闭环管理下的急诊支援一线医护人员医院获得性 COVID-19 防控现状的影响因素：一项横断面研究。
Influencing factors of hospital-acquired COVID-19 prevention and control status among emergency support frontline healthcare workers under closed-loop management: a cross-sectional study.
机构信息
Department of Hospital Infection Control, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Department of Hospital Infection Control, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China.
出版信息
Front Public Health. 2023 Jul 27;11:1209646. doi: 10.3389/fpubh.2023.1209646. eCollection 2023.
BACKGROUND
This study aimed to understand the hospital-acquired COVID-19 infection rate and infection prevention and control status of emergency support frontline healthcare workers (ESFHCWs) under closed-loop management, and to explore the related factors affecting hospital-acquired COVID-19 prevention and control status.
METHODS
The study site was a provincial-level tertiary hospital in the Xinjiang Uygur Autonomous Region specializing in treating COVID-19 patients. ESFHCWs were assigned from different hospitals in Zhejiang Province to provide emergency medical support in this specialized hospital. All ESFHCWs were managed using a closed loop. A self-designed questionnaire was used to estimate basic information, work experience, and the status of infection prevention and control (SIPC). A total of 269 ESFHCWs responded to the questionnaire. A generalized linear regression model was used to estimate the factors influencing SIPC.
RESULTS
There were six hospital-acquired COVID-19 cases, with an infection rate of 2.23%. The independent risk factors influencing COVID-19 prevention and control status were work seniority, anxiety disorder, and consumption of gastrointestinal, anti-inflammatory and anti-asthmatic, and hypnotic sedative drugs. Compared with ESFHCWs with more than 10 years of work seniority, ESFHCWs with less than 5 years of work seniority and 5-10 years of work seniority had lower COVID-19 SIPC scores. Among ESFHCWs with anxiety disorder, the SIPC score was significantly lower than that of ESFHCWs without anxiety disorder. The SIPC scores of ESFHCWs taking other medications (gastrointestinal, anti-inflammatory and anti-asthmatic, and hypnotic sedative drugs) were lower than those of ESFHCWs who did not.
CONCLUSION
The closed-loop management method may be effective in reducing the infection rate of hospital-acquired COVID-19 among ESFHCWs. HCWs with less than 10 years of work seniority, anxiety disorder, and other medications (gastrointestinal, anti-inflammatory and anti-asthmatic, and hypnotic sedative drugs) were probably not suitable for participating in emergency assistant actions because of their poor SIPC scores. Further studies are needed to develop the selection criteria for ESFHCWs.
背景
本研究旨在了解闭环管理下的应急支援前线医护人员（ESFHCWs）的医院获得性 COVID-19 感染率和感染预防控制状况，并探讨影响医院获得性 COVID-19 预防控制状况的相关因素。
方法
研究现场为新疆维吾尔自治区一家专门收治 COVID-19 患者的省级三级医院。从浙江省不同医院抽调 ESFHCWs 到该专科医院提供紧急医疗支援。所有 ESFHCWs 均采用闭环管理。使用自行设计的问卷评估基本信息、工作经验和感染预防控制状况（SIPC）。共有 269 名 ESFHCWs 对问卷做出回应。使用广义线性回归模型估计影响 SIPC 的因素。
结果
共发生 6 例医院获得性 COVID-19 病例，感染率为 2.23%。影响 COVID-19 预防控制状况的独立危险因素为工作年限、焦虑障碍和使用胃肠、抗炎和抗哮喘以及催眠镇静药物。与工作年限超过 10 年的 ESFHCWs 相比，工作年限不足 5 年和 5-10 年的 ESFHCWs 的 COVID-19 SIPC 评分较低。有焦虑障碍的 ESFHCWs 的 SIPC 评分明显低于无焦虑障碍的 ESFHCWs。使用其他药物（胃肠、抗炎和抗哮喘以及催眠镇静药物）的 ESFHCWs 的 SIPC 评分低于未使用药物的 ESFHCWs。
结论
闭环管理方法可能有效降低 ESFHCWs 医院获得性 COVID-19 的感染率。工作年限不足 10 年、有焦虑障碍和使用其他药物（胃肠、抗炎和抗哮喘以及催眠镇静药物）的 HCWs 可能由于 SIPC 评分较低，不适合参与应急助理行动。需要进一步研究来制定 ESFHCWs 的选拔标准。
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