In recent years, along with more importance having been given by health care facilities and health administrative departments nationally, the work force of infection prevention and control is constantly increasing. In the new era, to help infection prevention and control practitioners and all health care workers make the right direction in infection prevention and control professional business and make sure the infection prevention and control measures are implemented, what we need is to define the target of infection prevention and control scientifically, identify obligation subjects, and improve the infection prevention and control system and working mechanism from the top-level.
Objective To construct a multi-dimensional risk assessment system and scale for the prevention and control risk of respiratory infectious diseases in general hospitals, and make evaluation and early warning. Methods Through the collection of relevant literature on the prevention and control of respiratory infectious diseases during the period from January 1st, 2020 to December 31st, 2022, the articles related to the risk assessment of respiratory infectious diseases such as severe acute respiratory syndrome, COVID-19 and influenza A (H1N1) were screened, and the Delphi method was used to evaluate the articles and establish an indicator system. The normalized weight and combined weight of each item were calculated by analytic hierarchy process. The technique for order preference by similarity to the ideal solution method was used to calculate the risk composite index of 38 clinical departments in a tertiary general hospital in Jiangxi Province in December 2022. Results A total of 16 experts were included, including 4 with senior titles, 8 with associate senior titles, and 4 with intermediate titles. After two rounds of Delphi consult, a total of 4 first-level indicators, 11 second-level indicators, and 38 third-level indicators of risk assessment for the prevention and control of respiratory infectious diseases were determined. The reliability and validity of the scale were good. The top three items with the largest combined weights in the scale were spread by aerosol, spread by respiratory droplet, and commonly used instruments (inspection instruments and monitoring equipment). After a comprehensive analysis on the 38 departments, the top 10 departments in the risk index were the departments of medical imaging, pediatrics, ultrasound, cardiac and vascular surgery, infection, emergency, respiratory and critical care, general medicine, otolaryngology and neck surgery, stomatology, and obstetrics. Conclusions This study constructed the risk assessment scale of respiratory infectious diseases in general hospitals, and the scale has good reliability and validity. The use of this scale for risk assessment of general hospitals can provide a theoretical basis for the risk characteristics of prevention and control of respiratory infectious diseases in general hospitals.
Objective To evaluate the current status of human resources in healthcare-associated infection prevention and control (infection control) in Jiangxi Province, and explore the impact of emergency public health events on the human resources of infection control professionals in various levels and types of medical institutions. Methods From October 1st to 31st, 2023, questionnaire and on-site interviews were conducted to investigate the human resources situation of infection control professionals in various levels and types of medical institutions in Jiangxi Province. Three stages were selected for the investigation: before the outbreak of COVID-19 (before the event, December 2019), during the event (June 2022), and after the transition of COVID-19 (after the event, June 2023), focusing on the characteristics of human resources between before the event and after the event by the comparative analysis. Results Finally, 289 medical institutions were included. There was a statistically significant difference in the number of infection control professionals in medical institutions among 2019, 2022, and 2023 (χ2=189.677, P<0.001). The number of infection control professionals in 2019 was lower than that in 2022 (P<0.001) and 2023 (P<0.001), but there was no statistically significant difference between 2022 and 2023 (P=0.242). The number of infection control professionals per thousand beds in 2019, 2022, and 2023 was 4.40, 6.16, and 5.76, respectively. There was no statistically significant difference between 2019 and 2023 in terms of professional titles, gender, educational level, or professional background (P>0.05). Conclusion Emergency public health events have promoted the increase in the number of infection control professionals, but there is no statistical significance in the professional titles, educational level, or professional background of infection control professionals.
ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.
ObjectiveTo optimize procedures of going out for examination for patients with multidrug-resistant organism, strengthen prevention and control management of nosocomial infection, and prevent nosocomial infection.MethodsPatients with multidrug-resistant organism who went out for examination were selected from April to November 2018. April to July 2018 (before implementation) was process construction stage, and August to November 2018 (after implementation) was process optimization implementation stage. In April 2018, process and management system of going out for multidrug-resistant organism patients were formulated, training of transporters was strengthened, and measures such as checklist identification, accompany patients for examination, patient handover, isolation and protection, and disinfection of materials were implemented, to realize the infection prevention and control management in the whole process of going out for multidrug-resistant organism patients. We compared relevant indicators before and after implementation.ResultsA total of 262 cases times of patients with multidrug-resistant organism were included, including 134 cases times before implementation and 128 cases times after implementation. Compared with before implementation, the hand hygiene, wearing gloves, disinfection of inspection instruments and articles, patient transfer, isolation measures in waiting process (special elevator, isolation after waiting for inspection, arrange inspection time reasonably), education and training after implementation improved(P<0.05). Before and after implementation, the Methicillin resistant staphylococcus aureus detection rate difference was statistically significant (P<0.05).ConclusionsThe optimization of procedures of examination for patients with multidrug-resistant organism can increase implementation rate of indirect indicators such as hand hygiene, disinfection of inspection instruments and articles, isolation and protection, education and training in the prevention and control of multidrug-resistant organism in nosocomial infection. And it is important for the prevention and control of multi-disciplinary collaboration of multidrug-resistant organism.
Objective To scientifically evaluate the nosocomial infection prevention and control ability of respiratory infectious diseases in general hospitals, and to construct a set of quantitative assessment system for the prevention and control ability of respiratory infectious diseases in general hospitals. Methods Papers, standards and guidelines online related to respiratory hospital infections published between January 1, 2010 and December 31, 2023 were selected, and infection control experience was summarized to build a pool of evaluation pionts. Then, this study used experts consultation to select the evaluation pionts, to calculate the weight coefficient and reached a consensus on the quantitative evaluation methods of each evaluation point. Results A total of 27 articles were included. The evaluation system included 17 evaluation points in 4 categories: “Basic management capacity” “Basic conditions of facilities and equipments” “The prevention and control capacity of nosocomial infection” and “The emergency response capacity”. Each evaluation point contained 3 quantitative evaluation indicators. The Cronbach’s α coefficients of the expert questionnaire consultation were 0.914 and 0.883, respectively. The scale-level content validity index was 0.932, and the item-level content validity index ranged from 0.823 to 1. Conclusions The evaluation system constructed in this study can be used for quantitative evaluation and quality self-examination of the prevention and control ability of respiratory infectious diseases in general hospitals. It also contributes to the continuous improvement of the quality of nosocomial infection prevention and control.
To prevent and control 2019 novel coronavirus pneumonia diseases (COVID-19), hundreds of medical teams and tens of thousands of medical professionals throughout the nation were transferred to Hubei to assist COVID-19 control efforts. Medical professionals were at high risk of novel coronavirus pneumonia infections. To ensure the prevention and control of infection in medical teams and prevent cross-infection among medical staff at the medical station, this management standard includes routine management standards, resident disinfection, personnel entry and exit process, and logistics support management, so as to provide reference for medical teams combating COVID-19 in the future.
The prevention and control of hospital infection should be precise. Otherwise, a lot of medical resources will be wasted. To achieve accuracy, prevention and control should be considered from the microbial level to enhance its scientific nature. It is specifically reflected in the need of having knowledge of microorganisms, understanding the pathogens of infection and their transmission routes, therefore to carry out prevention and control work contrapuntally. Specific measures include infection surveillance at the microbial level, establishing the idea and habits of infection diagnosis from the microbial level, being familiar with microbial perspective to identify infection risks and vulnerabilities, implementing evidence-based prevention and control measures for different pathogens, encouraging researches on infection control and management at the microbial level, and developing precise prevention and control regulations, standards, or guidelines for specific pathogens.
Coronavirus disease 2019 has been widespread in Hubei province since the beginning of 2020. Many medical teams went to aid Hubei from the whole country. The medical team of West China Hospital of Sichuan University arrived in Jianghan district of Wuhan on January 25, 2020. As one of the earliest teams arriving Hubei, we explored the measures for infection prevention and control of resident, in order to reduce the risk for infection of medical team. The infection prevention and control experiences on the establishment of infection control team, process management, behavior management, clean disinfection, infection monitoring and emergency response and emergency response to exposure of the medical team of West China Hospital were summarized in this article.