01 Basic Requirements
Management of Key Departments
03 Protection of Medical Personnel
04 Patient Management
（一） Formulate contingency plans and workflow
Medical institutions shall, according to the etiological characteristics of Novel Coronavirus, establish an early warning mechanism and formulate emergency plans and work procedures in combination with the source of infection, transmission route, susceptible population and diagnosis and treatment conditions.
（二） Carry out all-staff training
According to the job responsibilities, determine the training content for different personnel, so that they can master the prevention and control knowledge, methods and skills of Novel Coronavirus infection, and achieve early detection, early reporting, early isolation, early diagnosis, early treatment and early control.
（三） Do a Good Job in Protecting Medical Personnel
Medical institutions shall standardize disinfection, isolation and protection work, reserve qualified quality and sufficient quantity of protection materials, and ensure that the personal protection of medical personnel is in place. On the basis of strict implementation of standard prevention, we will strengthen the prevention and control of infection caused by contact transmission, droplet transmission and airborne transmission.
（四） Pay Attention to the Health of Medical Personnel
Medical institutions should reasonably allocate human resources and shift arrangements to avoid overwork of medical personnel. According to the post characteristics and risk assessment results, carry out active health monitoring. Take various measures to ensure that medical personnel provide medical services to patients healthily.
（五） Strengthen infection surveillance
Do a good job in early warning and forecasting, strengthen the supervision and guidance of infection prevention and control work, find hidden dangers, and improve in time. When pneumonia patients suspected or confirmed of Novel Coronavirus infection are found, they shall report in a timely manner in accordance with the relevant requirements, and report the information within 2 hours, so as to do a good job in the corresponding disposal.
（六） Do a good job in cleaning and disinfection management
According to the “Hospital Air Purification Management Standard”, the ventilation of the diagnosis and treatment environment should be strengthened. Conditional medical institutions can carry out air disinfection or be equipped with circulating air disinfection equipment.
Strict implementation of the “Technical Specifications for Disinfection of Medical Institutions”, do a good job in the cleaning and disinfection of diagnosis and treatment environment, medical devices, patients’ articles, etc., strict treatment of respiratory secretions, excretions and vomitus of patients, and strict final disinfection.
（七） Strengthen the management of patients seeking medical treatment.
Medical institutions should do a good job in the management of patients and minimize the congestion of patients so as to reduce the risk of hospital infection. When patients suspected or confirmed to be infected with Novel Coronavirus are found, isolation or transmission control measures shall be taken in accordance with the law, and medical observation and other necessary preventive measures shall be taken for the accompanying personnel and other close contacts of the patients in accordance with the regulations. If the patient does not have the rescue capability, the patient shall be referred to a medical institution with the rescue capability for diagnosis and treatment in a timely manner.
（八） Strengthen patient education
Medical institutions should actively carry out the education of patients and their accompanying personnel, so that they can understand the protection knowledge of Novel Coronavirus, and guide them to correctly wash hands, cough etiquette, medical observation and home isolation, etc.
（九） Strengthen the management of infection outbreaks
Strict implementation of various rules and regulations for infection prevention and control in medical institutions to minimize the risk of infection outbreaks. To enhance sensitivity, in the event of a suspected outbreak or outbreak of Novel Coronavirus infection, medical institutions must report in a timely manner in accordance with regulations, and in accordance with relevant standards and procedures, start the emergency plan, cooperate with the investigation and disposal work.
（十） Strengthening Management of Medical Waste
Medical wastes generated by patients with confirmed or suspected infection in Novel Coronavirus shall be included in the management of infectious medical wastes, and shall be disposed of in a standardized manner in strict accordance with the relevant provisions of the Regulations on the Management of Medical Wastes and the Measures for the Management of Medical Wastes in Medical and Health Institutions.
Key Department Management
（一） Fever clinic
1. The building layout and work flow of the fever clinic shall conform to the relevant requirements of the “Technical Specification for Hospital Isolation” and so on.
2. Strengthen ventilation in the observation room or emergency room; If mechanical ventilation is used, the air flow direction should be controlled from the clean side to the polluted side.
3 equipped with meet the requirements, a sufficient number of medical personnel protective equipment, fever clinic entrance and exit should be equipped with quick-drying hand disinfectant and other hand hygiene facilities.
4 Medical personnel to carry out diagnosis and treatment work should implement standard prevention. To correctly wear surgical mask or medical protective masks, hand washing or hand hygiene disinfection should be carried out before wearing the masks and after taking off the masks. In and out of fever clinics and observation wards, wear and take off protective articles correctly in strict accordance with the requirements of the “Procedures for Medical Personnel to Wear and Take off Protective Articles”.
5. Medical personnel should master the epidemiological and clinical characteristics of Novel Coronavirus infection, screen patients according to diagnosis and treatment standards, and immediately take isolation measures for suspected or confirmed patients and report them in a timely manner.
6. After the patient is transferred out, the final treatment shall be carried out according to the “Technical Specification for Disinfection in Medical Institutions”.
7. Medical institutions shall provide masks for patients and accompanying personnel and guide them to wear them correctly.
1. Implement the pre-screening triage system, guide fever patients to the fever clinic, formulate and improve the emergency plan for the transfer and treatment of severe patients and strictly implement it.
2. Reasonably set up isolation areas to meet the needs of on-site isolation and treatment of suspected or confirmed patients.
3. Medical personnel strictly implement preventive measures and manage personal protection and diagnosis and treatment environment. When implementing emergency tracheal intubation and other diagnosis and treatment measures with high risk of infectious occupational exposure, preventive measures shall be taken in accordance with the requirements of confirmed patients.
4. The diagnosis and treatment area shall be well ventilated and regularly cleaned and disinfected.
5. Take effective measures such as setting up waiting areas to avoid crowds gathering.
(3) General ward (room)
1. Emergency isolation wards shall be set up for isolation and treatment of suspected or confirmed patients, relevant working systems and procedures shall be established, and sufficient disinfection and protective articles shall be provided to deal with acute respiratory infectious diseases.
2. If suspected or confirmed patients are found in the ward (room), relevant emergency plans and work processes shall be started, and timely and effective isolation, treatment and referral shall be implemented according to the specification requirements.
3. Suspected or confirmed patients should be treated and cared for by special personnel, and the access of irrelevant medical personnel should be restricted. In principle, no visits should be made. Conditional can be placed in negative pressure ward.
4. Non-designated hospitals that do not have the conditions for treatment shall be transferred to designated hospitals with isolation and treatment capabilities in a timely manner. Effective isolation and treatment measures shall be taken for patients while waiting for referral.
5. After the patient is transferred out, the final treatment shall be carried out on the contact environment according to the “Technical Specification for Disinfection in Medical Institutions”.
(four) the ward (room) for the treatment of pneumonia patients suspected or confirmed of Novel Coronavirus infection
1. The building layout and work flow shall conform to the relevant requirements of the “Technical Specification for Hospital Isolation” and other relevant requirements, and shall be equipped with protective articles for medical personnel that meet the requirements and are in appropriate quantities. Medical institutions that set up negative pressure wards (rooms) shall implement standardized management according to relevant requirements.
2. Isolation measures shall be taken in a timely manner for suspected or confirmed patients, and suspected patients and confirmed patients shall be placed separately; Suspected patients are isolated in a single room, and patients confirmed by etiology can be placed in the same room.
3. On the basis of implementing standard prevention, measures such as contact isolation, droplet isolation and air isolation shall be taken. Specific measures include:
(1) To enter and leave the isolation ward, the “Technical Specifications for Hospital Isolation” and “Procedures for Medical Personnel to Wear and Take off Protective Articles” shall be strictly implemented, and hand hygiene and wearing and taking off protective articles shall be correctly implemented.
(2) A process for medical personnel to wear and take off protective articles should be formulated; Make flow charts and configure full-length mirrors. Personnel skilled in infection prevention and control technology shall be equipped to supervise the wearing and taking off of protective articles for medical personnel to prevent pollution.
(3) Stethoscope, thermometer, sphygmomanometer and other medical instruments and nursing articles used for diagnosis and treatment of suspected or confirmed patients shall be specially assigned. If the conditions are limited and cannot guarantee the special use of medical devices, standardized cleaning and disinfection shall be carried out after each use.
4. Intensive care patients shall be admitted to intensive care units or wards with monitoring and rescue conditions. Intensive care units for intensive care patients or wards with monitoring and rescue conditions shall not admit other patients.
5. Strict visiting system, in principle, no escort. If the patient’s condition is critical and other special circumstances must be visited, the visitor must do a good job of personal protection in strict accordance with the regulations.
6. Carry out air purification in accordance with the provisions of the “Hospital Air Purification Management Standard”.
Protection of medical personnel
（一） Medical institutions and medical personnel should strengthen the implementation of standard preventive measures, do a good job in the ventilation management of the diagnosis area and ward (room), strictly implement the requirements of the “Medical Personnel Hand Hygiene Standard”, wear surgical mask/medical protective masks, and wear latex gloves when necessary.
（二） Take droplet isolation, contact isolation and air isolation protection measures, according to different situations, to achieve the following protection.
1. When contacting patients’ blood, body fluids, secretions, excretions, vomitus and contaminated articles: Wear cleaning gloves and wash hands after taking off gloves.
2. Wear medical protective masks, goggles and anti-seepage isolation gown when it may be splashed by patients’ blood, body fluids, secretions, etc.
3. When performing aerosol-producing operations (such as tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation and bronchoscopy, etc.) for suspected or confirmed patients:
(1) Take air isolation measures;
(2) Wear medical protective masks and conduct sealing performance tests;
(3) Eye protection (such as goggles or masks);
(4) Wear long-sleeved isolation gown and gloves to prevent body fluid infiltration;
(5) The operation shall be carried out in a well-ventilated room;
(6) The number of people in the room is limited to the minimum number of care and support required by patients.
(three) the protective equipment used by medical personnel shall conform to the relevant national standards.
(four) surgical mask, medical protective masks, goggles, isolation gown and other protective equipment should be replaced in a timely manner when contaminated by patients’ blood, body fluids, secretions and other contamination.
(five) the correct use of protective equipment, should wash hands before wearing gloves, should immediately flow water to wash hands after taking off gloves or isolation clothing.
(six) strictly implement the sharp injury prevention measures.
(7) The medical devices and instruments used by each patient shall be cleaned and disinfected in accordance with the requirements of the Technical Specification for Disinfection of Medical Institutions
(a) Suspected or confirmed patients shall be isolated in a timely manner, and shall be guided into the isolation area by special personnel according to the designated standard route.
(2) Before the patient enters the ward, he/she changes the patient’s clothing, personal belongings and the changed clothes. After centralized disinfection treatment, they are stored in the designated place and kept by the medical institution.
(3) Guide patients to correctly choose and wear masks, and correctly implement cough etiquette and hand hygiene.
(four) to strengthen the management of patients visiting or accompanying personnel.
(5) For isolated patients, in principle, their activities are limited to the isolation ward to reduce the movement of patients and switch wards. If it is really necessary to leave the isolation ward or isolation area, corresponding measures such as wearing surgical mask shall be taken to prevent patients from polluting other patients and the environment.
(6) When suspected or confirmed patients are discharged from hospital or transferred to hospital, they should change clean clothes before leaving, and carry out final disinfection on their contact environment according to the “Technical Specifications for Disinfection of Medical Institutions”.
(seven) suspected or confirmed patient death, the body should be handled in a timely manner. The treatment method is as follows: 3000mg/L chlorine-containing disinfectant or 0.5% peracetic acid cotton ball or gauze is used to fill all open channels of the patient’s mouth, nose, ear, anus, etc. Wrap the corpse with a double-layer cloth sheet, put it into a double-layer corpse bag, and send it directly to the designated place for cremation by a special vehicle. Personal belongings used by patients during hospitalization can only be taken home with patients or their families after disinfection.
Fight the epidemic, we go together!
Source: Jiangsu Provincial Hospital Infection Management Quality Control Center