Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
BMJ Open. 2020 Dec 8;10(12):e041622. doi: 10.1136/bmjopen-2020-041622.
The aim of this review, conducted in April 2020, is to examine available national primary care guidelines for COVID-19 and to explore the ways in which these guidelines support primary care facilities in responding to the demands of the COVID-19 pandemic.
Rapid review and narrative synthesis.
PubMed, Embase and Google, as well as the websites of relevant national health departments, were searched from 1 January 2020 to 24 April 2020.
Documents included must be issued by a national health authority, must be specific to COVID-19 care, directed at healthcare workers or managers, and must refer to the role of primary care in the COVID-19 response.
We identified 17 documents from 14 countries. An adapted framework on primary care challenges and responses to pandemic influenza framed our analysis. Guidelines generally reported on COVID-19 service delivery and mostly made specific recommendations for ensuring continued delivery of essential primary care services through telehealth or other virtual care modalities. Few offered guidance to support surveillance as a public health function. All offered guidance on implementing outbreak control measures, largely through flexible and coordinated organisational models with partners from various sectors. There was a lack of guidance to support supply chain management and practice resilience in primary care, and lack of personal protective equipment represents a serious threat to the provision of quality care during the pandemic.
Current national primary care guidelines for COVID-19 provide guidance on infection control and minimising the risk of spread in primary care practices, while supporting the use of new technology and coordinated partnerships. However, to ensure primary care practice resilience and quality of care are upheld, guidelines must offer recommendations on supply chain management and operational continuity, supported by adequate resources.
本次综述于 2020 年 4 月进行，旨在考察当前针对 COVID-19 的国家初级保健指南，并探讨这些指南在哪些方面支持初级保健机构应对 COVID-19 大流行的需求。
快速审查和叙述性综合。
从 2020 年 1 月 1 日至 2020 年 4 月 24 日，检索了 PubMed、Embase 和 Google，以及相关国家卫生部门的网站。
纳入的文件必须由国家卫生部门发布，必须针对 COVID-19 护理，面向医疗保健工作者或管理人员，必须涉及初级保健在 COVID-19 应对中的作用。
我们从 14 个国家确定了 17 份文件。我们使用了一个经过改编的初级保健应对大流行性流感的挑战和应对框架来进行分析。这些指南通常报告了 COVID-19 的服务提供情况，并且主要针对通过远程医疗或其他虚拟护理模式确保基本初级保健服务的持续提供提出了具体建议。很少有指南提供支持监测作为公共卫生职能的建议。所有指南都提供了实施疫情控制措施的指导，主要是通过与来自不同部门的合作伙伴建立灵活和协调的组织模式。在初级保健中，缺乏支持供应链管理和实践弹性的指导，而个人防护设备的缺乏严重威胁到大流行期间提供高质量护理的能力。
目前针对 COVID-19 的国家初级保健指南提供了关于感染控制和最大限度减少初级保健实践中传播风险的指导，同时支持使用新技术和协调的伙伴关系。然而，为了确保初级保健实践的弹性和护理质量，指南必须提供关于供应链管理和运营连续性的建议，并提供充足的资源支持。
