A, work content
The medical institutions should focus on strengthening the management of fever clinic and hospital infection prevention and control work, strengthen the pre-screening and triage system and the implementation of the system of responsibility for the first diagnosis, to strengthen the management of outpatient and emergency patient visits and inpatient wards, nucleic acid testing, disposal of medical wastes, please all health care institutions in accordance with the "new coronavirus infection in health care institutions, the prevention and control of the technical guidelines ( Third Edition) and other latest policy documents for strict implementation.
(I) effectively strengthen the fever clinic management
The main person in charge of each medical institution should effectively assume responsibility for the management of fever clinic, the vice president in charge of medical work should be directly in charge of fever clinic work, to establish and improve and strictly abide by the rules and regulations, to conscientiously implement the requirements of the "Four Early" to improve the quality of medical care. To conscientiously implement the "four early" requirements, improve the fever clinic medical staff early diagnosis and treatment awareness and ability. All medical institutions must set up fever clinics in independent areas of hospitals in accordance with the "Fever Clinic Setting and Management Standards", and separate them from emergency clinics. The location does not meet the requirements, the layout is unreasonable fever clinic, should be immediately shut down and rectified as soon as possible according to the requirements; not equipped with a special CT to stop all clinics as soon as possible to configure the equipment, to be equipped with the equipment in place before receiving treatment. During the epidemic, all the staff of the fever clinic should implement closed-loop management, arrange for single-person, single-room centralized residence during the work period, and all the staff should travel in accordance with the two-point-one line between the place of residence and the fever clinic and arrange for a commuter car, so as to provide good protection and reduce cross-infection. Fever clinic to strengthen the screening of suspected patients, nucleic acid testing of all patients, test results must be retained before feedback, patients in the fever clinic during the consultation should be strictly in accordance with the relevant requirements to take the full closure management. Medical institutions that do not regulate the establishment of fever clinic shall not privately accept or refuse to diagnose suspicious patients (patients with fever, dry cough, fatigue, loss of smell and taste, sore throat and diarrhea, and other manifestations related to the new coronary artery pneumonia), and shall strictly implement the system of responsibility for the first diagnosis, and shall refer the suspicious patients to the medical institutions that have a fever clinic in a standardized manner.
(2) effectively strengthen the management of hospital infection prevention and control in medical institutions
The medical institutions should effectively strengthen the organizational leadership of hospital infection prevention and control, in accordance with the "new coronavirus infection prevention and control in health care institutions (third edition)" requirements, improve the infection prevention and control system and early warning mechanism, optimize the workflow, develop emergency response plans in different situations and implementation of drills, in accordance with the requirements of the state and the province with a full set of hospital infection prevention and control system and early warning mechanism, optimize the workflow, develop different scenarios and implementation of drills, in accordance with the requirements of the state and the province. In accordance with the requirements of the country and the province, the hospital infection prevention and control personnel should be fully equipped, and the training should be strengthened, and the personnel should be qualified after the training and examination before they can take up their duties. Specialized personnel for hospital infection prevention and control must enter the ward to carry out daily inspection and guidance work. During the epidemic period, each medical institution should inform patients of the requirements and policies for medical consultation through official websites, public numbers, and posting announcements at hospital entrances. Strictly implement the system of "all tests should be conducted", and all patients should not be hospitalized without proof of a negative nucleic acid test within 48 hours. The hospitalized patients, their escorts and all staff members should conduct a comprehensive check, and if they are found to have a history of travelling to the infected areas and manifestations related to the new coronary pneumonia, they should be reported in a timely manner, the information should be registered, and they should be transferred to the medical institutions that have set up fever clinics for further treatment as soon as possible according to the requirements, and the whole process should be strictly managed in a closed-loop manner. All personnel in medical institutions (including patients, escorts, logistics, etc.) must be routinely every 24 hours of the new coronavirus nucleic acid test, abnormal test results, immediately isolate in situ, and the first time to report the epidemic joint prevention and control leading group, at the same time, the implementation of the closed management of this institution.
(C) effectively strengthen the management of pre-screening and triage
The pre-screening and triage point of each medical institution should be set up at the entrance of the hospital and outpatient emergency clinic in a conspicuous position, clearly marked, relatively independent, well ventilated, with disinfection and isolation conditions. Need to have fever patients with masks, thermometers (non-contact), hand disinfectant, medical waste barrels, patients' basic information registration form. All medical institutions should be equipped with pre-screening and triage staff in accordance with the requirements, and effectively enhance the ability of pre-screening and triage. During the epidemic, temperature measurement, three-code verification (health code, trip code, nucleic acid test certificate), and inquiring about epidemiological history, sojourn history and gathering history are strictly implemented. Enhance the appointment mode of consultation (except for emergency) to reduce the gathering of patients. All patients (except emergency patients, infants and children under 1 year of age) must register with a certificate of negative nucleic acid test for new coronavirus within 48 hours.
(4) Effectively strengthen the management of outpatient emergency patients
Medical institutions should implement the pre-screening triage system, according to the prescribed route to guide patients with fever or / and respiratory symptoms and can not rule out the new coronavirus infection to the fever outpatient clinic. During the epidemic period, general outpatient clinics will implement the system of "one doctor, one patient, one clinic" and set up a 1-meter line in the areas of fee registration, medical insurance settlement, waiting for consultation, waiting for examination, and medicine collection. Outpatient halls should be assigned to uninterrupted inspections, found that the gathering of people should be diverted in a timely manner, and those who are not found to be wearing masks correctly should be corrected immediately. Develop and improve the emergency plan for referral and treatment of seriously ill patients and strictly implement it. Reasonably set up in line with the requirements of isolation and treatment, can provide local emergency services for new coronavirus infected patients in the treatment area or emergency room.
(E) effectively strengthen the management of patients and accompanying
during the epidemic, the medical institutions should be closed to the management of the ward. In principle, hospitalized patients are not accompanied, the need to accompany the strict implementation of the "one patient, one accompanying" system. In principle, hospitalized patients and their companions can not leave the ward, subject to the unified management of the hospital, the hospital to provide meal delivery service, daily meal distribution to the hospital area, the delivery personnel shall not enter the hospital area and patients and their companions to contact. The medical institutions should try to take bedside manner for testing and inspection, and for those who really need to leave the hospital area for testing and inspection, they should determine a special person to guide the patients in accordance with the fixed channels and fixed routes, and should not be mixed with the channels of the medical staff, and during the inspection period, they should strictly follow the principle of "one person, one room, one inspection", and the inspection should be completed and thoroughly disinfected before continuing to check on the next patient. The next patient will be examined only after the examination is completed and thoroughly sterilized.
(F) effectively strengthen nucleic acid testing and quality control
during the epidemic, we should increase the closed-loop management of all personnel in medical institutions (including staff, patients, companions, etc.), nucleic acid sampling personnel, laboratory nucleic acid testing personnel and other key populations with high risk, and carry out nucleic acid testing of the above populations every 24 hours, and implement a single sampling and single testing. People who have been vaccinated with the new coronavirus vaccine within 24 hours are not allowed to carry out sampling work. Nucleic acid sampling should be staggered in the morning, afternoon or evening to avoid detection errors caused by fixed-time sampling. Nucleic acid sampling personnel from key populations should be managed separately from sampling personnel from the general population, and sampling should be conducted in separate areas to avoid the risk of infection. Be sure to reasonably select the sampling point, resolutely disallow sampling in infectious disease areas and other high-risk areas, medical personnel shall not sample for themselves, and those with abnormal test results shall be immediately isolated on the spot and reported to the Provincial Joint Prevention and Joint Control Leading Group Office (Provincial Health Commission) and the Municipal Joint Prevention and Joint Control Leading Group for Disposal of the Epidemic at the first time. Personnel engaged in vaccination against the new coronavirus cannot carry out sampling work at the same time.
(VII) effectively strengthen the personal protection of medical personnel
The medical institutions should be clear about the level of protection and requirements of each position, each section, increase the training of personal protection of medical personnel, proficiency in mask wearing, hand hygiene, wearing and taking off protective clothing and other basic knowledge of protection. During the epidemic, medical staff should constantly enhance the awareness of risk prevention, grasp the risk areas, risk points and positive case trajectory, travel consciously to avoid, if there is a time and space intersection with the trajectory of positive cases, the first time to report according to the regulations, and actively cooperate in carrying out the flow, nucleic acid sampling, isolation and observation and other follow-up work.
(VIII) effectively strengthen the management of medical waste
The medical institutions should attach great importance to the management of medical waste during the epidemic of new coronavirus-infected pneumonia, and effectively implement the main responsibility of its legal representative is the first person responsible for the management of medical waste, the specific departments and operators who generate medical waste are directly responsible for the person. During the epidemic, each medical institution should strictly implement the "Medical Waste Management Regulations", "Measures for the Management of Medical Waste in Healthcare Institutions" and the relevant requirements of Gansu Provincial Health and Health Commission's "Notice on Doing a Good Job in Medical Waste Management in Medical Institutions During the Pneumonia Epidemic Infected by the New Coronavirus" (Ganwei Medical Affairs Letter 〔2020〕 No. 60), to practically implement the main responsibility to enhance the classification and collection of epidemic-related medical waste In order to strengthen the management of the whole process of handover, transfer, temporary storage and transfer to the centralized medical waste disposal unit, the use of double-layer bags to contain medical waste, the use of gooseneck knot sealing, layered sealing, each bag, sharps box should be tied or pasted with Chinese labels, the labeling content, including: the unit of generation of medical waste, the generation of the department, the generation of the date, the category, and in the special instructions marked " New coronavirus infection of pneumonia" or abbreviated as "new crown". Medical waste collection, transfer, management personnel in contact with or disposal of medical waste should wear work clothes, hats, boots, masks, gloves and other protective equipment, close operation or there may be liquid spills should wear goggles, suspected or diagnosed new coronavirus pneumonia patients used fabrics should also be collected according to the procedures of collection, transfer and incineration to ensure safety.
(IX) Effectively strengthen the management of the setting up of designated hospitals for the treatment of new coronavirus
The designated hospitals for the treatment of new coronavirus have to complete the relevant settings in accordance with the requirements of the "Code of Practice for the Setting Up and Management of the Setting Up of Designated Hospitals for the Treatment of New Coronavirus Pneumonia", so as to ensure that they can readily carry out the work of treating new coronavirus-infected patients (including confirmed cases and those with no symptomatic infections). All ward buildings in designated hospitals must meet the requirements for the prevention and control of respiratory infectious diseases, and "three zones and two channels" must be set up in a standardized manner. New coronavirus infected persons treatment unit must be an independent area of independent buildings, not with other diseases admitted to the hospital at the same time in the same area or the same ward building, do not **** with the same medical area and medical equipment. The sentinel hospital must make early reserves of materials and equipment, and be equipped with well-functioning oxygen supply equipment, with an oxygen supply capacity capable of meeting the demand for simultaneous high-flow oxygen intake by 10% of the patients when operating at full capacity. All staff in the isolation wards of the sentinel hospitals and other staff who are in direct or indirect contact with patients infected with the new coronavirus are subject to strict closed-loop management. All wards in the sentinel hospitals are prohibited from admitting patients with extra beds, and new coronavirus-infected patients are not to be visited or accompanied. Sensory control specialists should enter the fever clinic, isolation wards and other key areas to supervise and guide the work of sensory control.
Second, the work requirements
(a) to improve the position, and effectively enhance the awareness of risk. The medical institutions should fully understand the severity, complexity, importance and urgency of the current epidemic prevention and control of the new crown pneumonia, with a high sense of responsibility and sensitivity, to improve the political stance, adhere to the people's health as the center, firmly establish a sense of crisis and the bottom line thinking, tighten the epidemic prevention and control of this string, not paralysis, no carelessness, no fluke, no laxity. Establish the epidemic prevention and control of the main line, bottom line, red line thinking, enhance risk awareness, the prevention and control of the work of the re-deployment, re-enforcement, re-implementation.
(2) Unified leadership, the implementation of all work measures. The main person in charge of the medical institutions to effectively fulfill the hospital infection prevention and control of the work of the first person responsible for the duty to convene regular meetings of the sense of control, and in accordance with the national and provincial hospital infection prevention and control of the relevant policies and regulations, the implementation of the work of all measures without compromise. During the epidemic, the designated medical institutions, set up a fever clinic (fever clinic) medical institutions require at least once a day to convene a special meeting on sensory control, other medical institutions in principle, at least once a week to convene a special meeting on sensory control. All medical institutions should carry out special training for all staff (including cleaning, security, drivers, etc.) in accordance with their work positions and duties through various means. If the hospital infection incident is caused by inadequate management or responsibility, it will be seriously investigated and punished, and the relevant personnel will be held accountable.
Attachment: 1. On further strengthening the medical institutions of the new coronary pneumonia nosocomial infection prevention and control work notice (Gan epidemic prevention office Mingdianfa [2021] No. 148)
2. On strengthening the medical institutions of nosocomial infection prevention and control work notice (Gan epidemic prevention office Mingdianfa [2021] No. 227)
3. On further standardizing the management of fever clinics, sentinel hospitals Notice on further standardizing the management of fever clinics, designated hospitals, nucleic acid testing and nosocomial infection prevention and control work (Gan Epidemic Prevention Office Mingdian [2021] No. 244)
4. Emergency notice on further strengthening of infection prevention and control of medical institutions during the epidemic (Gan Epidemic Prevention Office Mingdian 〔2021〕 No. 268)
5. Emergency notice on the further standardization of the work of medical waste disposal during the epidemic (Gan Epidemic Prevention Office Mingdian [2021] No. 277)
5. Emergency notice on further standardization of medical waste disposal during the epidemic (Gan Epidemic Prevention Office Mingdian [2021] No. 277) Supplementary Notice on Strengthening the Prevention and Control of Nosocomial Infection in Medical Institutions during the Epidemic (Gan Epidemic Prevention Office Mingdian [2021] No. 286)
7. Prevention and Control Program of New Coronavirus Pneumonia (Eighth Edition)
8. Technical Guidelines for the Prevention and Control of New Coronavirus Infections in Healthcare Institutions (Third Edition)
(Please refer to the attachment above for more details. p>(The above attachments can be downloaded from the website of Jinchang Municipal Health Commission)