基层医疗卫生机构发热哨点诊室设置标准:基于专家讨论的归纳总结  

Standards for Setting up a Fever Sentinel Surveillance Clinic in Primary Healthcare Institutions:Findings of a Qualitative Delphi Study

作　　者：闫云云 范腾阳 王海棠 张剑敏 杜兆辉 孙晓明[5] YAN Yunyun;FAN Tengyang;WANG Haitang;ZHANG Jianmin;DU Zhaohui;SUN Xiaoming(Department of General Practice,Zhongshan Hospital,Fudan University,Shanghai 200030,China;Department of General Practice,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Pudong New Area Shanggang Community Health Center,Shanghai 200126,China;Yangpu District Changbai Community Health Center,Shanghai 200082,China;Shanghai Pudong Institute of Health Development,Fudan University,Shanghai 201200,China)

机构地区：[1]复旦大学附属中山医院全科医学科,上海市200030 [2]遵义医科大学附属医院全科医学科,贵州省遵义市563000 [3]上海市浦东新区上钢社区卫生服务中心,200126 [4]上海市杨浦区长白社区卫生服务中心,200082 [5]复旦大学上海市浦东新区卫生发展研究院,上海市201200

出　　处：《中国全科医学》2021年第10期1190-1197,共8页Chinese General Practice

摘　　要：背景国际范围内许多国家建立了基于传染病的哨点监测,在目前新型冠状病毒肺炎常态化防控背景下,国家卫生健康委基层健康司建议基层医疗卫生机构设置发热哨点诊室。目的为了监测和防控秋冬季新型冠状病毒肺炎局部流行及可能发生的其他传染病,基于我国不同地区间的医疗水平及医疗资源差异,制定基层医疗卫生机构发热哨点诊室设置标准。方法采用目的抽样的方法选取专家,并设计两轮专家讨论法。参考上海市基层医疗卫生机构发热哨点诊室建设,设计第一轮专家讨论会(15人),会议时间为2020-06-30。在第一轮讨论提纲基础上,结合国家、各省市有关发热哨点诊室建设的政府政策文件,以及国内外有关哨点建设文献,设计《基层医疗卫生机构发热哨点诊室设置指导原则讨论稿》,邀请全国不同地区、不同单位基层医疗专家进行第二轮专家讨论(29人),会议时间为2020-08-14。结果基层医疗卫生机构发热哨点诊室设置标准主要包括6个方面:设置原则、功能设置、诊室设置、人员配备、工作路径及工作要求。二级指标包括:功能设置(日常功能、疫情期间功能要求)、诊室设置(房屋要求、设施设备配置及标志标识)、人员配备(医护、行政与工勤人员配置)、工作路径(预检、接诊、处置及健康宣教)、工作要求(接诊、防护、管理、培训、消毒、督导及保障)。结论基层医疗卫生机构发热哨点诊室建设是基层医疗服务能力的体现,发热哨点诊室的功能应包括预检分诊、发热患者的接诊筛查、及时上报并协助安排转诊,同时可有效防止院内感染;发热哨点诊室的硬件与人员配置可根据基层医疗卫生机构自身条件按不同级别配置。Background Many countries have carried out sentinel surveillance programs to monitor infectious diseases.As containing COVID-19 has become normalized,the Department of Primary Health of the National Health Commission of the People’s Republic of China recommends primary healthcare institutions to set up a fever sentinel surveillance clinic.Objective To develop a set of nationwide used standards for the establishment of a fever sentinel surveillance clinic in primary healthcare institutions with regional differences in healthcare level and medical resources taken into account,to surveil and contain possible regional epidemiology of COVID-19 and other infectious diseases in autumn and winter in China.Methods We designed and carried out a two-round Delphi survey.The first round of survey was conducted with primary care experts selected from Shanghai’s various institutions by purposive sampling to discuss setting up a fever sentinel surveillance clinic in primary care in Shanghai.And the second round of survey was implemented with a purposive sample of primary care experts from various healthcare institutions in different regions of China to improve the results of the first survey based on relevant national and regional government policy documents and the reviewing of relevant studies to draw up Draft Guiding Principles for Setting up a Fever Sentinel Surveillance Clinic in Primary Healthcare Institutions.Results The developed standards include six domains:principles of setting up a fever sentinel surveillance clinic,functions of a fever sentinel surveillance clinic(items:daily functions and anti-epidemic functions),architectural and equipment specifications of a fever sentinel surveillance clinic(items:room,equipment and logo),staffing profile of a fever sentinel surveillance clinic(items:appropriate allocation of physicians,nurses,administrative workers,and handymen),working procedure of a fever sentinel surveillance clinic(fever pre-screening and triage,reception,management and health education and propaganda),

关 键 词：基层医疗卫生机构 发热哨点诊室 建设标准 专家讨论 

分 类 号：R197[医药卫生—卫生事业管理]