<\/li>\r\n\t
- Tehnica\u00a0VAM<\/a><\/li>\r\n\t
- Demonstra\u021bii de lucru \u0219i practica cu instrumentele vacuum aspiratoare.<\/li>\r\n<\/ul>\r\nCea dea doua zi a trainingului a \u00eenceput cu un subiect foarte interesant \u0219i actual \u00een zilele noastre \u0219i anume: consultarea (consilierea) \u0219i preg\u0103tirea pacientelor, acordul informat.\r\n\r\nUn alt subiect prezentat \u00een forma ampl\u0103 a fost: profilaxia infec\u021biilor (inclusiv prelucrarea \u0219i reutilizarea instrumentelor).\r\n\r\nAu urmat jocuri de echipa pacient vs medic. Scopul acestor jocuri a fost elucidarea tuturor posibilelor situa\u021bii, care pot ap\u0103rea in procesul consult\u0103rii si consilierii pacientului. Alt subiect abordat a fost analgezia, dup\u0103 care s-a trecut la simularea vacuum aspira\u021biei.\r\n\r\nParticipan\u021bii au fost instrui\u021bi referitor la procedura\u00a0VAM<\/a>, s-a lucrat \u0219i simulat pe mulaje speciale cu instrumente necesare. Scopul acestor simul\u0103ri: deprinderi practice \u00een efectuarea corecta a procedurii de\u00a0VAM<\/a>.\r\n\r\nIn cea dea treia zi a seminarului au avut loc \u00eencerc\u0103ri clinice. Medicii \u00een prezenta exper\u021bilor \u0219i cu acordul pacientului au putut realiza procedura de VAM<\/a>, dup\u0103 care a fost examinat \u021besutul. Alte teme care au fost abordate au fost: \u00eengrijirea \u0219i supravegherea \u00een perioada post-avort \u0219i complica\u021biile ce pot ap\u0103rea \u00een urma avortului chirurgical.\r\n\r\nCea de-a patra zi a debutat cu \u00eencerc\u0103ri clinice, discu\u021bii \u0219i analize. Temele care au fost abordate \u00een aceasta zi au fost:\r\n
\r\n\t- AM<\/a>.\u00a0Istoria AM<\/a>.<\/li>\r\n\t
- Mecanismul de ac\u021biune a mifepristonului \u0219i misoprostolului.<\/li>\r\n\t
- Mifepristonul \u0219i misoprostolul \u2013 indica\u021bii \u0219i contraindica\u021bii.<\/li>\r\n\t
- Metodele de diagnostic a sarcinii normale \u0219i a sarcinii extrauterine la stadiu incipient.<\/li>\r\n\t
- Protocoale de prescriere a preparatelor.<\/li>\r\n<\/ul>\r\nSubiectele zilei a 5-a au fost:\r\n
\r\n\t- Complica\u021biile care pot surveni \u00een urma AM<\/a>, efectele secundare.<\/li>\r\n\t
- Vizita de control, \u00eengrijirea post-avort. Contracep\u021bia dup\u0103 AM<\/a>.<\/li>\r\n\t
- Discu\u021bii referitor la training \u0219i perspectivele de introducere a AM<\/a>\u00a0\u0219i VAM<\/a>\u00a0\u00een practica de zi cu zi.<\/li>\r\n<\/ul>\r\nS-au organizat diferite jocuri pacient vs medic vs Ministerul Sanatatii. Scopul acestor jocuri a fost de a reda problemele cu care se confrunta fiecare participant al societ\u0103\u021bii si eventualele decizii care ar putea duce la solu\u021bionarea problemelor \u0219i lacunelor din sistem.\r\n\r\nDeasemeni \u00een cadrul ultimei zile a trainingului a fost prezent\u0103 \u0219i presa. Reportajul \u0219i interviul dnei Rodica Comendant \u0219i Dnei Oxana Ceban referitor la proiectul SAAF \u0219i s\u0103n\u0103tatea reproductiv\u0103 \u00een Transnistria \u00eel pute\u021bi vedea acces\u00eend linkul:\r\n\r\nhttps:\/\/tv.pgtrk.ru\/news\/20150703\/33603<\/a>\r\n\r\nFiecare institu\u021bie medico-sanitara a primit c\u00eete un set VAM<\/a> care const\u0103 din seringa VAM<\/a> Plus \u0219i canule de diferite dimensiuni.\r\n\r\nSpre final participan\u021bii au completat c\u00eete un test de evaluare a trainingului. To\u021bi medicii s-au declarat foarte mul\u021bumi\u021bi de petrecerea unui asemenea seminar.\r\n\r\nPentru a vedea care sunt pa\u0219ii urm\u0103tori \u00een implementarea metodelor moderne de avort, participan\u021bii au fost \u00eemp\u0103r\u021bi\u021bi \u00een grupe de lucru. Fiecare institu\u021bie medico-sanitar\u0103 a elaborat recomand\u0103ri \u0219i pa\u0219i urm\u0103tori \u00een vederea implement\u0103rii \u0219i utiliz\u0103rii pe scara larga a metodelor modern de \u00eentrerupere a sarcinii.\r\n\r\nRecomand\u0103rile grupurilor de lucru:\r\n\r\nInstitu\u021bia de stat \u201cSpitalul Raional Grigoriopol\u201d or. Grigoriopol<\/strong>\r\n
\r\n\t- Implementarea VAM<\/a>, utilizarea pe scara larga a acestei metode.<\/li>\r\n\t
- Revizuirea condi\u021biilor de acordare a acestui serviciu.<\/li>\r\n\t
- Instruirea personalului.<\/li>\r\n\t
- Prezentarea rapoartelor conform noilor forme de raportare.<\/li>\r\n\t
- Implementarea principiilor \u0219i recomand\u0103rilor de avort \u00een siguran\u021b\u0103.<\/li>\r\n\t
- Utilizarea preferen\u021bial\u0103 a anesteziei locale.<\/li>\r\n\t
- Petrecerea sondajelor (cu scopul convingerii celorlal\u021bi colegi).<\/li>\r\n\t
- Achizi\u021bionarea de seringi VAM<\/a> si canule.<\/li>\r\n<\/ul>\r\nInstitu\u021bia de stat \u201cCentrul Mamei si Copilului Bender\u201d or. Bender<\/strong>\r\n
\r\n\t- Implementarea VAM.<\/a><\/li>\r\n\t
- Implementarea AM<\/a>.<\/li>\r\n\t
- Preg\u0103tirea colului uterin \u00eenainte de procedura VAM<\/a>.<\/li>\r\n\t
- Utilizarea pe scara mai larga a anesteziei locale.<\/li>\r\n\t
- Instruirea personalului in procedura VAM<\/a>.<\/li>\r\n<\/ul>\r\nInstitu\u021bia de Stat \u201cCentrul de \u00eengrijire \u00een ambulator\u201d or. Bender<\/strong>\r\n
\r\n\t- Raportarea avortului medicamentos conform noilor formulare de raportare.<\/li>\r\n\t
- Utilizarea VAM<\/a> in biopsie, endometrie, cu preg\u0103tirea colului uterin cu misoprostol \u0219i sub anestezie local\u0103.<\/li>\r\n\t
- Diseminarea informa\u021biei cu privire la p\u0103r\u021bile pozitive \u00een efectuarea \u00eentreruperii de sarcin\u0103 \u00een condi\u021bii de siguran\u021b\u0103 \u00een r\u00e2ndul colegilor.<\/li>\r\n\t
- Informarea administra\u021biei despre posibilitatea acord\u0103rii \u0219i prest\u0103rii serviciilor de \u00eentrerupere a sarcinii \u00een condi\u021bii de ambulator.<\/li>\r\n<\/ul>\r\n \r\n\r\nInstitu\u021bia de Stat \u201cSpitalul or\u0103\u0219enesc Dnestrovsc\u201d or. Dnestrovsc<\/strong>\r\n
\r\n\t- Informarea administra\u021biei despre noile metode de \u00eentrerupere a sarcinii.<\/li>\r\n\t
- Elaborarea unui ordin intern de implementare a metodei VAM<\/a>.<\/li>\r\n\t
- \u00cembun\u0103t\u0103\u021birea condi\u021biilor de \u00eentrerupere a sarcinii pentru paciente.<\/li>\r\n\t
- Diseminarea informa\u021biei \u00een r\u00e2ndul femeilor de v\u00e2rsta reproductiv\u0103, \u0219i \u00een r\u00e2ndul adolescen\u021bilor.<\/li>\r\n\t
- Diseminarea informa\u021biei \u00een r\u00e2ndul colegilor. Instruirea personalului \u00een procedura VAM<\/a>.<\/li>\r\n\t
- Punerea \u00een aplicare a metodelor de raportare. Analiza indicatorilor.<\/li>\r\n\t
- Instruirea moa\u0219elor \u0219i a surorilor medicale \u00een consiliere \u0219i consultare \u00een timpul efectu\u0103rii procedurii VAM<\/a> \u0219i AM<\/a>.<\/li>\r\n\t
- Implementarea VAM<\/a> \u0219i\u00a0 utilizarea activ\u0103 a acestei proceduri.<\/li>\r\n<\/ul>\r\nInstitu\u021bia de stat \u201c Spitalul Raional R\u00e2bni\u021ba\u201d or. R\u00e2bni\u021ba<\/strong>\r\n\r\nSta\u021bionar\r\n
\r\n\t- Informarea administra\u021biei, colegilor, medicii mai des sa presteze VAM<\/a> pentru \u00eentreruperea sarcinii.<\/li>\r\n\t
- Preg\u0103tirea colului uterin \u00eenainte de procedura VAM<\/a>.<\/li>\r\n\t
- Informarea femeilor despre metodele de anestezie, asigurarea dreptului de a alege.<\/li>\r\n\t
- Posibilitatea de a achizi\u021biona instrumente\u00a0VAM<\/a>.<\/li>\r\n\t
- Revizuirea documentelor de raportare.<\/li>\r\n<\/ul>\r\nAmbulator\r\n
\r\n\t- \u00cembun\u0103t\u0103\u021birea calit\u0103\u021bii de acordare a serviciului de \u00eentrerupere a sarcinii, consiliere.<\/li>\r\n\t
- Implementarea \u0219i utilizarea VAM<\/a>.<\/li>\r\n\t
- Revizuirea documentelor de raportare.<\/li>\r\n\t
- Diseminarea informa\u021biei \u00een r\u00e2ndul colegilor despre metodele sigure de \u00eentrerupere a sarcinii.<\/li>\r\n\t
- Instruirea colegilor \u00een consiliere.<\/li>\r\n<\/ul>\r\nInstitu\u021bia de Stat \u201cSpitalul Raional Camenca\u201d or. Camenca<\/strong>\r\n
\r\n\t- Diseminarea informa\u021biei \u00een r\u00e2ndul colegilor.<\/li>\r\n\t
- Instruirea moa\u0219elor.<\/li>\r\n\t
- Elaborarea unui ordin intern \u00een vederea raport\u0103rii serviciilor de \u00eentrerupere a sarcinii precum \u0219i elaborarea unei forme de raportare.<\/li>\r\n\t
- Asigurarea unui spa\u021biu cu instrumente necesare \u00een vederea efectu\u0103rii procedurii de \u00eentrerupere a sarcinii prin metoda VAM<\/a>.<\/li>\r\n<\/ul>\r\nInstitu\u021bia de Stat \u201eCentrul Mamei si Copilului\u201d or. Tiraspol<\/strong>\r\n
\r\n\t- Instruirea personalului \u00een tehnica VAM.<\/a><\/li>\r\n\t
- Raportarea statistica a \u00eentreruperilor de sarcin\u0103 dup\u0103 noile forme de raportare.<\/li>\r\n\t
- Consiliere adecvata \u00eenainte \u0219i dup\u0103 procedura de \u00eentrerupere a sarcinii.<\/li>\r\n\t
- Trecerea de la \u00eentreruperi de sarcina prin metoda EVA \u0219i chiuretaj la metodele moderne de \u00eentrerupere a sarcinii.<\/li>\r\n<\/ul>\r\nTrainingul a culminat cu \u00eenm\u00e2narea certificatelor de participare aprobate \u0219i semnate de c\u0103tre Ministerul S\u0103n\u0103t\u0103\u021bii Transnistriei \u0219i exper\u021bii participan\u021bi.\r\n\r\n \r\n\r\nV\u0103 prezent\u0103m:\r\n
\r\n\t- Agenda\u00a0<\/a><\/li>\r\n\t
- Lista participantilor<\/a><\/li>\r\n\t
- \u0412\u0441\u0435\u0441\u0442\u043e\u0440\u043e\u043d\u043d\u044f\u044f \u043f\u043e\u043c\u043e\u0449\u044c \u043f\u0440\u0438 \u0430\u0431\u043e\u0440\u0442\u0435 \u041e\u0431\u0443\u0447\u0430\u044e\u0449\u0438\u0439 \u043a\u0443\u0440\u0441<\/a><\/li>\r\n\t
- \u0412\u0432\u0435\u0434\u0435\u043d\u0438\u0435 \u0432 \u041c\u0412\u0410<\/a><\/li>\r\n\t
- \u041c\u041e\u0414\u0423\u041b\u042c 4: \u041f\u043e\u0434\u0442\u0432\u0435\u0440\u0436\u0434\u0435\u043d\u0438\u0435 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0438 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0435\u0435 \u0441\u0440\u043e\u043a\u0430 \u041e\u0442\u0431\u043e\u0440 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u043a \u0438 \u043a\u043b\u0438\u043d\u0438\u043a\u043e-\u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u043e\u0435 \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435<\/a><\/li>\r\n\t
- \u041f\u0440\u043e\u0444\u0438\u043b\u0430\u043a\u0442\u0438\u043a\u0430 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438 \u0438 \u043e\u0431\u0440\u0430\u0431\u043e\u0442\u043a\u0430 \u0438\u043d\u0441\u0442\u0440\u0443\u043c\u0435\u043d\u0442\u0430\u0440\u0438\u044f \u0434\u043b\u044f \u041c\u0412\u0410<\/a><\/li>\r\n\t
- \u0411\u043e\u043b\u044c \u0438 \u0435\u0435 \u0431\u043e\u0440\u044c\u0431\u0430 \u0441 \u043d\u0435\u0439<\/a><\/li>\r\n\t
- \u041e\u043a\u0430\u0437\u0430\u043d\u0438\u0435 \u043f\u043e\u043c\u043e\u0449\u0438 \u043f\u043e\u0441\u043b\u0435 \u043f\u0440\u043e\u0446\u0435\u0434\u0443\u0440\u044b \u0438 \u043a\u043e\u043d\u0441\u0443\u043b\u044c\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u043f\u043e \u0432\u043e\u043f\u0440\u043e\u0441\u0430\u043c \u043a\u043e\u043d\u0442\u0440\u0430\u0446\u0435\u043f\u0446\u0438\u0438<\/a><\/li>\r\n\t
- \u0418\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u0442\u043a\u0430\u043d\u0435\u0439<\/a><\/li>\r\n\t
- \u041e\u0441\u043b\u043e\u0436\u043d\u0435\u043d\u0438\u044f \u0438 \u044d\u043a\u0441\u0442\u0440\u0435\u043d\u043d\u044b\u0435 \u0441\u0438\u0442\u0443\u0430\u0446\u0438\u0438<\/a><\/li>\r\n\t
- \u0420\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0430\u0446\u0438\u0438 \u0412\u041e\u0417 \u043f\u043e \u0431\u0435\u0437\u043e\u043f\u0430\u0441\u043d\u043e\u043c\u0443 \u0430\u0431\u043e\u0440\u0442\u0443<\/a><\/li>\r\n\t
- \u041a\u043e\u043d\u0441\u0443\u043b\u044c\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u043a\u0430\u043a \u043d\u0435\u043e\u0442\u044c\u0435\u043c\u043b\u0438\u043c\u044b\u0439 \u043a\u043e\u043c\u043f\u043e\u043d\u0435\u043d\u0442 \u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0430 \u0443\u0441\u043b\u0443\u0433. \u041a\u043e\u043d\u0442\u0440\u0430\u0446\u0435\u043f\u0446\u0438\u044f \u043f\u043e\u0441\u043b\u0435 \u0430\u0431\u043e\u0440\u0442\u0430<\/a><\/li>\r\n\t
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- \u041c\u0435\u0434\u0438\u043a\u0430\u043c\u0435\u043d\u0442\u043e\u0437\u043d\u044b\u0439 \u0430\u0431\u043e\u0440\u0442. \u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f \u0438 \u043f\u0440\u043e\u0442\u0438\u0432\u043e\u043f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f<\/a><\/li>\r\n\t
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