Kwan Wai-Man, Mok Chun-Keung, Kwok Yick-Ting, Lam Hon-Wai, Chan Kwan-Ho, Law Tat-Hong Samuel, Leung Pik-Man, Mak Man-Yu, Que Tak-Lun, Tang Yiu-Hang
Quality and Safety Division, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong.
Medicine and Geriatrics Department, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong.
BMJ Open Qual. 2020 Nov;9(4). doi: 10.1136/bmjoq-2020-000990.
Since the outbreak of COVID-19 in December 2019, there had been global shortage of personal protective equipment (PPE) supply due to the breakage of supply chain and also the forbidding of PPE exported by various countries. This situation had greatly affected the healthcare services in local hospitals of Hong Kong. To maintain the availability of PPE for healthcare workers in high-risk clinical settings, the cluster management of New Territories West Cluster, Hospital Authority, had implemented a bundle of interventions in controlling and managing the PPE consumption and ensuring its proper use. A Taskforce on Management of PPE was set up in February 2020 with the aim to monitor and manage the use of PPE in five local hospitals and eight general outpatient clinics of New Territories West Cluster, which were governed in a cluster basis, under the COVID-19 epidemic. Interventions including cutting down non-essential services, implementing telecare, monitoring PPE consumption at unit level and PPE stock at the Cluster Central Distribution Centre and forming mobile infection teams were implemented. The updated PPE standards and usage guidelines to clinical staff were promulgated through forums, newsletters and unit visits. The PPE consumption rates of individual unit were reviewed. Significant decrease in PPE consumption rates was noted when comparing with the baseline data. Comparing the data between 20 February and 1 June 2020, the overall PPE consumption rates were reduced by 64% (r=-0.841; p<0.001) while the PPE consumption rates in anaesthesia and operating theatres, and isolation and surveillance wards were reduced by 47% (r=-0.506; p=0.023) and 49% (r=-0.810; p<0.001), respectively. A bundled approach, including both administrative measures and staff education, is effective in managing PPE consumption during major infection outbreaks especially when PPE supply is at risk.
自2019年12月新型冠状病毒肺炎疫情爆发以来，由于供应链中断以及各国禁止个人防护装备（PPE）出口，全球出现了个人防护装备供应短缺的情况。这种情况严重影响了香港本地医院的医疗服务。为了确保高危临床环境下医护人员能够获得个人防护装备，医院管理局新界西医院联网实施了一系列干预措施，以控制和管理个人防护装备的消耗，并确保其正确使用。2020年2月成立了个人防护装备管理特别工作组，旨在监测和管理新界西医院联网的五家本地医院和八家普通科门诊诊所（这些机构在疫情期间以联网形式进行管理）在2019冠状病毒病疫情期间个人防护装备的使用情况。采取的干预措施包括减少非必要服务、实施远程护理、在科室层面监测个人防护装备的消耗以及在联网中央配送中心监测个人防护装备库存，并组建流动感染控制小组。通过研讨会、通讯和科室走访等方式，向临床工作人员发布了最新的个人防护装备标准和使用指南。对各科室的个人防护装备消耗率进行了审查。与基线数据相比，个人防护装备消耗率显著下降。比较2020年2月20日至6月1日的数据，整体个人防护装备消耗率降低了64%（r=-0.841；p<0.001），而麻醉科和手术室以及隔离和监测病房的个人防护装备消耗率分别降低了47%（r=-0.506；p=0.023）和49%（r=-0.810；p<0.001）。包括行政措施和员工教育在内的综合方法，在重大感染疫情期间管理个人防护装备消耗方面是有效的，尤其是在个人防护装备供应面临风险的情况下。
