投稿分類 感控監測

主委發表種類: 壁報

投稿標題(中): 某病房新增流感病人異常增加感染管制措施介入成效經驗分享

投稿標題(英): Experience sharing on the effectiveness of infection control measures due to an abnormal increase in new influenza patients in a ward

投稿摘要: Background:
A certain ward is located on the 12th floor of the Second Medical Building of our hospital. The department attribute for admitting patients is non-specialized and the attribute is general ward. This ward has a total of 36 beds, TEAM I has 15 single rooms, and TEAM II has 4 4-bed health care rooms and 1 single room. Environmental cleaning is performed daily. Since July 11, 2023, the unit's infectious disease manager received a call from the head nurse of a general ward informing the health care ward of infection control measures for a patient who was positive for type A influenza. The next day, a second patient tested positive for influenza A in the same ward. Influenza A positive. Therefore, the infection control nurse started an investigation and retrospectively checked that no influenza clusters had occurred in the unit.
Method:
1. Check the disease-related information. The information mainly includes the infectious period, incubation period and transmission route of the disease:
The incubation period of influenza (from infection to the onset of symptoms) is about 1-4 days, with an average of 2 days; influenza is most contagious within 3-4 days after symptoms appear. Some adults may be contagious 24 hours before onset of illness until day 5 after illness onset. Transmission route: Mainly through droplets produced by coughs or sneezes of patients infected with influenza, which spread the virus to people around them.
2. Use retrospective investigation of cases and symptom monitoring of staff.
3. On-site observation method to observe the care behavior of staff and high contact points in the TEAM II environment.
3. Result:
Immediate intervention in infection control measures:
1. Monitor the symptoms of patients in the influenza A-positive ward and the adjacent ward where TEAM II is detected.
2. Remind unit nurses and nursing assistants to implement fever monitoring and symptom registration. If the body temperature exceeds 38 degrees, stop riding
class. And if you have symptoms (including fever), please go to our hospital for medical treatment and proactively inform the doctor that there is a suspected influenza A cluster in the unit.
3. Define high-touch points in the TEAM II ward area and ward area and add new high-touch point wiping frequency to the original once/day.
For three times/day, perform it for one week first.
4. On July 12, 2023 and July 13, 2023, the infection control nurse went to the site to observe and conduct retrospective
The investigation unit found the following information and results:
1. Common characteristics of patients in the same ward:
(1) Have fever or respiratory symptoms and no influenza-related inspections have been performed.
(2) Stayed in the emergency room of our hospital between July 6th and July 11th.
(3) There are two patients in the same ward who need sputum extraction.
2. Staff fever and symptom monitoring system:
(1) The number of symptomatic people logged into the unit from July 1 to July 12 was 0
(2) A total of 5 staff members had respiratory or fever symptoms on July 13.
3. Unit hand hygiene monitoring results from May to July 2023.
(1) In May 2023, the hand hygiene compliance rate is 100% and the accuracy rate is 95%.
In June 2023, the hand hygiene compliance rate is 100% and the accuracy rate is 95%.
In July 2023, the hand hygiene compliance rate is 100% and the accuracy rate is 100%.
4. Influenza vaccination rate: In 2022, the vaccination rate for staff will be 100%.
Conclusion:
On July 12, an abnormal event suspected of causing an influenza cluster was initiated, and a total of 2 wards were monitored and 7 patients were tested for influenza. Antigen rapid screening, 4 patients tested positive for type A influenza antigen rapid screening, and the nurses and nursing assistants in the monitoring unit were also monitored? Five unit nurses developed respiratory or fever symptoms, and four were diagnosed with influenza by doctors and prescribed anti-influenza drugs.poisonous drugs. It has been 9 months since the staff last received influenza vaccination in July 2023, and the antibody titers have gradually declined. Four nurses have been in these two wards between 7/9 and 7/11. Stay up late at night and be exposed to the environment of expectoration. The last day a staff member developed flu symptoms was July 17. After five days of tracking, no new staff members or patients were confirmed to be influenza patients. The epidemic was declared over on July 22.

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