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"

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 infection control,pays attention to the importance of the process,and advocates the concept of"system slimming,process fattening".Fifthly,it emphasizes that the future development depends on artificial intelligence,in order to improve the quality and efficiency of prevention and control to the greatest extent.Sixth,hospitals need to strengthen continuous training and retraining.We utilize diverse training methods,including artificial intelligence,to ensure that infection control policies and procedures are simple.We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.