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在 COVID-19 大流行期间,感染控制监测工作组和感染控制协调员团队对医护人员感染预防和控制措施进行监测。

Surveillance of the infection prevention and control practices of healthcare workers by an infection control surveillance-working group and a team of infection control coordinators during the COVID-19 pandemic.

机构信息

Infection Control Department, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea; Department of Pediatrics, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea.

Quality Improvement Unit, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea.

出版信息

J Infect Public Health. 2021 Apr;14(4):454-460. doi: 10.1016/j.jiph.2021.01.012. Epub 2021 Jan 30.

Abstract

BACKGROUND

During the ongoing coronavirus disease (COVID-19) pandemic, hospitals have strengthened their guidelines on infection prevention and control (IPC), and a rigorous adherence to these guidelines is crucial. An infection control surveillance-working group (ICS-WG) and infection control coordinators (ICCs) team were created to monitor the IPC practices of the healthcare workers (HCWs) in a regional hospital in Korea. This study analyzed the surveillance results and aimed to identify what IPC practices needed improvement.

METHODS

During phase 1 (March to April 2020), the ICS-WG performed random audits, recorded incidences of improper IPC practices, and provided advice to the violators. During phase 2 (April to July), the ICCs inspected the hospital units and proposed practical ideas about IPC. The surveillance and proposals targeted the following practices: patient screening, usage of personal protective equipment (PPE), hand and respiratory hygiene, equipment reprocessing, environmental cleaning, management of medical waste, and social distancing.

RESULTS

In phase 1, of the 127 violations observed, most (32.3%) corresponded to hand and respiratory hygiene. In phase 2, the highest proportion of violation per category was observed in the management of medical waste (37.8%); among these, a higher proportion of violation (71.4%) was observed in the collection of medical waste. Of the 106 proposals made by the ICCs, the most addressed practice was patient screening (28.3%). No case of nosocomial infection was reported during the study period.

CONCLUSION

Adherence to proper hand and respiratory hygiene was inadequate at the early stage of the COVID-19 pandemic. The results indicate that more attention and further training are needed for the management of medical waste, particularly medical waste collection, and that continuous upgrading of the strategies for patient screening is essential. These results will be useful in helping other healthcare facilities to establish their IPC strategies.

摘要

背景

在持续的冠状病毒病(COVID-19)大流行期间,医院加强了感染预防和控制(IPC)的指南,严格遵守这些指南至关重要。韩国一家地区医院成立了感染控制监测工作组(ICS-WG)和感染控制协调员(ICC)团队,以监测医护人员(HCWs)的 IPC 实践。本研究分析了监测结果,旨在确定哪些 IPC 实践需要改进。

方法

在第一阶段(2020 年 3 月至 4 月),ICS-WG 进行了随机审计,记录了不当 IPC 实践的事件,并向违规者提供了建议。在第二阶段(4 月至 7 月),ICC 检查了医院科室,并就 IPC 提出了切实可行的想法。监测和建议针对以下实践:患者筛查、个人防护设备(PPE)的使用、手和呼吸卫生、设备再处理、环境清洁、医疗废物管理和社交距离。

结果

在第一阶段,观察到的 127 起违规行为中,大多数(32.3%)与手和呼吸卫生有关。在第二阶段,每一类违规行为中比例最高的是医疗废物管理(37.8%);其中,医疗废物收集的违规比例(71.4%)更高。ICC 提出的 106 项建议中,最多的是患者筛查(28.3%)。研究期间没有发生医院感染病例。

结论

在 COVID-19 大流行的早期,适当的手和呼吸卫生习惯遵守情况不足。结果表明,需要进一步关注和培训医疗废物管理,特别是医疗废物收集,并且需要不断升级患者筛查策略。这些结果将有助于其他医疗机构制定 IPC 策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eed6/7847193/92d56f9eb0dd/gr1_lrg.jpg

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