“An integrated system,three separated responsibilities”,a new fever clinic management model,in prevention and control of novel coronavirus pneumonia

BACKGROUND Since December 2019,there have been many new cases of coronavirus pneumonia in Wuhan,Hubei Province,which has gradually spread throughout the country.AIM To explore our hospital’s innovative management system to ensure the efficient operation of fever clinics during the epidemic,since controlling the spread of disease is an important way to prevent and control the epidemic.METHODS In total,200 outpatients with fever at our hospital between November 2019 and July 2020 were selected and allocated into two groups.RESULTS The fever clinic in our hospital operated smoothly,and infection with the novel coronavirus disease(COVID-19)has not been reported in our hospital.Additionally,we did not have any cases of missed diagnosis.The awareness regarding COVID-19 infection sources,transmission routes,early symptoms,and preventive measures was significantly higher in our fever clinic than in those of the pre-management group.CONCLUSION"An integrated system,three separate responsibilities"ensured the efficient functioning of our fever outpatient clinic and early screening of COVID-19 cases,which effectively curbed the transmission of COVID-19 and hence prevented COVID-19 pneumonia epidemic in our hospital,ultimately achieving the maximum effect of epidemic prevention and control.

Analysis of Epidemic Prevention Strategies of Omicron Variant Abroad

Omicron variant was first found in Botswana, southern Africa, on November 9, 2021. The variant has many mutations and spreads quickly. It also has immune escape to existing COVID-19 vaccines, and the infection rate and repeated infection rate have increased worldwide. For such variant, at this stage, foreign countries mainly adopt three strategies to prevent and control the epidemic. First, big data is used to track the potential infection of the epidemic, trace the spread of the epidemic, screen close contacts, and control the scope of infection. The second is to maximum the coverage rate of vaccination, especially the coverage rate of the third injection, so as to reduce the infection level of Omicron variant. At last, they are developing a general coronavirus vaccine to prevent infection caused by SARS-CoV-2 variants, including the Omicron variant, so as to fundamentally eliminate the potential threat of variants to human beings. In this paper, three major epidemic prevention strategies of Omicron variant abroad were summarized in detail.

Clinical Research of Pre-Hospital Emergency Care, Nursing, Infection Prevention and Control for Senile Osteoporotic Vertebral Compression Fracture during Epidemic Period

Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.

Preventive Effect of Xiangsha Yangwei Pills on the Novel Coronavirus Pneumonia from"Genuine Qi Exists,Illness Never"

The preventive effect of traditional Chinese medicine on the novel coronavirus(COVID-19)pneumonia is embodied in the"prevention before disease onset"of"treatment of disease"theory of thought,and it is considered that the key to the success or failure of prevention is whether the healthy qi is abundant or not.This article discusses and understands the"genuine qi"from the The Medical Classic of the Yellow Emperor,and describes its meaning comprehensively and systematically,combining with the expansion and supplement of many doctors in later generations.The"genuine qi"includes healthy qi,pulse qi,congenital qi,personal qi,Jing qi primordial qi and food energy,all of which are closely related to spleen-stomach.The function of spleen-stomach is normal,water and grain are transported properly,and the rise and fall of qi is appropriate,then the human body's qi is abundant,the anti-evil force is strong,and people are not easy to cause disease;even if the disease,the prognosis is better.This the novel coronavirus pneumonia comprehensive analysis,belongs to the traditional Chinese medicine science"damp-toxin epidemic",therefore the prevention should pay more attention to strengthen spleen and stomach,eliminate dampness,and Xiangsha Yangwei Pills is the appropriate choice.

Development Path and Urgency of Further Strengthening Construction of Public Hospitals Based on Novel Coronavirus Pneumonia Treatment

During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.

新冠病毒感染“乙类乙管”背景下构建医患命运共同体的思考

2022年12月26日,国家卫生健康委员会将新型冠状病毒肺炎更名为新型冠状病毒感染,自2023年1月8日起由“乙类甲管”调整为“乙类乙管”。当前,我国疫情防控已进入新阶段,工作重心从“防感染”转向“保健康、防重症”。然而,我国人口基数大,老年化程度加深,慢性病和基础病患者众多,但医疗卫生资源总量不足且分布不均,势必会面临医疗资源挤兑、短期内重症率、死亡率显著波动等新形势、新问题。除优化医疗资源配置、系统筹备、科学应对外,需重点树立、强化命运共同体意识,共同应对新形势、新问题,力争以最快速度、最短时间、最小代价实现疫情防控最大胜利。本文以构建医患命运共同体为着力点,浅析构建医患命运共同体的现实基础及意义,诠释医患命运共同体的科学内涵及举措,为新阶段全面打赢疫情防控战提供参考。

基于主成分分析的新型冠状病毒感染防控影响因素研究

当前新冠疫情对世界各国存在多方面的影响,研究新型冠状病毒(COVID-19)的预防和控制依然是维护世界公共卫生安全的重点工作。分析不同防控因素对疫情发展的影响程度,以美国、英国、匈牙利、以色列、塞尔维亚等14个疫情国家为例,构建新型冠状病毒感染防控评估模型,运用主成分分析法,对新型冠状病毒感染发展和防控影响较大的因素进行了提取,并分析以上国家的疫情数据。结果表明严格的管控措施和较高的疫苗接种率对疫情防控非常有效。各国在疫情出现反弹时,收紧管控措施能降低疫情蔓延的速度,盲目放松管控措施会损害已有的防疫效果;疫苗接种率的提高对控制确诊病例的下降效果较为明显。针对影响因素合理制定疫情防控措施,可以控制疫情的发展蔓延,为今后各国应对重大传染病提供思路。

不同家庭新型冠状病毒肺炎临床影像学及防控对策分析

目的 提高对家庭聚集性新型冠状病毒肺炎的临床和影像改变的认识,探索具有针对性的疫情防控策略。方法 回顾性分析10组新型冠状病毒肺炎家庭共27例病例的临床症状及影像学检查资料。结果 27例病例中,男12例,女15例,年龄6个月至57岁,轻型12例,普通型15例。所有患者中5例表现为发热,20例表现为咳嗽咳痰,13例表现为鼻塞流涕,5例表现为咽干咽痛,5例表现为嗅觉味觉丧失,2例表现为头晕头痛。15例普通型患者中,病变累及双肺10例,累及单侧肺5例,累及下叶8例,胸膜下9例;表现为磨玻璃影9例,高密度影7例,胸膜增厚3例;未见胸腔积液、纵隔及腋窝淋巴结肿大征象。结论 家庭聚集性新型冠状病毒肺炎临床及影像学具有一定的特点,重视发热门诊的哨点监测作用,积极控制传染源、采取非药物干预联合强化疫苗接种是打赢疫情防控攻坚战重要策略。

综合SEIR-FAHP的城市疫情防控评价

新型冠状病毒感染疫情防控已成为各国各级政府重要任务之一,为掌握疫情对城市公共卫生系统的影响程度,对疫情发展变化趋势进行预测并评判防控措施实施效果。以政府公开数据为信息源,建立评价对象城市的SEIR传染动力学模型,通过模型参数的灵敏度分析,以累计感染者人数为标准,确定模型各参数的重要程度序列,进而综合模糊层次分析法进行评价,最终建立综合SEIR-FAHP的城市疫情防控系统评价模型。然后以2019年武汉市疫情为实例,应用该模型对武汉市疫情防控系统进行评价。将疫情发展划分为疫情早期、中期和后期3个阶段,应用该评价模型进行评价,得到结果R_(1)·V_(1)=[0.0253846160.0792307690.250.3946150.250769];R_(2)·V_(2)=[0.01350.04960.20130.40670.3290];R_(3)·V_(3)=[000.15870.36450.4767]。根据最大隶属度原则,武汉疫情早期、中期及后期公共卫生系统评价结果依次为“良好”、“良好”、“优秀”。研究表明该方法能够客观反映城市疫情防控系统现状,可为政府进一步制定疫情防控政策提供合理参考。

新型冠状病毒感染者器官捐献专家共识

新型冠状病毒(新冠病毒)感染疫情传播、防控和新冠病毒从捐献者传播到受者的潜在风险及其不确定性等,给器官捐献和移植工作带来严重影响和巨大挑战。越来越多的证据表明使用来自新冠病毒感染的捐献者非肺脏器官(肾脏、肝脏和心脏)无论在获取时是否存在症状,传播的风险都很低。推迟新冠病毒抗原或核酸检测阳性者逝世后的器官捐献时间,待病毒检测阴性后再行捐献,将导致相当数量医学上适合移植的器官丢失。为最大限度满足终末期器官衰竭患者移植就医需求,中华医学会器官移植学分会组织相关专家,结合国内新冠病毒感染流行形势及器官捐献和移植工作的临床实践,参考国内外相关研究结果及临床研究证据制定了公民逝世后器官捐献《新型冠状病毒感染者器官捐献专家共识》,旨在为新冠病毒感染者捐献器官的获取和应用提供建议和参考。

叶天士温疫辨治特色及对新型冠状病毒感染儿童防治的启示

叶天士是新安医学代表性医家,温病学派奠基人,其辨治温、疫理论特色鲜明,提出湿秽致疫说,治疫重视轻解宣窍逐秽法与轻扬理上法;创立卫气营血辨证理论,是指导温热时邪外感疾病在不同阶段采取不同辨治方法的重要依据;提出小儿四时温病辨治理论,强调要根据不同季节的气候特点,结合儿童体质特征,制定不同的治疗策略;诊法上重视望舌验齿,通过舌齿查病情之轻重,断津液之存亡,测疾病之转归。叶天士的温、疫相关理论和儿科论治特色对时下新型冠状病毒感染儿童防治策略的制定具有一定的指导价值。

新冠肺炎疫情下国家紧急医学救援队建设探讨与思考

目的探讨新冠肺炎疫情下国家紧急医学救援队建设及今后发展方向。方法梳理国家紧急医学救援队(宁夏)在抗击新冠肺炎疫情和自治区2次输入性鼠疫疫情中的主要任务、职能作用发挥及经验,分析其不足,为今后发展方向提出建议。结果国家紧急医学救援队(宁夏)在支援武汉“新冠肺炎”、应对自治区2两起输入性新冠肺炎及2起输入性鼠疫等传染病疫情防控中,整建制快速投入疫区,参加方舱医院建设和运行、院感防控、预检分诊、门急诊、发热门诊等多元化任务,但在制度建设、应急预案制定、组织构架、人员配置、装备建设、信息化、智能化、队员胜任等方面仍存在不足。结论国家紧急医学救援队(宁夏)在疫情防控、保障疫区人民正常就诊中发挥出重大作用,新形势下应对和抗击重大传染病疫情成为其主要任务之一,今后应在保留国家紧急医学救援队现有优势的前提下,向应对重大传染病疫情方向发展。

基于FMEA模型的质控管理措施在新冠疫情常态化防控期间医院感染管理中的应用

目的 探讨基于失效模式和效应分析(FMEA)模型的质控管理措施在新冠疫情常态化防控期间医院感染管理中的应用效果。方法 选取2020年3月至2021年3月新冠疫情常态化防控期间文昌市人民医院接收诊治的1 294例患者为观察组(实施基于FMEA模型的质控管理措施后),选取2019年12月至2020年2月文昌市人民医院接收诊治的473例患者为对照组(实施基于FMEA模型的质控管理措施前)。比较两组患者的卫生检查合格情况、医院感染发生情况及其对医院感染管理工作的满意度。结果 观察组患者的空气消毒机滤网清洁、物品放置及分区、门把手、座椅、地面及仪器的检查合格率分别为100.00%、100.00%、100.00%、100.00%、100.00%、100.00%,明显高于对照组的93.50%、94.50%、93.50%、94.50%、96.00%、95.50%,差异均有统计学意义(P<0.05);观察组患者的医院感染率为0.77%,明显低于对照组的3.59%,差异有统计学意义(P<0.05);观察组患者对医院感染管理工作的满意率为98.45%,明显高于对照组的91.75%,差异有统计学意义(P<0.05)。结论 基于FMEA模型的质控管理措施在新冠疫情常态化防控期间医院感染管理中的应用能明显提高卫生检查合格率,减少医院感染率,强有力地保障患者及医院医务人员的生命安全,进一步提高患者对医院感染管理工作的满意度。

医院人力资源监测在新型冠状病毒感染疫情防控中作用的思考与分析

新型冠状病毒感染疫情对医院的诊疗活动产生了深远影响。医院作为疫情防控的主力,人力资源监测在疫情防控过程中具有重要作用。本文以北京市某公立三甲医院为例,对其在人力资源监测过程中以数据支撑为基础建立的医院职工健康监测系统在疫情防控及特定时期的医院综合管理中发挥的作用进行阐述,对工作实践进行思考和经验总结。以期为后疫情时代医疗机构运用信息化手段加强人力资源监测在疫情防控和公共卫生管理工作中发挥更大作用提供参考。

新冠疫情防控进入新阶段后天津全血采集情况初步调查

目的了解新冠疫情防控进入新阶段后天津市全血采集情况。方法采用回顾性阶段分析方法,收集新冠病毒感染从“乙类甲管”调整为“乙类乙管”后第1个春节前15 d(2023年1月7日~2023年1月21日)天津市无偿献血者全血采集情况的相关数据,同时选取新冠疫情发生前2年各自春节前15 d(2018年2月1日~2018年2月15日、2019年1月21日~2019年2月4日)的同类数据,比较新冠疫情前后同时段天津市全血捐献(采集)情况。结果天津市2023年春节前15 d全血捐献(采集)情况与2018、2019年同期比较:全血捐献人数为6124 vs 3940 vs 4069、采血量总量(U)9623 vs 7378 vs 7808、初次献血者比例69.17%(4236/6124)vs 65.86%(2595/3940)vs 62.05%(2525/4069)、本地献血者比例59.31%(3632/6124)vs 23.27%(917/3940)vs 18.19%(740/4069)、团体献血者比例43.42%(2659/6124)vs 8.05%(317/2595)vs 0.15%(6/4069)(均为P<0.05)。结论新冠疫情防控政策的调整对无偿献血工作有重大影响,采供血机构因时因势调整献血者招募策略提高了全血采集量。

基于PMC指数模型的我国医疗机构新冠疫情防控政策量化评价

目的对医疗机构疫情防控政策进行量化评价,为我国疫情防控政策的制定和优化提供建议,完善我国疫情防控政策体系。方法采用ROST CM 6.0进行文本挖掘,构建PMC指数模型,包括9个一级变量和32个二级变量,对我国2020年1月-2022年12月的6项国家层面医疗机构疫情防控相关政策进行政策文本量化评价。结果6项医疗机构疫情防控政策PMC指数平均值为7.14,其中有2项政策为优秀政策,4项政策为良好政策,政策整体制定水平较高;但在政策性质、政策工具及政策受众方面有所不足。结论我国医疗机构疫情防控政策基本完善,但新阶段新常态有新要求,在政策性质、工具、受众方面亟须进一步优化,可从加强对现有疫情防控成果的阶段性总结,提升需求型政策工具的使用频率以及注重医疗机构与政府、非盈利组织、企业的联动协作等方面入手。

以北京冬奥会为例对新冠疫情背景下大型赛事医疗保障模式的探讨

大型赛事医疗保障任务是医院为民服务中的一项重要内容。然而在新冠疫情的影响下,赛事中的医疗保障愈加复杂,承担任务的医院需要严密组织,详尽落实各类政策,才能在疫情防控条件下做好赛事医疗保障。通过不断完善政策制度,加强人员培训教育,优化诊疗处置流程,全面构建一体化诊疗专区等方式,丰富了赛事医疗保障经验,为其他医疗机构和未来的大型赛事医疗保障运行模式提供借鉴与参考。

基于信息系统的铁路企业新冠病毒感染防控管理与研究

为了落实铁路关于新冠病毒感染防控的总体部署与要求,某铁路局集团公司疫情防控指挥部推行“核酸检测、疫苗接种、疫情排查、隔离管控和集中管控”五位一体的疫情防控管理体系,同时利用信息化技术建设集团公司防疫系统,并结合近期国家防疫政策的调整,进行了系统业务功能的完善。该系统的实施有效提高了疫情防控工作的质量与效率,在铁路局集团公司推广使用并取得了良好效果,系统的开发应用为铁路处理重大公共卫生事件提供了一定参考。

疫情防控新阶段黑龙江省推进家庭医生服务的实践与思考

在新冠病毒感染由“乙类甲管”调整为“乙类乙管”的新阶段,黑龙江省积极推进家庭医生服务工作,家庭医生在做好为轻型、中型新冠感染者提供居家监测管理、用药指导的同时,积极参与重症患者的协助转运、转诊工作,在“保健康、防重症”疫情防控新阶段发挥了重要作用。文章主要介绍了疫情防控新阶段黑龙江省推进家庭医生服务的主要做法和成效,分析了目前家庭医生服务存在的问题,并提出对策建议,为推进家庭医生签约服务高质量发展提供了思路。

新型冠状病毒感染下南充市居民防控知识和心理状况调查分析

目的调查新型冠状病毒感染(COVID-19)下南充市居民防控知识和心理状况。方法选取3939名南充市居民,以一般资料调查表、COVID-19防控知识调查表、90项症状自评量表(SCL-90)进行问卷调查,了解新型冠状病毒感染下南充市居民防控知识和心理状况。结果南充市居民SCL-90总均分(1.53±0.39)分。南充市居民不同防控知识回答正确率分别为传播途径81.11%~100.00%,症状表现10.28%~97.79%,预防措施40.82%~99.64%。南充市居民防控知识获取渠道主要为网络社交工具(97.79%,3852/3939)。不同人口学特征南充市居民防控知识和心理状况调查结果比较,差异有统计学意义(P<0.05)。结论新型冠状病毒感染下南充市居民防控知识和心理状况均有待提高,建议有关部门采取多样化方式加强COVID-19知识教育,同时进行积极心理调控,维护疫情时期南充市居民心理健康。