With nearly four decades of progress in healthcare-associated infection prevention and control in China, the national quality control efforts in this field have been ongoing for the past ten years, advancing rapidly with significant achievements. Over the last decade, the team of infection control professionals involved in quality management and control in China has consistently expanded, accompanied by an enhancement of their skills. Management capabilities have steadily grown, and operational mechanisms have been continuously refined. As public hospitals transition into a new phase of high-quality development, emphasizing refined management models and intrinsic development of medical quality, it becomes crucial to further fortify the foundation and foster innovation in infection control work to ensure quality. This article provides an overview of the establishment and implementation of the National Center for Quality Control of Infection Prevention and Control, examines the current shortcomings and challenges in the field, and collectively explores the positioning and direction of the development of quality control efforts for infection prevention and control in China.
ObjectiveTo construct a rapid screening tool for the donor of heart dead organ donation (donation after circulatory death, DCD) in the background of novel coronavirus (SARS-CoV-2) infection.MethodsBased on literature analysis and core group discussion, two rounds of expert consultation were carried out by Delphi method to establish dimension and index.ResultsThe screening tool included 3 dimensions, including epidemiological history, hospital exposure history, and clinical manifestations, with 15 entries. The mean of the two rounds of expert authority coefficient was 0.757 and 0.768, and the effective recovery rate of the expert consultation questionnaire was 88% and 100%, respectively. The second round dimension and index coordination coefficients was 0.417 and 0.319, respectively. The content validity of the questionnaire was 0.91.ConclusionsThe DCD liver transplant donor's new rapid screening tool for SARS-CoV-2 infection is scientific and reliable. During the epidemic period, the DCD liver transplant donor risk screening tool is of great significance to the prevention and control of liver transplantation risk.
Carbapenemase producing Enterobacteriaceae (CPE) has emerged as a significant global public health challenge and placing infected patients at risk of potentially untreatable infections. When resistance to carbapenems occurs, there are often few alternative treatments available. Numerous international guidelines have performed systematic and evidence review to identify new strategies to prevent the entry and spread of CPE in healthcare settings. Several key strategies have been shown to be highly effective. Firstly a new strategy that is proven to be effective is the early identification of the CPE carrier patients through active surveillance cultures. While waiting for the screening results, suspected CPE carriers will be put on preemptive isolation in single room and healthcare worker will at the same time practice contact precautions. The active surveillance culture and prompt preemptive isolation will limit the entry and spread of CPE from getting into hospital. Secondly, it is of utmost importance to incorporate enforcement of the basic infection prevention and control best practices in the hospital including, full compliance to hand hygiene, appropriate use of personal protective equipment, execute antibiotic stewardship program to control abuse of antibiotics, effective environmental cleaning and decontamination, staff education and feedback, as well as surveillance of healthcare-associated infections. Such a holistic approach has been shown to be effective in inhibiting CPE from gaining foothold in the hospital.
Running an infection control regular meeting is an effective way to develop and improve the communication between the infection control team and clinical units. This paper introduces the infection control regular monthly meeting which is held in the last week of each month in a newly-opened branch hospital of a university teaching hospital in China. Through collecting the issues for discussion beforehand, feeding back the surveillance data of last month including nosocomial infection, hand hygiene, multidrug-resistant organisms, occupational exposure, and medical waste, discussing the current infection control issues from each ward and trying to solve them together, and delivering and sharing new knowledge, skills, and information in terms of infection control, the monthly meeting achieves remarkable successes in the aspects of promoting the hospital infection control-related cultural construction, enhancing the supervision and implementation of infection control measures, and running new projects on hospital infection management, etc. Infection control regular monthly meeting builds up a study and work platform, promotes the multidisciplinary and multi-department communication and collaboration, and improves the quality of infection control eventually.
Targeted initiatives of West China Hospital of Sichuan University to cope with coronavirus disease 2019 epidemic in three stages were summarized, including “three reconstructions” to mobilize in pre-epidemic stage, “three earlies” strategy to precisely treat critically ill patients in epidemic stage, and “three orderlies” to resume hospital operation in post-epidemic stage. The development of comprehensive hospitals in China after the epidemic was also discussed. It’s recommended to continuously strengthen the role of emergency response, early warning, comprehensive treatment, high-level talent training, international exchange, regional leadership, and collaborative innovation, in response to the shortcomings exposed in the epidemic.
The coronavirus disease 2019 (COVID-19) epidemic has had a serious impact in the world. In the absence of vaccines and therapeutic drugs, disinfection has become an important technical means to block the spread of the virus. By analyzing the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we studied a series of disinfection technologies for COVID-19. During the outbreak of COVID-19, Jinan Second Center for Disease Control and Prevention disinfected the houses of the cases to be investigated in a community. The effectiveness of the disinfection technology was verified through the process of disinfection preparation, sampling before disinfection, field disinfection, sampling after disinfection and evaluation of disinfection effect. Compared the data before and after disinfection, the killing rate of the total bacterial colonies in the air and on the surface of the object was more than or equal to 90%, and no SARS-CoV-2 was detected after disinfection. The results show that the disinfection effect of the disinfection technology meets the standard. Finally, through the analysis of the wrong way of disinfection and the harm of over disinfection, the importance of scientific disinfection and precise disinfection are emphasized, and the research has a good guiding value for prevention and control of the epidemic.
Novel coronavirus pneumonia is a new type of respiratory infectious disease that has rapidly spread in many countries or regions around the world. The World Health Organization (WHO) named it “coronavirus disease 2019 (COVID-19)”. Glucocorticoids (GC) have certain application value in patients with COVID-19, but they need to be used with caution and strict indications and dosage. Application of large doses of GC can also cause osteonecrosis of femoral head (ONFH). On the basis of the latest literature and evidence-based medical evidence on the fight against COVID-19 epidemic and steroid ONFH diagnosis and treatment, the Bone Circulation and Osteonecrosis Professional Committee, Shockwave Medical Specialty Committee of Chinese Research Hospital Association organized Chinese bone necrosis related experts to jointly write this consensus, focusing on the prevention strategy and the protective management measures in the ONFH diagnosis and treatment process during the prevention and control of COVID-19, which can provide reference for hospitals at all levels to carry out early prevention and treatment of ONFH.
Objective To understand the influence of organisational support and professional identity of hospital infection prevention and control (HIPC) practitioner in public hospitals. Methods HIPC practitioner of the public medical institutions secondary level and above in Neijiang City, Sichuan Province were used as the research object. A questionnaire survey was used to analyze their organizational support and professional identity in May 2022, to compare the differences in organizational support and professional identity among HIPC practitioner with different positions, working ages, and majors, and analyze the correlation between organizational support and professional identity among HIPC practitioner. Results A total of 90 valid questionnaires were retrieved from investigation. The average scores for organizational support and professional identity among HIPC practitioner were (3.409±0.625) and (2.518±0.504) points. Among them, the organizational support of intermediate professional title personnel [(3.155±0.785) points], personnel with 5-10 years of service [(3.071±0.696) points], and clinical physicians [(3.342±0.860) points] were the lowest; the professional identity of personnel with intermediate professional titles [(2.357±0.477) points], those with more than 10 years of service[(2.431±0.454) points], and other professionals [(2.471±0.260) points] were the lowest. The Pearson correlation analysis results showed that there was a positive correlation between organizational support and professional identity (r=0.490, P<0.05), self-identity and work support (r=0.364, P<0.05), and environmental identity and relationship interests (r=0.698, P<0.05). Conclusions Due to the low level of organizational support, there is a decrease in professional identity and significant job burnout, which in turn leads to an increase in the turnover rate of infection control professionals. Therefore, it is necessary to enhance the sense of organizational support for specialized personnel in infection control to promote their professional identity and stabilize the infection control team. Suggest providing necessary support at the organizational level and self-improvement at the individual level.
Based on the national 2020 and 2022 versions of Accreditation Standards for Tertiary Hospital, the Hospitals Accreditation Office of the Sichuan Provincial Health Commission organized to develop Implementation Rules for the Accreditation Standards for Tertiary Comprehensive Hospitals in Sichuan Province (2023 Edition). In order to guide the evaluated hospitals to comprehensively understand and master the content of hospital infection prevention and control (IPC), this article interprets the main evaluation points and scoring methods of hospital infection management in the detailed rules, emphasizes on organizational management, system implementation, monitoring/supervision, and connotation improvement for IPC. The purpose is to make the evaluated hospitals attach importance to the standardized implementation of daily work of IPC, focus on the routine, objective, and quantitative approach to accreditation work, and continuously achieve the effect of quality improvement in IPC.
In Shaanxi, some medical institutions especially the primary medical institutions, have outstanding problems such as unbalanced and inadequate development of infection prevention and control efficiency. The concept, knowledge and attention of infection prevention and control of the medical institution managers need to be improved. With the strong support of the health administration department, the Infection Control Professional Committee of Shaanxi Provincial Preventive Medicine Association has given full play to its functions and explored innovative service models for infection prevention and control in recent years. This paper is written to share the measures and achievements for building a multi-dimensional leadership improvement platform to improve the infection prevention and control ability, aiming to offer a reference for other medical institution managers and infection prevention and control professionals.