新冠疫情防控期间综合医院发热门诊的运行机制及策略  

Mechanisms and strategies for operation of fever clinics in a general hospital during prevention and control of COVID-19

作　　者：肖红菊[1] 祝伟秀[2] 田琳[2] 陈同金[2] 孙文峥[2] 张娟[2] 刘刚[2] 刘运喜[3] 杨华[1] XIAO Hong-ju;ZHU Wei-xiu;TIAN Lin;CHEN Tong-jin;SUN Wen-zheng;ZHANG Juan;LIU Gang;LIU Yun-xi;YANG Hua(First Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第一医学中心门诊部,北京100039 [2]解放军总医院第一医学中心急诊科发热门诊,北京100039 [3]解放军总医院第一医学中心疾病预防控制科,北京100039

出　　处：《中华医院感染学杂志》2022年第2期303-307,共5页Chinese Journal of Nosocomiology

基　　金：国家重点研发计划重点专项基金(2020YFC2008601)。

摘　　要：目的 探索新冠疫情防控中综合医院发热门诊的运行机制及策略。方法 分析总结解放军总医院第一医学中心发热门诊新冠疫情无本土病例的常态化防控期与有本土病例的局部暴发期两种状态的工作特点和管理模式。结果 常态化防控期:严格人员岗前准入,新入职人员需通过特殊岗位资质考试;强化人员日常培训;优化就诊流程,将传染病识别第一关前移至分诊;完善信息化闭环管理,实现了传染病识别、处置提醒、预警和上报等各个环节;落实标准预防措施。局部暴发期:提出人员抽组和防控物资需求申请、设计扩建发热门诊、培训支援人员、合理安排班次、增设防护监督员、增设24 h保障班。在此次疫情防控中医院再次实现了医务人员零感染、医院感染零发生的成绩。结论 发热门诊是医院传染病防控的前哨,结合平战特点,医院无论在科室建设、人员管理还是硬件建设方面的做法建议固化推广。OBJECTIVE To explore the mechanisms and strategies for operation of fever clinics of a general hospital during prevention and control of COVID-19. METHODS The working characteristics and management modes of the fever clinic of the First Medical Center of Chinese PLA General Hospital were analyzed and summarized during the period of normalized prevention and control without cases and the period with local outbreak. RESULTS During the period of normalized prevention and control, strict pre-job admission was carried out, the new recruits must pass the qualification test for special positions, the daily training was intensified, the treatment procedures were optimized, the step of identification of infectious diseases was moved forward to the triage;the closed-loop management of information was improved, the links such as identification of infectious diseases, treatment warning, prewarning and reporting have been achieved, and the standard prevention measures were taken. During the period of local outbreak, the application for demand of personnel and prevention supplies was put forward, fever clinic was designed and expanded, supporting personnel was trained, shifts were reasonably arranged, supervisors were added, and 24-hour logistic shifts wee also added. Zero infection of health care workers and zero case of nosocomial infection were achieved during the prevention and control of epidemic. CONCLUSION The fever clinic is an outpost of prevention and control of infectious diseases. Combined with the characteristics, it is recommended that the construction of departments, personnel management and hardware configuration should be solidified and promoted.

关 键 词：综合医院 发热门诊 新型冠状病毒肺炎 医院感染 防控 

分 类 号：R184[医药卫生—流行病学]