Nursing Care Management Strategies in Isolation Wards during the COVID-19 Outbreak

Coronavirus disease 2019 (COVID-19) is highly infectious and has spread worldwide. Medical staff may be exposed to the infection under circumstances of medical supply shortages and improper protection. How to better protect medical staff has become the focus of all walks of life. Therefore, during the COVID-19 outbreak, timely adjustments and optimization of nursing management strategies in isolation wards are important for improving care quality and reducing the infection of medical staff. Based on a literature review and clinical nursing management practices, this article summarizes the nursing management strategies in isolation wards during the COVID-19 outbreak, aiming to provide references for clinical nursing managers.

Adaptive Wall-Based Attachment Ventilation:A Comparative Study on Its Effectiveness in Airborne Infection Isolation Rooms with Negative Pressure

The transmission of coronavirus disease 2019(COVID-19)has presented challenges for the control of the indoor environment of isolation wards.Scientific air distribution design and operation management are crucial to ensure the environmental safety of medical staff.This paper proposes the application of adaptive wall-based attachment ventilation and evaluates this air supply mode based on contaminants dispersion,removal efficiency,thermal comfort,and operating expense.Adaptive wall-based attachment ventilation provides a direct supply of fresh air to the occupied zone.In comparison with a ceiling air supply or upper sidewall air supply,adaptive wall-based attachment ventilation results in a 15%–47%lower average concentration of contaminants,for a continual release of contaminants at the same air changes per hour(ACH;10 h^(-1)).The contaminant removal efficiency of complete mixing ventilation cannot exceed 1.For adaptive wall-based attachment ventilation,the contaminant removal efficiency is an exponential function of the ACH.Compared with the ceiling air supply mode or upper sidewall air supply mode,adaptive wall-based attachment ventilation achieves a similar thermal comfort level(predicted mean vote(PMV)of0.1–0.4;draught rate of 2.5%–6.7%)and a similar performance in removing contaminants,but has a lower ACH and uses less energy.

Application and Effect of Intelligent Disinfection Robot in Non-Negative Pressure Isolation Ward of Novel Coronavirus Pneumonia Designated Hospital

The application of intelligent disinfection robot in designated non-negative pressure isolation ward during the outbreak in novel coronavirus pneumonia. The construction and competition, disinfection mode of intelligent disinfection robot, the setting of disinfection point built on area and number of isolation ward, can be introduced below. Frequency can realize remote control when staff uses a table to give instruction and set disinfection mode, and then the intelligent disinfection robot returns automatically to the charging pile to charge when the instruction is completed. It can also autonomously move to sterilize without human participation, which makes man-machine separation and accurate disinfection come true. The chance of contact infection and exposure is decreased when an intelligent disinfection robot is used to sterilize the environment and object surface in an isolation ward, which can also reduce occupational exposure, achieve occupational protection of medical workers and ensure there is no hospital infection.

Application of Intelligent Equipment on Novel Coronavirus Pneumonia Designated Hospital

Objective: To explore the application of intelligent equipment in non-negative pressure isolation ward for COVID-2019 patients. Method: From February 1 to March 17, 2020, intelligent equipment, such as communication interaction system, intelligent disinfection robot, delivering robot, were used in non- negative pressure isolation ward of COVID-2019. With the help of communication interaction system to supervise the implementation of infection prevention and control, and observe the incorrect situation of pee use and personal behavior before and after the implementation. The disinfection robot and meal delivery robot were used in ward disinfection and life nursing combined with nursing practice. Result: Through the supervision of communication interaction system, the frequency of pee use and personal behavior was reduced. The frequency of bad articles before and after improvement was wearing protective clothing (2.80%/0.84%), taking off protective clothing (5.87%/0.84%), personal behavior observation (8.38%/1.90%), P < 0.01. The robot disinfected and delivered medicine for 912.5 h, saving 225 shifts of nursing staff. Conclusion: Intelligent equipment is a good option for infection control in isolation ward of COVID-2019. It can not only reduce the workload of health workers, but also the cross-infection.

Prevalence and Anti-Microbial Susceptibility of Methicillin Resistant Staphylococcus aureus at Moi Teaching and Referral Hospital Eldoret

Background: Methicillin-resistant Staphylococcus aureus (MRSA) are pathogens that have major negative impact in all aspects of patient care and are increasingly being recognized as troublesome pathogens in the community. The MRSA are multi-drug resistant bacteria responsible for higher morbidity, mortality and cost of treatment in the affected patients. Research on MRSA antimicrobial susceptibility and resistance in developing countries is limited;hence accurate burden is not certain. Objective: To determine the prevalence and susceptibility pattern of MRSA in S. aureus isolates from patients treated in various units at Moi Teaching and Referral Hospital. Study Design: Cross-sectional design was used to conduct the study. Methods and Materials: Staphylococcus aureus stored isolates from patients at various units at Moi Teaching and Referral Hospital (MTRH) were identified by laboratory conventional methods. Methicillin resistant Staphylococcus aureus was determined using cefoxitin and oxacillin, discs and confirmed by Penicillin Binding Protein (PBP2a’) latex agglutination test. Susceptibility testing was performed according to the Clinical Laboratory Standards Institute procedures. Control strains used were: ATCC 43300 for Methicillin resistant S. aureus (MRSA) strains and ATCC 29213 for methicillin susceptible S. aureus (MSSA) strains. Nine anti-microbials (Erythromycin, Gentamycin, Tetracycline, Vancomycin, Rifampin, Linezolid, Ciprofloxacin, Clindamycin and Fucidicacid) were used to test the anti-microbial susceptibility patterns. Control organisms were run along with the isolates for quality Assurance. The data was analyzed using STATA version 11. Categorical variables were summarized as frequencies and the corresponding percentages. Results were presented using tables and graphs. Results: A total of 107 isolates of S. aureus were obtained, of which 39 (37%) were MRSA. Most of the MRSA, 13 (33%) and 7 (17%), were found in pus and tracheal aspirate samples respectively. Majority of the MRSA isolates were from surgical wards and intensive care unit. The MRSA isolates were highly resistant to erythromycin (92%;36/39) and tetracycline (92% 36/39) and moderately susceptible to linezolid (77% 30/39), Vancomycin (75% 29/39) and fucidic acid (67% 26/39). A total of 28 (74.4%) MRSA isolates were Clindamycin inducible resistant. Conclusions and Recommendations: This study showed that MRSA is a significant pathogen at MTRH. The MRSA were most detected in pus specimens and least in peritoneal aspirates. Routine Screening of S. aureus isolates for MRSA strains at MTRH is therefore imperative. Infection control measures should be put in place to reduce prevalence and prevent the spread of MRSA at MTRH.

The influence of air supply inlet location on the spatial-temporal distribution of bioaerosol in isolation ward under three mixed ventilation modes

The outbreak of COVID-19 and the spread of infectious pathogens through bioaerosols have once again aroused widespread concern worldwide.Isolation ward is an important place to prevent the spread of infectious bioaerosols.However,infection of health care workers(HCWs)in the isolation ward often occurs,so it is ur-gent to carry out relevant research to reduce the cross-infection between HCWs and patients.In this paper,the temporal and spatial distribution characteristics of bioaerosols under three mixed ventilation modes in a single ward were studied,namely,upper supply side return air of Case 1 and side supply and side return ventilation are Case 2 and Case 3 respectively.The results show that the removal efficiency of bioaerosol in the ventilation mode of Case 3,in which directional airflow is formed from the air supply inlet to the release source and then to the exhaust outlet,is 46.6%and 67.7%higher than that of Case 1 and Case 2,respectively.In addition,ventilation methods based on mixed theory do not guarantee good air quality in the breathing zone(1.3 m to 1.7 m)of HCWs,which may increase the inhalation risk for HCWs.It is hoped that our results can provide some useful suggestions for optimizing the airflow layout of the isolation ward,reducing the risk of cross-infection,and virus elimination.