Danial J, Ballard-Smith S, Horsburgh C, Crombie C, Ovens A, Templeton K E, Hardie A, Cameron F, Harvey L, Stevenson J, Johannessen I
Infection Prevention and Control Team, Royal Infirmary of Edinburgh, Edinburgh, UK.
NHS Lothian Directorate of Nursing, Waverley Gate, Edinburgh, UK.
J Hosp Infect. 2016 Jun;93(2):127-34. doi: 10.1016/j.jhin.2016.02.002. Epub 2016 Feb 26.
Norovirus outbreaks are a major burden for healthcare facilities globally.
Lessons learned to inform an action plan to improve facilities as well as responses to norovirus within the medicine of the elderly (MoE) hospital as well as other NHS (National Health Service) Lothian facilities.
This study investigated the impact of a prolonged outbreak at an MoE hospital in one of the 14 Scottish health boards between February and March 2013.
In all, 143 patients (14.80 cases per 1000 inpatient bed-days) and 30 healthcare staff (3.10 cases per 1000 inpatient bed-days) were affected clinically and 63 patients were confirmed virologically. Restricting new admissions to affected units resulted in 1192 lost bed-days. The cost due to lost bed-days in addition to staff absence and management of the outbreak was estimated at £341,534 for this incident alone. At certain points during the outbreak, the whole facility was closed with resulting major impact on the health board's acute care hospitals.
Due to the outbreak, new measures were implemented for the first time within NHS Lothian that included floor-by-floor (instead of individual) ward closures, enhanced cleaning with chlorine-based products throughout the hospital, reduction in bed capacity with enhanced bed-spacing and interruption to direct admissions from the Board's general practice surgeries, and temporary suspension of visitors to affected areas. Together with regular communication to staff, patients, relatives, and the public throughout the outbreak and good engagement of staff groups in management of the incident, the outbreak was gradually brought under control.
诺如病毒爆发是全球医疗机构面临的重大负担。
总结经验教训，为改善老年医学（MoE）医院及其他NHS（英国国家医疗服务体系）洛锡安地区医疗机构的设施以及应对诺如病毒制定行动计划提供参考。
本研究调查了2013年2月至3月期间，苏格兰14个卫生委员会之一的一家MoE医院发生的长期疫情的影响。
共有143名患者（每1000个住院床位日有14.80例病例）和30名医护人员（每1000个住院床位日有3.10例病例）出现临床症状，63名患者病毒学检测呈阳性。限制受影响病房接收新患者导致1192个床位日损失。仅此次事件，因床位日损失、员工缺勤和疫情管理造成的成本估计为341,534英镑。疫情爆发期间的某些时段，整个设施关闭，对卫生委员会的急症医院造成重大影响。
由于此次疫情，NHS洛锡安地区首次实施了新措施，包括逐层（而非逐个）关闭病房、在全院加强使用含氯产品清洁、通过增加床位间距减少床位数量、中断卫生委员会全科诊所的直接入院、暂时禁止访客进入受影响区域。在疫情期间与工作人员、患者、家属和公众保持定期沟通，并让工作人员群体积极参与事件管理，疫情逐渐得到控制。
