改良LEC 法在SARS-CoV-2标本检测感染风险评估中的应用与效果分析  

Application and Effect Analysis of Modified LEC Method in Infection Risk Assessment of SARS-CoV-2 Sample Testing

作　　者：陈飞 李俊[1] 陈小燕[1] 张建伟[1] 朱玲凤[1] CHEN Fei;LI Jun;CHEN Xiao-yan;ZHANG Jian-wei;ZHU Ling-feng(Taizhou Hospital of Zhejiang Province)

机构地区：[1]浙江省台州医院

出　　处：《医院管理论坛》2020年第9期45-48,32,共5页Hospital Management Forum

摘　　要：目的运用改良LEC评价法(Likelihood exposure consequence method,LEC)对新型冠状病毒(SARS-CoV-2)标本检测的全流程进行风险评估,对感染风险高的流程及风险点进行防控,确保医务人员安全。方法我院于2020年1月19日成立SARS-CoV-2感染控制督导工作小组(简称督导组),跟踪COVID-19确诊病例或疑似病例标本检测的全流程,运用改良LEC评价法,对现行措施的24个风险点进行感染风险等级评估。督导组确定D值≥70,风险等级≤3的风险点为高度风险或不可容忍的风险,对此加强管理。结果督导组根据评估结果和存在的风险,对SARS-CoV-2标本检测实验室(如检验科、中心实验室)限期完成整改,跟踪改进的全过程,并再次进行风险等级评估。结果所有的风险点均D值<70,风险等级>3,督查工作取得明显效果。结论运用改良LEC评价法可以客观、科学地识别SARS-CoV-2标本检测流程中的感染风险,明确工作重点,加强高风险流程的资源配置,集中有限的防疫物资,保障高风险岗位使用,实现院内“零感染”目标。Objective To carry out whole process risk assessment of SARS-CoV-2 sample testing using the modified likelihood exposure consequence(LEC)method,to control the high-risk process and points for the safety of medical staff.Methods On January19th,2020,the SARS-CoV-2 infection control supervision group was set up in our hospital to follow the whole process of sample testing of confirmed or suspected COVID-19 cases.Modified LEC method was used to evaluate the infection risk level of 24 risk points in the current measures.The supervision group determined the D value≥70 and risk level≤3 as high or intolerable risks and strengthened the management of them.Results According to the assessment results and existing risks,the supervision group urged the laboratory testing SARS-CoV-2 samples(clinical laboratory or central laboratory)to rectify in given time,tracked the whole process of rectification,and re-evaluated the risk levels.It was found that all risk points had D value<70 and risk level>3,showing that supervision work has achieved remarkable results.Conclusion By using the modified LEC method,we can identify the infection risks in SARS-CoV-2 sample testing process objectively and scientifically,clarify the focus of infection control,improve the resource allocation of the high-risk processes,and concentrate the limited epidemic prevention resources for the high-risk posts,so that we can achieve the goal of"zero infection"in the hospital.

关 键 词：新型冠状病毒肺炎 风险评估 LEC评价法 感控督查 院内感染 

分 类 号：R197.3[医药卫生—卫生事业管理]