1993

1994

1995

1996

1997

1998

Emergency Medicine

• Over the course of the partnership, a core team of 30 Russian physicians and nurses were prepared to serve as EMS trainers. They participated in a series of intensive train-the-trainers seminars in Iowa, which prepared them to conduct similar training programs in basic and advanced life support for their colleagues in Stavropol.

Infection Control

• An Infection Control Committee was created based upon the US Commission for Nosocomial Infection Prevention. The Committee is responsible for all personnel training and evaluation of the effectiveness of infection control policies and practices.
• Job descriptions for all medical personnel were revised to include infection control tasks and responsibilities.
• In the third quarter of 1995 an infection control program was established at Hospital #2.
• As of 1994, over 300 physicians and nurses had participated in infection control education programs and seminars conducted by US and NIS physicians and nurses.
• The positions of Hospital and Assistant Epidemiologist were established in partner institutions.
• By 1997, average length of hospital stay had decreased by six days. Delegations to Stavropol visited the operating room and recovery areas at the Krai Regional Hospital and Hospital #2. They observed significant improvements in infection control technique and practices, which they believed to directly, associated with the decreased stays.
• In October 1997, a Russian delegation visiting Iowa observed cleaning and sterilizing procedures used for endoscopes. The delegation from Stavropol made recommendations to the Krai Health Ministry for these changes and improved procedures were adopted in March 1998.
• The Stavropol partners reported that the new infection control program resulted in savings for local hospitals because of decreased expenditures on antibiotics and dressing materials. One surgical department reported savings of over 535 million rubles.
• Patients are now classified upon admission as having infectious or non-infectious conditions, and when needed are isolated accordingly.
• Software was introduced to monitor infections electronically. The new system resulted in greater accuracy in statistical data collection, and the number of reported nosocomial infections has risen to 77.
• Disinfectants and antibacterial solutions are now chosen on the basis of prevalent infections in the hospitals and organisms islolated.
• The Ministry of Health standardized procedures for routine environment culturing.
• Two surgical teams from Stavropol, including a surgeon, anesthesiologist and nurse, were trained in infection control techniques in the operating room and post-operative recovery room during visits to Iowa in 1994 and 1995.

Pediatric Hematology

• In 1994 and 1995 new treatment protocols were developed for leukemia and other pediatric cancers.
• In March 1998, the Associate Director of the Oncology Center (and medical advisor to the NRC) established a volunteer program at the Oncology Center. Modeled after programs observed in Iowa, the program is staffed by former cancer patients treated at the center.

Orthopedics

• In conjunction with a series of partnership visits, local capacity for prosthetic therapy and production was developed. In cooperation with Russian colleagues and officials in the Health and Social Protection Ministries, the US team developed two proposals, which would eventually cut costs and provide better prosthetics. The proposals are currently under review at the Ministry of Social Protection.

 
Biomedical Engineering

• A biomedical engineer from Iowa worked with Stavropol hospital staff to develop a preventive maintenance program for the institution's electronic equipment.

Cardiovascular Surgery

• The post of Deputy Chief Surgeon was established at Hospital #4 in Pyatigosk.
• New treatment protocols for acute extremity ischemia were introduced in Stavropol hospital.

Nursing

• Job descriptions for staff nurses were re-designed and the position of senior department nurse was added.
• The Stavropol Ministry of Health created a Chief Midwife position for the region.
• As a result of partnership activities in nursing, all nurses are now required to complete a CPR training course.
• Two nursing associations have been established as a result of the partnership, one in the city of Stavropol and the other for Stavropol Krai. Each adopted bylaws and established a focus on professional education for their constituencies. Another nursing association is currently being established in Essentuki.

Women's Wellness

• A program for family deliveries was established in Essentuki, whereby fathers could attend and participate in deliveries.
• A job description for the position of Obstetrician/Gynecologist physician was created and a physician was assigned to the position.
• Childbirth courses were provided to expectant parents at the Women's Wellness Center and at local hospitals.
• The Women's Wellness Center in Essentuki initiated family planning services, including the provision of a wide range of modern contraceptives.
• The Women's Health Center developed patient education programs on family planning, which are played over loudspeakers in the facility's waiting areas.
• Bi-monthly television broadcasts about family planning and contraception are now regularly featured on a local television station.
• Essentuki Maternity Hospital reported that the average length of stay for a normal vaginal delivery declined from 14 to 5 days over the course of the partnership.
• Postpartum home visits by a neonatologist were implemented by Essentuki Maternity Hospital to assess the progress of the newborn.
• The new Women's Wellness Center introduced education courses to the public in areas of contraception, prenatal care, sexually transmitted diseases, and breast self examination.
• Partners reported that maternal and perinatal morbidity and mortality rates have decreased since the start of the partnership.

 
Other

• Internet-based resources are now used extensively in clinical decision-making and residency training. In two particular areas Internet research led to new policies: treatment of ruptured vessels and patient care in the intensive care unit.
• NIS partners now frequently participate in videoconferencing, thanks to the addition of the Internet video conferencing equipment.
• A National Committee on Medical Information Technologies was established under the aegis of the Commission for State Standards.
• Continuing educational programs for all levels of health care professionals were established at the Ministry of Health and the Stavropol State Medical Academy.