综合医院重点部门2019冠状病毒病防控质量核查表的设计与应用  

Development and application of quality checklist for the prevention and control of COVID-19 in fever clinic and isolation ward of the general hospital

作　　者：程丽丽[1] 祝海香[1] 潘红英[1] 黄素素 庄一渝[1] 朱陈萍[1] 袁玉华[2] 朱红芳[1] 陈慧颖[1] 徐虹霞[1] CHENG Lili;ZHU Haixiang;PAN Hongying;HUANG Susu;ZHUANG Yiyu;ZHU Chenping;YUAN Yuhua;ZHU Hongfang;CHEN Huiyin;XU Hongxia(Nursing Department,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Department of Nosocomial Infections,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院护理部,浙江杭州310016 [2]浙江大学医学院附属邵逸夫医院院感科,浙江杭州310016

出　　处：《浙江大学学报（医学版）》2021年第1期74-80,共7页Journal of Zhejiang University(Medical Sciences)

基　　金：浙江省医药卫生科技计划(2018KYB480)。

摘　　要：目的:构建2019冠状病毒病(COVID-19)防控质量核查体系,规范督察疫情期间制度及流程落实,防范医院感染事件。方法:结合COVID-19相关防控方案及技术指南,通过德尔菲法筛选评估指标,经两轮专家修改,最终根据专家给出的重要性赋值和变异系数确定各指标,形成发热门诊COVID-19防控质量核查表(8个维度,共32项)和隔离病房COVID-19防控质量核查表(7个维度,共27项),使用表单分别对发热门诊和隔离病房进行医院感染质控,评估表单使用的效果及成效。结果:专家权威系数为0.88,表单中各指标重要性均数不低于4.8,变异系数未超过0.07。2020年2月1日至29日,发热门诊和隔离病房在表单质控下当场整改医院感染相关问题累计8个,每日质控落实率为100%,员工洗手依从性和正确率均为100%,防护用品穿脱正确率从96%增至100%。同期发热门诊共接诊患者1915例,其中COVID-19疑似患者191例(确诊3例),无院内感染事件发生。结论:使用COVID-19防控质量核查表对医院重点部门进行监控管理,保障了疫情期间医院感染制度的规范落实,以稳、准、快的方式预防了医院感染事件的发生。Objective:To develop a quality control checklist for the prevention and control of coronavirus disease 2019(COVID-19)in fever clinic and isolation ward of the general hospital and to assess its application.Methods:Based on the relevant prevention and control plans and technical guidelines for COVID-19,Delphi method was used to identity items for evaluation,and a quality control checklist for the prevention and control of COVID-19 in the fever clinic and isolation ward was developed in Sir Run Run Shaw Hospital.The checklists included 8 dimensions and 32 items for fever clinic,7 dimensions and 27 items for the isolation ward.The appointed inspectors conducted daily quality control for each shift with this checklist.Results:The expert authority coefficient was 0.88,the mean of the importance of each index in the quality control table was not less than 4.8,and the coefficient of variation was not more than 0.07.During the entire February 2020,8 problems were found and rectified on-the-spot with the application of the checklist.Quality inspection rate was 100%in both isolation wards and fever clinic.The compliance rate and accuracy rate of hand hygiene were 100%;the correct rate of wearing and removing protective equipment increased from 96%to 100%.During the same period,a total of 1915 patients were admitted to the fever clinic,including 191 suspected patients(all were isolated in the hospital,3 were confirmed).There were no medical staff infected with COVID-19,no cross infection of patients and their families in the hospital.Conclusion:A quality control checklist for the prevention and control of COVID-19 has been developed and applied in the isolation wards and fever clinic,which plays an important role in preventing nosocomial infection.

关 键 词：2019冠状病毒病 质量控制 隔离病房 发热门诊 德尔菲法 

分 类 号：R18[医药卫生—流行病学]