Order
No. 127n dated 02/25/2016

!!! Lost force in accordance with order No. 1043n dated December 22, 2017!!!

In accordance with part 1.1 of Article 100 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2013, N 27, Art. 3477; N 48, Art. 6165; N 52, Art. 6951; 2014, N 49, Art. 6927; 2016, N 1, Art. 9) I order:

1. Approve the attached terms and stages of accreditation of specialists, as well as categories of persons with medical, pharmaceutical or other education and specialists subject to accreditation.

2. Department medical education and personnel policy in healthcare of the Ministry of Health of the Russian Federation, organize the accreditation of specialists, taking into account the stages of transition.

3. Entrust control over the implementation of this order to the First Deputy Minister of Health of the Russian Federation I.N. Kagramanyan.

Minister
V.I.Skvortsova

Approved
by order of the Ministry of Health
Russian Federation
dated February 25, 2016 N 127n

Deadlines and stages
accreditation of specialists, as well as categories of persons with medical, pharmaceutical or other education and specialists subject to accreditation

Stage	Term	Category of persons
First stage	from January 1, 2016	persons who received after January 1, 2016 higher education by main educational programs in accordance with federal state educational standards in the specialties "Dentistry" and "Pharmacy"
Second phase	from January 1, 2017	persons who received higher education in basic educational programs after January 1, 2017 in accordance with federal state educational standards in the field of education “Healthcare and Medical Sciences” (specialty level)
Third stage	from January 1, 2018	persons who received higher education in basic educational programs after January 1, 2018 in accordance with federal state educational standards in the field of education “Healthcare and Medical Sciences” (residency level)
		persons who received higher education after January 1, 2018 in basic educational programs in accordance with federal state educational standards in the field of education "Healthcare and Medical Sciences" (bachelor's level, master's level)
		persons who received secondary education after January 1, 2018 professional education in accordance with federal state educational standards in the field of education "Healthcare and Medical Sciences"
		persons who received additional professional education under professional retraining programs after January 1, 2018
		persons who received medical and pharmaceutical education in foreign countries after January 1, 2018
		persons who received another higher education after January 1, 2018 in basic educational programs in accordance with federal state educational standards
Fourth stage	from January 1, 2021	other persons who have not passed the specialist accreditation procedure at stages 1 - 3

In accordance with Part 1.1 of Article 100 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”.

Judicial practice and legislation
Order of the Ministry of Health of Russia dated February 25, 2016 N 127n
“On approval of the terms and stages of accreditation of specialists, as well as categories of persons with medical, pharmaceutical or other education and specialists subject to accreditation”

<Письмо>Ministry of Health of Russia dated 05.08.2016 N 16-5/10/2-4838<Об осуществлении медицинской деятельности специалистами, прошедшими аккредитацию по специальностям "Стоматология" или "Фармация">

order dated 02/25/2016 N 127n “On approval of the terms and stages of accreditation of specialists, as well as categories of persons with medical, pharmaceutical or other education and specialists subject to accreditation” (registered with the Ministry of Justice of Russia on 03/14/2016, N 41401) (hereinafter referred to as order N 127n);

<Письмо>Ministry of Health of Russia dated July 7, 2016 N 16-5/10/2-4126<Об аккредитации специалистов>

In accordance with the provisions of Order N 127n, persons who have received higher education in basic educational programs after January 1, 2016 in accordance with federal state educational standards in the specialties “Dentistry” and “Pharmacy” undergo the specialist accreditation procedure.

"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"

Revision 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 APPROVAL OF 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, FAR THE ULTIMATE USE OF WHICH IN MEDICAL PRACTICE IS RECOGNIZED INAPPROPRIATE

(as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 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 instruments and equipment that have been confiscated or withdrawn from illegal circulation or the further use of which is considered inappropriate "(Collected Legislation of the Russian Federation, 1999, No. 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. Entrust control over the implementation of this Order to Deputy Minister A.V. Katlinsky.

Minister
Y.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, FURTHER USE OF WHICH IT IS RECOGNIZED UNAPPROPRIATE IN MEDICAL PRACTICE

(as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 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 referred to as narcotic drugs and psychotropic substances, List), the further use of which in medical practice is considered inappropriate. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 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” (Collected Legislation of the Russian Federation, 1998, N 27, Art. 3198; 2004, N 8, Art. 663 ; N 47, Art. 4666; 2006, N 29, Art. 3253; 2007, N 28, Art. 3439; 2009, N 26, Art. 3183; N 52, Art. 6752; 2010, N 3, Art. 314 ; N 17, Art. 2100; N 24, Art. 3035; N 28, Art. 3703; N 31, Art. 4271; N 45, Art. 5864; N 50, Art. 6696, 6720; 2011, N 10, Article 1390; N 12, Article 1635; N 29, Article 4466, 4473; N 42, Article 5921; N 51, Article 7534; 2012, N 10, Article 1232; N 11, Article 1295; N 19, Art. 2400; N 22, Art. 2864; N 37, Art. 5002; N 41, Art. 5625; N 48, Art. 6686; N 49, Art. 6861; 2013, N 6, Art. 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, Art. 1626; N 23, Art. 2987; N 27, Art. 3763; N 44, Art. 6068; N 51, Art. 7430; 2015, N 1 Art. 1593). (as amended by Order of the Ministry of Health of the Russian Federation dated 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 influence, 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 (vias), the presence of turbidity or discoloration of the solution due to for non-compliance with storage conditions, damage to the primary packaging); (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 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 cannot be used for medical, scientific or other purposes. (as amended by Order of the Ministry of Health of the Russian Federation 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 carrying out their seizure or confiscation, are subject to destruction in full, except in 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 local representatives of these ministries and the body that carried out the seizure or confiscation, a decision will be made to turn them into state revenue and to transfer them for use for the purposes provided for by the legislation of the Russian Federation. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

1.4. The basis for the destruction of confiscated or withdrawn from illicit trafficking of narcotic drugs and psychotropic substances is a court decision, a resolution 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 resolution of an authority or official to impose an administrative penalty or to terminate administrative proceedings<*>.

<*>Decree of the Government of the Russian Federation of July 24, 2002 N 557 “On introducing amendments to Decree of the Government of the Russian Federation of June 18, 1999 N 647” (Collection of Legislation of the Russian Federation, 07.29.2002, N 30, Art. 3057).

1.5. The destruction of narcotic drugs and psychotropic substances, the further use of which in medical practice is considered inappropriate, including those confiscated or withdrawn from illegal circulation, is carried out by state unitary enterprises and government institutions in the manner established by Federal Law of January 8, 1998 N 3-FZ " About narcotic drugs and psychotropic substances"<2>and the regulatory legal acts of the Russian Federation adopted in accordance with it. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

<2>Collection of Legislation of the Russian Federation, 1998, No. 2, Art. 219; 2002, N 30, art. 3033; 2003, N 2, art. 167; N 27, art. 2700; 2004, N 49, art. 4845; 2005, N 19, art. 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, art. 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 Yu, art. 1166; N 53, Art. 7630; 2013, N 23, art. 2878; N 30, art. 4057; N 48, art. 6161.6165; 2014, N 23, art. 2930; 2015, N 6, art. 885. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

The destruction of narcotic drugs and psychotropic substances (with the exception of the destruction of confiscated or withdrawn from illicit trafficking of narcotic drugs and psychotropic substances) included in List II of the List may be carried out by municipal unitary enterprises included in the municipal health care system and municipal institutions in the manner established by Federal Law No. 3-FZ of January 8, 1998 “On Narcotic Drugs and Psychotropic Substances” and the regulatory legal acts of the Russian Federation adopted in accordance with it, when providing medical care citizens in the Russian Federation by medical organizations of the municipal healthcare system<3>. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

The destruction of narcotic drugs and psychotropic substances is carried out by enterprises and institutions specified in paragraphs one and two of this paragraph, if they have a license to operate in the circulation of narcotic drugs, psychotropic substances and their precursors, the cultivation of narcotic plants, indicating the work (service) for the destruction of narcotic drugs drugs and psychotropic substances<4>. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

<4>Decree of the Government of the Russian Federation of December 22, 2011 N 1085 “On licensing activities for the trafficking of narcotic drugs, psychotropic substances and their precursors, cultivation of narcotic plants” (Collected Legislation of the Russian Federation, 2012, N 1, Art. 130; N 22, Art. 2879; N 37, Art. 5002). (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 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 Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

In the event of the destruction of confiscated or withdrawn from illicit trafficking of narcotic drugs and psychotropic substances, 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 their parts 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 the further use of which is considered inappropriate"<5>. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

<5>Collection of Legislation of the Russian Federation, 1999, No. 27, Art. 3360; 2002, N 30, art. 3057; 2004, N 8, art. 663; N 47, art. 4666; 2009, N 12, art. 1429; 2011, N 46, art. 6519; N 51, art. 7526; 2012, N 37, art. 5002. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

Write-off of narcotic drugs and psychotropic substances subject to destruction is carried out 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 Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

In this case, an order is issued to write off narcotic drugs and psychotropic substances and their subsequent destruction, which indicates:

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 medicines, - gross weight); (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

Reasons for decommissioning and destruction;

The person responsible for decommissioning and destruction;

Place and method of destruction.

Date and number of the agreement (in case of transfer of narcotic drugs and psychotropic substances for destruction to enterprises and institutions specified in paragraph 1.5 of these Instructions). (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

For subject-quantitative accounting, write-off 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 drawing into a syringe and preparing for injection. (as amended by Order of the Ministry of Health of the Russian Federation 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 (landfills) and (or) in specially prepared premises.

2.2. Personnel carrying out work on the destruction of narcotic drugs and psychotropic substances must have permission to work with narcotic drugs and psychotropic substances, know the physico-chemical and toxic properties of the substances being destroyed and the chemical reactions that occur during their neutralization and destruction.

2.3. Features of the destruction of narcotic drugs and psychotropic substances: (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

Liquid dosage forms in glass ampoules and bottles are destroyed by crushing the primary packaging; liquid dosage forms in plastic ampoules and syringe tubes are destroyed by crushing the primary packaging, followed by diluting the resulting contents with water in a ratio of 1:100 and draining the resulting solution into the sewer; (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

Solid dosage forms containing water-soluble pharmaceutical substances of narcotic drugs and psychotropic substances must, after crushing to a powder state, be diluted with water in a ratio of 1:100 and the resulting suspension (solution) drained into the sewer; (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

Water-soluble pharmaceutical substances are destroyed by diluting with water in a ratio of 1:100 and pouring the resulting solution into the sewer; (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 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 burning; (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

Pharmaceutical substances that are insoluble in water are destroyed by incineration. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

Remains of crushed (fragmented) primary packaging 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 classification as medical waste - in the manner established by the legislation of the Russian Federation in the field of ensuring the sanitary and epidemiological well-being of the population<7>. (as amended by Order of the Ministry of Health of the Russian Federation dated May 7, 2015 N 228n)

2.4. When destroying narcotic drugs and psychotropic substances, the commission draws up an act indicating:

Date and place of drawing up the act;

Place of work, position, last name, first name, patronymic of the persons taking part in the destruction;

Reason for destruction;

Information about the name (indicating the type of dosage form, dosage, unit of measurement, series) and quantity of the narcotic drug, psychotropic substance being destroyed, 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
Document type:	Order of the Russian Ministry of Health
Receiving authority:	Ministry of Health of Russia
Status:	Active
Published:	New Pharmacy, No. 8, 2003
Acceptance date:	March 28, 2003
Start date:	May 25, 2003
Revision date:	07 May 2015

On 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 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

Document with changes made:
(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 instruments and equipment that have been confiscated or withdrawn from illegal circulation or the further use of which is considered inappropriate " (Collection of Legislation of the Russian Federation, 1999, No. 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. Entrust control over the implementation of this order to Deputy Minister A.V. Katlinsky.

Minister
Yu. 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
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 considered 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 referred to as narcotic drugs and psychotropic substances, List), the further use of which in medical practice is considered inappropriate.
by order of the Russian Ministry of Health of 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” (Collected Legislation of the Russian Federation, 1998, N 27, Art. 3198; 2004, N 8, Art. 663; N 47, Art. 4666; 2006, N 29, Art. 3253; 2007, N 28, Art. 3439; 2009, N 26, Art. 3183; N 52, Art. 6752; 2010, N 3, Art. 314; N 17, Art. 2100; N 24, Art. 3035; N 28, Art. 3703; N 31, Art. 4271; N 45, Art. 5864; N 50, Art. 6696, 6720; 2011, N 10, art. 1390; N 12, art. 1635; N 29, art. 4466, 4473; N 42, art. 5921; N 51, art. 7534; 2012, N 10, art. 1232; N 11, art. .1295; N 19, art. 2400; N 22, art. 2864; N 37, art. 5002; N 41, art. 5625; N 48, art. 6686; N 49, art. 6861; 2013, N 6, Art. 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 , art. 1626; N 23, art. 2987; N 27, art. 3763; N 44, art. 6068; N 51, art. 7430; 2015, N 11, art. 1593).
(Footnote additionally included from August 11, 2015 by order of the Russian Ministry of Health dated 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 influence, 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 from - for non-compliance with storage conditions, damage to the primary packaging);
by order of the Russian Ministry of Health of May 7, 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 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 carrying out their seizure or confiscation, are subject to destruction in full, except in 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 local representatives of these ministries and the body that carried out the seizure or confiscation, a decision will be made to turn them into state revenue and to transfer them for use for the purposes provided for by the legislation of the Russian Federation.
(Clause as amended, put into effect on August 11, 2015 by order of the Ministry of Health of Russia dated May 7, 2015 N 228n.

________________

* Decree of the Government of the Russian Federation of July 24, 2002 N 557 “On introducing 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 government institutions in the manner established and adopted in accordance with the regulatory legal acts of the Russian Federation.
________________
Collection of Legislation of the Russian Federation, 1998, No. 2, Art. 219; 2002, N 30, art. 3033; 2003, N 2, art. 167; N 27, art. 2700; 2004, N 49, art. 4845; 2005, N 19, art. 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, art. 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, art. 1166; N 53, art. 7630; 2013, N 23, art. 2878; N 30, art. 4057; N 48, art. 6161, 6165; 2014, N 23, art. 2930; 2015, N 6, art. 885.

The destruction of narcotic drugs and psychotropic substances (with the exception of the destruction of confiscated or withdrawn from illicit trafficking of narcotic drugs and psychotropic substances) included in List II of the List may be carried out by municipal unitary enterprises and municipal institutions included in 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 healthcare 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 enterprises and institutions specified in paragraphs one and two of this paragraph, if they have a license to operate in the circulation of narcotic drugs, psychotropic substances and their precursors, the cultivation of narcotic plants, indicating the work (service) for the destruction of narcotic drugs drugs and psychotropic substances.
________________
Decree of the Government of the Russian Federation of December 22, 2011 N 1085 “On licensing activities for the trafficking of narcotic drugs, psychotropic substances and their precursors, cultivation of narcotic plants” (Collected Legislation of the Russian Federation, 2012, N 1, Art. 130; N 22, Art. 2879; N 37, Art. 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.
(Clause 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 these Instructions, commissions are created.

In case of destruction of confiscated or withdrawn from illicit trafficking of narcotic drugs and psychotropic substances, 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 instruments and equipment that have been confiscated or withdrawn from illicit circulation or the further use of which is considered inappropriate."
________________
Collection of Legislation of the Russian Federation, 1999, No. 27, Art. 3360; 2002, N 30, art. 3057; 2004, N 8, art. 663; N 47, art. 4666; 2009, N 12, art. 1429; 2011, N 46, art. 6519; N 51, art. 7526; 2012, N 37, art. 5002.

Write-off of narcotic drugs and psychotropic substances subject to destruction is carried out 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.
(Clause 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 to destroy narcotic drugs and psychotropic substances, with the exception of those confiscated or withdrawn from illegal circulation, is justified by the responsible person appointed by order of the head of a medical organization or 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.

In this case, an order is issued to write off 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 write-off and destruction;

The person responsible for decommissioning and destruction;

- place and method of destruction;

- date and number of the agreement (in the case of transfer of narcotic drugs and psychotropic substances for destruction to enterprises and institutions specified in paragraph 1.5 of these Instructions).
(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 has lost force since August 11, 2015 - order of the Ministry of Health of Russia dated May 7, 2015 N 228n;

the paragraph has lost force since 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 Russian Ministry of Health 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 the ampoules (vials) is ensured using available material (for example, sealing wax, plasticine, wax, paraffin and other material); the ampoules (vials) are placed in any packaging container and stored in safe on a separate shelf until destruction (transferred for destruction).

For subject-quantitative accounting, write-off 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 drawing into a syringe and preparing for injection.
(The item was additionally included on August 11, 2015 by order of the Russian Ministry of Health dated May 7, 2015 N 228n)

2. The 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 (landfills) and (or) in specially prepared premises.

2.3. Features of the destruction of narcotic drugs and psychotropic substances:

- liquid dosage forms in glass ampoules, bottles are destroyed by crushing the primary packaging, liquid dosage forms in plastic ampoules, syringe tubes are destroyed by crushing the primary packaging, followed by diluting the resulting contents 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 powder state, must be diluted with water in a ratio of 1:100 and the resulting suspension (solution) must be 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 burning;

- pharmaceutical substances insoluble in water are destroyed by incineration.

Remains of crushed (fragmented) primary packaging of narcotic drugs and psychotropic substances are destroyed in accordance with the legislation of the Russian Federation on production and consumption waste or, if classified as medical waste, in the manner established by the legislation of the Russian Federation in the field of ensuring the sanitary and epidemiological well-being of the population.
________________
Federal Law of June 24, 1998 N 89-FZ “On Production and Consumption Waste” (Collected Legislation of the Russian Federation, 1998, N 26, Art. 3009; 2001, N 1, Art. 21; 2003, N 2, Art. 167 ; 2004, N 35, art. 3607; 2005, N 19, art. 1752; 2006, N 1, art. 10; N 52, art. 5498; 2007, N 46, art. 5554; 2008, N 30, art. .3616; N 45, art. 5142; 2009, N 1, art. 17; 2011, N 30, art. 4590, 4596; N 45, art. 6333; N 48, art. 6732; 2012, N 26, art. .3446; N 27, art. 3587; N 31, art. 4317; 2013, N 30, art. 4059; N 43, art. 5448; N 48, art. 6165; 2014, N 30, art. 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, art. 6165; N 52, art. 6951; 2014, N 23, art. 2930; N 30, art. 4106, 4244, 4247, 4257; N 43, art. 5798; N 49, art. 6927 , 6928; 2015, N 1, art. 72, 85; N 10, art. 1425).

It is allowed to burn the dosage forms specified in paragraphs two and three of this paragraph, and pharmaceutical substances specified in paragraph four of this paragraph.

Combustion of pharmaceutical substances and dosage forms after dousing with 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 ovens. Ash is removed or buried in the manner established by Federal Law No. 89-FZ of June 24, 1998 “On Industrial and Consumption Waste”.
(Clause 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 indicating:

- date and place of drawing up the act;

Place of work, positions, surnames, first names, patronymics of persons taking part in the destruction;

- grounds for destruction;

- information about the name (indicating the type of dosage form, dosage, unit of measurement, series) and quantity of the narcotic drug, psychotropic substance being destroyed, 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 monitoring activities related to the circulation of narcotic drugs and psychotropic substances.

________________

* (Collection of Legislation of the Russian Federation, 1998, No. 2, Art. 219).

Revision of the document taking into account
changes and additions prepared
JSC "Kodeks"

Document's name:
Document Number:	127
Document type:	Order of the Russian Ministry of Health
Receiving authority:	Ministry of Health of Russia
Status:	Active
Published:	Rossiyskaya Gazeta, N 89, 05/14/2003 Appendix to " Rossiyskaya newspaper", N 27, 2003 Bulletin of normative acts of federal executive authorities, N 33, 08.18.2003 New Pharmacy, No. 8, 2003 Healthcare, N 10, 2003 Babayan E.A., Gaevsky A.V., Bardin E.V. Legal aspects of the circulation of narcotic, psychotropic, potent, toxic substances and their precursors: State and departmental acts. Part III. - M., 2003
Acceptance date:	March 28, 2003
Start date:	May 25, 2003
Revision date:	07 May 2015

Footnote. Lost force by order of the Minister of Health of the Republic of Kazakhstan dated May 31, 2017 No. 357 (shall be enforced after twenty-one calendar day after the day of its first official publication).

5. When designing for construction, it is not allocated land plot in areas previously used for landfills, sewage disposal fields, cattle burial grounds, cemeteries with soil contamination of an organic, chemical, or radiation nature.

6. Healthcare 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, drug treatment) and complexes with a capacity of over 1000 beds for the stay of patients for a long time are located in the suburban area or outlying areas, in green areas, maintaining gaps from residential areas less than 500 meters (hereinafter – m).

8. The passage of main engineering communications (water supply, sewerage, heat supply, electricity) through the territory of healthcare facilities is not allowed.

9. The set and area of the main and auxiliary premises of healthcare facilities are determined by the design assignment and in accordance with the current building codes and the rules of “Medical 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 varying degrees of epidemiological danger.

11. In rural areas, it is planned to locate medical outpatient clinics, paramedic and 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. Residential and public buildings, built-in and attached premises, if there is a separate entrance, accommodate organizations providing outpatient care with a capacity of no more than 150 visits per shift, including day hospitals, outpatient surgery centers (patient stays no more than 5 days) with the exception of those intended to serve infectious patients and persons suffering from alcohol and drug addiction.

14. Rooms for magnetic resonance imaging are not located adjacent (horizontally and vertically) to wards for pregnant women, children and cardiac patients.

15. Reception and ward departments for patients, electro-phototherapy rooms, labor and delivery rooms, operating rooms, dressing rooms, treatment rooms, manipulation rooms, central sterilization departments, workshops, warehouses of toxic, potent, flammable and combustible liquids are not located in the ground and basement floors of buildings.

It is not allowed to place X-ray rooms directly under ward and residential premises.

16. Dental facilities are not located in the basements and ground 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 and visitors, and delivery of food to patients.

18. Infectious, psychiatric, dermatovenerological, anti-tuberculosis departments that are part of multidisciplinary hospitals are located in separate buildings.

19. In infectious diseases and anti-tuberculosis departments, a separate entrance (entrance) and a platform for disinfection of transport are provided.

20. Facilities buildings are connected to centralized cold and hot water supply and sewerage systems.

21. If there is no centralized water supply system in a settlement, imported water or water from the local system is used, which meets the sanitary and epidemiological requirements for the safety of water bodies.

22. In wards, offices, toilets, treatment rooms, dressing rooms, and auxiliary rooms of healthcare facilities, sinks with hot and cold water supply through mixers are installed. In rooms where instruments are processed, there is a separate sink for washing hands and a sink for processing instruments.

23. Preoperative, dressing rooms, delivery rooms, resuscitation rooms, treatment rooms, nursing stations in newborn wards, surgical, gynecological rooms, airlocks of boxes, half-boxes, laboratories are equipped with sinks with hot and cold water supply, for facilities with a centralized water supply with the installation of elbow taps, as well as elbow dispensers with liquid antiseptic soap and antiseptic solutions.

24. In maternal and child health organizations, surgical and infectious diseases hospitals, elbow dispensers with antiseptic for hand treatment are installed at the entrance to each department.

Additionally, medical personnel use individual dispensers with antiseptic for hand treatment.

25. In newborn wards, sinks with a wide bowl and hot and cold water supply through mixers are installed for washing children.

26. In the absence of a 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 of age, sanitary rooms, washing rooms, buffets, distribution rooms, catering units, laundries, continuous water heaters are installed actions.

27. When placing an object in non-sewered and partially sewered populated areas a local sewerage system and an export treatment system are provided. Waterproof container (pit) for receiving Wastewater equipped with a lid, placed in the utility area and cleaned as it is filled to two-thirds of its volume.

28. Cleaning and disinfection of wastewater from objects is carried out at general city sewerage treatment plants. In infectious diseases and anti-tuberculosis hospitals (departments) local treatment facilities are provided.

29. In infectious diseases, tuberculosis, dermatovenerology departments, washbasins with elbow or contactless taps are installed in the locks of boxes, half-boxes and staff toilets, and pedal releases are also provided for flush tanks in all toilets.

30. The discharge of wastewater from the premises of mud procedures and the mud kitchen of the mud baths is carried out through special ladders into the mud sump. In rooms for preparing gypsum, a gypsum sedimentation tank is installed under the washbasin. In rooms for preparing gypsum, it is necessary to install gypsum sedimentation tanks with a capacity of 0.1 cubic meters (hereinafter referred to as m3) under the washbasin.

31. To purify industrial wastewater from the catering department, grease traps are installed at the facilities.

32. Floor drains are equipped with a slope in the rooms for washing and disinfecting vessels, for processing cleaning equipment, the main workshops of catering departments and laundries.

33. Pipes of water supply and sewerage systems are covered with casings along their entire length and are made of material resistant to detergents and disinfectants.

34. Natural lighting is provided in the premises of the facilities.

35. Windows oriented to the southern point of the horizon are equipped with sun-protection devices (visors, blinds).

36. Artificial lighting is provided in all premises.

37. Lighting fixtures placed on ceilings are equipped with solid (closed) shades.

38. To illuminate the wards (except for children's and psychiatric departments), wall-mounted combined 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 second light or only artificial lighting is allowed in storerooms, sanitary facilities, enema rooms, personal hygiene rooms, showers and dressing rooms for staff, thermostat, microbiological boxes, preoperative and operating rooms, hardware rooms, anesthesia rooms, photo laboratories, rooms where operating rules do 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 light pockets does not exceed 24.0 m and to the pocket no more than 36.0 m. The corridors of treatment, 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 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 rooms 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 are carried out according to the approved schedule of the institution.

44. Buildings are equipped with forced-air ventilation systems. In infectious diseases hospitals (departments), including anti-tuberculosis ones, a separate exhaust ventilation system with gravity assist is installed in each box and half-box in the ward section. If there is no supply and exhaust ventilation with artificial impulse in infectious diseases departments, natural ventilation is installed with each box and half-box equipped with a recirculation-type air disinfection device.

45. In healthcare facilities, by order of the manager, a person is appointed who is responsible for the operation of ventilation and air conditioning systems and the implementation of the schedule for planned preventative repairs of ventilation systems.

46. In all rooms, except operating rooms, in addition to mechanically driven supply and exhaust ventilation, natural ventilation is provided.

47. The intake of outside air for ventilation and air conditioning systems of anti-tuberculosis organizations is carried out from a clean area at a height of at least 3 m from the ground surface, the emission is at least 2 m.

48. The air supplied to operating rooms, anesthesia rooms, labor and delivery rooms, resuscitation rooms, 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 rooms, maternity wards, treatment rooms, 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 suction or the installation of fume hoods. In laboratories that use complex techniques for various staining of preparations, biological safety cabinets are installed.

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, intensive care units, in wards for newborns, infants, premature, injured children. Not provided in wards fully equipped with incubators.

52. The use of split systems in premises requiring compliance with a special anti-epidemic regime is permitted in the presence of high efficiency filters.

53. The frequency of air exchange is selected based on calculations to ensure the specified purity and maintain the gas composition of the air. Relative air humidity no more than 60%, air speed no more than 0.15 meters per second (hereinafter referred to as m/sec).

54. Air ducts, grilles, ventilation chambers are kept clean, without mechanical damage, signs of corrosion, or leaks. The inner surface of the supply and exhaust ventilation (air conditioning) air ducts prevents the removal of particles of the air duct material and protective coating into the premises. Internal coating made of material that does not have sorbing properties. Cleaning and disinfection of ventilation systems is carried out in accordance with the established schedule of the medical institution.

55. General supply and exhaust and local exhaust units are turned on five minutes before the start of work and turned off five minutes after the end of work.

56. In all rooms, air is supplied to the upper zone, to sterile rooms, by laminar or slightly turbulent jets at a speed of no more than 0.15 m/sec.

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 is installed.

59. In aseptic rooms, hidden installation of air ducts, pipelines, and fittings is carried out.

60. Exhaust ventilation with artificial impulse without an organized inflow device is equipped in autoclaves, showers, toilets, sanitary rooms, rooms for dirty linen, temporary storage of waste and storage rooms for disinfectants.

61. Independent supply and exhaust ventilation and air conditioning systems are provided for the following premises: operating units, resuscitation rooms and intensive care wards (separately for septic and aseptic departments), delivery rooms (delivery wards), neonatal wards, oncohematology, dialysis, burn dressing rooms, separate ward sections, x-ray rooms.

62. In anti-tuberculosis hospitals (departments):

1) the ventilation system provides at least six air exchanges per hour in wards and twelve times in rooms for performing aerosol-generating procedures (sputum collection room, bronchoscopy), preventing the occurrence of stagnant zones;

2) rotary or plate type recuperators are not used;

3) exhaust units serving areas high risk and biological safety cabinets of class 1-2, 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 airlocks are equipped with devices for automatic closing, doors of chambers and boxes (in the lower part of the door) with ventilation grilles for air flow;

7) exhaust ventilation from departments for patients with multidrug-resistant mycobacteria is arranged separately from each room with gravity assist and the installation of a deflector. Supply ventilation in these departments is provided with mechanical stimulation and air supply into the corridor;

8) the exhaust air flow rate is at least 80 cubic meters per hour (hereinafter referred to as m3/hour) per bed. Wards for patients who do not emit bacteria are equipped with supply and exhaust ventilation with a supply air flow rate of 80% of the exhaust air volume;

9) staircases, 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, category of cleanliness in the premises, including the day hospital of healthcare facilities, correspond to the parameters established in Appendix 2 to these Sanitary Rules.

65. Permissible levels of bacterial contamination of the air environment of premises, depending on their functional purpose and the cleanliness class of healthcare facilities, correspond to the parameters established in Appendix 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 bacterial excretion and unknown drug susceptibility status are kept in single rooms until drug susceptibility test results are available.

122. In the wards, beds are installed in strict accordance with the area.

123. In the compulsory treatment department, separate hospitalization of tuberculosis patients is provided depending on drug sensitivity.

124. Patients with chronic forms of tuberculosis with constant bacilli excretion, who require symptomatic treatment, are subject to isolation in specialized organizations or departments at anti-tuberculosis organizations until the period of abacillation.

125. In anti-tuberculosis dispensaries, separate rooms are allocated for outpatient treatment of patients secreting multi- (poly-) resistant strains.

126. In anti-tuberculosis hospitals, a cycle of filling wards within fourteen calendar days is observed.

127. Each department of tuberculosis hospitals is divided into “clean” and “dirty” zones, with a gateway between them equipped with air disinfection devices and a sink for washing hands.

128. Hermetic doors are placed along the entire perimeter of the airlock, opening towards the “dirty” area 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, the 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 hand washing sink with a dispenser with antiseptic soap and antiseptic solution, containers with a disinfectant solution, containers for clean containers and containers with sputum (bins, metal boxes with handles made of galvanized or stainless steel), 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 studies:

1) for preparing and staining smears;

2) for bacterioscopy;

3) for registration and storage of drugs.

132. Visiting inpatients to anti-tuberculosis organizations is not allowed.

133. Patients with the release of Mycobacterium tuberculosis eat food in the wards.

134. The sleeping quarters of rehabilitation centers for children consist of isolated ward sections. The sections are additionally equipped with: a playroom, a bedroom, a dressing room with drying cabinets, and a pantry.

The capacity of dormitory rooms for children does not exceed five beds. There is a room for ironing and cleaning clothes and a storage room for children's belongings in two sections.

135. In the rehabilitation center for adults, provide single and double bedrooms. The residential building of the center includes a treatment room, separate storage rooms for clean and dirty linen, a utility room, a room for duty personnel and a storage room for cleaning equipment, detergents and disinfectants.

136. The area of therapeutic, orthopedic, surgical, and orthodontic dental offices is determined at the rate of 14 m2 for the main dental chair and 7 m2 for each additional one. If the additional chair has a universal dental unit, the area increases to 10 m2.

137. Dental organizations are located in separate, built-in (built-in-attached) premises located on the first floors of residential and public buildings with a separate entrance, subject to the requirements of these Sanitary Rules.

138. In dental laboratories, the dental technician’s workplace in the main room is equipped with a special dental table and an electric grinding machine with local dust suction. The area of the dental laboratory is at least 7.0 m2, per workplace at least 4.0 m2. Mechanically driven fume hoods are equipped in sterilization and soldering rooms; local dust extraction at the dental technicians' workplaces 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, light therapy and ultrasound therapy is equipped at a rate of at least 6 m 2 per stationary device.

140. The electrical sleep room is located in a non-passable area, taking into account the orientation of the windows into a quiet area, under soundproof conditions. The office has a walk-through equipment room with an observation window for observation.

141. The group inhalation room is isolated from other rooms.

142. Physiotherapy departments are divided into a “dry” zone (electrical, light, heat therapy rooms) and a “wet” zone (hydrotherapy, mud therapy). Separate rooms are equipped for carrying out procedures for each type of treatment. It is allowed to place equipment for electrotherapy and light therapy in the same room.

143. The acupuncture department provides: 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 using the stairs between the pools.

145. The mud therapy room consists of separate cabins with adjacent shower cabins and two cabins for undressing patients. The entrance for patients is only through changing cabins and showers.

146. Electromud procedures are carried out in a separate isolated room, which is part of the mud treatment premises.

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 hirudotherapy office provides the following premises: for waiting for an appointment, an office for dispensing medical procedures, sanitary premises (bathroom, room for storing cleaning equipment). A certificate of conformity is provided for each batch of leeches. Leeches are used once, they are not used repeatedly. After use, leeches are placed in trays with salt after regurgitation of blood, then 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 at the facilities.

The CSO premises are divided into three zones:

1) dirty (reception of dirty material, sorting, putting into a disinfection-washing machine);

2) clean (unloading cleaned, disinfected and dried material from the disinfection-washing machine, packaging, placing it in the sterilizer). A separate room is provided for packaging medical linen;

3) sterile (receipt of sterile material from sterilizers and its storage).

150. Entrance to the premises of clean and sterile areas is carried out through a sanitary entrance.

151. Additional premises: expedition (issuance of sterile material), sanitary facilities and living quarters for medical personnel.

152. In independently organized medical and dental offices, provide a washing and sterilization area of at least 6.0 m2 for up to three workplaces, and at least 8.0 m2 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 for one bed in a hospital and 0.4 kg of dry linen per day for one visit to an outpatient clinic.

154. At small healthcare facilities, a mini-laundry is provided (for washing work clothes, towels, napkins) 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 area are determined by the capacity of the hospital). If there is no own disinfection department, disinfection of bedding is carried out in organizations that have disinfection chambers.

156. The pathology department and morgue have three entrances and exits, two for separate reception and delivery of corpses, the third for staff use.

157. The morgue provides the following premises: reception and storage of corpses, sectional rooms (at least two), including a small sectional room for autopsy and delivery of corpses of people who died from infectious diseases with a separate external entrance and access roads, a hall for ritual procedures and delivery of corpses , storage of fixed material, clothing, coffins and other property, living quarters for staff.

158. Premises associated with the transportation of corpses inside the building, performing autopsies, processing and storing unfixed sectional material are separated by a vestibule or corridor from the histological laboratory, premises for doctors and service personnel, the museum and household premises.

159. The layout of doorways and the design of doors in the rooms for storing corpses, pre-section, section, room for dressing corpses and in the mourning hall ensure the free passage of stretchers and the passage of gurneys.

160. In forensic medical examination centers, the examination department for living persons is located in an isolated compartment, with an independent entrance.

161. The room for storing corpses is equipped with refrigeration units providing a temperature of +2 o C - +4 o C, mechanization means for transporting corpses, racks, shelves or special safes. Storing corpses on the floor is not permitted. When storing corpses on different floors, an elevator is equipped.

162. Cold and hot water. The sectional table is equipped with a container for collecting and disinfecting wastewater before draining it into the sewer. The work place at the sectional table is equipped with a wooden grid.

163. Section tables, gurneys, stretchers and other devices for transporting corpses are covered with waterproof material that is resistant to detergents and disinfectants.

164. The floor is washed daily hot water with detergents, wall panels, doors are washed as they become dirty, but at least once a week.

165. At least once a month and after autopsy of corpses who died from infectious diseases, the premises are thoroughly cleaned using detergents and disinfectants.

166. Work with sectional material is carried out using personal protective equipment (robe, gloves, aprons, goggles). 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 (floors, 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 indicating the premises and types of cleaning work, is used strictly for its intended purpose, and is disinfected after use.

169. The outer and inner surfaces of medical furniture are made of smooth materials that are resistant to detergents and disinfectants.

170. All technological, sanitary, engineering and other equipment available in the hospital are in good condition.

171. General cleaning of the premises of ward departments, functional rooms and offices using detergents and disinfectants approved 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. To carry out general cleaning, personnel are provided with special clothing, personal protective equipment, marked cleaning equipment and clean rags.

173. After discharge, transfer, or death of the patient, the vacated ward is cleaned 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, maternity rooms, treatment rooms, manipulation rooms, sterilization rooms, intensive care wards, rooms with aseptic conditions is carried out once a week with the treatment and disinfection of equipment, furniture, and equipment.

175. In operating rooms, dressing rooms, maternity rooms, intensive care wards, wards for newborns, premature babies and children under one year of age, treatment rooms, infectious disease boxes, rooms with aseptic conditions, after each current cleaning, ultraviolet irradiators are turned on for thirty minutes, after general cleaning for 2 hours . When using other installations for air disinfection, the calculation is carried out in accordance with the operating instructions. The accounting of time worked by bactericidal irradiators is recorded in a log in the form according to Appendix 5 to these Sanitary Rules.

176. Unshielded mobile bactericidal irradiators are installed at a power rate of 2.0-2.5 watts (hereinafter referred to as W) per cubic meter of room. Shielded bactericidal irradiators with a power 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 towards 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 sign “Do not enter, the bactericidal irradiator is on!” in the state and Russian languages.

178. To reduce air contamination to a safe level, the following technologies are used:

1) exposure to ultraviolet radiation using open and combined bactericidal irradiators used in the absence of people, and closed irradiators, including recirculators, allowing air disinfection in the presence of people;

2) the use of bacterial filters.

Irradiators and filters are used in accordance with the operating instructions.

179. Patients' linen is changed once every seven days and when soiled.

Tuberculosis patients undergoing inpatient treatment are provided with TB hospital clothing.

180. Bed linen for postpartum women is changed every three days and when soiled.

181. In operating rooms, maternity rooms, and rooms with aseptic conditions, sterile or disposable linen is used.

182. Collection of used linen is carried out in dense special containers (oilcloth, plastic bags, equipped linen trolleys). Dirty linen is not sorted in the departments.

183. Temporary storage (no more than twelve hours) of dirty linen in departments is carried out in sanitary rooms, specially designated premises for this purpose in closed containers (metal, plastic tanks), which are easily washed and disinfected. To work with dirty linen, personnel are provided with a change of sanitary clothing.

184. Clean linen is stored in specially designated rooms on racks, in cabinets on shelves.

185. Laundry is washed 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. Linen from infectious diseases, purulent-surgical and pathology departments is disinfected before washing.

186. Transportation of clean and dirty linen is carried out packaged in closed, marked 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 at the healthcare facility, which provides for:

1) high quality and quantitative composition generated waste;

2) waste collection procedure;

3) applied methods of disinfection (neutralization) and waste disposal;

4) hygienic training of personnel in the rules of epidemic safety when handling waste.

188. In order to organize a medical waste management system, the following are appointed by order of the head of a healthcare facility:

1) a person organizing waste management and monitoring compliance with the requirements of these sanitary rules, sanitary and epidemiological legislation, waste legislation, who undergoes periodic training on waste management issues at advanced training courses;

2) persons responsible for waste management in each structural unit who are trained in the management of medical waste. Instructions for handling medical waste are carried out by the person specified in the previous paragraph of these sanitary rules.

189. Personnel undergo preliminary and periodic medical examinations. Persons under 18 years of age are not allowed to work with waste.

190. Personnel are provided with sets of workwear and personal protective equipment (robes, overalls, gloves, masks, respirators, special shoes, aprons, oversleeves).

191. To collect waste, disposable, waterproof bags, packages, metal and plastic containers, containers for collection and safe disposal are used.

To collect each class of waste, bags, packages of different colors are used (class waste A - white, B - yellow, C - red, D - black), containers, containers - labeling. 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 carts or inside reusable containers. Waste collection containers and carts 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 (puncture-resistant) containers yellow color or having a yellow marking.

194. Piercing and sharp objects are collected separately from other types of medical waste into puncture-proof and waterproof KBSU without prior disassembly and disinfection.

If there are special devices for cutting off needles (needle pullers, needle destructors, needle cutters and others), it is allowed to collect used syringes without needles together in disposable soft bags (bags) with other class B waste that is subject to destruction in special installations.

195. To collect organic, liquid waste of class B, disposable moisture-resistant containers with a lid that ensures their sealing are used. Liquid waste is subject to mandatory disinfection (disinfection), after which it is discharged into the drainage system.

196. KBSU are filled to no more than three-quarters of the volume.

Once filled, the KBSU is tightly closed with a lid and sent to a room for temporary storage of medical waste, where it is stored for no more than three days.

197. When organizing waste disinfection using special neutralization installations, the collection, temporary storage, and transportation of class B waste is carried out without prior disinfection at the places of generation, provided that epidemiological safety is ensured.

198. Pathological and organic operational waste of class B (organs, tissues, etc.) 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 disinfection (disinfection) by physical methods (thermal, microwave, radiation and others) at a healthcare facility. Application chemical methods Disinfection is allowed only for the disinfection of food waste and patient secretions, as well as when organizing primary anti-epidemic measures in outbreaks. Removal of non-disinfected Class B waste outside the territory of the organization is not permitted.

Class B waste is collected in disposable soft packaging (bags) or hard (puncture-proof) containers that are red or have red markings. Used disposable piercing (cutting) instruments and other medical devices (hereinafter referred to as medical devices) are placed in hard (puncture-proof) moisture-resistant sealed containers. Liquid biological waste of class B after disinfection (disinfection) is discharged into the sewer system.

200. During the final packaging of waste of classes B and C for removal from the unit, disposable containers (bags, KBSU) are marked with the appropriate inscriptions “Waste. Class B/Class C (respectively). Name of the organization, unit, date and name 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. Once filled, the containers are tightly closed and stored in a temporary storage room for medical waste. As they accumulate, they are removed and disposed of by specialized organizations.

The 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, which has 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. Class D radioactive “long-lived” medical waste is sent for disposal at special landfills (burial grounds).

203. The responsible person of the medical organization keeps daily records of medical waste in a journal in the form according to Appendix 6 to these Sanitary Rules.

5. Requirements for temporary storage of medical waste at
healthcare facilities

204. For the temporary storage of medical waste of class B, C, D, a separate room is allocated at a healthcare facility.

205. Storage of food waste, non-disinfected class B waste, for more than twenty-four hours is carried out in refrigerators and freezers.

In medical organizations (health centers, offices, medical stations), waste of classes B and B in containers is temporarily stored in utility rooms (for storage of more than 24 hours, refrigeration equipment is used).

206. Containers with class A waste are stored in a special area.

207. Containers are located no closer than 25 m from the healthcare facility. The area for such containers is fenced on three sides to a height of 1.5 m.

208. The room for storing medical waste is equipped with exhaust ventilation, refrigeration equipment for storing biological waste, shelving, containers for collecting bags of medical waste, a sink with hot and cold water supply, and a bactericidal lamp.

209. Waste of classes A, B, C is stored at the place of generation for no more than one day (with the exception of KBSU with sharp objects, which are removed when three-quarters of the volume is filled), in containers at special sites or in premises for temporary storage of waste containers no more than three days. Class B biological waste is stored at a temperature not exceeding +5 o C.

210. After loading medical waste from temporary storage premises to motor vehicle, the premises, used inventory and equipment are disinfected.

211. The premises for temporary storage of medical waste are located in close proximity to the exit from the health care facility and with access roads for removal.

6. Requirements for transportation of medical waste

212. When transporting medical waste of class A, a vehicle designed for transporting solid household waste is used.

213. Discharge of liquid medical waste of classes B and C into the sewer network without neutralization is not permitted.

214. Residues from pathogenic biological agents, used utensils, and solid medical waste from the “infectious” zone of laboratories are collected in containers and neutralized in autoclaves or with disinfectants.

215. Transportation of hazardous medical waste of class B and C is carried out in accordance with sanitary and epidemiological regulation 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 the regulation 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 vehicle for transporting medical waste is equipped with a waterproof closed body that can be easily disinfected. This vehicle is not used for other purposes.

7. Requirements for the disposal of medical waste

217. The burning of medical waste of class B, C on the territories of healthcare organizations outside specialized installations is prohibited.

218. Thermal waste neutralization is carried out by thermal exposure of medical waste at a temperature not lower than +800 - +1500 o C, or according to the operating temperature of a special installation for the neutralization of medical waste.

The incineration of medical waste is provided in special installations (non-disinfected medical waste of class “B” and all medical waste of class “B”), located taking into account the size of the sanitary protection zone in accordance with regulatory documents.

219. To accommodate the installation, the following are provided: a temporary storage room for waste with an area of at least 10 m2, an installation room with an area of at least 20 m2 (unless otherwise provided by the manufacturer), equipped with supply and exhaust ventilation with a predominance of exhaust over inflow, with drainage into the system drainage and water supply, service premises (staff room, bathroom, shower).

For interior decoration, materials are used in accordance with the functional purpose of the premises.

220. Class A waste from places of generation is delivered to a container located on the territory of a healthcare facility and transported to solid waste landfills as the containers are filled, at least once every three days.

221. Final products waste treatment is disposed of in municipal solid waste landfills.

8. Sanitary and epidemiological requirements for the organization
nutrition of patients, to the working conditions of medical personnel at
healthcare facilities

222. The catering unit of a healthcare facility is located in a separate building, connected to the main building and other buildings, convenient above-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 and food products are stored in compliance with the rules of commodity proximity. Storing perishable food products in the absence of refrigeration equipment is not permitted.

224. When drawing up the weekly menu layout, the approved nutrition standards are taken into account.

225. When replacing products and dishes, a weekly count is carried out chemical composition and nutritional value (calorie content) of diets.

226. Every day a daily sample of prepared dishes is left at the catering unit. For a daily sample, half portions of first courses are left, portioned second courses are selected entirely in quantities of at least 100 grams (hereinafter referred to as grams), third courses are selected in quantities of at least 200 grams.

Daily samples are stored in sealed lids 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 prepared food. After 24 hours, the daily sample is discarded as food waste. The containers for storing the daily sample (containers, lids) are treated by boiling for five minutes.

227. To deliver prepared food to hospital pantries, labeled (for food) thermoses or dishes with lockable lids are used. Transportation is carried out using special trolleys.

228. Distribution of ready-made food is carried out by barmaids and nurses on duty in the department wearing gowns marked “for food distribution”. The distribution of food in accordance with the prescribed diets is monitored by the senior nurse.

229. During distribution, first courses and hot drinks have a temperature of not lower than + 75 o C, second courses - not lower than +65 o C, cold dishes and drinks - from +7 o C to +14 o C. Until the moment of distribution, first and second courses are on a hot stove for up to two hours from the moment of preparation. It is not allowed to mix food with leftovers from the previous day and food prepared in a early dates the same day.

230. In the buffet departments, two rooms are provided: for distributing food and washing dishes with the installation of a three-cavity bath.

231. Backup water heaters with water supply to washing baths are installed in pantry rooms, and sterilizers for processing tableware are installed in pantry rooms of infectious disease, skin and venereal disease, and anti-tuberculosis departments.

232. The processing of dishes is carried out in the following sequence: mechanical removal of food and washing in the first sink with degreasers, rinsing with hot water in the second sink and drying the dishes on special shelves and racks.

233. In the pantries of infectious, dermatovenerological, anti-tuberculosis hospitals (departments), for epidemiological indications in departments of other profiles:

1) after eating, the dishes are collected in the pantry on a separate table, freed from food residues, disinfected, washed and dried. Disinfection is carried out chemically (solutions of disinfectants, including in a washing machine) or thermally (boiling, treatment in an air sterilizer);

2) food remains are dumped into a special marked tank with a lid and disinfected according to the regimes for the corresponding infections by adding a dry disinfectant in a ratio of one to five (one hour exposure). The table for used dishes, brushes, and ruffers are disinfected after each use. Cloths for tables and washing dishes are disinfected by immersing in a disinfectant solution, rinsing and drying.

234. Transfers for patients are sent in plastic bags indicating the patient’s last name, first name, and date of transfer. At the places where deliveries are received, lists of permitted (indicating their quantity) and prohibited products for transfer are posted.

235. When providing medical care to children under one year of age, the children's department provides a room for preparing and dispensing infant formula. After opening the package, dry milk formulas are marked with the date and time of opening and are stored under the conditions and terms indicated on the package “storage after opening the package.” Dilution of mixtures is carried out using sterile containers. Ready-made milk formulas are transported, used, stored and distributed in accordance with the manufacturer's documents.

236. Household premises for personnel are equipped as a 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 cabinets for storing special and personal clothing.

237. To provide food for staff, it is necessary to provide canteens or buffets; all departments have a staff room with an area of 12.0 m2, equipped with a refrigerator, devices for heating water and food, and sinks for washing hands. Food is not accepted at work places.

238. Medical personnel are provided with three sets of replacement work clothes: gowns, caps (kerchiefs), and replacement shoes. Sanitary clothing is changed daily and when soiled. Washing of sanitary clothes is carried out centrally, separately from the patients’ linen.

239. Medical personnel providing advisory assistance, technical, administrative and economic personnel performing temporary work in hospital departments are provided with a change of clothes and shoes.

9. Sanitary and epidemiological requirements for conditions
carrying out sterilization and disinfection of medical products
appointments at healthcare facilities

240. Disposable medical instruments are subject to disposal without prior disinfection.

241. After use, reusable medical products are subject to disinfection, pre-sterilization cleaning, drying, packaging and sterilization.

242. Disinfection of instruments is carried out at places of use using various methods (boiling, steam, air, chemical).

243. Two containers are used to disinfect medical devices. In the first container, the instruments are washed from residual blood, mucus, and medications, then 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 first washed in a separate container with water and then disinfected.

244. Disinfectant solutions are used according to 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 mechanized (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 (azopyram, phenolphthalein) for residual amounts of blood and alkaline components of synthetic detergents. At least 1% of medical products of each name (at least 3-5 units) of each batch are subject to control.

247. Pre-sterilization cleaning and sterilization of medical devices is carried out in a centralized sterilization department, or, if not available, in a specially designated area of departments of healthcare facilities.

Sterile material is delivered to departments in closed transport containers, special bags, and a transport elevator.

248. Sterilization of medical devices is carried out by physical (steam, air, infrared, glass-perlene), chemical (solutions of chemicals, 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 specific product, in the operating instructions for the sterilizer.

250. Control of the operation of sterilizing equipment is carried out using physical methods(control and measuring instruments), chemical (thermochemical indicators), biological tests.

251. Persons over eighteen years of age who have passed a medical examination, course training 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-soda solution, rinsed with running water, and dried. Doll clothes are washed and ironed once a week. Soft toys are not used.

253. Germicidal chambers equipped with ultraviolet lamps are used only for storing sterile instruments.

10. Sanitary and epidemiological requirements for the organization and
carrying out sanitary and anti-epidemic
(preventive) measures at healthcare facilities

254. In the emergency department, an examination of the pharynx, temperature measurement, examination for lice, scabies, and dermatomycosis of incoming patients are carried out, with a note in the medical history. Biological material is 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 emergency department (box) until transferred to the infectious disease department (hospital).

256. Patients are sanitized upon admission to the hospital and given a set of clean underwear, pajamas, and slippers. It is allowed for patients in the hospital to wear home clothes, with the exception of patients undergoing treatment in anti-tuberculosis organizations.

257. Sanitary treatment of the woman in labor is carried out after examination according to indications or at the request of the woman.

258. Observe the cyclic 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 of patients with purulent discharge are carried out in a septic dressing room, if there is none, in an aseptic dressing room, after dressings of patients who do not have purulent discharge.

261. After use, cleaning equipment is disinfected, dried and subsequently 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 plane for normalizing the coefficient of natural light (KEO) and illumination (L-horizontal, V-vertical) and the height of the plane above the floor	Level and sublevel 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, physical therapy, massage rooms
Rooms: hydrotherapy, therapeutic baths, shower rooms
occupational therapy
For sleep therapy
Facilities for the preparation of paraffin, ozokerite, gasket processing, dirt regeneration
Day wards
Storage areas for medicines and dressings
Disinfectant storage facilities
Procedural, manipulative
Offices, nurses' stations
Premises for day care of patients
Meal facilities
Hardware rooms (control panels), washing, sterilization, sorting and storage rooms, linen rooms
Registry
Corridors
Storage areas for portable equipment
Sanitary facilities: Washrooms, latrines; Smoking rooms; Showers, dressing rooms street clothes

table 2

Natural lighting		Combined lighting		Artificial lighting
KEO, e 11, %		KEO, e 11, %		Illumination, lux, general lighting	Index discomfort M no more	Coefficient pulsation - illumination K p, %, no more
At the top or combined lighting	With lateral lighting	At the top or combined lighting	With lateral lighting	Illumination, lux, general lighting	Index discomfort M no more	Coefficient pulsation - illumination K p, %, no more

Temperature, air exchange rate, cleanliness category in
premises, including day hospital facilities
health

Name premises	Design air temperature,	Multiplicity air exchange per 1 hour		premises	Multiplicity hoods at natural air exchange
Name premises	Design air temperature,			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 sick (adults, children)		80 m 3 /h for 1 bed
Chambers for tuberculosis sick (adults, children)
Chambers for patients with hypothyroidism		80 m 3 /h for 1 bed
Wards for patients with thyrotoxicosis
Postoperative wards, resuscitation halls, chambers intense therapy, birth boxes, operating rooms, anesthesia rooms, wards for 1-2 beds for burn patients Pressure chambers		By calculation, but not less than tenfold			Not allowed
			aseptic (20% anesthesia, sterilization) septic		Not allowed
Postpartum					Not allowed
Wards for 2-4 beds for burn patients, wards for children					Not allowed
Chambers for premature, newborns and injured		By calculation, but not			Not allowed
Chambers for premature, newborns and injured			aseptic 100% septic		Not allowed
Boxes, half-boxes, filter boxes, preboxes		(feed from corridor
Ward sections infectious departments		for 1 bed	80 m 3 /h at
Prenatal filters, reception and examination boxes, viewing dressings, manipulation preoperative rooms, rooms for feeding children under 1 year, premises for vaccinations
Sterilization during operating rooms			3 - septic departments 3- aseptic departments
Small operating rooms, incl. in daily hospitals
Doctors' offices, offices reflexology day room stay		Influx from corridor
		working out in the gym
Functional cabinets diagnostics sigmoidoscopy
Treatment room physical education, mechanotherapy, offices sounding
Lobbies, rooms for eating, compressor inhalators, linen and storerooms premises
Microwave cabinets and ultra-high frequency therapy rooms thermotherapy, treatment rooms ultrasound					Not allowed
Storage pantries dirty laundry, cleaning items disinfectants

Acceptable levels of bacterial contamination in air
indoor environment depending on their functional purpose
and cleanliness class of healthcare facilities

Table 1

Cleanliness class	Name of premises	Sanitary and microbiological indicators
		total number of microorganisms in 1 m 3 of air (colony forming units (CFU/m 3)		number of colonies of Staphylococcus aureus in 1 m 3 of air (colony forming units (CFU/m 3)		the number of mold and yeast fungi in 1 dm3 of air
		Before you start	During work	Before you start	During work	Before you start	During work

Extra pure (A)	Operating rooms, maternity rooms, dialysis rooms, aseptic boxes for hematology and burn patients, wards for premature babies, aseptic block of pharmacies, sterilization room (clean half), boxes for bacteriological laboratories	No more than 200	No more than 500	Must not be	Must not be	Must not be	Must not be
Clean (B)	Treatment rooms, dressing rooms, preoperative rooms, intensive care wards and rooms, children's wards, rooms for collecting and pasteurizing breast milk, assistant and packaging 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 pure (B)	Surgical wards, corridors adjacent to operating rooms, maternity rooms, examination rooms, boxes and wards of infectious diseases departments, residents' rooms, material rooms, clean linen storage rooms	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 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 "lin" characteristic L, dB
Purpose of premises or territories	Times of Day

Wards of hospitals and sanatoriums, operating hospitals	Around the clock
Territories directly adjacent to the buildings of hospitals and sanatoriums	Around the clock
Recreation areas on the territory of hospitals and sanatoriums	From 7 a.m. to 11 p.m.
Territories directly adjacent to the buildings of clinics, outpatient clinics, dispensaries,	Around the clock

Permissible noise levels generated by individual species
medical equipment depending on operating modes (noise
characteristics at a distance of one meter from the equipment)

table 2

Product name	Permissible sound level L A, dBA	Operating mode

Surgical equipment, equipment for artificial ventilation, anesthesia and respiratory equipment		Continuous
Laboratory equipment (for clinical, biochemical, bacteriological and other studies)		Continuous
Sterilization and disinfection equipment		Continuous
Physiotherapeutic, X-ray equipment, devices for functional diagnostics, similar equipment		Repeatedly short-term
Dental and laboratory equipment (centrifuges, thermostats, similar equipment)		Repeatedly short-term
Washing equipment		Repeatedly short-term

Logbook of hours worked for bactericidal irradiators

Daily medical waste log

For 20___ year

(name of healthcare facility)

Classes of medical waste	Name of the department of healthcare facilities	Volume of medical waste delivered to the temporary storage room	Signature of the healthcare worker who accepted the medical waste	Due date	Sent for disposal (disposed of)	Signature of the person responsible for disposal

Class B, kg
Class B, kg
Thermometers; Germicidal lamps; Fluorescent lamps b) cytostatics: Liquid, l; Solid, Mr. c) medications: Liquid, l; Solid, Mr.

routine inspections at healthcare facilities

Table 1

No.	Types of research	Frequency of research


	Temperature, relative air humidity, air exchange rate, illumination.	1 time per year	Wards for patients, post-operative wards, resuscitation rooms, intensive care wards, labor and delivery boxes, operating rooms and anesthesia rooms, hyperbaric chambers, postpartum wards, wards for premature babies, newborns, boxes, half-boxes, pre-boxes, filters, viewing rooms, dressing rooms, manipulation rooms, procedural rooms, sterilization rooms , exercise therapy rooms, functional diagnostic 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 staff workplaces, in rooms and areas adjacent to the treatment room
	Determining the effective radiation dose to a patient using an X-ray emitter radiation output meter	at least once a year	For each medical X-ray diagnostic device that is 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, treatment rooms, resuscitation, post-operative, burn wards, functional diagnostic departments, clinical diagnostic laboratories, physiotherapy rooms, x-ray rooms
		1 time per year	X-ray rooms
		1 time per year	Wards, treatment rooms, intensive care units, postoperative rooms, burn wards, clinical diagnostic laboratories, pathology departments
		1 time per year	Resuscitation, post-operative, burn wards, physiotherapy rooms
			Preoperative, procedural, dressing, manipulation, clinical diagnostic laboratories, pathology departments, functional diagnostic departments, buffets - dispensing (at least 2 types)
		According to the established frequency of inspections	Centralized sterilization and according to indications
4. Research on products, ready meals and diets
		1 time per year	Food units of organizations
	Heat treatment efficiency	According to the established frequency of inspections	Ready-made dishes from meat and fish products on the distribution line
	Microbiological indicators of food safety	According to the established frequency of inspections	Food units of organizations, buffet - dispensing
5. Water research
	Water for bacteriological and sanitary-chemical indicators	According to indications	Water used for domestic and drinking purposes (from the distribution network and imported water)
6. Sanitary and bacteriological indicators when 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 corresponds to hygienic requirements to the air of the working area.

Laboratory and instrumental studies carried out at
production control (self-control) at facilities
health

table 2

No.	Types of research	Frequency of research	Location of measurements or sampling

	1. Control of physical factors
	Air exchange rate	1 time per year	Wards for patients, postoperative wards, resuscitation rooms, intensive care wards, birth boxes, operating rooms and anesthesia rooms, hyperbaric chambers, postpartum wards, wards for premature babies, infants, newborns, boxes, half-boxes, pre-boxes, filters, viewing rooms, dressing rooms, manipulation rooms, treatment rooms, sterilization rooms, exercise therapy rooms, functional diagnostic rooms, patient reception rooms, main stock storage rooms: medicines, dressings and medical products
2. Sanitary and chemical control
	Determination of the concentration of active substances in disinfectants and solutions	1 time every 3 months	Preoperative, procedural, dressing, manipulation, clinical diagnostic laboratories, pathology departments, functional diagnostic departments, buffets - dispensing
	Quality control of pre-sterilization cleaning (azopyram, phenolphthalein tests)	at least 1% of medical products of each type (at least 3 – 5 units)	After pre-sterilization cleaning of medical devices
3. Sanitary and bacteriological indicators when assessing the sanitary condition of organizations
	Bacteriological study of swabs from external environment(for coliform bacteria, pathogenic staphylococcus, opportunistic and pathogenic microflora)	1 time every 3 months	Medical equipment and inventory, linen, hands and overalls for personnel, equipment for catering departments and distribution areas
	Bacteriological study of the air environment	1 time every 3 months	Operating rooms, preoperative rooms, maternity rooms, wards and intensive care rooms, aseptic boxes, sterilization, dressing, manipulation, treatment rooms, dental rooms, wards for premature babies, aseptic block of pharmacies, premises of bacteriological and clinical laboratories
	Sterility testing (washes, material)	1 time per month	Operating rooms, maternity rooms, resuscitation rooms, sterilization rooms, dressing rooms, manipulation rooms, dental rooms, treatment rooms, aseptic ward rooms
	Bacteriological control of disinfection and sterilization equipment	1 time every 3 months	Sterilization and disinfection departments
4. Physical and chemical control of equipment
	Monitoring the operation of disinfection and sterilization equipment	Every day on every download	Sterilization and disinfection departments

P R I K A Z Ministry of Health of the Russian Federationdated March 28, 2003 N 127On approval of the Instructions for Destructionnarcotic drugs and psychotropic substances,psychotropic substances and their precursors subject tocontrol in the Russian Federation, furtherthe use of which in medical practicefound inappropriateRegistered by the Ministry of Justice of the Russian FederationMay 5, 2003 Registration No. 4484In 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 instruments and equipment that have been confiscated or withdrawn from illegal circulation or the further use of which is recognized inappropriate" (Collected Legislation of the Russian Federation, 1999, No. 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. Entrust control over the implementation of this order to Deputy Minister A.V. Katlinsky. ____________ Application APPROVED by order of the MinistryhealthRussian Federation dated March 28, 2003 N 127 I N S T R U C T I O Nfor 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 controlin the Russian Federation, the further use of whichconsidered inappropriate in medical practice 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 referred to as narcotic drugs and psychotropic substances), the further use of which is considered inappropriate in medical practice .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 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 cannot 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 carrying out their seizure or confiscation, are subject to destruction in full, except in 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 local representatives of these ministries and the body that carried out the seizure or confiscation, a decision will be made to turn them into state revenue and to transfer them for use for the purposes provided for by the legislation of the Russian Federation.1.4. The basis for the destruction of confiscated or withdrawn from illicit trafficking of narcotic drugs and psychotropic substances is a court decision, a resolution 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 resolution of an authority or official to impose an administrative penalty or to terminate administrative proceedings<1>. 1.5. The destruction of narcotic drugs and psychotropic substances, the further use of which is recognized as inappropriate, including those confiscated or withdrawn from illicit 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<2>. 1.6. For the destruction of narcotic drugs and psychotropic substances in state unitary enterprises or government 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 care authorities and security authorities environment. Legal entities that do not have licenses for activities related to the trafficking of narcotic drugs and psychotropic substances with the right to destroy them, but carrying out activities related to the trafficking of narcotic drugs and psychotropic substances, enter into agreements with state unitary enterprises or government agencies that have such licenses, and hand over to them the 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 and subsequently destroyed within no later than five days.1.7. The need to destroy narcotic drugs and psychotropic substances, with the exception of those confiscated or withdrawn from illegal circulation, is justified by the responsible person appointed by order of the head of the healthcare institution, pharmacy institution (organization).In this case, an order is issued to write off 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;- reasons for write-off 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 agreement and the date of its conclusion with the state unitary enterprise or government agency who have similar licenses.Copies of the order are sent to:- to the health care management body of the constituent entity of the Russian Federation;- to the internal affairs body of a 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 drugsand psychotropic substances2.1. The destruction of narcotic drugs and psychotropic substances is carried out at specially equipped sites (landfills) and (or) in specially prepared premises.2.2. Personnel carrying out work on the destruction of narcotic drugs and psychotropic substances must have permission to work with narcotic drugs and psychotropic substances, know the physico-chemical and toxic properties of the substances being destroyed and the chemical reactions that occur during their neutralization and destruction.2.3. Features of the destruction of narcotic drugs and psychotropic substances:- liquid dosage forms (injection solutions in ampoules and bottles, mixtures, drops) are destroyed by crushing (ampoules) followed by diluting the contents of ampoules and bottles with water in a ratio of 1: 100 and draining the resulting solution into the sewer; the remains of ampoules and vials are removed 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 powder state, must be diluted with water in a ratio of 1: 100 and the resulting suspension (or solution) must be drained into the sewer;- solid dosage forms (powders, tablets, capsules) containing substances of narcotic drugs and psychotropic substances, 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, generously moistened with an available flammable liquid, placed in a baking tray and burned under draft (if destruction is carried out indoors) or over a fire (if destruction is carried out at a landfill). The ash is removed or buried in the usual manner as a substance of hazard class 4 in the prescribed manner.2.4. When destroying narcotic drugs and psychotropic substances, the commission draws up an act indicating:- date and place of drawing up the act;- place of work, positions, surnames, first names, patronymics of persons taking part in the destruction;- grounds for destruction;- information about the name (indicating the type of dosage form, dosage, unit of measurement, series) and quantity of the narcotic drug, psychotropic substance being destroyed, 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 monitoring activities related to the trafficking of narcotic drugs and psychotropic substances<3>. ____________ <1>dated July 24, 2002 N 557 “On introducing 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). <2>Decree of the Government of the Russian Federation of June 21, 2002 N 454 “On licensing activities related to the trafficking of narcotic drugs and psychotropic substances” (Collected Legislation of the Russian Federation, 2002, N 26, Art. 2597; N 41, Art. 3983). <3>Article 10 of the Federal Law of January 8, 1998 N 3-FZ “On Narcotic Drugs and Psychotropic Substances” (Collected Legislation of the Russian Federation, 1998, N 2, Art. 219). ____________

Order No. 127n dated 02/25/2016

!!! Lost force in accordance with order No. 1043n dated December 22, 2017!!!

Approved by order of the Ministry of Health Russian Federation dated February 25, 2016 N 127n

Deadlines and stages accreditation of specialists, as well as categories of persons with medical, pharmaceutical or other education and specialists subject to accreditation

MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

ORDER dated March 28, 2003 N 127

1. GENERAL PROVISIONS

2. PROCEDURE FOR THE DESTRUCTION OF NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES

On approval of the Instructions for the destruction of narcotic drugs and psychotropic substances included in lists II and further...

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...

1. General Provisions

2. The procedure for the destruction of narcotic drugs and psychotropic substances

3. Sanitary and epidemiological requirements for the content and operation of premises and equipment of healthcare facilities

4. Requirements for the collection of medical waste

5. Requirements for temporary storage of medical waste at healthcare facilities

6. Requirements for transportation of medical waste

7. Requirements for the disposal of medical waste

8. Sanitary and epidemiological requirements for the organization nutrition of patients, to the working conditions of medical personnel at healthcare facilities

9. Sanitary and epidemiological requirements for conditions carrying out sterilization and disinfection of medical products appointments at healthcare facilities

10. Sanitary and epidemiological requirements for the organization and carrying out sanitary and anti-epidemic (preventive) measures at healthcare facilities

Natural and artificial lighting of premises healthcare facilities

Temperature, air exchange rate, cleanliness category in premises, including day hospital facilities health

Acceptable levels of bacterial contamination in air indoor environment depending on their functional purpose and cleanliness class of healthcare facilities

Permissible levels of infrasound and low-frequency noise in healthcare facilities

Permissible noise levels generated by individual species medical equipment depending on operating modes (noise characteristics at a distance of one meter from the equipment)

Logbook of hours worked for bactericidal irradiators

Daily medical waste log

routine inspections at healthcare facilities

Laboratory and instrumental studies carried out at production control (self-control) at facilities health

Order
No. 127n dated 02/25/2016

Approved
by order of the Ministry of Health
Russian Federation
dated February 25, 2016 N 127n

Deadlines and stages
accreditation of specialists, as well as categories of persons with medical, pharmaceutical or other education and specialists subject to accreditation

ORDER
dated March 28, 2003 N 127

3. Sanitary and epidemiological requirements for the content and
operation of premises and equipment of healthcare facilities

5. Requirements for temporary storage of medical waste at
healthcare facilities

8. Sanitary and epidemiological requirements for the organization
nutrition of patients, to the working conditions of medical personnel at
healthcare facilities

9. Sanitary and epidemiological requirements for conditions
carrying out sterilization and disinfection of medical products
appointments at healthcare facilities

10. Sanitary and epidemiological requirements for the organization and
carrying out sanitary and anti-epidemic
(preventive) measures at healthcare facilities

Natural and artificial lighting of premises
healthcare facilities

Temperature, air exchange rate, cleanliness category in
premises, including day hospital facilities
health

Acceptable levels of bacterial contamination in air
indoor environment depending on their functional purpose
and cleanliness class of healthcare facilities

Permissible levels of infrasound and low-frequency noise
in healthcare facilities

Permissible noise levels generated by individual species
medical equipment depending on operating modes (noise
characteristics at a distance of one meter from the equipment)

Laboratory and instrumental studies carried out at
production control (self-control) at facilities
health