In order to further enhance our hospital's ability to cope with the epidemic situation in COVID-19, we should make scientific, rapid, stable and orderly response and disposal when the COVID-19 nucleic acid test is positive in the hospital, and control the epidemic situation within the controllable range. According to the spirit of the Notice on Printing and Distributing the Emergency Response Plan for COVID-19 Nucleic Acid Test Positive in Gansu Medical Institutions [2021] No.8, combined with the actual situation of our hospital, this plan is formulated.
First, the work goal is to further enhance our hospital's ability to deal with the COVID-19 epidemic, give full play to the role of medical institutions as "sentries", and fully protect people's lives, health and safety. When there is a positive report of nucleic acid detection in medical institutions, we should deal with the COVID-19 epidemic scientifically, quickly, steadily and orderly, control the epidemic in the shortest time, reduce or avoid the occurrence of hospital infection, reduce the social impact, and ensure the quality and safety of medical care.
Two. Organization and command system and responsibilities Our hospital has set up an emergency response leading group headed by the president, which is responsible for organizing, leading, coordinating and supervising the implementation of emergency response. There are several working groups under the medical working group and the hospital infection prevention and control group to achieve clear tasks and division of responsibilities.
Page 2 *** 18 has clear work, orderly command and management, and smooth information communication, so as to ensure that the epidemic situation is dealt with in the first time, and the epidemic situation is handled smoothly, quickly and efficiently. The division of responsibilities of the working group is as follows:
(1) Medical treatment group.
Group length:
Deputy team leader:
Members:
Responsibilities: Responsible for the medical treatment, referral, consultation, transfer and medical personnel dispatch of patients, organize COVID-19 nucleic acid testing according to the needs of epidemic prevention and control, report the diagnosis and treatment information in time, and fully guarantee the medical treatment needs of patients.
(2) Hospital Infection Prevention and Control Team.
Responsibilities: Actively cooperate with the disease control department to do relevant epidemiological investigation, and at the same time do a good job in regional division, channel setting, terminal disinfection, personnel training, risk investigation and disposal according to the degree of risk to prevent hospital infection.
(3) Information Reporting Group.
Responsibilities: responsible for coordinating and mastering the work information of our hospital and summarizing and reporting it in time. Timely sort out the information of inpatients, family members, logistics property, security, administration and other personnel, and provide a basis for administrative decision-making and other work.
(4) Material Support Group.
Page 3 *** 18 responsibilities: timely sort out all kinds of protective materials in medical institutions, including protective materials for medical personnel, various disinfection products and instruments, various drugs, nucleic acid detection supplies, medical instruments and other materials to ensure that the quantity and quality meet the actual selection needs.
(5) Logistics Support Group.
Responsibilities: Ensure food, shelter, transportation, etc. All medical staff and all kinds of staff should meet their living needs, understand the living needs of patients in time and solve them in time. Actively coordinate with relevant departments, contact relevant materials and match them timely and accurately. Do a good job in the water and electricity needed by medical institutions for emergency, and do a good job in the collection and transfer of medical wastes.
(6) Comprehensive coordination group.
Responsibilities: Assist the emergency leading group (headquarters) of our hospital to coordinate and dispatch, establish the interconnection mechanism of each group's work information, fully grasp the work situation of each group in time, summarize and report in time, and be responsible for meeting organization, manuscript writing, media communication and file management.
(7) others. Each medical institution may, according to its actual situation and the needs of prevention and control work, set up other working groups or professional classes such as information publicity group and nucleic acid detection group.
Three, ward nucleic acid test positive emergency response plan
Page 4 *** 18 I. Information report and emergency meeting 1. The laboratory reported that the nucleic acid test results in the ward were positive. The nucleic acid test in the laboratory was positive, and the patient was diagnosed as a patient in our hospital after checking the information. The laboratory called the ward and the patient's nucleic acid test was positive.
2, ward telephone personnel immediately report to the director and the head nurse.
3, director of the telephone report to the hospital department.
4. The hospital sensory department reported to the dean and organized an emergency meeting. After receiving the report, the hospital infection department reports to the dean and informs the epidemic emergency team (medical department, nursing department, safeguard department, general affairs department, medical machinery department, etc. ) held an emergency meeting to discuss reconciliation and information reporting, personnel deployment support, prevention and control technical guidance, personnel removal and closed management, disinfection material supply, etc., and convened a hospital expert rescue team to verify, diagnose and treat the case. At the same time, the hospital reported to the Municipal Health and Health Commission and the CDC within two hours.
Second, quickly control the ward: the head nurse informed all the staff in the department to reduce the operation and narrow the scope of work. Everyone in the ward should improve the protection level, take a quick hand disinfectant nearby for strict hand disinfection, check whether the mask is properly worn and adjust it to avoid direct contact with the face; All patients and caregivers are not allowed to enter or leave the ward and keep a safe distance from each other.
At the same time, the director and the head nurse make the following arrangements:
Page 5 *** 18 1) Arrange the staff to send protective equipment to the outdoor corridor of the transitional disease; 2) Doctor A and nurse B wear hats, protective clothing, gloves, masks and shoe covers/boots in the outdoor corridor of the transition ward (without changing the protective masks), and then enter the transition ward to appease the patients and ask about their illness and epidemiological history again. At the same time, COVID-19 nucleic acid samples were collected from all patients, nurses and medical staff in the ward, and patients were instructed to wear protective masks at the end. After the collected nucleic acid samples are put into a double-layer sample bag, they are wiped or sprayed layer by layer for disinfection, and then put into a sample transfer bucket. Initially, patients, caregivers and medical staff who entered and left the ward after the day of admission of nucleic acid positive patients were checked and registered. Check and register the patient's action track after admission.
3) Other personnel on duty are responsible for explaining and appeasing (at the door as far as possible), and ensuring that other patients' caregivers are not allowed to leave the ward and keep a safe distance from each other.
4) Access control management personnel shall close the entrance of the department and post a warm reminder of "No Entry" outside the ward door.
5) The chief physician in charge of the department will report the basic information of the patient to the Medical Department, and the Medical Department will organize the COVID-19 expert group in the hospital to conduct remote consultation within 30 minutes, issue expert group consultation opinions, and report the consultation results to the hospital epidemic commander.
6) The Security Section shall deploy security personnel (the protection level shall be guided by the Sense Control Section) to guard the outer area of each channel of the Department, prohibit irrelevant personnel from entering and leaving, and guide 120 to transfer vehicles. Hospital logistics, pharmacy, inspection and other departments should do a good job in ward closure control.
Page 6 *** 18 Patients continue to receive treatment and life support for doctors and patients, and all materials, medicines and daily necessities are handed over without contact at the door of the ward.
Hospital: All personnel in the relevant building stay where they are, while others restrict the activity area and control the flow of people.
Third, quickly find out the personnel situation.
Ward through the monitoring system to check the sensitive time (2 days before the patient's nucleic acid detection results), activity route, stay position, stay time, nucleic acid positive people wearing masks; Protect nucleic acid positive personnel who are in close contact with hospital staff and individuals; The appearance, stay and action route of other staff in the ward in the possibly polluted area. Collect the information of personnel in sensitive period, count the number of patients and staff in sensitive period, as well as those who may be infected outside the ward, and initially determine the scale of personnel at risk of infection.
Four, immediately start the epidemiological investigation.
City and district disease control personnel immediately settled in our hospital for investigation, and our hospital provided the floor plan and building layout of the ward. According to the results of epidemiological investigation, close contacts, sub-close contacts and high-risk exposure areas related to the epidemic situation are scientifically determined, and strict isolation control is implemented. For special groups such as medical staff, the scope of high-risk personnel is initially determined, and after the risk judgment of hospital experts, corresponding disposal work (fixed-point isolation, hospitalization isolation, etc.) is carried out. ) someone is taken.
Five, quickly find out the personnel and materials base.
Page 7 *** 18 first, immediately sort out the base of all patients, caregivers, medical staff, staff property personnel and administrative personnel in our hospital; The second is to clarify the condition of all patients, involving majors, especially the situation of critically ill patients. The third is to sort out and count all kinds of materials such as protection, disinfection, diagnosis and treatment, and immediately supplement the scarce materials.
Six, rapid environmental control and disinfection.
Wards, nucleic acid sampling points and auxiliary inspection departments that control the passing and staying of nucleic acid positive personnel. Focus on the places where nucleic acid positive personnel stay for a long time, wear masks irregularly, are crowded and have high risks, and immediately collect samples of environment and articles for nucleic acid detection. Immediately after the sampling is completed, organize a thorough terminal disinfection of potentially polluted environment and articles. After disinfection, sample again and do nucleic acid detection to ensure that all indicators meet the standards after disinfection. Combined with the preliminary determination of the high-risk exposure environment area by the disease control department, our hospital is divided into emergency areas, and the key areas are strictly disinfected.
Seven, patient transport. The hospital received a notice from the superior health department to transfer the nucleic acid positive patients to the designated hospital, and the hospital sensory department organized the security department to conduct closed control on the transfer route to ensure that the transfer process was smooth and did not cross with other personnel. The medical department organizes patients' medical records to be shared with designated hospitals, prepares the receipt for transfer, prepares the transfer handover, and establishes contact with the transfer vehicles. After the transfer personnel arrive at the ward through the designated route (the personnel will be cleared and closed in advance by the security department), the department staff will accompany the patients (wearing surgical masks) from the special transfer channel to the door, and complete the handover registration with the transfer personnel. Disinfect the place where the patient passes.
Page 8 *** 18 VIII. Terminal disinfection. The hospital infection department instructs the medical staff of the department to carry out terminal disinfection of the ward. 1000ml/L chlorine-containing disinfectant is used for air spray disinfection in wards. Close the doors and windows before disinfection, spray evenly from top to bottom, from left to right and from inside to outside for 60mino, and then open the window for ventilation. Items that patients need to take away must be soaked and wiped with chlorine-containing disinfectant containing available chlorine 1000mg/L for 30min, and then cleaned with clean water before taking away. The elevator machine room shall be disinfected with 1000mg/L chlorine-containing disinfectant for 30min. Wipe and disinfect walls, floors and surfaces with 1000mg/L chlorine-containing disinfectant; Instruments and equipment can be wiped and disinfected with 1000mg/L chlorine-containing disinfectant or 75% alcohol according to the material; The toilet is wiped and disinfected with 2000mg/L chlorine-containing disinfectant; After use, the rag should be treated as medical waste. After mopping the floor, soak it in 2000mg/L chlorine-containing disinfectant for 30 minutes, rinse it with clear water and dry it for later use (special use). After taking off the protective equipment, put it into a double-layer medical waste bag, spray 2000mg/L chlorine-containing disinfectant for surface disinfection, and inform the medical waste transporter to transport it away by special car. After disinfection, multi-point sampling and inspection should be carried out.
Nine, medical waste disposal. Medical wastes and domestic garbage generated by patients are treated as wastes. After the double bags are sprayed and disinfected, the COVID-19 logo shall be affixed, and the medical waste transport vehicle (standard protection) shall be notified to transport by special vehicle.
X. Follow-up management of the personnel on duty in the ward shall be escorted to all centralized isolation observation points, and other medical personnel shall be transferred to isolation hotels for isolation observation, which shall be handled according to the investigation by the disease control department.
Page 9 *** 18 Results All close contacts and close contacts were taken corresponding control measures, and those who came into contact outside the hospital were tracked and disposed of by the disease control department and the public security department.
Under the guidance of the Municipal Center for Disease Control and Prevention and the Municipal Health and Health Commission, the hospital was divided and closed.
Ten, plan to terminate the plan to terminate by our hospital epidemic emergency leading group according to the outcome of suspected patients to judge, in principle, suspected patients ruled out COVID-19 infection, its close contacts can be released from isolation; If the suspected patient is diagnosed with COVID-19 infection, all the secret staff in his department should concentrate on the isolation point and observe it in isolation for 14 days. Other secret-related personnel should monitor their health at home and conduct nucleic acid testing on time. Upon the expiration of the observation period, if all the staff are normal, the emergency leading group can report to the joint prevention and control office to release the isolation and terminate the scheme, and the hospital will receive patients normally after terminal disinfection.
Hospital nucleic acid test positive emergency 1, laboratory report hospital infection department nucleic acid test results positive. The nucleic acid test report in the clinical laboratory was positive. I checked the information and confirmed that it was an outpatient service in our hospital. The clinical laboratory telephoned the infectious diseases department of the hospital, and the patient was positive for nucleic acid detection. At the same time, call the outpatient nucleic acid sampling point.
2. The hospital sensory department reported to the dean and organized an emergency meeting. After receiving the report, the hospital infection department reports to the dean and informs the epidemic emergency team (medical department, nursing department, security department, general affairs department, medical machinery department, etc.) after receiving the instruction. Hold an emergency meeting to discuss information report, personnel deployment support and prevention and control technology.
Page 10 * * Page 18: Guidance, personnel evacuation and closed management, disinfection material supply, and convening an expert rescue team in the hospital for case verification, diagnosis and treatment. At the same time, the hospital reported to the Municipal Health and Health Commission and the CDC within 2 hours.
Second, quickly control personnel. Isolate the people who are positive for nucleic acid immediately, and all the people in the relevant buildings stay where they are. Other people restrict the activity area and control the flow of people. The Security Section will deploy security personnel (whose protection level is guided by the Sense Control Section) to guard at the entrance of the hospital and the outside areas of each passage, prohibit irrelevant personnel from entering and leaving, and guide 120 to transfer vehicles.
Third, quickly find out the personnel situation. Check the personnel situation quickly. Check the route, stay position, stay time and wearing masks of nucleic acid positive personnel during the sensitive period (60 minutes before the patient's visit to the present) through the hospital monitoring system; Protect nucleic acid positive personnel who are in close contact with hospital staff and individuals; The appearance, stay and action route of other hospital staff in the possibly polluted area. Collect the information of patients in sensitive period, count the number of patients in sensitive period, the number of hospital medical staff and logistics staff, and initially determine the population size at risk of infection.
City and district disease control personnel immediately settled in our hospital for investigation, and our hospital provided the building layout and the floor plan of each floor and ward. According to the results of epidemiological investigation, close contacts, sub-close contacts and high-risk exposure areas related to the epidemic situation are scientifically determined, and strict isolation control is implemented. For medical staff and other special
Page 1 1 * * 18 group, initially determine the range of high-risk personnel and take corresponding measures (fixed-point isolation, hospitalization isolation, etc.). ) after the hospital experts judge the risk.
Seven, patient transport. The hospital received a notice from the superior health department to transfer the nucleic acid positive patients to the designated hospital, and the hospital sensory department organized the security department to conduct closed control on the transfer route to ensure that the transfer process was smooth and did not cross with other personnel. The medical department organizes patients' medical records to be shared with designated hospitals, prepares the receipt for transfer, prepares the transfer handover, and establishes contact with the transfer vehicles. After the transfer personnel arrive through the designated route (the security department completes the management of personnel removal and closure in advance), the patient (wearing a surgical mask) is accompanied by the staff of the isolation clinic (level 3 protection) from the dedicated transfer channel to the door and completes the transfer registration with the transfer personnel. Disinfect the place where the patient passes.
Eight, terminal disinfection. 1000ml/L chlorine-containing disinfectant was used to spray disinfect the air in the isolation clinic. Close the doors and windows before disinfection, spray evenly from top to bottom, from left to right and from inside to outside for 60mino, and then open the window for ventilation. Items that patients need to take away must be soaked and wiped with chlorine-containing disinfectant containing available chlorine 1000mg/L for 30min, and then cleaned with clean water before taking away. The elevator machine room shall be disinfected with 1000mg/L chlorine-containing disinfectant for 30min. Wipe and disinfect walls, floors and surfaces with 1000mg/L chlorine-containing disinfectant; Instruments and equipment can be wiped and disinfected with 1000mg/L chlorine-containing disinfectant or 75% alcohol according to the material; The toilet is wiped and disinfected with 2000mg/L chlorine-containing disinfectant; After use, the rag should be treated as medical waste. After mopping the floor, soak it in 2000mg/L chlorine-containing disinfectant for 30 minutes, rinse it with clear water and dry it for later use (special use). Take off protective articles and put them into a double-layer medical waste bag.
Page 12 * * Page 18: After packaging, spray 2000mg/L chlorine-containing disinfectant for surface disinfection, and notify the medical waste transporter to transport it away by special car. After disinfection, multi-point sampling and inspection should be carried out.
Nine, medical waste disposal. All medical wastes and domestic garbage generated by positive patients are treated as COVID-19 wastes. After double-bag spraying and disinfection, COVID-19 logo is affixed, and medical waste transporters (for standard protection) are notified to transport them by special car.
According to the investigation results of the disease control department, corresponding control measures shall be implemented for all close contacts and close contacts. According to the epidemiological investigation, the risk level of hospital staff is distinguished, and centralized isolation observation or home isolation is determined according to the risk level. Contact personnel outside the hospital shall be tracked and disposed by the disease control department and the public security department.
XI。 The termination of plan four. Carry out follow-up work in a scientific and orderly manner, such as checking that the nucleic acid test result is negative, ending the emergency disposal work and restoring the normal diagnosis and treatment order; If the nucleic acid test result is positive, the next work should be carried out in a scientific and orderly manner.
(1) Scientific decision-making and disposal scheme. According to the Centers for Disease Control, ...