In recent years, the public can learn from many new media reports that village clinics, as the first whistle of prevention and control, have frequently "fallen".
How can village clinics achieve "four mornings" and achieve the goal of strong early warning? I want to discuss my personal experience with you.
First of all: Understand the ten related symptoms of COVID-19.
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When the village clinic accepts patients, the most critical link is not to be careless, and strictly implement "looking, checking, measuring and asking", that is, checking whether to wear a mask, taking temperature, checking health code, trip code, place code and asking epidemiological history.
As one of the typical symptoms of COVID-19, patients should attach great importance to the treatment in village clinics. Other symptoms such as dry cough, fatigue, stuffy nose, decreased sense of smell and taste, runny nose, sore throat, conjunctivitis, myalgia, diarrhea, etc. Asking about epidemiological history is an important barrier for prevention and control of village clinics.
Second, master how to treat patients with fever in closed loop.
Closed-loop treatment of patients with fever can be divided into two situations:
For fever patients who have been to high-risk areas within 14 days, they are required to wear masks, wait in the open space and report to township hospitals immediately, and contact 120 ambulance for transshipment;
For patients who haven't been to high-risk areas within 14 days, they can't go to the fever clinic by bus.
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Third, do "three wants and two don't want" in consultation.
In the process of consultation, it is difficult to avoid meeting patients with COVID-19's ten related symptoms in village clinics. Don't simply refuse consultation and tell patients to do "three wants and two don't want":
We should take the initiative to register with the community neighborhood Committee and accept management.
Go to the nearest fever clinic in time. Wear a mask to see a doctor all the time, avoid taking public transportation, try to keep a distance of more than 1 meter from others, and keep hand hygiene at all times.
Take the initiative to explain the situation to the doctor and cooperate with him.
Don't take medicine by yourself, so as not to delay treatment.
Don't hide your illness, report the situation truthfully.
In addition, when crowds gather in village clinics, we should actively maintain the order of medical treatment and strictly implement the distance interval of 1 meter.
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Fourth: Prepare various work records and ledgers.
During the prevention and control of epidemic normalization, the village clinic should make all work records and accounts. , including two and three copies, and keep it for future reference.
Disinfection: namely, surface disinfection records and ultraviolet disinfection records.
Three books: pre-examination triage register, fever patient register and outpatient register.
Records are medical waste handover records.
Surface disinfection record book: disinfect with 500mg/l chlorine-containing disinfectant twice a day, which is now required.
Ultraviolet disinfection record book: disinfect with ultraviolet lamp twice a day, each time 1 hour. The ultraviolet lamp tube needs to be replaced after it is used 1000 hours.
Outpatient register: patients who are truthfully registered in the village clinic.
Pre-examination and triage register: The contents are basically the same as those in outpatient register, but there are three more contents, namely, temperature record, medical treatment in middle and high-risk areas in COVID-19 for 14 days and ten related symptoms, which are truthfully filled in for patients who go to the village clinic.
Register of Fever Patients: Fever patients visiting village clinics should report to township health centers within 1 hour. At the same time of registration in the register of fever patients, it should also be registered in the outpatient register and the pre-inspection register.
Fifth, standardize the disposal of medical waste.
Domestic garbage, using black packaging bags; Medical wastes shall be packed in yellow special packaging bags with warning signs.
Medical wastes generated by general patients can be classified, collected, transported and temporarily stored according to conventional medical wastes.
Garbage cans for collecting medical wastes should be covered in time after use and placed in polluted areas. The polluted area and clean area in the treatment room should be clearly divided.
The storage time of medical waste shall not exceed 2 days. When it reaches 3/4 of the package or container, gooseneck sealing method shall be adopted.
The seal of the package or container should be tight and tight. If the package or container is polluted, it should be disinfected or added with a layer of packaging.
How to configure disinfectant in village clinics?
Under normal circumstances, the disinfectant commonly used for daily disinfection in village clinics is chlorine-containing disinfectant, that is, 84 disinfectant.
During the prevention and control of epidemic normalization, village clinics generally adopt the following configuration methods of 84 disinfectant:
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Primary medical institutions should do the following.
1, standardize pre-inspection and triage. All personnel who enter clinics and village clinics (community health service stations) must carry out "masks must be worn, body temperature must be measured, health codes must be checked, boarding codes must be seen, and place codes must be swept"; The triage desk (point) should be equipped with masks, thermometers, disinfection supplies, etc. And do a good job in the patient's real-name registration system (registration ID number, contact information).
2, strictly implement the first diagnosis responsibility system. Patients with ten related symptoms such as fever, dry cough, fatigue, poor sense of smell and taste, nasal congestion, runny nose, sore throat, conjunctivitis, myalgia, diarrhea and rash in COVID-19 should attach great importance to and implement closed-loop management, do a good job in epidemiological inquiry, register basic information of patients and report step by step according to regulations.
3, all clinics, village clinics (community health service stations) should be posted in a prominent position "no fever patients" logo, the suspicious COVID-19 cases found are not allowed to be disposed of without authorization, to register the relevant information in detail, and report in a timely manner according to relevant procedures.
4. Strengthen the prevention and control of hospital infection, complete necessary and sufficient protective equipment, and strictly implement standard preventive measures. Medical personnel should strictly implement the relevant technical operation norms and work norms in their practice activities to prevent the spread of infectious disease pathogens, drug-resistant bacteria, conditional pathogenic bacteria and other pathogenic microorganisms.
5. Strengthen the health monitoring of medical staff (including workers and cleaners), and dynamically monitor the nucleic acid of medical staff in clinics and village clinics (community health service stations) to ensure that the hand hygiene, medical environment, aseptic operation technology and occupational health protection of medical staff meet the national regulations.
6. Practice in strict accordance with the law. Non-health technical personnel shall not carry out diagnosis and treatment activities, and carry out diagnosis and treatment activities in strict accordance with the diagnosis and treatment subjects approved and registered by the health administrative department, and shall not carry out false medical propaganda. Strengthen business study and training, strengthen emergency drills, and improve the ability of finding COVID-19 cases and emergency handling.
7. Do a good job in ventilation and disinfection management of medical institutions and consulting rooms, implement disinfection management measures, strictly implement technical specifications for disinfection of medical devices, establish and implement disinfection products incoming inspection system, and correctly use disinfection products.
8. The medical wastes shall be classified, collected and disposed in strict accordance with the Regulations on the Management of Medical Wastes, and the temporary storage time of medical wastes shall not exceed 2 days. Establish and improve the handover registration, and keep the registration for 3 years. class monitor