NATIONAL EXPERIENCE OF CREATING AND IMPLEMENTING MEDICAL STANDARDS IN CASE EVIDENCE APPEARS «LATER¼ (DURING THE COVID-19 CORONAVIRUS DISEASE PANDEMIC).

OBJECTIVE: The aim: Identification of methodological processes to accelerate the development of clinical guidelines in an emergency situation (in particular, coronavirus disease COVID-19), analysis of the practice of implementing clinical guidelines and clinical pathway. PATIENTS AND METHODS: Materials and methods: The processes of developing COVID-19 clinical guidelines are described on the websites of the developers. Implementing the patient's own clinical pathway. Survey of 117 health professionals involved in medical care at COVID-19 on management information. A retrospective pragmatic study of organizational and clinical aspects of medical care for 9,259 patients over 18 years with COVID-19 from March 18, 2020 to March 31, 2021. RESULTS: Results: Acceleration of the methodology of clinical guidelines, changes in legislation have contributed to the improvement of medical care for patients with COVID-19. Clinical pathway (CPw) professionals surveyed: 88.2% satisfied with the structure of CPw, 91.0% were in favor of local instructions and explanations, templates of registration forms, 72.7% needed on-the-job training, 78.1% needed training on medical features, 74.5% noted the positive impact of remote interaction, 61.6% required standard operating procedures. 9259 patients with suspected COVID-19 confirmed PCR in 55.2%. Among those checked, 31.2% of chest computed tomography confirmed pneumonia in 95.7% of CT; 9.3% were hospitalized; fatalities 5.5% of hospitalized or 0.5% of verified. CONCLUSION: Conclusions: Changes in the methodology of clinical guidelines, changes in legislation, education based on clinical guidelines have contributed to improving the results of management in COVID-19.

APPROACHES TO DEVELOPING AND IMPLEMENTING CLINICAL AND ORGANIZATIONAL REGULATIONS ENSURING INFECTIOUS SAFETY AND EPIDEMIOLOGICAL RESPONSE IN THE WORK PROCESS (THE CASE OF COVID-19).

OBJECTIVE: The aim: Of the work was to develop clinical and organizational regulations ensuring infectious safety and epidemiological response in the work process (the case of COVID-19) based on the current legislative acts of Ukraine to combat the spread of coronavirus disease (COVID-19), as well as on the data from international practices. PATIENTS AND METHODS: Materials and methods: The research objective was carried out in accordance with the Methodology for the development of medical and technological documents for the standardization of medical care. RESULTS: Results: The Protocol includes organizational elements to prevent the spread of coronavirus disease, such as "The development of general provisions on infectious safety and antiepidemic measures during the COVID-19 pandemic in the company's workplaces, taking into account the legislative acts of Ukraine and international practices", which include: the development of "Health Questionnaire" (epidemiological data questionnaire) for daily monitoring of the company employee health; the development of "Checklist for self-assessment of the workplace", "Checklist for self-assessment of the public space"; the development of "Analytical report on compliance with the infectious safety rules in the workplace and in the public space on the basis of self-assessment", thirteen Appendices. CONCLUSION: Conclusions: "The Protocol for infectious safety and antiepidemic measures in the work process" is a detailed instruction that provides a balance of compliance with medical standards and reasonable needs of employees and employers through the implementation of scientific evidence base in antiepidemic and infectious safety measures in the workplace.