Rebmann Terri, Wilson Rita, LaPointe Sue, Russell Barbara, Moroz Dianne
Institute of Biosecurity, Division of Environmental and Occupational Health, St. Louis University, School of Public Health, St. Louis, MO 63104, USA.
Am J Infect Control. 2009 Feb;37(1):1-8. doi: 10.1016/j.ajic.2008.02.007. Epub 2008 Dec 9.
Hospital preparedness for infectious disease emergencies is imperative.
A 40-item hospital preparedness survey was administered to Association for Professionals in Infection Control and Epidemiology, Inc, members. Kruskal-Wallis tests were used to evaluate the relationship between hospital size and emergency preparedness in relation to various surge capacity measures. Significant findings were followed by Mann-Whitney U post hoc tests.
Most hospitals have an infection control professional on their disaster committee, 24/7 infection control support, a health care worker prioritization plan for vaccine or antivirals, and nonhealth care facility surge beds but lack health care worker, laboratory, linen, and negative-pressure room surge capacity. Many hospitals participated in a disaster exercise recently and are stockpiling N95 respirators and medications. Few are stockpiling ventilators, surgical masks, or patient linens; those that are have <or=7 days worth of supplies. Less than one quarter have cross trained their staff, convened their ethics committee to discuss preparedness issues, or developed policies/procedures for altered standards of care during disasters. Approximately half of all hospitals' plans include staff work incentives. The smallest hospitals (<or=99 beds) are less prepared than larger hospitals on a variety of surge capacity indicators.
US hospitals lack laboratory, negative-pressure room, health care worker, and medical equipment/supplies surge capacity. Hospitals must continue to address gaps in infectious disease emergency planning.
医院做好应对传染病突发事件的准备势在必行。
对感染控制与流行病学专业人员协会的成员进行了一项包含40个项目的医院准备情况调查。采用Kruskal-Wallis检验来评估医院规模与应急准备之间在各种应急能力指标方面的关系。对于显著结果，随后进行Mann-Whitney U事后检验。
大多数医院在其灾难委员会中有感染控制专业人员、提供全天候感染控制支持、有针对疫苗或抗病毒药物的医护人员优先排序计划，以及有非医疗设施应急床位，但缺乏医护人员、实验室、亚麻制品和负压病房的应急能力。许多医院最近参与了灾难演习，并且正在储备N95口罩和药品。很少有医院储备呼吸机、外科口罩或患者亚麻制品；储备这些物资的医院所储备的物资量可供使用的天数≤7天。不到四分之一的医院对其员工进行了交叉培训、召集其伦理委员会讨论准备问题，或者制定了灾难期间改变护理标准的政策/程序。所有医院计划中约有一半包括员工工作激励措施。在各种应急能力指标方面，规模最小的医院（≤99张床位）比大型医院准备得更差。
美国医院缺乏实验室、负压病房、医护人员以及医疗设备/物资的应急能力。医院必须继续解决传染病应急规划方面的差距。
