2.2 Strengthen infection control and block transmission routes
We emphasized hand hygiene and provided supplies and instruction on respiratory hygiene, including alcohol-based hand rub (ABHR) with 75% alcohol, tissues, and no-touch receptacles for disposal, at the entrances of inpatient building and our ward. Instruction on hand hygiene, limiting surfaces touched, and use of personal protective equipment(PPE) according to current hospital policy were provided at every entrance. We updated the cleaning and disinfection procedures : using cleaners and water to pre-clean surfaces prior to applying an hospital-grade disinfectant to frequently touched surfaces and objects every day.
A separate and well-ventilated conversation room was specially set up and ventilated during the conversation. All the rooms underwent appropriate cleaning and surface disinfection before it is returned to use once again and records must be made to ensure all work done.
The level of healthcare personal protection(HCP) was determined according to the patient’s condition and exposure risk to SARS-CoV-2. The primary protection including hand hygiene and facemask was performed before and after all patient contact, and when facing patients and family members with symptoms of COVID-19 or other respiratory infection (e.g., fever, cough) , we provided supplies and equipment necessary for the consistent observance of Standard Precautions(second grade protection),11National Health Committee of People’s Republic of China. Regulation for prevention and control of healthcare associated infection of airborne transmission disease in healthcare facilities. December 27, 2016. http://www.nhc.gov.cn/wjw/s9496/201701/7e0e8fc6725843aabba8f841f2f585d2.shtml. including hand hygiene products and personal protective equipment(PPE) (e.g.N95 respirators, gloves, gowns, face and eye protection). Adhere to standard precautions, appropriate PPE were selected according to PPE supply and the level of anticipated contamination. When available, N95 respirators are preferred which should be prioritized for situations where the care of patients with respiratory protection.
Once the patient conforms to any two of fever, respiratory symptoms and chest CT with covid-19 imaging characteristics, the contingency plan made at the begining of the COVID-19 is activated. The plan includes isolating symptomatic patients as soon as possible in a separate, well-ventilated room with door closed and private bathroom, disinfection and isolation of the room, healthcare personnel protection, et.al. Primary nurses were dedicated to care for patients during their shift to avoid the situation that multiple nurses carry out different nursing operations for the same patient. A special operating room would be arranged for such patients requiring emergency surgery, on the contrary elective procedures and surgeries would postponed.
Provide all healthcare personnel including but not limited to medical, nursing, clinical technicians, rear service personnel, patients and family members with job or task specific education and training on COVID-19 and preventing transmission of infection, such as epidemiological investigation, hand hygiene and PPE. We enhanced timely education and training by applying multiform learning, combining online and offline education. Online education, such as Tencent Meeting Application and WeChat education became our main education approach. Group offline learning was eliminated, so guidelines document, video and morning questions became our instructional materials. We updated information periodically during ongoing education programs according to the continuous update of infection control guidelines. Nursing department, Medical department and Infection-Control department surveilled every infection control link strictly and at any time to ensure continuous rectification of potential risk factors.