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洛杉矶县一家大型独立综合性癌症中心的 COVID-19 感染控制应对措施。

The COVID-19 infection control response at a large stand-alone comprehensive cancer center in Los Angeles County.

机构信息

Department of Infection Prevention and Control, City of Hope National Medical Center, Duarte, California, USA.

Department of Quality, Risk and Regulatory Management, City of Hope National Medical Center, Duarte, California, USA.

出版信息

Cancer Rep (Hoboken). 2023 Jan;6(1):e1669. doi: 10.1002/cnr2.1669. Epub 2022 Jul 1.

Abstract

BACKGROUND

The City of Hope National Medical Center (COH) is the only stand-alone comprehensive cancer center in Los Angeles, a county that was deemed a COVID-19 pandemic epicenter at the height of the 2020 winter surge. The immunocompromised patient population frequently experienced delays in infection control guidelines from local and government bodies due to minimal data available in comparison to the general population. This required COH to make swift, informed decisions for the best interest of the patient population.

AIM

Here, we review the comprehensive COVID-19 infection control response conducted at COH within the context of a high-risk patient population, predominately comprised of patients with hematologic malignancies.

METHODS AND RESULTS

This infection control response focused on prevention of COVID-19 transmission on campus, COVID-19 testing, and isolation management. These efforts consisted of COVID-19 screening, limitation of personnel on campus, source control, contact tracing, COVID-19 vaccination, establishment of in-house testing and implementation and management of COVID-19 testing. Between January 2020 and September 2021, COH implemented a robust in-house testing program, completed well over 1000 contact traces, ensured COVID-19 vaccinations were distributed to all eligible staff and patients, and established an algorithm for COVID-19 infection resolution, all without compromising the number of hematopoietic stem cell transplants (HCTs) performed, surgical volume, or healthcare-associated standardized infection ratios (SIR).

CONCLUSION

Institutional collaboration and attention to infection control was pivotal to minimizing the burden of the COVID-19 pandemic.

摘要

背景

希望之城国家医疗中心(COH)是洛杉矶唯一一家独立的综合性癌症中心,该县在 2020 年冬季疫情高峰期被认为是 COVID-19 大流行的中心。由于与普通人群相比,免疫功能低下的患者人群可获得的数据很少,因此他们经常延迟遵循当地和政府机构的感染控制指南。这要求 COH 为了患者群体的最佳利益迅速做出明智的决策。

目的

在这里,我们回顾了在高风险患者群体(主要由血液系统恶性肿瘤患者组成)背景下在 COH 进行的全面 COVID-19 感染控制应对措施。

方法和结果

该感染控制应对措施侧重于校园内 COVID-19 传播的预防、COVID-19 检测和隔离管理。这些措施包括 COVID-19 筛查、限制校园内人员、源头控制、接触者追踪、COVID-19 疫苗接种、建立内部检测以及实施和管理 COVID-19 检测。从 2020 年 1 月到 2021 年 9 月,COH 实施了一项强大的内部检测计划,完成了 1000 多次以上的接触追踪,确保 COVID-19 疫苗接种覆盖了所有符合条件的员工和患者,并制定了 COVID-19 感染解决方案的算法,所有这些都没有影响到造血干细胞移植(HCT)的数量、手术量或与医疗保健相关的标准化感染率(SIR)。

结论

机构间的合作和对感染控制的关注对于减轻 COVID-19 大流行的负担至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5e2/9875599/1f0a12f316a9/CNR2-6-e1669-g005.jpg

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