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在越南建立医院基于事件的监测系统:一项定性研究,以确定事件报告的潜在促进因素和障碍。

Building the hospital event-based surveillance system in Viet Nam: a qualitative study to identify potential facilitators and barriers for event reporting.

机构信息

World Health Organization Viet Nam Country Office, Viet Nam.

Ha Noi University of Public Health, Viet Nam.

出版信息

Western Pac Surveill Response J. 2020 Sep 30;11(3):10-20. doi: 10.5365/wpsar.2019.10.1.009. eCollection 2020 Jul-Sep.

Abstract

INTRODUCTION

Hospitals are a key source of information for the early identification of emerging disease outbreaks and acute public health events for risk assessment, decision-making and public health response. The objective of this study was to identify potential facilitators and barriers for event reporting from the curative sector to the preventive medicine sector in Viet Nam.

METHODS

In 2016, we conducted 18 semi-structured, in-depth interviews, as well as nine focus group discussions, with representatives from the curative and preventive medicine sectors in four provinces. We transcribed the interviews and focus group discussions and used thematic analysis to identify the factors that appeared to affect public health event reporting.

RESULTS

We identified five major themes. First, the lack of a legal framework to guide reporting meant hospital staff relied on internal procedures that varied from hospital to hospital, which sometimes delayed reporting. Second, participants stated the importance of an enabling environment, such as leadership support and having focal points for reporting, to facilitate reporting. Third, participants described the potential benefits of reporting, such as support provided during outbreaks and information received about local outbreaks. Fourth, some challenges prohibited timely reporting such as not perceiving reporting to be the task of the curative sector and hesitancy to report without laboratory confirmation. Finally, limited resources and specialist capacities in remote areas hindered timely detection and reporting of unusual events.

DISCUSSION

This study identified potential opportunities to promote the detection and reporting of unusual events from health-care workers to the public health sector, and thus to improve the overall health security system in Viet Nam.The influenza virus is a respiratory pathogen that is transmitted through respiratory droplets. During seasonal influenza epidemics, high attack rates cause a significant public health burden. The infection is usually self-limited in young adults but can lead to severe infections in people in high-risk groups, including elderly people (> 65 years old), pregnant women, children aged 6-59 months and adults with chronic illnesses. .

摘要

简介

医院是早期识别传染病暴发和急性公共卫生事件的关键信息来源,可用于风险评估、决策和公共卫生应对。本研究的目的是确定越南从治疗部门向预防医学部门报告事件的潜在促进因素和障碍。

方法

2016 年,我们在四个省的治疗和预防医学部门代表中进行了 18 次半结构化深入访谈和 9 次焦点小组讨论。我们对访谈和焦点小组讨论进行了转录,并使用主题分析来确定似乎影响公共卫生事件报告的因素。

结果

我们确定了五个主要主题。首先,缺乏指导报告的法律框架意味着医院工作人员依赖于各医院不同的内部程序,这有时会延迟报告。其次,参与者表示,需要有一个有利的环境,如领导支持和报告的重点,以促进报告。第三,参与者描述了报告的潜在好处,例如在疫情期间提供的支持和收到的有关当地疫情的信息。第四,一些挑战阻止了及时报告,例如不认为报告是治疗部门的任务,在没有实验室确认的情况下不愿报告。最后,偏远地区资源有限和专业能力不足,阻碍了对异常事件的及时发现和报告。

讨论

本研究确定了一些潜在的机会,可以促进医疗保健工作者向公共卫生部门报告异常事件,从而改善越南整体卫生安全系统。流感病毒是一种通过呼吸道飞沫传播的呼吸道病原体。在季节性流感流行期间,高发病率会给公共卫生带来重大负担。这种感染通常在年轻人中是自限性的,但会导致高危人群(包括 65 岁以上的老年人、孕妇、6-59 个月大的儿童和患有慢性疾病的成年人)发生严重感染。

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