From SARS to the prevention and control of new crown hospital sense

"You can't go What do we do when you go?" To this day, Li Liuyi, director of infection management department of Peking University First Hospital, still can't forget that when SARS was raging in Beijing in April 2003, she was transferred to SARS special hospital to be responsible for hospital sense monitoring When she was on her way, her colleagues in the hospital held her back "At that time, when the medical staff saw their colleagues in the hospital, they realized that they were safe." Many years later, Li Liuyi recalled the past and expressed such sentiments to the media According to the data of the former Ministry of health, from the end of 2002 to 10:00 on August 16, 2003, there were 5327 clinically diagnosed cases of SARS, 4959 cured and discharged from hospital, 349 died (another 19 died of other diseases, not included in the death toll of SARS cases) [1] At that time, most of the medical institutions in China had weak hospital sense consciousness, which made some hospitals become the focus of the spread of SARS, and the medical staff fighting at the front line became the biggest victims of the SARS epidemic After all, the prevention and control of hospital sense in China started in 1986 In the early nineties of last century, a National Institute of hospital sense control was established to promote the work of hospital sense control In 1994, China promulgated the first "hospital infection management standard (Trial)", which will be further revised and improved in 2000 In 2001, the diagnostic standard of hospital infection was issued, which included the infection of medical staff in hospital into the scope of hospital infection, emphasizing that the prevention and control of hospital infection should not only protect the medical safety of patients, but also the safety of medical staff at work Nowadays, in many hospitals, the first thing we see in front of the outpatient building is the arrow indicating the fever outpatient service, which is the "mark" left by "SARS" to the hospital In the development of hospital management in China, the influence of SARS is far more than these The tragic lesson of SARS is a wake-up call for the health system, and it also promotes the prevention and control of hospital sense from a specific function to system construction, and the national level has also carried out long-term planning and deployment In 2006, the former Ministry of Health established the hospital infection control standard committee to guide the prevention and control of hospital infection from the perspective of laws and regulations After the establishment of the standards committee, the standard framework system was established, and the standards of hospital infection were established in order of the importance of specific monitoring work In 2009, the Committee issued the first batch of hospital infection standards in China, including hospital infection monitoring, hand hygiene, disinfection and supply center, isolation technical specifications, etc In 2012, the committee published a second set of standards In terms of management, the measures for the management of hospital infection was issued in 2006; in 2012, the former Ministry of health formulated a three-year action plan for the control of hospital infection, requiring all provinces and cities to establish a quality control center for hospital infection, and set about the establishment of a national quality control center for hospital infection The endless policy documents make the hospital's attitude to frequently urging medical staff to pay attention to hand hygiene and other inconspicuous "little things" changed from not paying attention to them to have to pay attention to them The novel coronavirus pneumonia outbreak occurred this Spring Festival As compared with 17 years ago, this time in the prevention and control of hospital sense, from the competent department to medical institutions, there is obviously a more professional and calm At the beginning of novel coronavirus pneumonia, the national health and Health Committee and the hospitals at all levels have launched the operation process of environmental disinfection, medical care protection and so on Novel coronavirus pneumonia was treated in the infectious diseases department of Wuhan University from January 7, 2020 to January 27th, and no case of infection was found in the Department, the China Youth Daily reported The Wuhan University people's Hospital in the disaster hit area of Shanghai, China, from January 27th to January 27th How did you hand in the excellent answer sheet? "On a daily basis, we have repeatedly stressed the sense of control of medical staff, requiring that we should do a good job of corresponding protection against different levels of infectious diseases," Yu Zhui, deputy director of the Department of critical medicine, said in an interview with the media The level of hospital infection prevention and control before the major epidemic is also a microcosm of the hospital's daily hospital infection work In recent years, hand hygiene awareness, the monitoring of drug-resistant bacteria and other indicators closely related to hospital sense have been included in the performance evaluation of the Department by the hospital, and the awareness of hospital sense of medical workers is also increasing In the Cancer Hospital of Peking University, the hand hygiene publicity month has been held for 7 consecutive years, and the clinical participation rate has increased year by year As Zhang Ji, director of the Department of Department of psychiatry of the hospital, said in an interview with the health community, "hospital sensory control is not only a technical management movement, but also a spread of ideas, and hand hygiene is my first hand Hand hygiene can best represent the spirit of hospital sense - prevention and control of infection, it can reduce the incidence of hospital infection, and it is a link that can not be ignored in any standard medical operation " The same attention has been paid to hand hygiene in the Department of abdominal oncology, West China Hospital, Sichuan University The health community learned that quick drying hand disinfectant was placed at the entrance of each ward in the abdominal Oncology Department of West China Hospital, and the steps of six step washing technique and warm prompt were posted beside the disinfectant, supervised by the general affairs nurse, and the disinfectant was changed regularly These measures greatly facilitate the medical staff to disinfect their hands in time before and after contacting patients, improve the compliance of hand hygiene, and play a role of escort for hospital sense prevention and control After all, the purpose of the continuous upgrading of macro policies and medical awareness is to give patients a higher level of security "Five kinds of multidrug-resistant bacteria - Enterococcus aureus, coliform baumannia are more difficult", "seven risk factors - sharp instrument free implantation, three tubes and all mouths" These pithy words have been deeply rooted in the minds of every medical worker in Qilu Hospital of Shandong University in recent years In order to facilitate the medical staff to remember the common trivial hospital sense points in clinical practice, Qilu Hospital forms the hospital sense knowledge into a formula and pocket book that are easy to remember, which not only does not increase the clinical burden of employees, but also can be well integrated into clinical practice and clinical services, so that patients are more safe Talking about the prevention and control of hospital sense and patient safety, we have to mention the most common clinical treatment method of intravenous infusion, in which the basic infusion as the carrier of intravenous medication, its quality plays an important role in ensuring the safety of patients The Department of health in the state of Naxi once received a report that a 56 year old patient was infected with Aspergillus meningitis after using injection in a medical institution The Department of health in the state of Naxi, in combination with CDC, found 519 samples of patients, 173 of them were confirmed to be infected, and 153 of them were infected with the fungus Similar events are not uncommon in the medical field In order to avoid adverse events such as nosocomial infection when using injection, the hospital and the whole pharmaceutical industry are constantly improving quality control, such as improving the indicators such as bacterial endotoxin, leakage rate and injection configuration on the basis of qualification In addition, high quality injection packaging and design is also an important "checkpoint" to ensure the safety of intravenous medication On August 24, 2018, China Pharmaceutical Packaging Association issued and implemented the evaluation guide for clinical use of basic infusion (hereinafter referred to as the "evaluation guide"), which provides reference standards for medical institutions to evaluate the quality of injection from the industry level The existing guidelines for enterprise benchmarking evaluation continue to optimize injection packaging technology and design concept For example, some fully closed soft bag injections on the market adopt independent double pipe and double valve design, which is specially designed for the mouth, so as to reduce the possibility of cross infection in the process of configuration and infusion, so as to ensure the safety of drug use; there are also advanced technologies such as radio frequency sealing instead of heat sealing, which can greatly reduce the occurrence of drug leakage events It has been reported in literature that the optimization of this technology can even make it leak The rate is reduced to 0.0014% [2]; at the same time, the high-quality fully closed infusion soft bag can be emptied without external exhaust needle or infusion set with exhaust valve, and the residual amount of drug solution is less than 5% or even less than 2% of the marked volume [3], and the contact between external air and infusion can also greatly reduce the risk of cross infection of patients Prevention and control of the epidemic, hospital first After the baptism of SARS, as well as the continuous construction and improvement of hospital sense prevention and control system in China over the past decade, the awareness of medical staff has been continuously enhanced, and the quality of medical equipment has been continuously upgraded It will be soon to win this epidemic Resistance War.