China News Service, January 19th. According to the website of the National Health Commission, the State Council’s Comprehensive Joint Prevention and Control Mechanism for the New Coronavirus Pneumonia Epidemic Issued on the 18th “About New Coronary Pneumonia in Gaocheng People’s Hospital of Shijiazhuang City, Hebei Province and Xinle City Hospital of Traditional Chinese Medicine "Notice on Ineffective Prevention and Control of Epidemic Infection."
The report pointed out that after the incident, Hebei Province and Shijiazhuang City have held accountable personnel.
details as follows:
Announcement on the ineffective prevention and control of the new crown pneumonia epidemic in Gaocheng People's Hospital and Xinle Traditional Chinese Medicine Hospital of Shijiazhuang City, Hebei Province
Joint Prevention and Control Mechanism Comprehensive Development (2021) No. 16
All provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps respond to the new crown pneumonia epidemic joint prevention and control mechanism (leading group, command post):
Recently, a new crown pneumonia epidemic occurred in Shijiazhuang City, Hebei Province.
In response to the epidemic, Gaocheng People’s Hospital of Shijiazhuang City, Hebei Province and Xinle City Hospital of Traditional Chinese Medicine have all diagnosed new coronary pneumonia in medical staff, inpatients, escorts, and nursing workers, which exposed the local implementation of infection prevention and control measures in medical institutions. Insufficient work in other aspects, there is a major risk of epidemic spread, which has serious adverse effects on epidemic prevention and control.
After the incident, Hebei Province and Shijiazhuang City have held relevant personnel accountable.
The relevant situation is reported as follows:
1. Basic situation
(1) Gaocheng People's Hospital of Shijiazhuang City.
On January 1, 2021, the attendant of a patient in the Department of Cardiology, Gaocheng People's Hospital developed dry cough symptoms. Nucleic acid testing was performed on the 3rd, and the nucleic acid test was positive on the 4th.
The hospital immediately took measures such as sealing and controlling the cardiology department, carrying out full-staff nucleic acid screening, and arranging for a large number of inpatients to be discharged.
According to the investigation by the national and provincial joint investigation team, as of January 14, a total of 8 cases in the new coronary pneumonia case database in Shijiazhuang City were related to the hospital.
The investigation team believes that although the incident cannot be determined as a medical institution infection for the time being, many problems were exposed during the occurrence, development and treatment of the incident, which resulted in patients, medical staff and the public being exposed to varying degrees of risk of infection.
The main manifestations are as follows: First, it is common for hospitalized patients and their accompanying staff to fail to do "all-in-one inspections" and to enter the ward first and then be tested.
Second, the extra beds in the ward are serious. The rate of extra beds in the two neurology wards and the cardiology ward both exceeds 90%, which is a serious violation of the anti-aggregation regulations.
The third is the chaotic management of the ward. The first confirmed escort is accompanied by his brother's residence permit. The escorts and visitors enter and leave the ward at will, and there are situations where the escorts change randomly.
Fourth, the setting and management of buffer wards are not standardized, and there is no single room for admission.
Fifth, the delineation of close contacts is not allowed. The cardiology department with confirmed cases has only been sealed for less than 3 days. Close contact personnel go to public places such as canteens and shops at will. It cannot be ruled out that close contact medical personnel still commute to get off work normally every day.
Sixth, for hospitalized patients with a history of close contact, as long as two consecutive nucleic acid test results are negative within 24 hours, they will be released from isolation and allowed to be discharged, and 70 patients in the cardiology department will be discharged from the hospital on 5-10 days.
(2) Xinle City Hospital of Traditional Chinese Medicine.
On January 2, a patient went to Xinle City Hospital of Traditional Chinese Medicine for acute cerebrovascular disease. On the third day, the nucleic acid test result was positive and became the first confirmed case in the hospital.
On the 9th, one after another, doctors, nurses, and escorts were found to have positive nucleic acid results.
As of January 11, a total of 6 positive results of nucleic acid tests have been found.
According to the investigation by the national, provincial, and municipal joint investigation team, this is an infection incident in a medical institution caused by a community infected with the new crown virus who brought the infection risk to the hospital, and the hospital's infection control measures were defective.
The main problems are as follows: First, emergency patients did not check the nucleic acid test results in time, and did not take samples and submit them for testing in time. Instead, they were directly admitted to the ward, and the requirements of inpatients and escorts were not effectively implemented.
Second, when the patient was admitted to the emergency department, he was placed in an ordinary double room in the ward without a nucleic acid test result, and a buffer ward was not set up as required.
The third is that the number of escorts is large and not fixed, they enter and leave the ward at will, and they go to the hospital many times.
Fourth, after the first patient was diagnosed, the epidemiological investigation was not scientifically standardized, and the determination of close contacts and their exposure risk levels was inaccurate.
In addition, the inspection experts of the Medical Treatment Team of the Joint Prevention and Control Mechanism of the State Council found in their work that there are widespread problems in the implementation of relevant policy requirements for infection prevention and control in relevant district and county medical institutions in Shijiazhuang City.
The 162 inpatients in Gaocheng Integrated Traditional Chinese and Western Medicine Hospital have as many as 228 escorts, and the escorts are not strictly managed; the nucleic acid test results of fever clinics are reported for too long, and individual patients even up to 16 hours; fever clinics and hemodialysis wards, high pressure The temporary storage sites for oxygen and medical waste are in the same small building, and the entrance and exit are only about 1 meter apart, which poses hidden dangers to production safety and medical safety.
2. Problems exposed
(1) The hospital management is chaotic and the sense of control is not strong.
The leadership teams of Gaocheng People's Hospital and Xinle City Hospital of Traditional Chinese Medicine did not perform well in their responsibilities for epidemic prevention and control, the division of responsibilities was not clear, and the linkage and communication between departments and departments were not smooth.
The management and medical staff are not very aware of hospital infection prevention and control, training is not in place, and standard preventive measures such as disinfection and isolation are not implemented.
A series of requirements for hospitalized patients and accompanying staff that the country has repeatedly emphasized, such as "should be checked and thoroughly inspected", timely reporting of nucleic acid test results, setting up management buffer wards, and strict escort and visitation management, have not been implemented.
(2) The lack of supervision responsibility of the health department.
After the hospital reported the positive cases to the local area, the local health administrative department failed to effectively perform its supervision and management duties, and the disease control agency failed to provide the hospital with technical guidance or support for epidemic prevention and control in a timely manner.
The hospital failed to conduct a series of treatments such as conducting epidemiological investigations, scientifically adopting isolation control measures, and effectively implementing environmental cleaning and disinfection under supervision and guidance.
In particular, Gaocheng People’s Hospital received feedback from the Shijiazhuang Center for Disease Control and Prevention. After the 11 positive samples sent to the center for review were all negative, they did not receive the guidance of the health administrative department and disease control agency. In response, the wrong decision was made to lift the cardiology department and divert patients, which increased the pressure on epidemic prevention and control.
(3) The local prevention and control command department failed to perform the duties of prevention and control leadership.
The local epidemic prevention and control command department is not fully aware of the role of medical institutions in epidemic prevention and control and the harmfulness of infection incidents, and leadership responsibilities are not implemented.
Failure to incorporate the epidemic prevention and control work of medical institutions in the jurisdiction into the overall epidemic prevention and control system, slow response to the problems and difficulties encountered by medical institutions in epidemic prevention and infection control, and fail to provide timely and powerful leadership and scientific and accurate professional guidance .
For example, after the Gaocheng People’s Hospital found a positive case, it submitted 8 reports to the District Prevention and Control Office, District Government Office, and District Health Bureau from January 5 to 10, but none of them received formal feedback. Leaders of the command department Liability is seriously missing.
Three, the next step
Several recent incidents of inadequate prevention and control of hospital infection have exposed shortcomings and loopholes in the prevention and control of epidemics in rural areas, especially in the prevention and control of hospital infection.
All localities must take a lesson and draw inferences from one another, always tighten the string of epidemic prevention and control, and do a good job in winter and spring prevention and control without any relaxation to ensure that the epidemic does not rebound.
(1) Further raise awareness and tighten the responsibilities of the Quartet.
All localities must thoroughly implement the spirit of General Secretary Xi Jinping's important instructions, earnestly implement the decisions and deployments of the Party Central Committee and the State Council on epidemic prevention and control, further improve ideological understanding and political positions, and prevent large needle-point holes from leaking into the wind.
Further compact the four-party responsibilities of territories, departments, units, and individuals.
All levels of local party committee governments and epidemic prevention and control command departments should effectively strengthen the leadership of the epidemic prevention and control of medical institutions, and strengthen the guidance and coordination of relevant forces in a timely manner after the detection of new coronary pneumonia infections in the hospital on the epidemic prevention and control matters reported by medical institutions. , Do a good job of isolation control, close contact investigation, epidemiological investigation, medical treatment, etc. immediately.
(2) Strengthen industry supervision and carry out inspections on prevention and control of hospitals.
Health administrative departments at all levels must earnestly perform their supervisory duties, and the main responsible comrades must personally control the prevention and control of hospital infections.
Organize hospital-sensing experts in the jurisdiction to establish an inspection system, conduct regular and random inspections, find and sort out hidden risks, establish problem accounts, and implement rectification measures one by one.
Before the Spring Festival, the health administrative department should organize and carry out special inspections on prevention and control of hospital infections, focusing on the inspection of medical institutions in the county.
At the same time, more attention has been paid to epidemic prevention and control in rural areas, and supervision and guidance of hospital infection prevention and control, epidemiological investigations, and nucleic acid testing have been strengthened.
(3) Implement the main responsibility and strictly prevent the occurrence of nosocomial infections.
Medical institutions must implement the main responsibility of hospital infection prevention and control, and the main responsible comrades are the first responsible persons for hospital infection prevention and control.
All staff of medical institutions should increase their sense of political responsibility and sensitivity, raise awareness of prevention and control of hospital infections, master basic knowledge of prevention and control, and implement the national measures for prevention and control of hospital infections.
The role of the leading unit of the medical consortium and the medical community should be brought into full play. The lead unit is responsible for the prevention and control of hospital infections in all medical institutions within the medical consortium and the medical community. For medical institutions with a large volume of diagnosis and treatment and higher risks, they should be sent out. Staff stationed supervision and guidance.
All provincial health administrative departments are requested to report to the State Council’s response to the new crown pneumonia epidemic prevention and control mechanism the medical treatment team of the State Council before January 29.
The State Council's response to the new coronavirus pneumonia
Comprehensive Epidemic Prevention and Control Mechanism
January 18, 2021