Wuhan Leishenshan Hospital was built within 12 days during the key period of fighting against coronavirus disease 2019 (COVID-19) in Wuhan. It was a field infectious disease hospital with 1500 beds. Due to the emergency of the epidemic situation, the operation mode of “parallel of construction, acceptance, training and treatment” was employed. During the peak period, nearly 3000 medical workers and 13000 builders worked on the same site. In 67 days, 2 011 patients with COVID-19 were treated. Through the bundle infection prevention and control (IPC) measures, Wuhan Leishenshan Hospital achieved zero infection, zero accident, and low level pollution of SARS-CoV-2 (0.3%) by environment monitoring. The bundle IPC measures of Leishenshan Hospital not only provided prevention and control experience for other field infectious disease hospitals at domestic and abroad during the period of COVID-19, but also put forward ideas and work flow for other medical institutions to deal with emerging infectious diseases.
In recent years, the widespread use of medical devices has led to the increasing frequency of device related pressure injuries (DRPI), which seriously affects the quality of life of patients and increases the burden on the healthcare system. The management model of DRPI has become an effective means of coping. This article reviews the application status of the care bundles model, SSKIN clinical management model, SECURE clinical management model in the prevention of DRPI. According to the characteristics of different management models, the key steps of implementation are given, aiming to provide a reference for exploring the prevention and management model of DRPI suitable for China’s national conditions.
ObjectiveTo study the effect of new bundle interventions on medical staff’s cognition of occupational exposure protection and exposure rate, and provide evidence for reducing medical staff’s occupational exposure.MethodsThe 1 435 medical practitioners in 37 clinical/technical departments of Nanchong Central Hospital were selected as the research objects. Bundle intervention strategies about occupational exposure for whole population and high risk population were implemented, and the medical staff’s cognition of occupational exposure, occurrence of occupational exposure, and post-exposure reporting in 2017 (before intervention) and 2018 (after intervention) were investigated and compared to evaluate the intervention effects.ResultsThe numbers of valid survey forms collected before intervention and after intervention were 1 160 and 1 421, respectively. The total awareness rate increased from 91.10% before intervention to 96.10% after intervention (P<0.001). The exposure rate and average rank of exposure frequency after intervention were lower than those before intervention (10.98% vs. 17.50%, 1 250.74 vs. 1 340.32), the reporting rate of initial exposure after intervention (69.23%) was higher than that before intervention (57.64%), and the differences were all statistically significant (P<0.05).ConclusionThrough gradually implementing the new bundle interventions, medical staff can improve the cognition of occupational exposure, reduce the occurrence of occupational exposure, improve the enthusiasm of reporting, and create a safe atmosphere.
目的 探討危重癥手足口病的集束化綜合救護的護理方案。 方法 通過比較兒科使用集束化綜合護理方案后1年（2009年5月－2010年4月）的26例危重癥手足口病并發癥的發生率，確定預防危重癥手足口病的集束化綜合護理方案的有效性。 結果 使用集束化綜合護理方案后，26例患兒均治愈出院，其中僅3例有后遺癥。 結論 集束化綜合護理救治作為主動預防措施比傳統的被動預防更有針對性和有效。
Objective To investigate the effect of a real-time compliance dashboard to help reduce ventilator-associated pneumonia ( VAP) with ventilator bundle. Methods 240 patients who were admitted into the intensive care unit ( ICU) of Shougang Hospital of Peking University and had received mechanical ventilation ( MV) for over 48 hours, between January 2010 and November 2011, were studied prospectively. The patients were divided into two groups by random number table, ie. a dashboard group ( n = 120) with implementation of a real-time compliance dashboard to help reduce VAP with ventilator bundle, and a control group ( n=120) with implementation of usually routine order to help reduce VAP with ventilator bundle. The success rate of ventilator bundle implementation, incidence of VAP, duration of MV, duration within ICU, mortality within 28 days, cost within ICU were compared between two groups. Results Compared with the control group, the success rate of ventilator bundle implementation obviously increased ( 81.6% vs. 52.5%) , incidence of VAP ( 14. 5/1000 days of MV vs. 36.2 /1000 days of MV) , duration of MV [ 5( 4,7) days vs. 8( 6,11) days] , duration within ICU [ 8( 6,12) days vs. 13( 8,16) days] , mortality of 28 days ( 12.6% vs. 28.6% ) , and cost within ICU ( 36,437 vs. 58,942) in the dashboard group obviously reduced ( Plt;0.05) . Conclusions Implementation of a real time compliance dashboard to help reduce VAP with ventilator bundle can obviously improve medical personnel compliance and reduce incidence of VAP, duration of MV, duration within ICU, mortality and cost in ICU than those of routine medical order to help reduce VAP with ventilator bundle.
【摘要】 目的 探討甲型H1N1流感危重癥患者的搶救療效。 方法 2009年10月－2010年1月，對我院ICU收治5例甲型H1N1流感危重癥患者采用集束化治療方案進行救治，并就患者的器官功能變化進行評價。 結果 5例患者平均住院天數為（11.8±5.59）d，4 例存活，1例死亡。存活患者在治療過程中急性生理和既往健康 （APACHE）Ⅱ、多器官功能障礙綜合征評分（MODS）、全身性感染相關的器官衰竭評分 （SOFA）總體呈逐漸下降趨勢。死亡者APACHEⅡ、SOFA評分均呈逐漸升高趨勢。 結論 對甲型H1N1流感危重癥患者采取集束化救治療效良好。【Abstract】 Objective To explore the effect of bundle therapy on severe patients with influenza A (H1N1). Methods Bundle therapy were used in 5 severe patients with influenza A from October 2009 to January 2010. The patients’ organ dysfunction were observed for. Results The average in-hospital duration was (11.80±5.59) days. Four patients survived and one died with the survival ratio of 80%. Acute physiology and chronic health evaluation (APACHE) II score, Multiple organ dysfunction syndrome (MODS) score and sepsis-related organ failure assessment (SOFA) score gradually decreased in 4 survived patients, while gradually increased in the died patient. Conclusion Bundle therapy is effective on patients with severe influenza A.
ObjectiveTo research on the influence of cluster management on the nutritional intervention for nasopharynx cancer patients undergoing intensity modulated radiation therapy (IMRT), in order to discuss effective and feasible nutrition management method. MethodEighty-three nasopharynx cancer patients undergoing IMRT between June 2013 and December 2014 were selected as the study subjects. They were divided into two groups randomly. Regular health education and nutritional guidance were carried out for the 41 patients in the control group, while nutritional risk screening (NRS)-2002 nutrition screening, nutrition assessment and nutritional intervention were carried out for the 42 patients in the intervention group. Nutrition risk, nutritional status and side-reaction were recorded and evaluated for both groups of patients. ResultsAfter treatment, NRS-2002 score of the intervention group was lower than the control group (P<0.05). Body weight, constitutional index, skinfold thickness of triceps brachii muscle, mid-arm circumference and mid-arm muscle circumference of the intervention group were better than the control group (P<0.05). Total serum protein, serum albumin, serum transferrin were better and the rate of levelⅢ-Ⅳ radiation-induced oral mucositis was lower in the intervention group than that in the control group (P<0.05). ConclusionsThe application of cluster management model in nutritional intervention is a way to promote patients' rehabilitation, which can effectively improve the whole body situation of nasopharynx cancer patients, and reduce malnutrition rate and side-reaction.
【摘要】 目的 總結2例特重燒傷患者在ICU的救治經驗和體會，旨在進一步提高特重燒傷患者的救治水平。 方法 回顧分析2009年6月2例重癥燒傷患者的診治經過程和臨床資料。 結果 1例患者病情好轉，轉出ICU繼續治療，1例患者傷后37 d因消化道出血死亡。 結論 特重燒傷患者的治療需要整體計劃和多科協作。【Abstract】 Objective To summarize the experiences of the management of two patients with severe burn, so as to improve the treatment of severe burn patients. Method Treating processes and clinical data of two patients with severe burn in June 2009 were analyzed retrospectively. Result After prompt treatments, one patient died of severe bleeding in the digestive tract 37 days after the burn and the other patient recovered and left ICU for further treatment. Conclusion Bundle treatment and multi-subject cooperation are important for treating patients with severe burn.