4R危机管理理论在儿科急诊于新型冠状病毒肺炎疫情中的应用

Novel Coronavirus Pneumonia in Pediatric Emergency Department by 4R Crisis Management Theory

【目的】在新型冠状病毒肺炎(COVID-19)流行期间,利用4R危机管理理论,采取积极有效的应对措施,避免感染发生及传播。【方法】于2020年1月24日至2020年3月7日对本院儿科急诊室采用4R危机管理的方法,以危机缩减、危机预备、危机反应、危机恢复四个环节为节点,建立健全特殊时期的科室护理管理体系进行综合防控。评估儿科急诊室收治筛查处理疑似病例情况、医护人员对COVID-19知识、儿科急诊筛查流程、口罩的正确使用、标准防护等知识的掌握情况,了解位于儿科急诊所有人的口罩佩戴率、佩戴的正确率,每日陪护人数,医院感染发生率。【结果】此期间由本院儿科急诊筛查出需要进一步评估的患儿共20例,其中10例确定为疑似病例前往定点医院进行留观,无确诊病例。医护人员对COVID-19知识、儿科急诊的就诊流程和应急预案、口罩的正确使用、标准防护等掌握的合格率由67%提高至100%。位于儿科急诊所有人的口罩佩戴率从最初的45.5%提高到96.0%,佩戴的正确率从80.6%提高至95.0%,探视及陪伴人数由管理前的每日人均3.1例次降低至每日人均1.8例次,暂时未发现医护人员感染,感染率为0。【结论】4R危机管理理论及方法有利于指导儿科急诊在COVID-19疫情传播期间疫情的防控和管理,可提高医院诊疗效率,降低了医院感染,并保障了患儿和家属及医护人员的安全,同时控制了疫情的传播,此研究可对类似情况下的科室管理,有一定的借鉴意义及参考价值。

【Objective】During the epidemic of novel coronavirus pneumonia(COVID-19),4R crisis management theory was adopted to take positive and effective measures to avoid recurrence and spread of infection.【Methods】From January 24,2020 to March 7,2020,a 4R crisis management method was adopted in the pediatric emergency room of our hospital.The four links of crisis reduction,crisis preparation,crisis response and crisis recovery were taken as nodes to establish and improve the department nursing management system in special period for comprehensive prevention and control.Our mission is to evaluate the situation of suspected cases treated by screening in pediatric emergency room,medical staff's mastery of covid-19 knowledge,pediatric emergency screening process,correct use of masks,standard protection and other knowledge,so as to understand the wearing rate and correct rate of masks of all people in pediatric emergency department,the number of accompanying persons per day,and the incidence of hospital infection.【Results】During this period,a total of 20 children who need further evaluation were screened out by pediatric emergency department of our hospital.Among them,10 cases were confirmed as suspected cases and went to the designated hospital for observation.No confirmed cases were found.The qualified rate of medical staff in mastering covid-19 knowledge,pediatric emergency treatment process and emergency plan,correct use of masks and standard protection increased from 67%to 100%.The rate of wearing masks increased from 45.5%to 96.0%and the correct rate of wearing masks increased from 80.6%to 95.0%.The number of visiting and accompanying persons decreased from 3.1 cases per day before management to 1.8 cases per day per capita per day.No infection was found among medical staff,and the infection rate was 0%.【Conclusion】4R crisis management theory and methods are conducive to guide the prevention and control and management of pediatric emergency during the spread of covid-19 epidemic,improve the efficiency of hospital diagnosis and treatment,reduce hospital infection,and ensure the safety of children,family members and medical staff,and control the spread of the epidemic.This study can be used for reference and reference for the management of departments in similar situations.