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Risk Manag Healthc Policy ; 13: 501-508, 2020.
Article in English | MEDLINE | ID: covidwho-592885


PURPOSE: Measures to prevent respiratory infection diseases (RIDs) in hospitals are important to protect both patients and physicians. In 2003, an outbreak of severe acute respiratory syndrome occurred in Inner Mongolia Autonomous Region (IMAR) of China. We aimed to evaluate competency in RID prevention procedures in terms of hospital performance and physician behavior. PATIENTS AND METHODS: We conducted a cross-sectional study in 10 tertiary general public hospitals in 3 cities of IMAR. In each hospital, we chose the respiratory and ear-nose-throat outpatient departments (OPDs) and the emergency department (ED) to invite patients with symptoms of cough to join the study before they consulted a physician. After their consultation, we asked the patients to complete a checklist to score the performance of the departments and the behavior of their physicians in terms of RID prevention practices according to international professional guidelines. RESULTS: From 711 respondents, in the domain of hospital performance, display of posters on directive to wash hands after coughing/sneezing had an average score of 0.452 (range 0-1), while other cough etiquette items had scores averaging between 0.33 and 0.39. The average score for air ventilation was 0.66. For physicians' performance, informing patients the location of handwashing facilities scored the highest (0.62), while low scores were seen for offering a mask to coughing patients (0.14) and encouraging coughing patients to distance themselves from others (0.17). Most RID prevention procedures received low scores in EDs in both hospital performance and physician behavior domains. CONCLUSION: Hospitals in IMAR should improve their performance in RID prevention procedures, especially in giving information to RID patients through the display of posters. The practice of physicians in preventing respiratory infection spread was suboptimum. ED staff and hospital administrators should improve their procedures to prevent the spread of respiratory infections, especially given the increasing occurrences of global pandemics such as COVID-19.

Postgrad Med ; 132(7): 643-649, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-382140


INTRODUCTION: Recent respiratory infectious disease (RID) outbreaks of influenza and the novel coronavirus have resulted in global pandemics. RIDs can trigger nosocomial infections if not adequately prevented. OBJECTIVE: The objective of this study was to rate the adequacy of healthcare workers (HCWs) and hospital settings on RID prevention using unannounced standardized patients (USP) in clinical settings of hospital gateways. METHODS: Trained USPs visited 5 clinical settings: information desks, registration desks, two outpatient departments and the emergency departments in 10 hospitals across 3 cities of Inner Mongolia, China. USPs observed the hospital air ventilation and distance from the nearest hand-washing facilities to each clinical setting, then mimicked symptoms of either tuberculosis or influenza before observing the HCW's behavior. A total of 480 clinical-setting assessments were made by 19 USPs. RESULTS: The overall adequacy of triage services was 86.7% and for prevention of the spread of airborne droplets was 83.5%. Almost all hospitals offered adequate air ventilation. Compared to the information desk, adequacy of triage and preventing the spread of airborne droplets by physicians in the three clinical departments was less likely to be adequate. Triage services for USPs simulating symptoms of influenza were 2.6 times more likely to be adequate than for those simulating symptoms of tuberculosis but there was no significant difference in the prevention of the spread of airborne droplets. CONCLUSIONS: There is a need to improve respiratory infectious disease procedures in our study hospitals, especially in outpatient and emergency departments.

Emergency Service, Hospital , Health Personnel/standards , Infection Control/standards , Outpatient Clinics, Hospital , Patient Simulation , Respiratory Tract Infections/prevention & control , Betacoronavirus , COVID-19 , China , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Guideline Adherence , Hand Disinfection/standards , Hospitals , Humans , Influenza, Human/prevention & control , Influenza, Human/transmission , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Respiratory Tract Infections/transmission , SARS-CoV-2 , Triage/standards , Tuberculosis, Pulmonary/prevention & control , Tuberculosis, Pulmonary/transmission , Ventilation/standards