Used in institutions and production various types inventory, each of which has its own characteristics of operation and accounting. In some types of institutions, soft equipment is the most common.
In the article we will consider what assets belong to soft inventory, what are the nuances of its use and write-off, as well as the norms of use.
Soft equipment according to instructions
Accountants need to know exactly which inventory items are classified as soft inventory because this category of assets has special accounting rules. Not all items that have a soft feel are considered soft inventory in the accounting sense.
The procedure for classifying assets as soft inventory is regulated by the Instructions for the application of the Unified Chart of Accounts for state authorities, local self-government, management of state extra-budgetary funds, state academies of sciences, state (municipal) institutions, approved by Order of the Ministry of Finance of the Russian Federation dated December 1, 2010 No. 157n v p .118.
Soft inventory– inventories of ready-to-use items that are used for a relatively long time in direct contact with human body. The instructions precisely define which assets should be considered soft inventory:
- everything related to underwear (shirts, pajamas, dressing gowns, etc.);
- bedding items (pillowcases, duvet covers, sheets, mattress covers, bedspreads);
- bedding (mattresses, blankets, pillows, sleeping bags, etc.);
- clothing, workwear, uniforms, uniforms (all types and items of clothing);
- shoes, including specialized ones (all types of shoes);
- sportswear and shoes;
- material property.
PLEASE NOTE!“Special clothing” includes, in addition to the actual items of clothing and footwear, also protective equipment: respirators, helmets, goggles, etc.
Soft inventory items are mainly ordered from suppliers or, if the base allows, they can be manufactured by the institution itself.
Not everything is soft and soft to the touch.
The key feature of classifying an asset as soft inventory is its accounting affiliation, determined by regulations, and not the actual feeling of softness. Accountants should not classify items into this category without reference to the Instructions, which clearly identify all types of inventory.
Often, by mistake, supplies that are not soft inventory are listed as soft inventory:
- Sewing products: tablecloths, curtains, drapes, napkins, towels, rugs, etc. These items are not mentioned in the said regulatory act; they cannot be classified into any of the categories presented there.
- Raw materials for soft equipment: fabric, accessories, foam rubber, lining materials. Soft inventory is not raw materials, but always finished products.
- Small personal items: handkerchiefs, toothbrushes, hair ties, etc. They cannot serve as soft equipment, since their service life is relatively short - less than a year.
- Rags– soft inventory turns into it after losing its suitability for use, but it itself is not such and cannot be written off as soft inventory.
- Selected soft items. For example, a backpack worn when working at height cannot be classified as soft equipment, because it does not provide individual protection, unlike a safety belt.
Another type of error is the failure to include relatively “hard” items in this type of asset, which in fact should be considered soft equipment, for example, helmets, hard hats, gas masks, etc.
Standards for soft equipment
Decree of the Government of the Russian Federation of November 7, 2005 No. 659 substantiates the standards for the use of soft equipment for children in full state support (boarding schools). Letter No. 164-M of the Ministry of Education of the Russian Federation dated September 22, 1993 contains similar standards for kindergartens, schools, vocational schools, etc. educational institutions. According to these standards, the period of use of the issued item does not exceed 1-2 years, then it is written off from the balance sheet, but if the product is not worn out, it can remain in personal use along with the new, freshly issued one.
Subtleties of “soft” accounting
There are some fundamental points related to taking into account and writing off soft inventory items:
- Dismantling before registration. Many items from the list of soft furnishings are purchased not one at a time, but in sets; for example, bed linen most often includes a sheet, duvet cover and one or two pillowcases. It would be a mistake to capitalize this inventory as a single accounting object, because the items included in it are not related to each other. The accountant must evaluate each item separately, recording the cost in the receipt order: the total amount of all items will be the cost of the set.
- Marking. It is applied only to soft equipment, as stated in paragraph 118 of the Instructions. Each registered item must be marked with a stamp and the name of the institution, made with indelible paint. Marking is carried out by financially responsible persons; the manager (or his deputy) and an accountant must be present. You should try not to spoil the appearance of the product too much.
- The accounting register is the inventory item itself. Also a unique feature of soft goods. When an item is issued from the warehouse for use, it is additionally marked with the date of issue (month and year).
IMPORTANT! The stamp used for marking is kept by management.
Wear and tear accounting
The long service life of soft equipment causes some difficulty in accounting for it due to wear and tear. The legislation did not provide ways to resolve this difficulty. The person financially responsible for soft inventory should regularly monitor:
- the amount of new inventory added to the balance sheet;
- number of units of products in use;
- period of use of soft equipment.
"Primary" for soft equipment
To justify this type of inventory, accounting provides for the following types of documentation (based on Order No. 52n):
- receipt order for acceptance of non-financial assets (upon entry onto the balance sheet);
- shipping documentation - if it is completed properly, it is not necessary to issue a receipt order, unless disassembly is required;
- an acceptance certificate is issued if the actual quantity of inventory does not correspond to the documented quantity;
- cards for quantitative accounting of material inventories;
- invoice requirements – to account for the movement of soft inventory within the organization;
- property issuance book – records the issuance and return of soft equipment (it indicates the norms, standard service life and number of units issued);
- write-off act – reflects the disposal of soft inventory.
Accounts for soft inventory accounting
To maintain accounting for this type of property, a special account 105 00 “Material reserves” is provided. This type of inventory can be classified as particularly valuable property, taken into account in the account 0 105 25 000, or simply as movable property - for this there is an account 0 105 35 000.
Accounting entries for receipts
Accounting for soft inventory goes through the following balance sheet transactions:
- debit 0 105 25 340 or 0 105 35 340, credit 0 302 34 730 or 0 208 34 660 – soft inventory purchased from a supplier;
- debit 0 105 25 340 or 0 105 35 340, credit 0 304 04 340 – soft inventory was received as part of the organization’s supply;
- debit 0 105 25 340 or 0 105 35 340, credit 0 401 10 180 – soft inventory was received free of charge;
- debit 0 106 24 340, credit 0 302 34 730 – formation of the cost of soft inventory in the delivery amount;
- debit 0 105 25 340 or 0 105 35 340, credit 0 106 24 340 or 0 106 34 340 - soft inventory is accepted for accounting at the formed value.
ATTENTION! If soft equipment is manufactured in the institution itself from its own materials, it is carried out in the same way as purchasing from a supplier; in addition, materials are written off and manufacturers are paid for labor.
Accounting entries for write-offs
Soft inventory can be written off due to:
- with wear and tear – debit 0 401 10 172;
- disposal for other reasons (theft, identification of shortages, etc.) – debit 0 401 10 172;
- with a state of disrepair due to external factors(accidents, disasters, natural disasters, etc.) – debit 0 401 20 273.
ATTENTION! Each type of disposal is recorded from a different debit account, the credit will be the same - 0 105 25 440 or 0 105 35 440.
If, as a result of writing off worn-out soft equipment, rags are obtained that will be used, it must be assessed and capitalized: debit 2,105 36,340 “Increase in the value of other material inventories - other movable property of the institution.”
Wide range of soft goods
Who doesn't know what soft equipment is? Most consumers are familiar with the concept of textiles and materials made from it. But this does not cover the broad significance of soft equipment and its assortment.
Textiles
The concept of soft equipment is very broad and it includes many products intended not only for the home, but also for various institutions of public or private importance. It is used:
In hotels,
In pioneer camps,
These are a wide variety of bedding, towels, bathrobes, bedspreads, pillows and blankets, shoe covers for hospitals, surgical diapers, mattresses and covers for them. All these products are very high quality so that it is long enough: textiles are used very actively, especially in public institutions. Hospitals and rest homes
For government institutions such as hospitals, textile stores receive government orders for the supply of soft goods. All textiles in the hospital are subject to frequent sanitary treatments and therefore their strength must be high. Changes of bedding, gowns and caps of medical personnel, doctors, nurses' uniforms, even mattresses and their covers - everything is processed in disinfection chambers. Service life of soft equipment depends on compliance with GOST rules during its manufacture. In order for holiday homes, hotels and pioneer camps to function smoothly, they must be fully provided with textile products. Stores offer different types towels: terry and waffle, all sizes. The range is wide and offers: blankets, pillows, duvet covers, mattress covers made of waterproof fabric, rugs, bathrobes and many other textiles, including curtains, tablecloths, napkins.
Current offers
A set of bedding designed for kindergartens and having special qualities is in great demand:
It is made of soft material, environmentally friendly,
Sets of different sizes, designed for small children,
Beautiful colors, using cartoon characters,
Color fastness, rich color,
High wear resistance of the material.
For hotels and hostels, you can order linen sets in the store at a lower price: service life of soft equipment It will be just as tall, it’s just made from calico – colored or bleached. Buying such linen will help reduce the cost of living in boarding houses and hostels. All textiles supplied to the store are provided with a quality certificate.
Topic 18.
ADMISSION DEPARTMENT OF CHILDREN'S HOSPITAL. HOSPITALIZATION, SANITARY TREATMENT AND TRANSPORTATION OF SICK CHILDREN. ORGANIZATION OF SANITARY-HYGIENIC AND ANTI-EPIDEMIC REGIMES. PERSONAL HYGIENE OF MEDICAL STAFF
Functions of the admission department of a pediatric hospital
The emergency department is a structural unit of the children's hospital.
The main functions of the reception department include:
- receiving sick children;
- their hospitalization in a department according to their profile;
- providing, if necessary, emergency care;
- organizing appropriate measures to prevent the occurrence of infectious diseases in the hospital;
- registration and maintenance of medical records.
The admissions department has a certain organizational and functional structure and a number of appropriate premises that meet the profile and capacity of the hospital. It is very important that the reception staff always treat the sick child with care; took into account the child’s condition and the parents’ anxiety; patiently listened to the complaints of both the child himself and those accompanying him.
The work of the reception department is carried out in a certain sequence:
1. Registration of a child admitted to the hospital in the hospitalization register.
2. Filling out the title page of the inpatient medical record (medical history).
3. Examination by a doctor who records the data of the anamnesis and objective examination of the child in the medical record of the inpatient (medical history).
4.Primary diagnosis of the disease and provision of necessary medical care.
5. Measuring body temperature and conducting anthropometry (determining height, weight, head and chest circumference).
6. Examination of the child for scabies and pediculosis. Carrying out the necessary sanitization, the method of which is prescribed by the doctor.
7. Transportation of a sick child to a department of the appropriate profile.
Documentation of the emergency department of a children's hospital
1. Register of patients admitted to the hospital - registration form No. 001/u,
2. Journal of refusal of hospitalization - registration form No. 001-1/у.
3. Medical record of an inpatient – registration form No. 003/у.
4. Statistical card of a patient who left the hospital - registration form No. 066/u.
5. Sheet of medical prescriptions - registration form No. 003-4/u.
6. Temperature sheet - registration form No. 004/у.
7. Emergency report of an infectious disease, food or chemical poisoning, unusual reaction to vaccination - registration form No. 058/u.
8. Journal of infectious diseases - registration form No. 060/u.
Sanitary and hygienic regime of the reception department. Hospitalization, sanitary and hygienic treatment and transportation of sick children
The operating mode of the pediatric hospital provides for compliance with the necessary sanitary and hygienic requirements and disinfection.
Implementation of the sanitary and hygienic regime begins from the reception department. The examination room and bathroom of the reception department must be kept perfectly clean. Upon completion of the examination of the child, objects (spatulas, thermometers) and furniture (couch, chairs, etc.) that were touched by the sick child are processed. The sheet on the couch should be changed after each patient. The oilcloth pillow and oilcloth on the couch are treated with a 0.2% solution of chlorantoin or other disinfectant after each patient.
After examining the child, the emergency department doctor, if necessary, prescribes a hygienic bath or shower. If the child's condition is extremely serious or unconscious, he is immediately provided with emergency assistance and sent to the intensive care unit.
Hospitalization of sick children. Sick children are admitted to the hospital on the referral of a local pediatrician, an emergency physician, or a consultant physician at a specialized clinic. In the event of an emergency, the child can be delivered by the parents without a referral (by self-referral).
Indications for inpatient treatment, as well as the profile of the children's hospital, are determined by the doctor who refers the child, however, if new symptoms appear or the child's condition worsens during an examination in the emergency department, these issues are determined by the doctor of the emergency department. Children early age hospitalized with one of the parents. When distributing sick children who are admitted to the hospital, it is necessary to adhere to a phased filling of the wards, which provides for the absence of contact with children who are in the recovery period.
If a child has an infectious disease (measles, scarlet fever, whooping cough, chicken pox, intestinal infection, etc.), the child is hospitalized in an infectious diseases hospital.
Children with non-infectious pathologies ( birth defects development, malnutrition, rickets, chronic diseases of various organs and systems, metabolic disorders, etc.) are hospitalized in specialized somatic departments.
In the case of acute surgical pathology or for a planned operation, the child is hospitalized in the children's surgical department of a multidisciplinary hospital or a specialized department: cardiac surgery, urology, thoracic, etc.
Sanitary and hygienic treatment of a sick child in the emergency department is carried out taking into account the severity of his condition. If the child needs emergency care, sanitary and hygienic treatment is carried out after the condition improves.
In the examination room of the reception department, the child is prepared for a hygienic bath. Before treating the child, the bathtub is thoroughly washed and treated with a disinfectant solution.
They wash the sick child in a certain sequence: first the head, then the torso and lower limbs. Places where sweat and secretions usually accumulate, which lead to diaper rash (groin area, perineum), are washed especially thoroughly. If a bath is contraindicated for a sick child for health reasons, a shower is prescribed, or other hygienic measures are taken in accordance with his condition (washing, treating natural folds of the skin, contaminated areas of the body, etc.). After bathing the child, wash the bathtub with a washcloth and treat it with a disinfectant.
Examination for pediculosis. Pediculosis (lice) is transmitted through direct contact with a patient and through the use of his clothing and personal hygiene items. The occurrence of pediculosis is facilitated by: sloppiness, violation of sanitary and hygienic rules, large overcrowding of people (stations and the like), poor organization of sanitary and educational work .
If pediculosis is detected, special sanitary treatment is carried out: without undressing the child, the hair is treated with one of the insecticidal solutions:
– benzyl benzoate ointment 10-20%;
– "Nitifor" lotion;
– “Nok” cream shampoo (1% permethrin solution);
– "Pedilin" emulsion or shampoo (0.5% malathion solution);
– “Para Plus” aerosol is a combination drug that contains malathion, permethrin, piperonyl butoxide;
– “Rod” shampoo (0.5% malathion solution);
– “Anti-bit” shampoo (0.5% malathion solution);
– “Itax” foamy lotion or aerosol (3% phenothrin solution);
– "Nix" shampoo (3% permethrin solution);
Exposure time is 10-30 minutes. depending on the chosen product and according to the attached instructions. After treatment with a special product, the child’s head is washed with hot water and regular shampoo. The hair is combed with a thick comb. The procedure is repeated after 7-10 days. The doctor notes the detection of pediculosis in the medical history, and sends an emergency notification to the regional sanitary and epidemic station.
If clothing is infested with lice, it is boiled in a 2% solution of soda ash for 15 minutes, after which it is sent in a separate bag for disinfection by frying in a special chamber.
In children, atypical localization of scabies mites is often found.
If scabies is detected, sanitary treatment is carried out by special means according to the instructions:
- "Spregal" aerosol (esdepaletrin and piperonyl butoxide);
- “Spray-pax” aerosol (extract of pyrethrum and piperonyl butoxide);
- “Itax” lotion or aerosol (3% phenothrin solution);
- "Nix" shampoo (3% permethrin solution);
- water mile suspension of benzyl benzoate 20% (10-30 ml);
- benzyl benzoate ointment 10-20%;
Transportation of sick children . From the emergency department, sick children are transported to the department taking into account their general condition.
Transportation to the department is carried out:
a) on foot, accompanied by a health worker;
b) in a wheelchair;
c) on a stretcher;
d) in the hands of parents or medical staff.
The question of the type of transportation is decided by the doctor, depending on the condition of the sick child. If the condition is satisfactory, the older child is sent to the department accompanied by a medical worker. It is more appropriate for some patients to be transported to the department in a wheelchair. Seriously ill patients are transported on a stretcher covered with a clean sheet and blanket (depending on the time of year) and placed on a special gurney.
In the ward, a child who is in serious condition is transferred from a stretcher to a bed. If one person is carrying a sick older child, then you need to place one hand under the shoulder blade and the other under the hips, and it is advisable for the child to grab the neck of the person who is carrying him. If a sick child is carried by 2 people, then one of them places his hands under the child’s shoulder blade, closer to the neck and lower back, the other - under the buttocks and legs. When transferring severely weakened and seriously ill patients, a third person is needed: the first holds the head and chest, the second holds the lower back and thighs, the third holds the legs.
The concept of medical-protective and sanitary-hygienic regimes, the peculiarities of their observance in a children's hospital
Each children's medical institution has a certain intra-hospital regime.
One of the most important conditions medical-protective regime is to spare the psyche of a sick child and the mother who cares for him, to create favorable conditions that provide patients with maximum physical and psychological peace. To do this, it is necessary to establish the most rational daily routine in accordance with the age of sick children and the profile of the department, with the elimination of adverse external environmental influences (loud conversation, noise, slamming doors, etc.).
Changes of medical staff, cleaning of premises, temperature measurement are carried out after patients wake up and no earlier than 7.00 am.
It is important to eliminate negative emotions which may occur in sick children when they see medical examination and care items (bloody linen, syringes and scalpels, basins with dirty cotton wool and bandages).
The organization of leisure time for patients is of great importance: placement of stands with books, magazines on child care, rational feeding, propaganda healthy image life, which parents and older children can become familiar with. For convalescent children, a playroom should be provided. Walking in the fresh air, especially in summer, is also an integral part of the healing process.
To ensure sanitary and hygienic regime, at least twice a day, in all departments of the children's hospital, general cleaning of the premises is carried out using a wet method using disinfectants. During cleaning, they first wipe the bedside tables, beds, door handles and window sills, clean the sinks, then wash the floor. Cleaning equipment must be labeled and stored in a separate room.
The sanitary and hygienic standards of the pediatric department provide for the allocation of each sick child with a bed covered with clean linen and a bedside table for storing personal belongings. If necessary, the child is given a potty, bedpan, and personal items (sippy cup, cup, clothes). Patients take personal hygiene items with them to the department.
The ward for infants is additionally equipped with a special cot with folding backrests that are fixed at different heights, a changing table, a linen cabinet, a bathtub for bathing the child, and a cistern for soaking dirty linen.
The air temperature in the ward and rooms where sick older children are located should be 20-22°C; in the ward for infants - 23-24°C; for newborns, the optimal (safe) temperature is 25-28°C. When the temperature in the room drops, it is necessary to additionally heat them while maintaining the required humidity. High temperature air is undesirable, since the child may overheat.
The lighting of the chamber can be natural or artificial and is 75-100 lux; noise level - no more than 50 dB.
The set of toys must be individual and appropriate for the child’s age. Toys should be easy to sanitize.
At least once every 7-10 days (more often if necessary), a sick child is given a hygienic bath with a complete change of underwear and bed linen. The child is toileted daily; Before eating, be sure to wash your hands. Seriously ill children are washed in bed.
It is very important to ventilate the rooms using a transom at least 4 times a day, regardless of the time of year, as well as quartz them, according to the schedule drawn up directly in the department. During these events, children are taken to other rooms (corridor, dining room, playroom).
Wet cleaning of the premises of the children's department is carried out daily. The panels are washed or wiped with a damp cloth once every 3 days. The upper part of the walls, ceilings, lampshades are cleaned of dust once a week; Window frames and doors are wiped with the same frequency. Daily wet wiping of radiators and central heating pipes is very important, since when dust burns, carbon monoxide can form, which is unacceptable. Soft items (carpets, curtains, bedspreads, blankets, pillows) are knocked out and shaken out in the open air or cleaned with a vacuum cleaner.
Special attention in pediatric departments, collection of dirty linen, sterilization of pacifiers and bottles are given to baby food. Boiling nipples and washing bottles is a fairly labor-intensive process and must be done carefully. This work is performed by a specially allocated junior nurse, which can simultaneously distribute food.
In the infectious diseases department, all these activities must be carried out strictly in accordance with the requirements for sanitary and hygienic standards, which exclude the possibility of infecting other children.
In children's hospitals, it is necessary to prevent the spread of infectious diseases and the occurrence of reinfection among children. This is achieved by obtaining data on the epidemic environment of children admitted to the hospital, the presence of boxes, phased filling of wards, compliance with the anti-epidemic regime in the department and in the pediatric hospital as a whole.
The anti-epidemic regime in the hospital provides for:
- strict adherence to the rules for hiring personnel;
- ensuring timely completion of mandatory preventive medical examinations;
- compliance with personal hygiene rules by staff and patients;
- a sufficient amount of detergents and disinfectants, protective clothing, and cleaning equipment.
- strict compliance by junior medical staff with the requirements for cleaning and storing cleaning equipment.
When a child is admitted to a hospital, it is necessary to find out whether the child had contact with infectious patients at home, at school or kindergarten over the last 3 weeks (this is the maximum duration of the incubation period for most childhood infectious diseases). It should be determined whether the child has had intestinal disorders during the last 3 days. The listed information should be displayed in the direction of the local pediatrician. Even in the absence of this data, the emergency department doctor must examine children for the presence of an infectious disease.
If an infectious disease is suspected or diagnosed, the sick child is immediately isolated in a box or sent to an infectious diseases hospital, and the room where the patient was, objects and furniture are disinfected (disinfected). The main purpose of the box is to isolate sick children with suspected infectious disease. There are open and closed boxes. In open boxes, patients are separated by a partition that is installed between the beds. An example of a closed box is the Meltzer box. The design of the latter provides for the elimination of any contact of the sick child with other children during the entire period of treatment. It consists of a vestibule, a ward, a bathroom, and a separate entrance for medical staff (gateway).
A sick child enters the box directly from the street, and upon discharge or transfer to another hospital, leaves it the same way. Medical personnel enter the airlock from the internal corridor, tightly closing the outer door, wash their hands,, if necessary, put on a second gown, cap, mask, and then go into the room where the patient is. When leaving the room, all actions are performed in reverse order. In order to prevent the spread of infection, it is necessary to ensure that when the door between the airlock and the department corridor is opened, the door to the ward is tightly closed.
Proper organization of children's nutrition, food preparation, transportation, and distribution, as well as compliance with food storage conditions are important in maintaining the anti-epidemic regime in the hospital. Storing food in cabinets is strictly prohibited. To do this, there must be a refrigerator in the pantry or dining room.
Particular attention should be paid to the prevention of nosocomial (nosocomial) infections.
A system of measures to destroy pathogens and create conditions that prevent their spread in the environment is called disinfection . Distinguish focal disinfection, which is carried out in the epidemic focus and preventive.
Focal disinfection according to time and purpose, divided into current and final.
Current disinfection consists of neutralizing all pathogens immediately after their isolation from the source of infection: processing the patient’s objects (vessels, examination items, linen, eating utensils, etc.). Routine disinfection is of utmost importance for intestinal infections.
Wet cleaning of the room where the patient is located is systematically carried out using disinfectant solutions, toys and dishes are boiled. One of the means of ongoing disinfection for droplet infections is ventilation and ultraviolet irradiation (quartz treatment) of rooms where sick children are. During quartzing of the wards, children are taken to other rooms.
Final disinfection in the outbreak is carried out by employees of the disinfection station when the infectious disease is eliminated (hospitalization or complete recovery of the patient). The following areas are subject to disinfection: the room where the patient was, all household items and the patient’s clothing. To disinfect premises, mechanical cleaning (washing, bleaching) using disinfectant solutions is used. Linen, dishes and household items are treated in the same way as during current disinfection.
Preventive disinfection carried out to prevent infectious diseases in medical institutions. It includes disinfecting water (boiling), washing the bathtub, ward, after discharging patients using disinfectant solutions, washing hands before eating, pasteurization or boiling milk, fighting vectors (carriers) of infectious disease agents .
To carry out disinfection, physical (mechanical, thermal, radiation) and chemical methods are used.
Mechanical methods include: washing clothes, washing hands, ventilating rooms, removing dust and dirt (with a vacuum cleaner, damp cloth, etc.).
Thermal ones include boiling, ironing, burning, steam treatment (in autoclaves), frying (in dry-heat ovens). The thermal method is used to disinfect patient care items, dishes, underwear and bed linen.
Radiation methods include: ultraviolet irradiation, ultrasound, radioactive radiation. These methods are used to disinfect wards and treatment rooms.
Chemical disinfection methods are the most common and involve the use of various disinfecting solutions. There is antiseptic for hands, skin and mucous membranes; disinfectants for treating hard surfaces, tools and equipment, as well as wet cleaning of premises. All these products are used in accordance with the attached instructions.
It should be noted that the effectiveness of disinfection measures increases when different processing methods are combined, for example, mechanical and chemical.
Preventive and ongoing disinfection in the epidemic outbreak is carried out by junior and middle nurses. Employees of sanitary and epidemiological control centers (sanitary and epidemiological stations) may be invited to carry out final disinfection in an epidemic outbreak.
Equipment for carrying out disinfection measures (buckets, mop, rag, etc.) is marked and used only in the premises for which they are intended.
Features of sanitary-hygienic and anti-epidemic
regimens for caring for newborns
Working with newborns has a certain feature, which is based on the WHO concept of physiological care for a child and provides for the limitation of medical interventions (Order No. 152 of 04/04/2005 “On approval of the Protocol for medical care of a healthy newborn child”).
The main requirement for junior medical personnel when working with newborns is to maintain the necessary sanitary and epidemic regime in order to prevent nosocomial infection. This largely depends on compliance with the rules and techniques of hand washing and antiseptics by the medical personnel themselves, the mother and relatives who care for the child.
Basic types of hand treatment.
1.Routine hand washing with soap is performed to remove dirt and transient microflora that contaminate the skin of the hands of medical personnel as a result of contact with infected objects.
Indications for hand washing:
Before and after contact with the patient
After using the toilet
Before and after meals
In all other cases when hands are dirty.
It is very important to adhere special equipment hand washing, since routine hand washing leaves the fingertips and inner surfaces contaminated.
Hand washing technique:
Remove rings and other jewelry, as they make it difficult to effectively remove microorganisms;
Under moderate pressure warm water It is necessary to vigorously soap your hands and rub one another for at least 15 seconds, after which you rinse your hands. You should try to cover the entire surface of your palms and fingers;
Dry your hands paper towel, with which to close the tap;
Do not use a common reusable towel to dry your hands;
Rings and nail polish make it difficult to remove microorganisms;
To wash your hands you must use liquid baby soap with dispenser.
Reusable dispensers become contaminated over time, so do not add liquid soap to a partially filled dispenser. First, you need to wash the dispenser, dry it, and only then fill it with a new portion of soap.
2. Hygienic antiseptics involves the removal and neutralization of transient microflora of the hands using antiseptic drugs. Alcohol antiseptics are more effective than water-soluble ones.
Indications for hygienic hand antisepsis:
Before performing an invasive procedure
Before and after wound manipulation
Before and after manipulation of catheters
Before using gloves and after removing them
After contact with secretions and objects that contained blood or are likely to be contaminated.
Technique for carrying out hygienic antiseptics:
At heavy pollution their hands must first be washed with water and liquid soap, and then applied with an antiseptic;
Apply an alcohol antiseptic (5 ml) to your hands and rub until it dries (do not wipe your hands).
It should be noted that the use of gloves does not replace hand washing and antiseptic treatment. Gloves should be removed after caring for the patient. It is not allowed to use one pair of gloves to care for two patients, even if the gloves are washed and antiseptically treated.
Indications for using gloves:
In all cases where contact with blood or other potentially contaminated biological materials is possible;
Gloves reduce the risk of occupational infection from contact with infected patients and their secretions;
The gloves reduce the risk of infection of patients with microbes that are part of the resident microflora of the hands medical workers;
Gloves reduce the risk of contamination of personnel's hands with transient pathogens and their subsequent transmission to patients.
Also, the work of junior medical staff includes cleaning rooms and contact with cleaning equipment.
Wet cleaning of rooms where mother and child stay together maternity hospital, as well as in the pediatric neonatal pathology department hospital, is carried out at least 2 times a day, of which 1 time - using detergents. Instead of quartzing rooms, it is recommended ventilate them. After the mother and child are discharged from the maternity hospital, final disinfection is carried out in the shared ward, followed by ventilation. Curtains, curtains, artificial flowers, posters, if they are not contaminated with biological materials, cannot be disinfected. They are processed as necessary. After cleaning the premises, cleaning equipment (buckets, basins, rags) is thoroughly washed using detergents, rinsed, dried and stored in a special sanitary room of the department.Upon discharge, used household linen of the mother and newborn is given home in plastic bags without prior disinfection. Hospital linen is collected in a plastic or rubberized bag, taken to the room for used linen, and then immediately removed from the department to a specially designated room. After sorting, the laundry is folded into a cotton bag, which is placed in a rubberized or polyethylene disposable bag, and delivered to the laundry. Washed hospital underwear for newborns, women in labor and postpartum is packaged in individual bags and sterilized. After sterilization, the linen must be dry.
Pillows, blankets, mattresses covered with oilcloth are treated with disinfectants; those not covered are disinfected in a disinfection chamber.
Washing the work clothes of medical personnel is carried out at a temperature of 90°C (it is possible to use a household automatic washing machine). After this, it is ironed.
Failure of junior medical staff to comply with the requirements of sanitary, hygienic and anti-epidemic regimes in the maternity hospital carries with it administrative, and in some cases, criminal liability.
The concept of personal hygiene of medical staff
Personal hygiene of medical personnel is one of the essential factors in compliance with the anti-epidemic regime in a children's hospital.
A medical worker must have a neat and tidy appearance, with short-cut nails. Do not use perfumes with a strong odor, as this may cause allergic reaction. Before and after each manipulation, the nurse washes his hands with warm water and soap, or treats them with a special disinfectant solution. During appointments, wedding rings and watches are removed.
While on duty, the nurse wears special shoes (slippers), which allows her to move silently in the department. Slippers should be easy to disinfect. At the end of duty, the robe, headdress and slippers are left in a locker specially designated for the medical worker..
In some cases, namely in infectious diseases departments, neonatal departments, during an epidemic, it is mandatory for medical workers to wear a mask that should cover the mouth and nose. The use of a mask is also necessary when performing certain medical procedures or when sanitizing patients. The mask is usually made of 4 layers of gauze. Every 4 hours (in some cases, more often), the mask must be changed, since prolonged wearing reduces the effectiveness of its action as a filter for germs. The used mask is placed in a separate bowl, boiled and ironed. Currently, disposable masks made of non-woven textiles are more often used.
Security questions
1. Functions of the reception department of a children's hospital.
2. Documentation of the emergency department of the pediatric clinic.
3. Hospitalization, sanitary treatment and transportation of sick children.
4. The concept of the features of sanitary-hygienic and anti-epidemic regimes in a pediatric hospital.
5. Requirements for junior medical personnel when working with newborns.
6. Personal hygiene of medical staff
"Budgetary healthcare institutions: accounting and taxation", 2011, N 11
The specifics of the activities of healthcare institutions require a supply of soft equipment sufficient for the normal functioning of the institutions. This can explain a significant number of questions that accountants of healthcare institutions have in the process of reflecting in accounting transactions for the acquisition, capitalization and write-off of soft inventory. This article reveals the main aspects of accounting for soft equipment in healthcare institutions and provides answers to private questions from our readers.
Soft inventory objects
According to paragraph 99 of Instruction No. 157n<1>soft inventory is reflected in accounting as part of material inventories. By general rule of the specified Instructions, material reserves include items used in the activities of the institution for a period not exceeding 12 months, regardless of their cost. In addition, the following are included in material inventories, regardless of cost and service life (clause 99 of Instruction No. 157n):
- special clothing, special shoes, uniforms, clothing, clothing and footwear, as well as sportswear and footwear in healthcare, educational institutions, social security and other institutions;
- bed linen and accessories;
- other soft equipment.
Thus, for accounting purposes, soft equipment items in healthcare institutions are taken into account as part of inventories, regardless of their cost and service life.
A detailed list of objects that are accounted for in account 0 105 05 000 “Soft inventory” is contained in clause 118 of Instruction No. 157n. It includes:
- linen (shirts, chemises, dressing gowns);
- bed linen and accessories (mattresses, pillows, blankets, sheets, duvet covers, pillowcases, bedspreads, sleeping bags);
- clothing and uniforms, including workwear (suits, coats, raincoats, short fur coats, dresses, sweaters, skirts, jackets, trousers);
- footwear, including special ones (boots, boots, sandals, felt boots);
- sportswear and footwear (suits, boots);
- other soft equipment.
At the same time, special clothing includes such types of clothing, shoes and safety devices as overalls, suits, jackets, trousers, dressing gowns, sheepskin coats, sheepskin coats, various shoes, mittens, glasses, helmets, gas masks, respirators.
FYI. The financially responsible person marks soft inventory items in the presence of the head (deputy head) of the institution and an accounting employee with a special stamp with indelible paint without damaging the appearance of the item, indicating the name of the institution, and when putting the items into operation, makes additional markings indicating the year and month of their issue from the warehouse . Marking stamps must be kept by the head of the institution or his deputy (clause 118 of Instruction No. 157n).
In tax accounting, all property of an institution is divided into depreciable and non-depreciable. So, according to paragraphs. 3 p. 1 art. 254 of the Tax Code of the Russian Federation, property that is not depreciable is classified as material reserves. Depreciable property is property that is used by an institution to generate income and the cost of which is repaid by calculating depreciation. At the same time, in order to recognize property as depreciable, two conditions must be simultaneously met (clause 1 of Article 256 of the Tax Code of the Russian Federation):
- the useful life of the object is more than 12 months;
- the initial cost of the object is more than 40,000 rubles.
Thus, if an institution acquires soft inventory, the cost of one object is more than 40,000 rubles, with a useful life of no more than a year, or soft inventory, the cost of one object of which is less than 40,000 rubles, with a useful life of more than a year, in For tax accounting purposes, it must reflect such property as depreciable and charge monthly depreciation for such property during its service life.
Soft inventory accounts
In budgetary and autonomous healthcare institutions, soft equipment is classified as movable property and is divided into two types:
- especially valuable movable property of institutions;
- other movable property of institutions.
Consequently, soft inventory in these institutions is taken into account in the accounts (clause 31 of Instructions N N 174n<2>and 183n<3>):
- 0 105 25 000 "Soft inventory - especially valuable movable property of an institution";
- 0 105 35 000 "Soft inventory - other movable property of the institution."
<3>Instructions for the use of the Chart of Accounts for accounting of autonomous institutions, approved. By Order of the Ministry of Finance of Russia dated December 23, 2010 N 183n.
Material reserves of state institutions, including soft equipment, are accounted for as other movable property, that is, legislators assumed that state institutions cannot have soft equipment that could be classified as particularly valuable property of institutions. Accordingly, government healthcare institutions use only account 0 105 35 000 (clause 21 of Instruction No. 162n<4>).
<4>Instructions for using the Chart of Accounts for Budget Accounting, approved. By Order of the Ministry of Finance of Russia dated December 6, 2010 N 162n.
The receipt of soft inventory can be reflected directly in the soft inventory accounts (accounts 0 105 25 000, 0 105 35 000) or using accounts 0 106 24 000 "Investments in inventories - especially valuable movable property of the institution", 0 106 34 000 " Investments in inventories - other movable property of the institution." The last option is used in case of receipt of soft inventory under several contracts.
Receipt of soft inventory
Soft equipment can be supplied to an institution as a result of its purchase for a fee, through centralized supply, free of charge, and can also be manufactured by the institution itself. Next, we will consider some of the options for receiving soft equipment into an institution.
Purchase of soft equipment for a fee. The capitalization of soft inventory purchased for a fee is carried out at the actual cost, which includes the amount in accordance with the agreement concluded with the supplier of soft inventory, the cost of information, consulting, intermediary services directly related to the acquisition of soft inventory, delivery costs in proportion to the cost of each item of soft inventory inventory, expenses for part-time work and improvement technical characteristics soft inventory, customs duties, other payments directly related to the acquisition of soft inventory (clause 102 of Instruction No. 157n).
Pay attention! The actual cost of soft inventory, at which it is accepted for accounting, is not subject to change (clause 107 of Instruction No. 157n).
The posting of soft equipment received under a state (municipal) agreement for the needs of a budgetary or autonomous institution is reflected on the basis of primary (consolidated) accounting documents confirming the fulfillment by the supplier (contractor, performer) of the terms of the agreement for the transfer of material assets. In the event of a discrepancy between the actual volume of material assets received, their quality and nomenclature with the data specified in the supplier’s accompanying documents, a Materials Acceptance Certificate (form 0315004) is drawn up (clause 33 of Instructions No. 174n and 183n).
State institutions reflect the posting of soft inventory on the basis of primary accounting documents - supplier invoices. Discrepancies with the data of the supplier’s documents are also documented using the above-mentioned act (clause 22 of Instruction No. 162n).
What is the unit of account for soft inventory items? For example, the institution purchased a bedding set that included two pillowcases, a sheet and a duvet cover. How to account for such a set: as one object or several objects? The unit of accounting for soft inventory is chosen by the institution independently and is indicated in its accounting policy. For example, it can take into account a set of bed linen as one object or as three independent objects (sheet, duvet cover, pillowcases). However, in this case, it becomes difficult to determine the price of an accounting unit if the supplier's invoice indicates the cost of the entire set without breaking it down into its components. According to the author, in this situation it is advisable to establish in the accounting policy of the institution a method for determining the cost of an accounting unit included in the set. For example, the cost of the duvet cover will be 50% of the cost of the set, the cost of the pillowcase - 12.5%, the cost of the sheet - 25%.
The soft inventory accounting unit is selected in such a way as to ensure the formation of complete and reliable information about the soft inventory stocks in the institution. In addition, when choosing an accounting unit, one should take into account the possibility of proper control over the availability and movement of soft inventory in the institution.
Example 1. A budgetary healthcare institution purchased 100 sets of overalls for doctors: cotton jackets and trousers. According to the contract, the cost of one set is 180 rubles. The cost of delivery of workwear was 900 rubles. The accounting policy of the institution establishes that the unit of accounting for workwear for a doctor is the type of workwear: jacket, trousers. The cost of an accounting unit for a type of workwear, if it is supplied as a set, is determined as follows:
- jacket for a doctor - 60% of the cost of the set;
- trousers for a doctor - 40% of the cost of the set.
In the accounting records of a healthcare institution, these transactions are reflected as follows:
Thus, the cost of one jacket is 113.4 rubles. (11,340 rubles / 100 sets), and the cost of one trousers is 75.6 rubles. (RUB 7,560 / 100 units).
In accordance with paragraph 119 of Instruction No. 157n, analytical accounting of material inventories is carried out by their groups (types), names, varieties and quantities in the context of financially responsible persons and (or) storage locations. In the example given, storekeeper Sirina I.S. must keep records of soft equipment in a book (card) for recording material assets by type of workwear (jackets, trousers) and its quantity.
Free soft equipment. In accordance with the rules established by the Accounting Instructions for state (municipal) institutions, there are several options for obtaining inventories free of charge, including soft inventory. Such options include securing the right of operational management, receiving under a gift agreement, through centralized supply, from supranational organizations, foreign governments and international financial organizations, as well as other options. For each individual case, there is a different option for determining the actual cost of soft inventory.
The actual value of soft inventory received under a donation agreement is its current market value as of the date of acceptance for accounting. If there are services associated with its delivery and bringing it into a condition in which the soft inventory is suitable for use, their cost is included in the actual cost of the soft inventory. In this case, the current market value is recognized as the amount of money that can be received as a result of the sale of soft inventory on the date of acceptance for accounting. The current market value is determined on the basis of the price in effect on the date of recording of property received free of charge for this or a similar type of property. Information about the current price must be confirmed by documents or experts. In addition, in order to accept soft inventory received under a gift agreement for accounting purposes, data on prices for similar material assets received in writing from manufacturing organizations, information on price levels available from state statistics bodies, trade inspectorates, and also in the media and specialized literature, expert opinions on the cost of individual (similar) objects. Responsibilities for determining the market price of soft inventory received under a gift agreement are assigned to the commission for the receipt and disposal of assets created in the institution on a permanent basis (clause 25 of Instruction No. 157n).
FYI. The actual cost of soft inventory identified during an inventory of assets is determined in a similar way (clause 31 of Instruction No. 157n).
Free receipt (transfer) of soft equipment within the framework of movement between state bodies, local government bodies (municipal bodies), state (municipal) institutions, management bodies of state extra-budgetary funds, state academies sciences, as well as between accounting subjects and other state (municipal) organizations created on the basis of state (municipal) property, in connection with the termination (consolidation) property rights(including operational management rights) is carried out according to the balance sheet (actual) value of accounting objects (clause 29 of Instruction No. 157n).
FYI. Instruction No. 157n is silent about the actual cost of material assets received from supranational organizations, foreign governments and international financial organizations. According to the author, in this case, if the accompanying documents do not indicate the cost of soft equipment, its market price is applied.
Correspondence of invoices for the free receipt of soft equipment
| Instruction N 162н | Instruction N 174n | Instruction N 183n | |||
| Debit | Credit | Debit | Credit | Debit | Credit |
| Free receipt of inventory as part of centralized supply | |||||
| 1 105 35 340 | 1 304 04 340 | <*> | <*> | ||
| Free receipt of soft equipment as part of the movement between institutions subordinate to different main managers (managers) of budgetary funds of budgets of the same level, institutions, subordinate to one main manager (manager), within income-generating activities, as well as when receiving from government and municipal organizations, other organizations (except for government and municipal) and individuals |
|||||
| 0 105 35 000 | 0 401 10 180 | <*> | <*> | ||
| Free receipt of soft inventory as part of the movement of objects between budgetary institutions of budgets of different levels |
|||||
| 0 105 35 000 | 0 401 10 151 | <*> | <*> | ||
| Acceptance for accounting of soft inventory (investments) received free of charge from the head office (separate division)<**> |
|||||
| <*> | 0 105 25 340 0 105 35 340 0 106 34 340 | 0 304 04 340 | 0 105 25 000 0 105 35 000 0 106 34 000 | 0 304 04 310 | |
| Acceptance for accounting of soft equipment received free of charge upon securing operational management rights<***> |
|||||
| <*> | 4 105 25 340 4 105 35 340 | 4 210 06 660 4 401 10 180 | 4 105 25 000 4 105 35 000 | 4 210 06 000 4 401 10 180 |
|
| Free receipt of soft equipment in other cases from residents of the Russian Federation and individuals who are not residents of the Russian Federation |
|||||
| <*> | 2 105 25 340 2 105 35 340 | 2 401 10 180 | 2 105 25 000 2 105 35 000 | 2 401 10 180 |
<**>Reasons - invoice, acceptance certificate, Notice (f. 0504805).
<***>Grounds - act of acceptance and transfer, Notice (f. 0504805).
Example 2. The autonomous institution received soft inventory related to other movable property of the institution in the amount of:
- 125,000 rub. - from the founder;
- 90,000 rub. - from an individual (as a gift in accordance with the donation agreement).
In the accounting records of an autonomous institution, these transactions are reflected as follows:
Internal movement and disposal of soft inventory due to wear and tear
A peculiarity of accounting for soft equipment in state (municipal) institutions, including health care institutions, is that its commissioning is reflected in accounting as an internal movement of material assets. Operations for the transfer of soft inventory into operation are reflected in the registers of analytical accounting of material inventories by changing the materially responsible person on the basis of primary accounting documents: Requirements-invoice (f. 0315006), Statement of issue of material assets for the needs of the institution (f. 0504210) (clause 24 Instructions N 162n, clause 32 of Instructions N N 174n and 183n). In this case, accounting entries are made to the debit and credit of the same soft inventory account.
Pay attention! In tax accounting, the cost of soft equipment put into operation is taken into account when determining taxable profit at the time of its transfer to operation (clause 3, clause 1, article 254 of the Tax Code of the Russian Federation).
The disposal of soft equipment is carried out on the basis of the Act on the write-off of soft and household equipment (f. 0504143)<5>, which is compiled by the institution’s commission for the receipt and disposal of assets when making a decision to write off soft inventory. The act indicates the basis for writing off soft inventory, the quantity and cost of materials (rags) generated as a result of its liquidation. It must be remembered that soft inventory can only be written off if two conditions are met simultaneously (clause 25 of Instructions No. 162n, clause 36 of Instructions No. 174n and 183n):
- expiration of the wear period (use period);
- inability to use soft equipment due to its physical wear and tear.
The cost of soft equipment, depending on the scope of its application, is written off to the following accounts:
- 0 401 20 272 "Consumption of inventories";
- 0 109 00 000 "Costs for the production of finished products, performance of work, services."
The disposal of inventories, including soft inventory, is reflected in accounting in two ways (clause 108 of Instruction No. 157n):
- at the actual cost of each unit;
- at the average actual cost.
The determination of the average actual cost of soft inventory items is carried out for each of its groups (types) by dividing the total actual cost of the group (type) of inventories by their quantity, which are formed, respectively, from the average actual cost (quantity) of the balance at the beginning of the month and the received inventories during of the current month on the date of their disposal.
Thus, healthcare institutions can choose different ways write-off of soft inventory for its various groups (types). For example, bathrobes can be written off at actual cost per unit, and sheets at average actual cost. It should be borne in mind that the use of one of the specified methods of write-off by group (type) of soft inventory is carried out within financial year continuously.
Pay attention! In accordance with paragraph 8 of Art. 254 of the Tax Code of the Russian Federation, when determining the amount of material costs from the write-off of soft inventory in accordance with the accounting policy adopted by the institution for tax purposes, one of the following valuation methods is used: at the cost of a unit of inventory, average cost, cost of the first inventory at the time of acquisition (FIFO), cost of the last at the time of acquisition inventory (LIFO).
Example 3. The accounting department of a government health care institution received an act on the write-off of soft equipment with the following data.
The amount of rags from the write-off of soft equipment was 2 kg at a price of 1 rub. for 1 kg. According to the accounting policy of the institution, bathrobes and towels are subject to write-off at the cost of each unit. Soft inventory was used in budgetary activities.
In the accounting records of a government institution, these transactions are reflected as follows:
Is it possible to increase the cost of workwear if, during the process of its internal movement (putting it into operation), costs were incurred to adjust the workwear to the employee’s figure? For example, gowns for doctors, laboratory assistants, sets of overalls for nurses, when issued to employees, were tailored to the workers’ figures. The services were provided by a tailor - a private entrepreneur. As stated above, in accordance with paragraph 107 of Instruction No. 157n, the actual cost of soft inventory does not change after it is accepted for accounting. If, during the internal movement, any expenses were incurred to bring soft equipment to a state in which it is suitable for use (for example, to adjust a gown to a doctor’s figure), these expenses are included in subarticle 225 “Works, services for maintaining property "KOSGU, depending on the content of the business transaction, either to account 0 401 20 225 "Costs for work, services for maintaining property" or the corresponding analytical accounts of account 0 109 00 000 "Costs for the manufacture of finished products, performance of work, services."
For reference. Personal protective equipment issued to employees must correspond to their gender, height, size (clause 12 of the Intersectoral Rules for Providing Workers with Special Clothing, Special Footwear and Other Personal Protective Equipment<6>).
<6>Approved by Order of the Ministry of Health and Social Development of Russia dated June 1, 2009 N 290n.
Example 4. From the warehouse of a budgetary healthcare institution (m. o. l. Pronin A.V.), the sister-housewife (Okuneva I.K.) was given 20 jackets worth 108 rubles for further supply of doctors. each and 20 trousers costing 72 rubles. per piece. The jackets and trousers were intended for the doctors of the institution. For the services of fitting jackets and trousers to the figures of doctors, funds in the amount of 2,250 rubles were transferred to a private entrepreneur - a tailor. Soft equipment was purchased as part of compulsory health insurance activities.
In the accounting records of a budgetary institution, these transactions are reflected as follows:
| Contents of the operation | Debit | Credit | Sum, rub. |
| Internal movement reflected soft equipment: | |||
| - jackets | 7 105 35 340 Pronin A.V. | 7 105 35 340 Okuneva I.K. | 2160 |
| - trousers | 7 105 35 340 Pronin A.V. | 7 105 35 340 Okuneva I.K. | 1440 |
| Costs for fitting jackets have been written off and trousers according to workers’ figures | 7 401 20 272 | 7 302 25 730 | 2250 |
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"Budgetary healthcare institutions:
accounting and taxation"
