Ma Li, Zou Shiyue, Liu Yanyi, Lai Jing, Yang Junhua
Department of Urology, Institute of Urology, West China Hospital Sichuan University, Chengdu, China.
The First People's Hospital of Longquanyi District, Chengdu, China.
Iran J Public Health. 2021 Feb;50(2):271-279. doi: 10.18502/ijph.v50i2.5339.
Coronavirus disease 2019 (COVID-19) has caused massive casualties, severe economic losses, and poses a threat to the world. This study's primary objective was to analyze the hospital's potential hazards of COVID-19 prevention and control. The second objective was to review the disaster plan and make recommendations to minimize the spread of COVID-19 in hospitals.
An expert group for the prevention and control of COVID-19 in the First People's Hospital of Long-quanyi Dis-trict, Chengdu, China was established. We adopted the hazard vulnerability analysis (HVA) to risk-stratify potential hazards and calculated relative risk values. We used the Delphi expert consultation method to propose and implement targeted improvement measures for the top five potential hazards. Then, the effects before and after the intervention were compared.
The top five hazards were: insufficient Personal Protective Equipment (PPE) (25.68%), inadequate diagnosis ability of clinicians (22.55%), and inadequate management strategies of patients and caregivers (22.38%), lack of professional ability of pre-checking and triage staff (16.96%), lack of knowledge of COVID-19 of medical staff (15.59%). After taking targeted improvement measures, the average score of the hospital staff's COVID-19 knowledge test increased from 73.26 points to 90.44 points, the average test score of the outsourcing company employees increased from 68.55 to 89.75 points. The differences were statistically significant <0.05).
HVA can be used to systematically risk-stratify potential threats, measure the probability of those potential hazards, and develop various hospital prevention and control measures for COVID-19 epidemics.
2019冠状病毒病(COVID-19)已造成大量人员伤亡、严重经济损失,并对全球构成威胁。本研究的主要目的是分析医院在COVID-19防控方面的潜在危害。第二个目的是审查灾难计划,并提出建议以尽量减少COVID-19在医院内的传播。
在中国成都龙泉驿区第一人民医院成立了COVID-19防控专家组。我们采用危害脆弱性分析(HVA)对潜在危害进行风险分层,并计算相对风险值。我们使用德尔菲专家咨询法针对排名前五的潜在危害提出并实施有针对性的改进措施。然后,比较干预前后的效果。
排名前五的危害分别是:个人防护装备(PPE)不足(25.68%)、临床医生诊断能力不足(22.55%)、患者及陪护人员管理策略不足(22.38%)、预检分诊人员专业能力不足(16.96%)、医务人员对COVID-19知识缺乏(15.59%)。采取针对性改进措施后,医院工作人员COVID-19知识测试平均得分从73.26分提高到90.44分,外包公司员工测试平均得分从68.55分提高到89.75分。差异具有统计学意义(<0.05)。
HVA可用于系统地对潜在威胁进行风险分层,衡量这些潜在危害的可能性,并制定针对COVID-19疫情的各种医院防控措施。