新冠肺炎疫情期间医疗机构不同区域工作岗位个人防护专家共识  

Expert consensus on personal protection in different regional posts of medical institutions during COVID-19 epidemic period

作　　者：李春辉[1] 黄勋[1] 蔡虻[2] 陈萍 陈文森[4] 陈修文[5] 邓子德[6] 董宏亮 付强 高武强 高晓东[9] 龚瑞娥[1] 巩玉秀 侯铁英[11] 胡国庆[12] 胡必杰[9] 李洁[1] 李卫光[13] 林玲 刘丁 刘聚源[2] 刘卫平 刘运喜[17] 陆群[18] 马红秋[19] 茅一萍 孟秀娟[1] 逄崇杰[21] 乔甫[22] 任南[1] 单淑娟 孙树梅[23] 汤灵玲 童德军[25] 王辉[26] 王力红[27] 王庆红[1] 文建国 吴红曼[1] 吴红梅 吴静[1] 吴秀颖[1] 鲜于舒铭[30] 向天新[31] 熊薇 徐艳[33] 阎颖[34] 杨怀[33] 杨亚红 姚希[36] 袁晓宁[37] 岳丽青[1] 曾翠[1] 曾烂漫[1] 张浩军 张静萍[38] 张乐[1] 张卫红[4] 张永栋[39] 周鹏程[1] 宗志勇[22] 左双燕[1] 李六亿[36] 吴安华[1] 无[40,41,42] LI Chun-hui;HUANG Xun;CAI Meng;CHEN Ping;CHEN Wen-sen;CHEN Xiu-wen;DENG Zi-de;DONG Hong-liang;FU Qiang;GAO Wu-qiang;GAO Xiao-dong;GONG Rui-e;GONG Yu-xiu;HOU Tie;-ying;HU Guo-qing;HU Bi-jie;LI Jie;LI Wei-guang;LIN Ling;LIU Ding;LIU Ju-yuan;LIU Wei-ping;LIU Yun-xi;LU Qun;MA Hong-qiu;MAO Yi-ping;MENG Xiu-juan;PANG Chong-jie;QIAO Fu;REN Nan;SHAN Shu-juan;SUN Shu-mei;TANG Ling-ling;TONG De;-jun;WANG Hui;WANG Li-hong;WANG Qing-hong;WEN Jian-guo;WU Hong-man;WU Hong-mei;WU Jing;WU Xiu-ying;XIAN YU Shu-ming;XIANG Tian-xin;XIONG Wei;XU Yan;YAN Ying;YANG Huai;YANG Ya-hong;YAO Xi;YUAN Xiao-ning;YUE Li-qing;ZENG Cui;ZENG Lan-man;ZHANG Hao-jun;ZHANG Jing-ping;ZHANG Le;ZHANG Wei-hong;ZHANG Yong-dong;ZHOU Peng-cheng;ZONG Zhi-yong;ZUO Shuang-yan;LI Liu-yi;WU An-hua;无(National Training Center of Healthcare-associated Infection Management,National Clinical Research Center for Geriatric Disorders,Xiangya Hospital,Central South University,Changsha 410008,China;Beijing Hospital,Beijing 100730,China;Public Health Center of Clinical Medical of Chengdu City,Chengdu 610000,China;Jiangsu Provincial Hospital,The First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China;Jiangxi Provincial Children’s Hospital,Nanchang 330006,China;Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;The Ninth Hospital of Xi’an,Xi’an 710054,China;National Healthcare-associated Infection Management and Control Center,Beijing 100191,China;Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China;National Health Commission of the People’s Republic of China Retired Cadres Bureau,Beijing 100044,China;Guangdong General Hospital,Guangzhou 510080,China;Zhejiang Provincial Centre for Disease Prevention and Control,Hangzhou 310051,China;Shandong Provincial Hospital,Jinan 250021,China;Heilongjiang Provincial Centre for Di-sease Prevention and Control,Harbin 150000,China;Army Medical Center,Chongqing 400042,China;Inner Mongolia People’s Hospital,Hohhot 010010,China;Chinese PLA General Hospital,Beijing 10

机构地区：[1]中南大学湘雅医院全国医院感染监控管理培训基地国家老年疾病临床医学研究中心(湘雅),湖南长沙410008 [2]北京医院,北京100730 [3]成都市公共卫生临床医疗中心,四川成都610000 [4]江苏省人民医院南京医科大学第一附属医院,江苏南京210029 [5]江西省儿童医院,江西南昌330006 [6]中山大学附属第三医院,广东广州510630 [7]西安市第九医院,陕西西安710054 [8]国家医院感染管理专业质控中心,北京100191 [9]复旦大学附属中山医院,上海200032 [10]国家卫生健康委离退局,北京100044 [11]广东省人民医院,广东广州510080 [12]浙江省疾病预防控制中心,浙江杭州310051 [13]山东省立医院,山东济南250021 [14]黑龙江疾病预防控制中心,黑龙江哈尔滨150000 [15]陆军特色医学中心,重庆400042 [16]内蒙古自治区人民医院,内蒙古呼和浩特010010 [17]解放军总医院,北京100039 [18]浙江大学医学院附属第二医院,浙江杭州310009 [19]安徽医科大学第一附属医院,安徽合肥230022 [20]徐州医科大学附属医院,江苏徐州221006 [21]天津医科大学总医院,天津300052 [22]四川大学华西医院,四川成都610041 [23]南方医科大学南方医院,广东广州510515 [24]浙江树人大学树兰(杭州)医院,浙江杭州310000 [25]中南大学湘雅二医院,湖南长沙410011 [26]北京大学人民医院,北京100044 [27]首都医科大学宣武医院,北京100053 [28]新乡医学院第一附属医院,河南新乡453100 [29]温州市人民医院,浙江温州325000 [30]海南省人民医院,海南海口570311 [31]南昌大学第一附属医院,江西南昌330006 [32]华中科技大学同济医学院附属同济医院,湖北武汉430030 [33]贵州省人民医院,贵州贵阳550002 [34]郑州人民医院,河南郑州450003 [35]甘肃省人民医院,甘肃兰州730000 [36]北京大学第一医院,北京100034 [37]北京大学第三医院,北京100191 [38]中国医科大学附属第一医院,辽宁沈阳110001 [39]青海大学

出　　处：《中国感染控制杂志》2020年第3期199-213,共15页Chinese Journal of Infection Control

摘　　要：为更好地防控新型冠状病毒(2019-nCoV)医院感染,保障医疗机构医务人员及其他工作人员的安全,合理使用个人防护用品,中华预防医学会医院感染控制分会、中国医院协会医院感染管理专业委员会、中国感染控制杂志编辑委员会组织国内专家(包括赴武汉抗疫一线的部分专家)共同制定本共识。本共识主要适用于同时收治新冠肺炎患者和普通患者的医疗机构;指导疫情期间医疗机构一线医务人员合理有效利用防护用品,同时也覆盖了几乎所有非一线医务人员及其他工作人员的防护用品使用。本共识通过评估医疗机构工作人员新冠肺炎暴露的风险,根据暴露风险来确定不同区域不同岗位工作人员的个人防护标准。本共识主要内容还包括:个人防护用品介绍及适用范围,三级防护穿脱流程,个人防护用品异常的防范与应急处理,新型冠状病毒肺炎职业暴露处置流程。同时,本共识特别强调,要合理进行新冠疫情期间医疗机构区域划分,以及重点分诊岗位安排有经验的感染科或呼吸科医生参与分诊,这些是风险评估的前提要求;在选择个人防护用品时,既要防止防护不足,又要避免滥用与过度使用,以保障工作人员安全为前提,预防新冠肺炎医院感染。In order to better prevent novel coronavirus(2019-nCoV)healthcare-associated infection,ensure the safety of health care workers(HCWs)and other staff in medical institutions,and rationally use personal protective equipment(PPE),Healthcare-associated Infection Control Branch of Chinese Preventive Medicine Association,Healthcare-associated Infection Management Committee of Chinese Hospital Association,and Chinese Journal of Infection Control jointly organize domestic experts(including some experts on the frontline of anti-epidemic in Wuhan)to jointly formulate this consensus.This consensus is mainly applicable for medical institutions which receive and cure both patients with coronavirus disease 2019(COVID-19)and common patients;guide frontline HCWs,non-frontline HCWs,and other staff in medical institutions to rationally and effectively use protective equipment.This consensus determines personal protection standards of staff at different locations and with different working posts through assessment on risk of exposure to COVID-19 among staff in medical institutions.The main contents of this consensus also include introduction and application scope of PPE,putting on and taking off process of three level protection,prevention and emergency treatment of abnormal PPE,treatment process of occupational exposure to COVID-19.At the same time,this consensus particularly emphasizes the rational division of medical institutions during COVID-19 epidemic period,arrange experienced clinicians of departments of infectious or respiratory diseases participate in triage at key triage location,which are the prerequisite requirements of risk assessment;for the selection of PPE,we should not only prevent inadequate protection,but also avoid abuse and overuse,so as to prevent HAI on the premise of ensuring the safety of staff.

关 键 词：新型冠状病毒 新型冠状病毒肺炎 2019-nCoV COVID-19 个人防护用品 区域岗位 分级防护 共识 

分 类 号：R197.323[医药卫生—卫生事业管理]