新冠病毒感染"乙类甲管"期间定点医院集束化院感防控体系的建设体会  

The experience on the construction of the cluster prevention and control system for COVID-19 infection in designated hospitals during the period of"Category B infectious disease treated as Category A"

作　　者：杨万杰 刘先夺 王西墨 徐卫国[5] 张磊 傅强[7] 杨积明[8] 钱静[9] 张富玉[10] 田丽[11] 张文龙 张宇 陈征 邵世峰 王湘[12] 耿莉[13] 任怡[14] 王莹[15] 史丽霞[16] 万振[17] 谢祎[18] 刘媛媛[19] 于维莉[12] 韩晶[16] 刘莉[13] 朱欢[13] 于自江 刘宏阳 王士梅[21] Yang Wanjie;Liu Xianduo;Wang Ximo;Xu Weiguo;Zhang Lei;Fu Qiang;Yang Jiming;Qian Jing;Zhang Fuyu;Tian Li;Zhang Wenlong;Zhang Yu;Chen Zheng;Shao Shifeng;Wang Xiang;Geng Li;Ren Yi;Wang Ying;Shi Lixia;Wan Zhen;Xie Yi;Liu Yuanyuan;Yu Weili;Han Jing;Liu Li;Zhu Huan;Yu Zijiang;Liu Hongyang;Wang Shimei(Tianjin Haihe Hospital,Tianjin 300350,China;Tianjin Institute of Respiratory Diseases,Tianjin 300350,China;Tianjin Health Commission,Tianjin 300070,China;Tianjin Third Central Hospital,Tianjin 300170,China;Tianjin Hospital,Tianjin 300211,China;Tianjin Academy of Traditional Chinese Medicine,Tianjin 300020,China;Tianjin Fourth Central Hospital,Tianjin 300140,China;Tianjin Second People's Hospital,Tianjin 300192,China;Department of Infection Control,Tianjin Second People's Hospital,Tianjin 300192,China;Department of Infection Control,Tianjin Third Central Hospital,Tianjin 300170,China;Department of Nursing Management,Tianjin Third Central Hospital,Tianjin 300170,China;Department of Infection Control,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Infection Control,Tianjin First Central Hospital,Tianjin 300192,China;Department of Nursing Management,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Nursing Management,Tianjin First Central Hospital,Tianjin 300192;Department of Medical Management,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Information Management,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Science and Education,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Public Health,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Medical Management,Tianjin People's Hospital,Tianjin 300121,China;The Third Emergency Department,Tianjin Emergency Center,Tianjin 300011,China)

机构地区：[1]天津市海河医院,天津300350 [2]天津市呼吸疾病研究所,天津300350 [3]天津市卫生健康委员会,天津300070 [4]天津市第三中心医院,天津300170 [5]天津市天津医院,天津300211 [6]天津中医药研究院,天津300020 [7]天津市第四中心医院,天津300140 [8]天津市第二人民医院,天津300192 [9]天津市第二人民医院感染管理科,天津300192 [10]天津市第三中心医院感染管理科,天津300170 [11]天津市第三中心医院护理部,天津300170 [12]天津市海河医院感染管理科,天津300350 [13]天津市第一中心医院感染管理处,天津300192 [14]天津市海河医院护理部,天津300350 [15]天津市第一中心医院护理部,天津300192 [16]天津市海河医院医务科,天津300350 [17]天津市海河医院信息科,天津300350 [18]天津市海河医院科教科,天津300350 [19]天津市海河医院公共卫生科,天津300350 [20]天津市人民医院医务处,天津300121 [21]天津市急救中心急救三科,天津300011

出　　处：《中华危重病急救医学》2024年第2期195-201,共7页Chinese Critical Care Medicine

基　　金：天津市医院协会医院管理研究项目(2022zc27,2022zc39);天津市津南区科技计划项目(20220102)。

摘　　要：波及全球的新型冠状病毒感染(新冠病毒感染)疫情持续3年,对人类生命健康和经济活动造成了严重影响。中国的疫情防控经历了应急性超常规防控阶段、应急常态化防控阶段和应急常态化向"乙类乙管"常态化过渡转段阶段,取得了疫情防控重大决定性胜利。天津市新冠病毒感染救治定点医院在疫情防控的各阶段均圆满完任务,积累了宝贵经验。本文总结定点医院"乙类甲管"期间院感防控(感控)体系建设经验,概括为集束化"3、2、1"感控体系,即外、中、内"三环",绿、橙、红"三区",前、中、后"三事";"两天预净化"和"双点长制";"一个模块"化管理。应急情况下,可采用简化版的集束化感控体系,其特点为:一是强调"集束化",即关键措施的整体效能,避免任何短板的发生。二是强调感控理念的转变,使感控最大化地为医疗服务提供安全保障。三是强调流程的优化,防控措施既要全面和重点突出,又要防止过度;利用最少的资源,达到最佳的感控效果。四是强调对感控工作的质量控制,关注流程的重要性,提倡"制度瘦身,流程增肥"的理念。五是强调未来的发展寄希望于人工智能,以期最大程度地提高防控质量和效率。六是强化持续的培训和再培训,利用包括人工智能在内的多样化的培训方法,确保感染控制的政策和程序清晰易懂、易于遵循,并建立实施评估和反馈机制,使医务人员随时保持应急状态。The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life,health and economic activities.China's epidemic prevention and control has gone through the following stages:emergency unconventional stage,emergency normalization stage,and the transitional stage from the emergency normalization to the"Category B infectious disease treated as Category B"normalization,and achieved a major and decisive victory.The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control,and has accumulated valuable experience.This article summarizes the experience of constructing a hospital infection prevention and control system during the"Category B infectious disease treated as Category A"period in designated hospital.The experience is summarized as the"Cluster"hospital infection prevention and control system,namely"three rings"outside,middle and inside,"three districts"of green,orange and red,"three things"before,during and after the event,"two-day pre-purification"and"two-director system",and"one zone"management.In emergency situations,we adopt a simplified version of the cluster hospital infection prevention and control system.In emergency situations,a simplified version of the"Cluster"hospital infection prevention and control system can be adopted.This system has the following characteristics:firstly,the system emphasizes the characteristics of"cluster"and the overall management of key measures to avoid any shortcomings.The second,it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control.The third,it emphasizes the optimization of the process.The prevention and control measures should be comprehensive and focused,while also preventing excessive use.The measures emphasize the use of the least resources to achieve the best infection control effect.The fourth,it emphasizes the quality control work of infe

关 键 词：新冠病毒感染 乙类甲管 集束化 防控体系 

分 类 号：R197.323[医药卫生—卫生事业管理]