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针对大型非新冠定点医院医护人员感染的新冠检测策略。

COVID-19 testing strategy in response to infection among healthcare workers in a large non-COVID-designated hospital.

机构信息

Clinical Research Centre, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.

Occupational Health Unit, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.

出版信息

Hosp Pract (1995). 2021 Apr;49(2):110-118. doi: 10.1080/21548331.2020.1857999. Epub 2020 Dec 16.

DOI:10.1080/21548331.2020.1857999
PMID:33249880
Abstract

Sarawak General Hospital, which is the only public access tertiary referral center in Sarawak State for all clinical specialties, was designated a hybrid hospital to treat both COVID-19 and non-COVID-19 patients. During the initial surge of patients admitted with COVID-19, there was also a corresponding increase in health-care workers (HCWs) detected with COVID-19 infection. The latter being isolated, and the large number of staff members that had come into contact with COVID-19 being quarantined from work, placed further strain on the health-care services. The staff mass screening strategy was a policy decision made by the hospital in response to infection among HCWs, and it aimed to reduce in-hospital transmission (particularly among asymptomatic staff), mitigate workforce depletion due to quarantining, and protect the health-care workforce. In this study, we assessed the detection rate of COVID-19 infection from staff mass testing over a five-week period, and described our experience of adopting this surveillance screening strategy alongside ongoing contact tracing and symptomatic screening strategies. Although it was thought that such periodic staff surveillance might be helpful in protecting the health-care workforce within a short period, the long-term implications, especially in settings with limited resources, is significant and therefore explored in this paper. Our findings might provide an evidence-based reference for the future planning of an optimal strategy with the least compromise in care for a larger proportion of non-COVID-19 patients amid efforts against COVID-19 in a large non-COVID-designated hospital with hybrid status.

摘要

砂拉越综合医院是砂拉越州唯一的所有临床专科的公共三级转诊中心,被指定为混合医院,以治疗 COVID-19 和非 COVID-19 患者。在最初大量 COVID-19 患者入院期间,也相应地增加了检测到 COVID-19 感染的医护人员 (HCWs)。这些人被隔离,而大量接触过 COVID-19 的员工被隔离在家,这给医疗服务带来了更大的压力。员工大规模筛查策略是医院针对 HCWs 感染做出的政策决定,旨在减少院内传播(特别是无症状员工),减轻因隔离而导致的劳动力枯竭,并保护医护人员。在这项研究中,我们评估了在五周内通过员工大规模检测发现 COVID-19 感染的检出率,并描述了我们在实施这种监测筛查策略的同时,结合正在进行的接触者追踪和症状筛查策略的经验。虽然人们认为这种定期的员工监测可能有助于在短时间内保护医护人员,但在资源有限的情况下,长期影响是重大的,因此在本文中进行了探讨。我们的研究结果可能为在大的非 COVID 指定混合医院中,在应对 COVID-19 的同时,为尽可能减少对非 COVID-19 患者的护理影响,规划出一种最佳策略提供一个基于证据的参考。

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