Problematic issues of organizing the work of supernumerary units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation

Relevance. One of the important principles of medical evacuation support for the affected population in emergency situations (ES) is the maximal approaching of medical care to the focus of mass sanitary losses. This can be achieved by recruiting various medical staff as part of supernumerary units (SUs) within the Disaster Medicine Service (DMS). During SU training, chiefs of medical organizations (military medical organizations) face some various clinical and organizational problematic issues.

Intention: To identify and study relevant problematic issues of the professional practice of medical staff recruited in various SUs of the DMS of the Russian Ministry of Defense for the elimination of the ES medical and sanitary consequences, and to determine the hierarchy of these issues by their significance among medical workers.

Methodology. 440 medical professionals who participated in DMS SU activity were surveyed. Initially, 10 diverse questions were defined with answers rated from 1 to 3: not an important problem – 1 point; an important problem – 2 points; a very important problem – 3 points. The results of the survey were evaluated and a factor analysis of the significance of the studied problematic issues was carried out.

Results and Discussion. The most significant problematic issues were “the lack of supply of supernumerary units with the necessary medical equipment” and “the poor training of medical staff in providing the assistance abroad”. During the factor analysis, 3 factors were defined, the total dispersion of which was 52.7 %. The 1st factor (30.3 % of the dispersion) included the problems of insufficient supply of supernumerary units with necessary medical equipment, poor training of medical personnel, non-compliance with their working conditions and protection of interests during their activity in the emergency zone, which is related, inter alia, to a lack of basic regulatory documents. The 2nd factor was defined as a poorly developed procedure for the functioning of supernumerary units. The contribution of the second factor to the total variance of baseline traits was 12.3 %. The 3rd factor with a share of 10.1 % grouped questions on low theoretical and practical readiness of specialists from non-staff DMS formations to operate in emergency situations.

Conclusion. The used methodology for studying the topical problematic issues of the professional activities of medical personnel in supernumerary units of the DMS allowed us to reliably establish their structure and propose methodological approaches to their resolution. The first approach is to improve the organization of DMS SU activities with a focus on the most significant problematic issues. The second approach is to conduct more in-depth research in this area with involvement of a wide range of specialists (experts) at various levels. The third approach includes training interactions of DMS SU personnel when performing actual tasks and solving problematic issues under study. Timely response of DMS medical authorities to the existing requests from SU medical personnel involved in the elimination of the medical and sanitary consequences of ES will boost their effectiveness and will have a positive impact on the overall system of medical and evacuation support of the AllRussian DMS.

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