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2020 年 3 月,在纽约熟练护理养老院进行实时虚拟感染预防和控制评估:试点项目。

Real-time virtual infection prevention and control assessments in skilled nursing homes, New York, March 2020-A pilot project.

机构信息

Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Infect Control Hosp Epidemiol. 2022 Mar;43(3):351-357. doi: 10.1017/ice.2021.100. Epub 2021 Mar 19.

Abstract

OBJECTIVE

To describe a pilot project infection prevention and control (IPC) assessment conducted in skilled nursing facilities (SNFs) in New York State (NYS) during a pivotal 2-week period when the region became the nation's epicenter for coronavirus disease 2019 (COVID-19).

DESIGN

A telephone and video assessment of IPC measures in SNFs at high risk or experiencing COVID-19 activity.

PARTICIPANTS

SNFs in 14 New York counties, including New York City.

INTERVENTION

A 3-component remote IPC assessment: (1) screening tool; (2) telephone IPC checklist; and (3) COVID-19 video IPC assessment (ie, "COVIDeo").

RESULTS

In total, 92 SNFs completed the IPC screening tool and checklist: 52 (57%) were conducted as part COVID-19 investigations, and 40 (43%) were proactive prevention-based assessments. Among the 40 proactive assessments, 14 (35%) identified suspected or confirmed COVID-19 cases. COVIDeo was performed in 26 (28%) of 92 assessments and provided observations that other tools would have missed: personal protective equipment (PPE) that was not easily accessible, redundant, or improperly donned, doffed, or stored and specific challenges implementing IPC in specialty populations. The IPC assessments took ∼1 hour each and reached an estimated 4 times as many SNFs as on-site visits in a similar time frame.

CONCLUSIONS

Remote IPC assessments by telephone and video were timely and feasible methods of assessing the extent to which IPC interventions had been implemented in a vulnerable setting and to disseminate real-time recommendations. Remote assessments are now being implemented across New York State and in various healthcare facility types. Similar methods have been adapted nationally by the Centers for Disease Control and Prevention.

摘要

目的

描述在纽约州(NYS)一个关键的两周期间,对熟练护理设施(SNF)进行的感染预防和控制(IPC)试点项目评估,当时该地区成为美国 2019 年冠状病毒病(COVID-19)的中心。

设计

对处于高风险或正在发生 COVID-19 活动的 SNF 的 IPC 措施进行电话和视频评估。

参与者

包括纽约市在内的纽约州 14 个县的 SNF。

干预措施

远程 IPC 评估的 3 个组件:(1)筛选工具;(2)电话 IPC 清单;(3)COVID-19 视频 IPC 评估(即“COVIDeo”)。

结果

共有 92 家 SNF 完成了 IPC 筛选工具和清单:52 家(57%)是 COVID-19 调查的一部分,40 家(43%)是主动的基于预防的评估。在 40 项主动评估中,有 14 项(35%)发现了疑似或确诊的 COVID-19 病例。在 92 项评估中有 26 项(28%)进行了 COVIDeo,提供了其他工具可能会错过的观察结果:个人防护设备(PPE)不易获得、冗余或不当佩戴、脱下或存放,以及在特定人群中实施 IPC 的具体挑战。IPC 评估每次耗时约 1 小时,在类似的时间内,预计可覆盖到的 SNF 数量是现场访问的 4 倍。

结论

通过电话和视频进行的远程 IPC 评估是及时且可行的方法,可以评估脆弱环境中 IPC 干预措施的实施程度,并实时传播建议。远程评估目前正在纽约州各地以及各种医疗保健设施类型中实施。疾病预防控制中心(CDC)在全国范围内也采用了类似的方法。

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