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Objective:To summarize the experience on accurate prevention and control of children′s emergency department during the epidemic of novel coronavirus Omicron variant.Methods:We retrospectively analyzed the strategies and management experience of emergency prevention and control of novel coronavirus infection in emergency department at Children′s Hospital of Fudan University from March to May 2022.Results:As a designated hospital for treating pediatric patients who contracted novel coronavirus in Shanghai, the emergency department in our hospital was confronted with the dual pressure of critical patients treatment and pandemic prevention and control.We carefully studied a series of laws and regulations, as well as the newest edition of Chinese clinical guidance for novel coronavirus pneumonia diagnosis and treatment, and combined with the characteristics of novel coronavirus infection in children, then formulated the independent emergency department, fever clinics and novel coronavirus clinics; Updated the emergency department pre-examination triage process, the precautions pratice of clinical stuffs and disfection strategy, and established the second emergency department.From the beginning of March to the end of May 2022, a total of about 12 000 patients were admitted to the emergency department in our hospital, including 704 patients in the resuscitation room, 652 patients in the observation room, and 164 patients in the emergency ward.There were six patients with novel coronavirus infection in the emergency department.Neither nosocomial infection nor occupational exposure occurred.Conclusion:After 3 months of practice, the results showed that it can fully guarantee the timely treatment of critically ill children and achieved zero cross-infection in the hospital, which has important reference significance for the treatment of children, epidemic prevention, control during the novel coronavirus epidemic.
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Objective:To apply the best evidence of pre-examination and triage management of patients with non-traumatic acute abdomen to clinical practice and evaluate its effects.Methods:Using convenience sampling method, 15 nurses and 237 patients with non-traumatic acute abdomen admitted in the emergency department of Shanxi Provincial People ′s Hospital from January to May 2021 were selected as the research objects, 114 cases as the baseline review group and 123 cases as the after-effect evaluation group. Following the clinical evidence practice application of JBI Evidence-Based Nursing Center Systematic standard procedures, using self before-after control study to compare the knowledge and behavior of triage nurses before and after evidence application, and compliance with each review index; using a non-contemporaneous controlled trial to compare the changes of pre-examination and triage time and triage accuracy between two groups. Results:After the application of evidence, the score of the triage nurses on the pre-examination and triage of non-traumatic acute abdomen increased from 98.00±6.56 in the after-effect evaluation group to 114.20±3.88 in the base-line review group, and the difference was statistically significant ( t=8.62, P<0.05); after the application of evidence, the compliance with indicators 1-9,12,13,15-17 was significantly improved and the difference was significant ( χ2 values were 11.46-123.06, all P <0.05). After the application of evidence, the compliance rate of those indicators <80% increased to more than 80% except indicator 6, the accuracy of patient triage rose from 84.21%(96/114) to 93.50%(115/123) with a statistically significant difference ( χ2=5.22, P<0.05); after the application of the evidence, the triage time was 2.00(1.00,4.00) min, shorter than 3.00(2.00,4.63) min in the base-line review group, and the difference was statistically significant ( Z=-3.18, P<0.05). Conclusions:The application of the best evidence of pre-examination and triage for non-traumatic acute abdomen can improve the nursing practice of non-traumatic acute abdomen triage, improve the accuracy of non-traumatic acute abdomen triage, and shorten the triage time.
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Since the outbreak of COVID-19, the epidemic has been spreading rapidly. As an important base to combat the epidemic, the hospital infection prevention and control work is facing great challenges. In particular, as one of the first COVID-19 designated hospitals in a province and a large general hospital at the same time, how to prevent and control nosocomial infection among patients and medical staff during the epidemic period of COVID-19 is of paramount importance. Our strategies start with the three key elements of infectious disease management, namely, "controlling the source of infection, cutting off the route of transmission, and protecting the susceptible population." The in-patients in pre-examination and triage, fever clinic, isolation ward and common ward were inspected from fever screening, pre-examination and triage, personal protection, in-patient management, emergency treatment, accompanying care management, and environmental disinfection. A series of interventions were carried out to effectively cut off the transmission of COVID-19 in hospitals. After effective screening and rational pre-examination and triage for outpatients, emergency patients and inpatients, medical personnel received a series of training, scientific protection, and accompanying personnel were effectively managed and controlled, there was not a single case of nosocomial infection during the epidemic of COVID-19. This series of intervention strategies provides some reference for other medical institutions to carry out effective prevention and control of the epidemic.
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ObjectiveDuring the prevention and control of COVID-19, it is a difficult problem to obtain the individual epidemiological status of outpatients efficiently and accurately in a large comprehensive third-grade class-A hospital. To discuss the application and effect of WeChat applet and integrity propaganda and education in outpatient pre-examination during the prevention and control of COVID-19.MethodsFirstly, the outpatients were treated with integrity propaganda and education (like informing the law and regulations, recording the personal credit) at the outpatient pre-examination office. Secondly, let them take real-name authentication in the hospital self-developed WeChat applet. Thirdly, the outpatients filled in the epidemiological questionnaire related to COVID-19 by WeChat. The differences between before using the application (8,186 patients) and after using (7,361 patients) were compared in pre-examination time and concealing the incidence of an individual's epidemiological history.ResultsAfter the application of WeChat applet and integrity propaganda and education, the pre-examination time after using application [(1.07±0.23)min] was shorter than that before using[(2.15±0.37) min] (P<0.05). The concealment rate of epidemiological history was 0.05% before using application and zero after using.ConclusionWeChat applet and integrity propaganda and education can shorten the pre-examination time of covid-19 and reduce the occurrence of concealing personal epidemiological history.
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The 2019 novel coronavirus infection has brought big challenges to prevention and control of the national epidemic in China.During the fight against the epidemic,how to properly carry out pre-examination and triage for patients with skin lesions and fever has been a practical problem encountered in dermatology hospitals of all grades and in general hospitals with a large number of dermatological outpatient visits.The Chinese Society of Dermatology organized experts to formulate the principles and procedures for pre-examination and triage in outpatient departments of dermatology at the stage of prevention and control of the 2019 novel coronavirus infection epidemic,so as to guide the current fight against the epidemic.
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The 2019 novel coronavirus infection has brought big challenges to prevention and control of the national epidemic in China. During the fight against the epidemic, how to properly carry out pre-examination and triage for patients with skin lesions and fever has been a practical problem encountered in dermatology hospitals of all grades and in general hospitals with a large number of dermatological outpatient visits. The Chinese Society of Dermatology organized experts to formulate the principles and procedures for pre-examination and triage in outpatient departments of dermatology at the stage of prevention and control of the 2019 novel coronavirus infection epidemic, so as to guide the current fight against the epidemic.
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Objective@#To explore the application effect of intelligent assistant decision-making in the five-level triage of pediatric emergency department.@*Methods@#The patients treated in the pediatric emergency department of Xiamen Children′s Hospital using the intelligent assistant decision-making system were divided into two groups before and after one month.In March 2018, 17 900 cases were in the traditional group, and in April 2018, 18 590 cases were in the intelligent group.The traditional group conducted manual triage according to the five-level pre-screening and triage standard.The intelligent group conducted triage based on the self-developed intelligent assistant decision-making system.Intelligent assistant decision-making included automatic identification of whether vital signs data was abnormal and automatic provision of basis for triage level to help nurses confirm two major functions.The patients′ information were collected according to the established content, and the system would automatically identify and present according to the corresponding triage basis to determine the triage level.The two groups of children were compared and analyzed in terms of disease distribution, triage level, triage accuracy.The clinical application effect of the emergency pediatric pre-check triage system was evaluated.@*Results@#There was no significant difference in disease distribution between the two groups.The top three were respiratory diseases, infectious diseases and digestive diseases.In the comparison of waiting time between the two groups, the waiting time of grade Ⅲ, Ⅳ and Ⅴ patients in the intelligent group was shorter than that in the traditional group, the difference was statistically significant (P<0.05). The consistency of triage grade in the intelligent group was higher than that in the traditional group.The family satisfaction of children in the intelligent group of Ⅲ, Ⅳ, and Ⅴ grade was higher than that in the traditional group.@*Conclusion@#The application of intelligent assistant decision-making could improve the efficiency and accuracy of the pre-examination of the nurses, ensure the effectiveness of the triage and the safety of the children, and improve the satisfaction of family members.
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Objective To explore the application effect of intelligent assistant decision-making in the five-level triage of pediatric emergency department. Methods The patients treated in the pediatric emergency department of Xiamen Children′s Hospital using the intelligent assistant decision-making system were divided into two groups before and after one month. In March 2018,17 900 cases were in the traditional group,and in April 2018,18 590 cases were in the intelligent group. The traditional group conducted manual triage accord-ing to the five-level pre-screening and triage standard. The intelligent group conducted triage based on the self-developed intelligent assistant decision-making system. Intelligent assistant decision-making included au-tomatic identification of whether vital signs data was abnormal and automatic provision of basis for triage lev-el to help nurses confirm two major functions. The patients′information were collected according to the estab-lished content,and the system would automatically identify and present according to the corresponding triage basis to determine the triage level. The two groups of children were compared and analyzed in terms of dis-ease distribution,triage level,triage accuracy. The clinical application effect of the emergency pediatric pre-check triage system was evaluated. Results There was no significant difference in disease distribution be-tween the two groups. The top three were respiratory diseases,infectious diseases and digestive diseases. In the comparison of waiting time between the two groups,the waiting time of grade Ⅲ,Ⅳ and Ⅴ patients in the intelligent group was shorter than that in the traditional group,the difference was statistically significant (P<0. 05). The consistency of triage grade in the intelligent group was higher than that in the traditional group. The family satisfaction of children in the intelligent group ofⅢ,Ⅳ,andⅤgrade was higher than that in the traditional group. Conclusion The application of intelligent assistant decision-making could improve the efficiency and accuracy of the pre-examination of the nurses,ensure the effectiveness of the triage and the safety of the children,and improve the satisfaction of family members.
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Objective To investigate the status of blood specimen acceptability for clinical chemistry tests in routine medical laboratories of China. Methods The questionnaires were assigned to the laboratories which participated in the routine chemistry exter-nal quality assessment (EQA) programs proposed by National Health Commission for Clinical Laboratory. The questionnaires included general information of participants and information about unacceptable blood specimens. Participants were required to record all the in-formation concerning unacceptable blood specimen received from 1stto 31stJuly, 2017. The data from each laboratory were reported and collected via special online system.Results A total of 866 valid questionnaires were collected.Of 15 981 752 specimens received dur-ing the data collection period unqualified 122 00 specimens were rejected with overall rejection rate of 0.076%. The main reasons for unacceptable specimens were hemolysis (33.98%), insufficient specimen quantity (10.78%) and chylemia/lipemia (10.62%). The rejected specimens were related to the original laboratories, types of container and specimen, transportation manner and operating staff of blood collection. Conclusion Certain problems existed in the receiving and management system for unqualified blood specimen in our country and remaining to be perfected. The clinical laboratories should pay more attention for pre-examination stage, including routinely monitoring unacceptable specimens, analyzing related data at the most possible granular levels, identifying the main problem and taking effective measures.
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Objective To explore the establishment of methods to evaluate the quality of two different separate gel tubes .Meth-ods An evaluation comparing two separate gel tubes with silicate glass tubes ,which are the standard tubes ,was performed using data from 50 subjects .The serum samples were assayed for routine chemistry or immunology after centrifugation using the quantita-tive or qualitative detection methods such as ECL ,enzyme-linked immunosorbent assay (ELISA) ,reflection luminescence or immu-nofluorescence .The data were collect for further statistical analysis .Results For quantitative results of the items ,the two separate gel tubes ,compared with the standard glass tube ,there was no significant difference between the test results (P>0 .05);for quali-tative projects ,two separate plastic tube ,compared with the standard glass tube ,really the positive rate and the true negative rate was no significant difference (P>0 .05 ,K>0 .75) .Conclusion By using different detection methods and test items ,it is demon-strated that using two separate gel tube for items assay does not affect the accuracy and consistency of the test results .As a result , the method for external supplies quality assessment is established in the laboratory for ISO15189 quality control .