Practice of closed-loop group nursing model in the makeshift intensive care unit for coronavirus disease 2019_West China Medical Journal

Authors：

FENG Mei ¹ ,  LI Ka ² , ZHU Jing ¹ , WAN Qijing ³ , SONG Zhifang ¹

1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Fever Ward 4, Wuhan Red Cross Hospital, Wuhan, Hubei 430000, P. R. China;

Corresponding?author：

LI Ka, Email: lika127@126.com

Keywords：

Closed-loop group nursing model; Coronavirus disease 2019; Makeshift intensive care unit; Management practice

DOI：

10.7507/1002-0179.202003022

Video：

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Objective To explore the effect of closed-loop group nursing model on the makeshift intensive care unit (ICU) in a hospital specialized for coronavirus disease 2019 (COVID-19).Methods Several fever wards had been shifted into ICUs and ran by the first medical team from Sichuan Province from January 30th to March 19th, 2020. Closed-loop group nursing model was utilized. The nursing model activated the nurses in management by empowerment and nursing group establishment. To ensure standard of care, measures were carried out in this model, namely, improving the physical work environment, nurse training, optimizing composition of nursing manpower, fine and standardized management of medical resources, “double-chain” medical supply system, “3S” management on first aid kit, protecting patient safety and dignity, and developing emergency nursing workforce deployment plan.Results The implementation of closed-loop group nursing model showed good results in treating severe to critically ill COVID-19 patients regardless of shortages in nursing workforce and facilities. The rescue work was carried out successfully in the makeshift ICUs. All the nurses showed great teamwork and were really involved in the management of the wards. Conclusions As the current ICUs were not adequate for the increasing number of critically ill patients during the epidemic, it was unavoidable to transform other wards into ICUs. Closed-loop group nursing model was utilized to break the hierarchy. As a result, all nurses were empowered to participate in nursing management and their potential was fully inspired. Furthermore, this working model presented a clear working framework in multidisciplinary teamwork in a limited time, which also provided patients with dignity and safety.

Citation： FENG Mei, LI Ka, ZHU Jing, WAN Qijing, SONG Zhifang. Practice of closed-loop group nursing model in the makeshift intensive care unit for coronavirus disease 2019. West China Medical Journal, 2020, 35(9): 1030-1034. doi: 10.7507/1002-0179.202003022 Copy

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1. 國家衛生健康委辦公廳. 新型冠狀病毒感染的肺炎診療方案(試行第五版修正版). (2020-02-08)[2020-03-07]. http://www.nhc.gov.cn/yzygj/s7653p/202002/d4b895337e19445f8d728fcaf1e3e13a/files/ab6bec7f93e64e7f998d802991203cd6.pdf.
2. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 2020, 382(8): 727-733.
3. 國家衛生健康委員會. 新型冠狀病毒感染的肺炎納入法定傳染病管理. (2020-01-20)[2019-03-03]. http://www.nhc.gov.cn/jkj/s7915/202001/e4e2d5e6f01147e0a8df3f6701d49f33.shtml.
4. World Health Organization. WHO declares coronavirus outbreak a global health emergency. (2020-01-30)[2020-03-03]. https://www.statnews.com/2020/01/30/who-declares-coronavirus-outbreak-a-global-health-emergency/.
5. 國家衛生健康委辦公廳. 新型冠狀病毒感染的肺炎診療方案(試行第六版). (2020-02-18)[2020-03-07]. http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2/files/b218cfeb1bc54639af227f922bf6b817.pdf.
6. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 2020, 395(10223): 514-523.
7. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus, infected pneumonia. N Engl J Med, 2020, 382(13): 1199-1207.
8. 李星梅, 張翠萍, 郭建新. 成組護理管理模式的應用對比研究. 解放軍護理雜志, 2009, 26(8A): 67-68.
9. 謝娥. 閉環管理模式在護理隱患排查處理中的應用. 護理實踐與研究, 2016, 13(15): 104-106.
10. 倪忠, 秦浩, 李潔, 等. 新型冠狀病毒肺炎患者經鼻高流量氧療使用管理專家共識. 中國呼吸與危重監護雜志, 2020, 19(2): 120-124.
11. 葛慧青, 代冰, 徐培峰, 等. 新型冠狀病毒肺炎患者呼吸機使用感染管理專家共識. 中國呼吸與危重監護雜志, 2020, 19(2): 116-119.
12. 羅紅, 張晗. 俯臥位通氣的細節與實施. 中華結核和呼吸雜志, 2016, 39(9): 666-668.
13. 廖浩, 宋景春. 重癥加強治療病房危重患者俯臥位通氣墊的研制與使用. 中國呼吸與危重監護雜志, 2020, 19(1): 78-80.
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16. 劉于, 汪暉, 陳軍華, 等. 突發新型冠狀病毒肺炎疫情的護理人力及物力應急管理. 中華護理雜志, 2020, 55(3): 343-346.
17. 夏晴晴. 閉環反饋控制模式在精神科護理管理中的應用. 中醫藥管理雜志, 2018, 26(18): 132-133.
18. 楊梅. 正反饋閉環管理系統在泌尿外科護理中的應用. 中醫藥管理雜志, 2017, 25(1): 181-182.

West China Medical Journal

Practice of closed-loop group nursing model in the makeshift intensive care unit for coronavirus disease 2019

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