Construction and implementation of a collaborative work system between designated hospitals and infection control departments during a local outbreak of Coronavirus disease 2019 infection
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摘要:
目的 探索新型冠状病毒感染(简称新冠感染)疫情局部暴发时定点医院联合感控部工作体系及运行机制,为应急状态下感染防控工作有效开展提供理论和实践参考。 方法 面对定点医院医务人员感染风险大、医疗队同质化管理不托底等困难,建立以国家感控专家为顾问和技术指导,省级感控专家担任主任,医疗队感控专业人员为成员的“联合感控部”,构建高效有力的指挥体系、科学周密的防控体系、人人参与的屏障体系。人人参与的屏障体系,提高各医疗队对感控工作的认可度和参与度,推动感控质量持续提升。 结果 定点医院累计救治新冠感染确诊患者985人,感控工作安全托底,无医疗安全事件及医务人员院内感染等问题发生。全院医务人员手卫生依从率从52.30%提高到98.89%,清洁消毒合格率由43.59%提高到99.25%,脱卸防护用品问题率由23.70%下降到0,患者手卫生知晓率从73.21%提高到100.00%。 结论 通过应急实战形成了一盘棋领导、多主体协作、层级化落实的定点医院感控管理模式,实现了多支医疗队感控管理同质化运行,保障了患者医疗救治高效有序实施。 Abstract:Objective To explore the work system and operational mechanism of designated hospitals and infection control departments during local outbreaks of coronavirus disease 2019 (COVID-19) infection, so as to provide theoretical and practical references for the effective implementation of infection prevention and control measures in emergency situations. Methods In response to the significant risk of infection among healthcare workers in designated hospitals and the challenge of managing homogeneous medical teams effectively, we established a "Collaborative Infection Control Department." This department comprised national infection control experts serving as advisors and providing technical guidance, provincial-level infection control experts as directors, and infection control professionals from medical teams as members. The department aimed to construct an efficient and powerful command system, a scientifically rigorous prevention and control system, and a everyone participatory barrier system, so as to increase the recognition and engagement of infection control work among medical teams and promote the continuous enhancement of infection control quality. Results A total of 985 patients with COVID-19 in the designated hospitals were included in the study. Throughout the treatment process, no adverse medical safety incidents or nosocomial infections among healthcare professionals occurred. The hand hygiene compliance rate among all healthcare workers in the hospital increased from 52.30% to 98.89%. Furthermore, the qualification rate for cleanliness and disinfection improved from 43.59% to 99.25%. Remarkably, the rate of issues related to the removal of protective equipment decreased from 23.70% to 0. Additionally, the patient's awareness rate of hand hygiene increased from 73.21% to 100.00%. Conclusion Through the emergency practice, a designated hospital infection control management model with comprehensive leadership, multi-subject cooperation, and hierarchical implementation had been formed, the infection control management of multiple medical teams had been carried out homogeneously, and the medical treatment of patients had been ensured efficiently and orderly. -
[1] HUANG C L, WANG Y M, LI X W, et al. Clinical features of patients infected infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395: 497. doi: 10.1016/S0140-6736(20)30183-5 [2] DHAMA K, KHAN S, TIWARI R, et al. Coronavirus Disease 2019-COVID-19[J]. Clin Microbiol Rev, 2020, 33(4): e00028-20. DOI: 10.1128/cmr.00028-20. [3] 房元圣, 武洁雯, 赵青, 等. 2023年7月全球新型冠状病毒感染疫情风险评估[J]. 疾病监测, 2023, 38(8): 901-904.FANG Y S, WU J W, ZHAO Q, et al. Risk assessment of global COVID-19 pandemic in July 2023[J]. Disease Surveillance, 2023, 38(8): 901-904. [4] 陈文森, 张浩军, 李六亿, 等. 超大型城市新型冠状病毒肺炎局部暴发疫情防控策略[J]. 中华医院感染学杂志, 2021, 31(24): 3687-3690.CHEN W S, ZHANG H J, LI L Y, et al. Research on control and prevention strategy of COVID-19 in metropolis[J]. Chinese Journal of Nosocomiology, 2021, 31(24): 3687-3690. [5] IACOBUCCI G. Covid-19: are high rates of B. 1.617.2 linked to vaccine hesitancy?[J]BMJ, 2021, 373: n1345. DOI: 10.1136/bmj.n1345. [6] MLCOCHOVA P, KEMP S A, DHAR M S, et al. SARS-CoV-2 B. 1.617.2 Delta variant replication and immune evasion[J]. Nature, 2021. DOI: 10.1038/s41586-021-03944-y. [7] 史庆丰, 高晓东, 胡必杰. Delta新冠病毒变异株的特性及流行现状与防控研究进展[J]. 中华医院感染学杂志, 2021, 31(24): 3703-3707.SHI Q F, GAO X D, HU B J. Research progress on characteristics, epidemiology and control measure of SARS-CoV-2 Delta VOC[J]. Chinese Journal of Nosocomiology, 2021, 31(24): 3703-3707. [8] LIU Y, ROCKLOV J. The reproductive number of the Delta variant of SARS-CoV-2 is far higher compared to the ancestral SARS-CoV-2 virus[J]. J Travel Med, 2021, 28(7): taab124. DOI: 10.1093/jtm/taab124. [9] ALISHAQ M, JEREMIJENKO A, AL-KANNAANI Z, et al. Prevalence and risk factors for SARS-CoV-2 infection and seroprevalence among clinical and non-clinical staff in a national health care system[J]. PLoS One, 2021, 16(9): e0257845. DOI: 10.1371/journal.pone.0257845. [10] GALANIS P, VRAKA I, FRAGKOU D, et al. Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis[J]. J Hosp Infect, 2021, 108: 120-134. DOI: 10.1016/j.jhin.2020.11.008. [11] KLOMPAS M, BAKER M A, RHEE C, et al. A SARS-CoV-2 Clusterinan acute care hospital[J]. Ann Intern Med, 2021, 174(6): 794-802. doi: 10.7326/M20-7567 [12] 李六亿, 姚希, 张冰丽. 新冠肺炎患者救治定点医院改建对策[J]. 中华医院感染学杂志, 2021, 31(19): 2881-2885.I L Y, YAO X, ZHANG B L. Countermeasures for the reconstruction of designated hospitals for the treatment of patients with COVID-19[J]. Chinese Journal of Nosocomiology, 2021, 31(19): 2881-2885. [13] 张浩军, 陈文森, 高晓东, 等. 应对新冠肺炎局部暴发疫情定点医院感染防控工作模式思考[J]. 中华医院感染学杂志, 2021, 31(24), 3691-3694.ZHANG H J, CHEN W S, GAO X D, et al. Consideration of the infection prevention and control mode in designated hospitals in response to local outbreaks of COVID-19[J]. Chinese Journal of Nosocomiology, 2021, 31(24), 3691-3694. [14] 符敏, 胡少华, 王婷, 等. 安徽省公立医院护士医用防护用品知识现状调查[J]. 中华全科医学, 2022, 20(1): 144-147. doi: 10.16766/j.cnki.issn.1674-4152.002298FU M, HU S H, WANG T, et al. Investigation on the current situation of knowledge of medical protective equipment amongst nurses in public hospitals in Anhui Province[J]. Chinese Journal of General Practice, 2022, 20(1): 144-147. doi: 10.16766/j.cnki.issn.1674-4152.002298 [15] 钟霞, 李伟, 郭德莹, 等. COVID-19流行期间非定点收治三级综合医院感染防控实践的探索[J]. 中华全科医学, 2020, 18(12): 2117-2119, 2148. doi: 10.16766/j.cnki.issn.1674-4152.001702ZHONG X, LI W, GUO D Y, et al. Practice of infection prevention and control in non-designated three grade general hospital during COVID-19 epidemic period[J]. Chinese Journal of General Practice, 2020, 18(12): 2117-2119, 2148. doi: 10.16766/j.cnki.issn.1674-4152.001702 [16] 付强. 基于COVID-19疫情应对的医疗机构内感染防控实践思考[J]. 中华医院感染学杂志, 2020, 30(8): 1121-1124.FU Q. Reflection on practice of prevention and control of infection in medical institutions based on response to COVID-19 epidemic[J]. Chinese Journal of Nosocomiology, 2020, 30(8): 1121-1124. [17] 李红, 江莉, 石月欣, 等. 新型冠状病毒肺炎定点医院中院感防控体系的构建和作用[J]. 环境卫生学杂志, 2021, 11(2): 220-223.LI H, JIANG L, SHI Y X, et al. Construction and role of a nosocomial infection prevention and control system in designated hospitals for COVID-19[J]. Journal of Environmental Hygiene, 2021, 11(2): 220-223.
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