Clear work objectives. Focusing on "protecting health and preventing serious diseases" and aiming at preventing epidemic input, cluster epidemic and death from serious diseases, we will focus on prevention and control management measures such as dynamic response mechanism of epidemic prevention and control in old-age care institutions, management of personnel and articles entering and leaving hospitals, environmental prevention and control, daily monitoring, emergency preparation and emergency disposal, and strengthen the mechanism of "three handshakes" between old-age care institutions and medical institutions, 120 emergency transport and streets.
Second, strengthen comprehensive work guidance.
Improve the dynamic response mechanism of prevention and control measures. After the approval of each district, when the epidemic situation is not prevalent, on the basis of strengthening the health monitoring of entry-exit personnel, open management will be implemented for the old-age care institutions in the jurisdiction; When the epidemic is prevalent, the old-age care institutions in the jurisdiction shall be closed in principle, and they may be managed in an orderly and open manner on the basis of strengthening the health monitoring of entry-exit personnel according to the actual work. When the epidemic situation is serious, with the consent of the leading group for epidemic prevention and control, the relevant areas can strictly close the management of the old-age care institutions in their respective jurisdictions and report to their superiors.
Implement regular research and scheduling system. The special classes for epidemic prevention and control of old-age care institutions at the city and district levels should regularly analyze and judge the epidemic situation, timely dispatch and command the epidemic prevention and control of old-age care institutions, and coordinate and solve key problems in epidemic prevention and control of old-age care institutions. When the epidemic situation is serious, work should be arranged daily.
Implement the "zero report" system of epidemic situation in old-age care institutions. Supervise and guide pension institutions to establish a 24-hour emergency duty system. If there is a positive result of nucleic acid or antigen test, it is necessary to report the infection in the first place and cooperate with the local government to carry out epidemic monitoring. When the epidemic situation is serious, supervise and guide the old-age care institutions to implement the daily "zero report" system.
Third, guard against the risk of epidemic input in old-age care institutions
Strengthen personnel access management. Supervise and guide the old-age care institutions to conscientiously implement the inspection and management system for personnel entering and leaving the institutions. Admission personnel must check the 48-hour nucleic acid negative certificate and the negative result of on-site antigen detection. During the open management of the institution, the staff of the old-age care institution can hold the negative certificate of nucleic acid test within 48 hours and the negative result of antigen test on the same day. During the period of closed management of institutions, closed-loop management should be implemented for inpatients. The elderly and workers who return to the hospital should first hold the negative certificate of nucleic acid test and the negative result of on-site antigen test within 48 hours, and implement health observation measures in the centralized health observation point or the isolated area with isolation conditions in the institution according to regulations before they can be admitted to the hospital or live and work in the closed loop in the hospital. During the period of strict closed management, family visits, reception visits, condolences and other non-urgent and necessary hospitalization activities are suspended; Suspension of group dining or party activities in the organization.
Strengthen the management of commodity access. Supervise and guide the old-age care institutions to strictly implement the relevant provisions on non-contact handover of foreign goods and materials, and set up a goods and materials handover area outside the agency gate. Materials and articles delivered by express delivery or family members may not directly enter the old-age care institutions, and must be disinfected and allowed to stand in accordance with the specified requirements.
Strengthen environmental monitoring and risk prevention. Supervise and guide the old-age care institutions to regularly carry out nucleic acid sampling and testing at key environmental points such as elevator buttons, door handles and sewers to prevent the risk of aerosol transmission such as floor drains, water seals and sewers. Supervise and guide the old-age care institutions to strengthen the daily protection, cleanliness and food security of staff and the elderly.
Fourth, prevent the cluster epidemic in the old-age care institutions.
Strictly implement the "early detection" mechanism. Supervise and guide the old-age care institutions to carry out full-time nucleic acid testing twice a week during the open management period, and carry out nucleic acid or antigen testing twice a week for the elderly in the hospital, and the testing between staff and the elderly is carried out alternately every other day; During the period of closed management, the staff carries out 1 nucleic acid detection every day, and the elderly in the hospital carry out nucleic acid or antigen detection twice a week. Conditional old-age care institutions, after training and guidance by the health and disease control departments, carry out nucleic acid testing and antigen testing on their own; In the old-age care institutions that do not have the conditions, nucleic acid sampling personnel will conduct nucleic acid testing and sampling, so as to reduce the risk of infection when personnel go out for nucleic acid testing. Nucleic acid detection should be "one sample, one test". According to the number of elderly people, the number of staff and the frequency of nucleic acid and antigen detection in local pension institutions, each district provides nucleic acid detection and antigen detection reagents free of charge.
Strengthen normalized health monitoring. Supervise and guide the old-age care institutions to monitor the health of all staff in the hospital every day and make records. Those with fever, respiratory infection and other symptoms 1 1 should be tested for antigen or nucleic acid 1 time in time, and the relevant personnel should be screened and isolated, and at the same time, they should be treated or sent to a doctor in time according to the symptoms. Support qualified old-age care institutions to provide necessary simple monitoring equipment for the elderly with basic diseases.
Implement regional management in hospitals. Supervise and guide the old-age care institutions to implement internal partition management, and set up closed-loop management areas, mobile management areas and health observation areas in combination with facilities and conditions to prevent cross-infection between different regions. Medical institutions that carry out pension services should manage the pension service area and medical service area separately, so as to achieve physical isolation and independent setting. Strengthen environmental ventilation and clean and disinfect the interior.
Improve emergency response capability. Each district organizes health and disease control departments to urge and guide the old-age care institutions to improve and refine the emergency plan in accordance with the requirements of "one hospital, one policy". Guide the old-age care institutions within their jurisdiction to do a good job in epidemic prevention and control, personnel training, emergency preparedness and emergency state conversion, and epidemic disposal. At least once a quarter, emergency plan drills. Supervise and guide the old-age care institutions to reserve protective articles, nursing articles and daily necessities according to the full-load operation standard.
Strengthen the handling of the epidemic situation. If the old-age care institutions find positive infected people, they should immediately adjust the division of labor and density, and implement measures such as transfer of residence, graded diagnosis and treatment, and terminal disinfection. Under the guidance of on-the-spot evaluation by professionals of health and disease control departments in various districts, the frequency of nucleic acid detection is determined according to the test results and risk assessment. Establish and improve the transfer mechanism of nosocomial infection, clarify the designated hospitals of old-age care institutions, establish a green channel mechanism for treatment, and isolate, transfer and give priority to hospitalized infection at the first time.
Strengthen the protection of centralized health observation points. Centralized health observation points will be included in the protection scope of each district, and centralized health observation will be carried out for positive personnel, newly accepted, rotated or returned personnel in old-age care institutions that do not have the conditions for district management. Strengthen the internal management of centralized health observation points, optimize infrastructure conditions and service support personnel.
Strengthen the reserve of emergency support forces such as nursing staff. Each district reserves emergency support forces such as nursing staff according to the proportion of the number of elderly people living in old-age care institutions 10%. Disabled dementia patients transferred to designated hospitals by old-age care institutions, and disabled dementia elderly people transferred to centralized health observation places or isolated areas by old-age care institutions should be equipped with nursing staff according to the standard of 1: 1. The elderly infected with self-care ability should be equipped with nursing staff according to their physical condition.
Five, to prevent the elderly from serious illness and death in old-age care institutions.
Strengthen the management of classified services for the elderly in hospitals. To find out the basic diseases and vaccination of the elderly in the old-age care institutions in COVID-19, classify them according to their basic diseases, COVID-19 vaccination and serious risk degree after infection, give play to the role of "net bottom" of primary medical and health institutions and "gatekeeper" of family doctors, and provide classified and graded health services such as vaccination, health education, health consultation, medication guidance and assistance in referral.
Implement and operate the handshake mechanism between pension institutions and medical institutions. Supervise and guide the medical institutions that establish a handshake mechanism with the old-age care institutions to provide daily diagnosis and health monitoring services for the elderly in the hospital through door-to-door visits, smart family doctors and remote consultations. And establish a medical security account according to "one person, one file, one person, one policy". Third-level and third-level hospitals that have established counterpart cooperation with old-age care institutions will implement a green channel for critically ill elderly people in old-age care institutions. All tertiary hospitals in China should open green channels for critically ill elderly people in old-age care institutions. Strictly implement the responsibility system for the first consultation of medical institutions, and any medical institution shall not shirk or refuse to consult critically ill elderly people transferred from pension institutions in the region or other regions for any reason.
Implement and operate the working mechanism of shaking hands with 120 emergency nursing institutions. Compacting the territorial responsibility of each district, each district should establish and improve the handshake mechanism between the old-age care institutions and the transfer institutions, and coordinate the first-aid and non-first-aid transfer resources within its jurisdiction 120 to ensure the medical needs of the old-age care institutions. City emergency center should do a good job in monitoring and early warning of emergency transport data of old-age care institutions, set up special seats for service guarantee of old-age care institutions, and make overall arrangements to ensure emergency transport of critically ill patients in old-age care institutions in emergency situations such as district-level resources cannot be guaranteed.
Implement and operate the working mechanism of shaking hands between pension institutions and local streets. We will continue to do a good job in drug security in old-age care institutions, realize the daily use of drugs for chronic disease management, and reserve antipyretic, analgesic, cough-relieving and expectorant drugs according to the proportion of 20% of the number of old-age care institutions. Strengthen the protection of traditional Chinese medicine decoction and distribute it to patients in need in the old-age care institutions in an orderly manner through neighborhood committees.
Strengthen vaccination in COVID-19. According to the standard procedure for judging the contraindications of vaccination in COVID-19, the contraindications of vaccination were judged for hospitalized elderly people, and a relatively fixed medical team was organized to enter the old-age care institutions in COVID-19 to carry out vaccination services. Accelerate the improvement of vaccination coverage in COVID-19, give priority to sequential immunization, and strive to achieve "all answers". On the basis of the first dose of booster immunization, we will promote the elderly in old-age care institutions to carry out the second dose of booster immunization.
Sixth, strengthen organizational guarantee.
Strengthen organizational leadership. Relevant departments and districts at the municipal level should conscientiously implement the decision-making and deployment of the municipal party committee and municipal government, be responsible according to the division of responsibilities and tasks, strengthen coordination and cooperation, strictly implement the "four-party responsibility", and do a solid job in epidemic prevention and control of old-age care institutions and various service guarantees during the epidemic to ensure that all measures are put in place. In the case of non-epidemic situation, all districts should strengthen the role of the lead department, form a joint force with relevant departments and territories, and actively and steadily promote the implementation of various prevention and control measures for old-age care institutions.
Strengthen the implementation of responsibilities. Relevant departments at the municipal and district levels shall, according to their respective responsibilities and actual work, timely optimize and adjust relevant policies for epidemic prevention and control of old-age care institutions, give play to the guiding role of the industry, and earnestly strengthen the guidance and services for epidemic prevention and control. All districts should widely publicize and emphasize the "four-party responsibility" and measures, respond to public concerns in a timely manner, and properly solve various demands of the masses.
Strengthen care and care. All districts should mobilize Party organizations at all levels, the Communist Youth League, trade unions and other forces and charitable organizations, take various ways to strengthen the care and service guarantee of the elderly and staff in pension institutions during the epidemic, strengthen psychological counseling, help them solve problems, and reduce psychological pressure and anxiety. It is necessary to urge and guide the old-age care institutions to strengthen publicity and guidance, and provide the elderly with family communication services with their loved ones through telephone and internet.
Strengthen training and supervision and inspection. Relevant municipal departments and districts should extensively carry out deployment training and policy interpretation of policies and measures for prevention and control of COVID-19 infection in old-age care institutions; It is necessary to regularly carry out on-site supervision and flight inspection on the implementation of epidemic prevention and control measures and related service guarantee work in old-age care institutions, focusing on the inspection of personnel and material access management, the implementation of early detection measures, the implementation of medical security services, etc., and timely notify the hidden dangers discovered by supervision and inspection, and do a good job in rectification and implementation.
Social welfare institutions such as community pension service stations, child welfare institutions and disabled service institutions that temporarily accept and support the elderly in each district shall be implemented with reference to this work plan.
The capital strictly enters Beijing to manage the office of joint defense and joint control coordination mechanism
Beijing novel coronavirus Infection Epidemic Prevention and Control Work Leading Team Office
65438+20231October 6th
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