新冠肺炎流行早期广州市医疗机构预检分诊及发热门诊现状调查  

Operation condition of pre-examination/triage desks and fever clinics in medical institutions during early stage of COVID-19 epidemic in Guangzhou city

作　　者：孙艺 陈怡然 黄勇[3] 张静波[4] 刘艳慧[5] 吴迪 罗雷[5] 景钦隆[5] 许建雄[3] SUN Yi;CHEN Yi-ran;HUANG Yong(Department of School Health,Guangzhou Municipal Center for Disease Control and Prevention;不详)

机构地区：[1]广州市疾病预防控制中心学校卫生部,广州510440 [2]广州市疾病预防控制中心 [3]广州市疾病预防控制中心免疫规划部 [4]广州市疾病预防控制中心放射卫生部 [5]广州市疾病预防控制中心传染病预防控制部

出　　处：《中国公共卫生》2021年第3期493-497,共5页Chinese Journal of Public Health

摘　　要：目的了解新型冠状病毒肺炎(COVID-19)流行早期广东省广州市医疗机构预检分诊和发热门诊现状,为进一步规范其设置、管理及感染防控工作提供参考。方法2020年1月25日—2月28日,采用分层抽样法,选取广东省广州市11个区46家医疗机构的预检分诊和发热门诊(40间),使用自行编制的广州市医疗机构发热门诊设置及管理调查表,通过现场观察和询问、查看相关记录等方式进行现场调查。结果预检分诊和发热门诊工作流程设置达标率为78.26%(36/46)。预检分诊项目中,"医护人员数量配备充足"(73.91%,34/46)、"指定路线室外距离最短、接触人员最少"(76.09%,35/46)、"位置布局合理醒目"(78.26%,36/46)项目落实率较低。发热门诊项目中,"挂号、候诊、就诊、治疗、检验、放射检查、取药区等各功能区相对隔离"(37.50%,15/40)、"自然通风良好,强制通风设施"(55.00%,22/40)、"备用诊室"(57.50%,23/40)、"三区,分隔合理,有物理隔断"(72.50%,29/40)、"独立区域,指引标识明显"(72.50%,29/40)、"两通道"(75.00%,30/40)项目落实率较低。隔离留观项目中,"室内通风良好"(55.00%,22/40)、"数量符合要求"(72.50%,29/40)、"疑似病例单人单间隔离,内设卫生间"(75.00%,30/40)项目落实率较低。50.00%(23/46)的医疗机构反映医护人员个人防护用品紧缺,社区卫生服务中心(乡镇卫生院)尤为严重(28.57%,6/21)。结论新冠肺炎流行早期广州市部分医疗机构的预检分诊和发热门诊设置和管理不规范,存在交叉感染风险,应整合相关资源,健全、强化其建设和管理。Objective To explore operation condition of pre-examination/triage desks and fever clinics in medical institutions during early stage of coronavirus disease 2019(COVID-19)epidemic in Guangzhou city of Guangdong province and to provide references for standardized setting,management and infection control in the operation of pre-examination/triage desk and fever clinic.Methods We carried field study and questionnaire survey on the operation of all preexamination/triage desks and 40 fever clinics in 46 medical institutions selected with stratified sampling in 11 districts of Guangzhou city from January 25 to February 28,2020–the early period of COVID-19 epidemic.The assessment on operation condition of the pre-examination/triage desks and fever clinics was performed based on relevant management regulations and technical specifications issued by national health administrations.Results The overall qualification rate for the operation condition of the pre-examination/triage desks and fever clinics was 78.26%(36/46).Among the preexamination/triage desks surveyed,the qualification rates were relatively low for adequate medical personnel(73.91%,34/46),most suitable allocation to reduce the probability of cross-infection(76.09%,35/46),and most suitable allocation to facilitate attendees′visits(78.26%,36/46).For the fever clinics surveyed,the qualification rates were relatively low for separating an attendee from visitors of other departments during whole process of medication-seeking(37.50%,15/40),sufficient natural/forced ventilation(55.00%,22/40),setting-up of a spare consulting room(57.50%,23/40),setting-up of contaminated/semi-contaminated/clean zones with clear boundary(72.50%,29/40),being allocated in a separated area with clear sign(72.50%,29/40),and the establishment of both medical staff and patient passageway(75.00%,30/40).For the reserved rooms for isolation and medical observation,the qualification rates were relatively low for good ventilation(55.00%,22/40),sufficient number(72.50%,29/40),and reserved singl

关 键 词：新型冠状病毒肺炎 预检分诊 发热门诊 调查 

分 类 号：R197.32[医药卫生—卫生事业管理]