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意大利帕多瓦三级医院在新冠疫情期间保障CT工作流程的改良组织模式回顾性分析

Retrospective Analysis of a Modified Organizational Model to Guarantee CT Workflow during the COVID-19 Outbreak in the Tertiary Hospital of Padova, Italy.

作者信息

Cester Giacomo, Giraudo Chiara, Causin Francesco, Boemo Deris Gianni, Anglani Mariagiulia, Capizzi Alfio, Carretta Giovanni, Cattelan Annamaria, Cecchin Diego, Cianci Vito, Crisanti Andrea, De Conti Giorgio, Donato Daniele, Flor Luciano, Gabrieli Joseph-Domenico, Munari Marina, Navalesi Paolo, Ponzoni Alberto, Scapellato Maria Luisa, Tiberio Ivo, Vianello Andrea, Stramare Roberto

机构信息

Department of Diagnostic Imaging and Interventional Radiology, Neuroradiology, Padua University Hospital, 35128 Padua, Italy.

Department of Medicine-DIMED, Institute of Radiology, Padua University Hospital, 35128 Padua, Italy.

出版信息

J Clin Med. 2020 Sep 21;9(9):3042. doi: 10.3390/jcm9093042.

Abstract

At the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) outbreak in Italy, the cluster of Vò Euganeo was managed by the University Hospital of Padova. The Department of Diagnostic Imaging (DDI) conceived an organizational approach based on three different pathways for low-risk, high-risk, and confirmed Coronavirus Disease 19 (COVID-19) patients to accomplish three main targets: guarantee a safe pathway for non-COVID-19 patients, ensure health personnel safety, and maintain an efficient workload. Thus, an additional pathway was created with the aid of a trailer-mounted Computed Tomography (CT) scanner devoted to positive patients. We evaluated the performance of our approach from February 21 through April 12 in terms of workload (e.g., number of CT examinations) and safety (COVID-19-positive healthcare workers). There was an average of 72.2 and 17.8 COVID-19 patients per day in wards and the Intensive Care Unit (ICU), respectively. A total of 176 high-risk and positive patients were examined. High Resolution Computed Tomography (HRCT) was one of the most common exams, and 24 pulmonary embolism scans were performed. No in-hospital transmission occurred in the DDI neither among patients nor among health personnel. The weekly number of in-patient CT examinations decreased by 27.4%, and the surgical procedures decreased by 29.5%. Patient screening and dedicated diagnostic pathways allowed the maintenance of high standards of care while working in safety.

摘要

在意大利严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫情爆发初期,沃埃加内奥聚集性疫情由帕多瓦大学医院负责管理。诊断影像科(DDI)构思了一种组织方法,针对低风险、高风险和确诊的冠状病毒病19(COVID-19)患者采用三种不同途径,以实现三个主要目标:为非COVID-19患者保证一条安全途径、确保医护人员安全以及维持高效的工作量。因此,借助一台用于确诊患者的车载计算机断层扫描(CT)扫描仪开辟了一条额外途径。我们评估了2月21日至4月12日我们这种方法在工作量(如CT检查数量)和安全性(COVID-19呈阳性的医护人员)方面的表现。病房和重症监护病房(ICU)每天平均分别有72.2名和17.8名COVID-19患者。总共对176名高风险和确诊患者进行了检查。高分辨率计算机断层扫描(HRCT)是最常见的检查之一,还进行了24次肺栓塞扫描。在诊断影像科,患者和医护人员中均未发生院内传播。住院患者CT检查的周数量减少了27.4%,外科手术减少了29.5%。患者筛查和专门的诊断途径使得在安全工作的同时能够维持高标准的医疗护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a93/7563301/84c13f202fb9/jcm-09-03042-g001.jpg

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