Kudo Daisuke, Sasaki Junichi, Ikeda Hiroto, Shiino Yasukazu, Shime Nobuaki, Mochizuki Toru, Morita Masanori, Soeda Hiroshi, Ohge Hiroki, Lee Jong Ja, Fujita Masahisa, Miyairi Isao, Kato Yasuyuki, Watanabe Manabu, Yokota Hiroyuki
Division of Emergency and Critical Care Medicine Tohoku University Graduate School of Medicine Sendai Japan.
Department of Emergency and Critical Care Medicine Keio University School of Medicine Tokyo Japan.
Acute Med Surg. 2018 Jul 30;5(4):374-379. doi: 10.1002/ams2.360. eCollection 2018 Oct.
Infection control in the emergency department is important for hospital risk management; however, few clinical guidelines have been established. This study aimed to determine whether hospitals in Japan have infection control manuals, and investigate the contents of manuals, consulting systems, and isolation facilities for emergency departments.
A total of 517 hospitals certified as educational institutions for board-certified acute care physicians in Japan were requested between March and May 2015 to provide a written evaluation of the infection control in the emergency department.
A total of 51 of 303 (16.8%) hospitals had no manuals regarding infection control in the emergency department. Among 250 hospitals having emergency department manuals, 115 (46.0%) did not include contents regarding disinfection and sterilization for imaging examination rooms, and only 44 (17.6%) had criteria for contacting the emergency medical service when patients are suspected of, or diagnosed with, communicable diseases. Of the 303 hospitals, 277 (91.4%) prepared specific manuals for the 2009 pandemic influenza. Of the 303 hospitals, 80 (26.4%) did not prepare manuals for the Ebola virus disease outbreak in West Africa in 2014. Furthermore, 92 (30.4%) of the 303 hospitals did not have any negative-pressure isolation rooms.
Practices and guidelines necessary for infection control in the emergency department were not sufficiently covered in the hospitals studied. Education, information sharing, and a checklist for preparing manuals are needed to establish better infection control systems in emergency departments.
急诊科的感染控制对医院风险管理很重要;然而,几乎没有制定临床指南。本研究旨在确定日本医院是否有感染控制手册,并调查急诊科手册的内容、咨询系统和隔离设施。
2015年3月至5月期间,要求日本517家被认证为经董事会认证的急性护理医师教育机构的医院提供对急诊科感染控制的书面评估。
303家医院中有51家(16.8%)没有关于急诊科感染控制的手册。在有急诊科手册的250家医院中,115家(46.0%)没有包括影像检查室消毒和灭菌的内容,只有44家(17.6%)有患者疑似或被诊断患有传染病时联系紧急医疗服务的标准。在303家医院中,277家(91.4%)为2009年大流行性流感编写了特定手册。在303家医院中,80家(26.4%)没有为2014年西非埃博拉病毒病疫情编写手册。此外,303家医院中有92家(30.4%)没有任何负压隔离病房。
在所研究的医院中,急诊科感染控制所需的实践和指南未得到充分涵盖。需要开展教育、信息共享并制定手册编写清单,以在急诊科建立更好的感染控制系统。