临床外科杂志 ›› 2020, Vol. 28 ›› Issue (5): 493-495.doi: 10.3969/j.issn.1005-6483.2020.05.029

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  1. 华中科技大学同济医学院附属同济医院手术室
  • 出版日期:2020-05-20 发布日期:2020-05-20

Work strategy in operating room in the prevention and control of COVID19

  • Online:2020-05-20 Published:2020-05-20

摘要: 由于新冠肺炎(COVID19)感染病例数的急剧增加,有负压手术间的感染性专科医院已无法满足COVID19病人的手术需求,综合性医院接收疑似或确诊的COVID19急诊病人的手术治疗无法避免,落实新冠病毒感染防控手术室工作策略迫在眉睫。防控期主要通过隔离手术区域的选择与改造使其达到三区两通道等独立手术区的要求;整个手术团队成员紧急培训与考核评估(手术医生、麻醉师、手术护士、辅助人员),做到既可双向防护,又可避免防护物资浪费,预防感染传播和防止防护物质更加紧缺;防护物资紧急调配、储存与管理,以保证临床需求;人力资源遴选及调配方案的快速制定与公布,关怀员工(特别是支援发热门诊、ICU和方舱医院等手术室外区域工作的护士),以快速应对手术和手术室外的支援;手术流程及应急预案的修订与共享,使整个团队成员知晓并遵守,防止自身感染,减少冲突;加强与援鄂医疗队之间的沟通,以便为援鄂医务人员提供紧急医疗服务。在防控过程中,最大的难度与挑战是临床医护人员进行新冠肺炎感染防控知识和技能的培训,合理人力资源调配与关怀及足够的知识储备以消除员工恐慌是关键,多学科协作讨论进行隔离区改建、流程修订和手术配合是保障,有序分组责任制是高效落实各项准备的有力推手。

关键词: 新冠肺炎, 感染防控, 手术室, 管理, 策略

Abstract: Due to the sharp increase of COVID19 infected cases,infectious specialized hospitals with negative pressure operating rooms have been unable to satisfy the needs of COVID19 surgical patients,and it is inevitable for general hospitals to make surgical treatment of suspected or confirmed emergency COVID19 patients.Therefore,it is urgent to implement the practice in the operating room at the stage of prevention and control of COVID19.During this period,the isolated operation area should be selected and transformed to meet the requirements of the three areas and two channels.The emergency training and assessment of the whole surgical team members(surgeons,anesthesiologists,surgical nurses,auxiliary staff)can not only provide mutual protection,but also avoid the waste of protective supplies,prevent the spread of infection and more shortage of protection materials.Emergency deployment,storage and management of protective supplies are to ensure clinical requirements.Rapid development of human resources plans,care of staff(especially nurses who support fever clinic,ICU and compartment hospital)quickly respond to the human support in and out of OR.Revision and sharing of surgical procedures and emergency plans,so that the whole team members know how to prevent from infection and compliant.Strengthen the communication with the medical aid teams for Hubei province to better deal with the emergency operation service for them.In the process of the practice,we realize the skills training with the infection prevention and control measures for medical staff is the biggest difficulty and challenges,reasonable human resource deployment and humanistic care and knowledge reserves are the key points to eliminate panic among employees,multidisciplinary collaborative discussion is to guarantee the area reconstruction and process revision,orderly grouping responsibility system is the driving force to carry out the practice efficiently.

Key words: coronavirus disease 2019, 〓infection prevention and control, 〓operating room, 〓management, 〓strategy

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