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National Health Commission: Primary medical institutions need to conduct nucleic acid testing on all fever patients
2020-12-08 10:20 Reporter: Dai Xuan Editor: Fan Yijing
Beijing News (Reporter Dai Xuan) Winter and spring are the seasons for high incidence of respiratory infectious diseases. In my country, sporadic cases of new coronary pneumonia still occur from time to time in some areas. Recently, the State Council has responded to the requirements of the Comprehensive Team of Joint Prevention and Control Mechanisms for the Novel Coronavirus Pneumonia Epidemic. Primary medical institutions need to conduct nucleic acid testing and blood routine examinations on all fever patients. Those who do not have the testing capabilities must pass other medical institutions or third-party testing. Institutional cooperation provides testing services for fever patients.
While many major hospitals are carrying out the renovation of fever clinics, primary medical institutions are also required to strengthen their ability to prevent and control the epidemic.
Recently, the State Council’s Comprehensive Team for the Joint Prevention and Control Mechanism for the Novel Coronavirus Pneumonia Epidemic issued the "Notice on Strengthening the Establishment of Fever Clinics in Primary Medical and Health Institutions", which requires the principles of "extensive design, reasonable layout, qualified conditions, and work standards" Combining the prevention and control of infectious diseases and the actual medical needs of the people, set up fever clinics in qualified township health centers and community health service centers. All grassroots medical and health institutions should strictly implement pre-inspection and triage and realize the function of "sentinel".
What is the fever clinic? According to the document description, this institution can ensure the registration, screening, isolation, reporting, treatment, and referral of fever patients under the requirements of normalized epidemic prevention and control. Localities can judge according to the emergency response level of public health emergencies, etc. Operation mode and timely adjustment. The fever clinic also has the function of "combining peace and war".
When setting up fever clinics, localities need to meet the requirements of pre-inspection and triage settings, infection prevention and control, and personnel.
Primary-level medical and health institutions shall strictly implement the pre-inspection and triage system, and set up pre-inspection and triage points in the outpatient and emergency department. Localities should formulate triage standards and procedures, and pre-inspection triage points should inform patients with fever of the instructions for treatment according to relevant standards, and be responsible for the guidance of patients with fever and their accompanying persons.
Nucleic acid testing is the gold standard for diagnosing new coronary pneumonia. Primary medical institutions need to conduct nucleic acid testing and routine blood tests on all fever patients. Those who do not have the testing capabilities must provide testing services for fever patients through cooperation with other medical institutions or third-party testing agencies. In addition, fever clinics should strictly implement the responsibility system for the first consultation, and should not refuse consultations or send or receive fever patients. All patients who go to the fever clinic must register valid identification information or scan the "health code". Strengthen early disease diagnosis and infectious disease screening, and transfer patients with infectious diseases who need centralized treatment to designated hospitals for intensive treatment as soon as possible, and register and report cases as required. For patients whose diagnosis is not clear and infectious diseases cannot be ruled out, they should also be reported in time, and the patients should be isolated, and they should not be allowed to transfer or leave the hospital without authorization. For patients with severe high-risk factors or rapid disease progression, they need to be transferred to qualified hospitals for further treatment.
The fever clinic should be located in a relatively independent area within the institution, with physical isolation barriers from ordinary outpatient (emergency) clinics, to avoid the intersection of fever patients and other patients. The consultation room should meet the requirements of "three areas and two passages" (contaminated area, potentially contaminated area, clean area, patient passage, and staff passage). The consultation room should be well ventilated and independent air-conditioning should be used. Significant locations such as entrances and exits of institutions are marked to guide fever patients to the fever clinic for treatment. The fever clinic should be combined with the actual setting of independent or temporary isolation observation (room) area. Conditions can be divided into waiting areas, treatment rooms, laboratory, pharmacy, etc. Separate toilets should be provided for fever patients. The facilities and equipment provided shall meet the actual functions of the clinic, including office equipment, diagnosis and treatment equipment, protective equipment and disinfection equipment, etc. The facilities and equipment shall be corrosion resistant and convenient for disinfection. There should be a certain reserve of protective equipment.
The medical staff assigned to the fever clinic shall be proficient in the diagnosis, treatment, protection, transfer, isolation and disinfection of infectious diseases, etc., and shall be trained in relevant laws and regulations and knowledge and skills of infectious diseases.
The reporter learned that the local government put forward more detailed requirements on the setting of hot sentinels.
For example, the Beijing Municipal Health Commission has clearly stipulated the procedures for the treatment of fever sentinel sites: after patients enter the sentinel site, they must first go through the five processes of pre-examination and triage, re-testing of body temperature, information registration, inquiry of medical history, and inquiry of performance, and ensure Closed-loop management, for patients with epidemiological history, clinical manifestations and examination results that meet or partially meet the diagnostic criteria for infectious diseases such as new coronary pneumonia or suspected patients who need further diagnosis, the receiving physician will guide them to the sentinel observation area for on-site isolation And report immediately; contact 120 or a special vehicle in time, transfer to the fever clinic designated by the district health committee, and make a referral and record. After the referral, disinfect the sentinel clinic and related areas.
The Shanghai Municipal Health Commission requires that fever sentinel clinics should have independent air conditioning and ventilation systems and should be equipped with senior physicians with certain clinical experience. For fever caused by unknown causes, or beyond the capacity of community diagnosis and treatment, the community health service center will refer patients to the nearest regional medical center for fever diagnosis and treatment. According to the plan, during the epidemic of infectious diseases, persons with fever of unknown origin should be registered, reported, handled and transferred in accordance with relevant regulations.
https://www.bjnews.com.cn/detail/160739350215064.html
2020-12-08 10:20 Reporter: Dai Xuan Editor: Fan Yijing
Beijing News (Reporter Dai Xuan) Winter and spring are the seasons for high incidence of respiratory infectious diseases. In my country, sporadic cases of new coronary pneumonia still occur from time to time in some areas. Recently, the State Council has responded to the requirements of the Comprehensive Team of Joint Prevention and Control Mechanisms for the Novel Coronavirus Pneumonia Epidemic. Primary medical institutions need to conduct nucleic acid testing and blood routine examinations on all fever patients. Those who do not have the testing capabilities must pass other medical institutions or third-party testing. Institutional cooperation provides testing services for fever patients.
While many major hospitals are carrying out the renovation of fever clinics, primary medical institutions are also required to strengthen their ability to prevent and control the epidemic.
Recently, the State Council’s Comprehensive Team for the Joint Prevention and Control Mechanism for the Novel Coronavirus Pneumonia Epidemic issued the "Notice on Strengthening the Establishment of Fever Clinics in Primary Medical and Health Institutions", which requires the principles of "extensive design, reasonable layout, qualified conditions, and work standards" Combining the prevention and control of infectious diseases and the actual medical needs of the people, set up fever clinics in qualified township health centers and community health service centers. All grassroots medical and health institutions should strictly implement pre-inspection and triage and realize the function of "sentinel".
What is the fever clinic? According to the document description, this institution can ensure the registration, screening, isolation, reporting, treatment, and referral of fever patients under the requirements of normalized epidemic prevention and control. Localities can judge according to the emergency response level of public health emergencies, etc. Operation mode and timely adjustment. The fever clinic also has the function of "combining peace and war".
When setting up fever clinics, localities need to meet the requirements of pre-inspection and triage settings, infection prevention and control, and personnel.
Primary-level medical and health institutions shall strictly implement the pre-inspection and triage system, and set up pre-inspection and triage points in the outpatient and emergency department. Localities should formulate triage standards and procedures, and pre-inspection triage points should inform patients with fever of the instructions for treatment according to relevant standards, and be responsible for the guidance of patients with fever and their accompanying persons.
Nucleic acid testing is the gold standard for diagnosing new coronary pneumonia. Primary medical institutions need to conduct nucleic acid testing and routine blood tests on all fever patients. Those who do not have the testing capabilities must provide testing services for fever patients through cooperation with other medical institutions or third-party testing agencies. In addition, fever clinics should strictly implement the responsibility system for the first consultation, and should not refuse consultations or send or receive fever patients. All patients who go to the fever clinic must register valid identification information or scan the "health code". Strengthen early disease diagnosis and infectious disease screening, and transfer patients with infectious diseases who need centralized treatment to designated hospitals for intensive treatment as soon as possible, and register and report cases as required. For patients whose diagnosis is not clear and infectious diseases cannot be ruled out, they should also be reported in time, and the patients should be isolated, and they should not be allowed to transfer or leave the hospital without authorization. For patients with severe high-risk factors or rapid disease progression, they need to be transferred to qualified hospitals for further treatment.
The fever clinic should be located in a relatively independent area within the institution, with physical isolation barriers from ordinary outpatient (emergency) clinics, to avoid the intersection of fever patients and other patients. The consultation room should meet the requirements of "three areas and two passages" (contaminated area, potentially contaminated area, clean area, patient passage, and staff passage). The consultation room should be well ventilated and independent air-conditioning should be used. Significant locations such as entrances and exits of institutions are marked to guide fever patients to the fever clinic for treatment. The fever clinic should be combined with the actual setting of independent or temporary isolation observation (room) area. Conditions can be divided into waiting areas, treatment rooms, laboratory, pharmacy, etc. Separate toilets should be provided for fever patients. The facilities and equipment provided shall meet the actual functions of the clinic, including office equipment, diagnosis and treatment equipment, protective equipment and disinfection equipment, etc. The facilities and equipment shall be corrosion resistant and convenient for disinfection. There should be a certain reserve of protective equipment.
The medical staff assigned to the fever clinic shall be proficient in the diagnosis, treatment, protection, transfer, isolation and disinfection of infectious diseases, etc., and shall be trained in relevant laws and regulations and knowledge and skills of infectious diseases.
The reporter learned that the local government put forward more detailed requirements on the setting of hot sentinels.
For example, the Beijing Municipal Health Commission has clearly stipulated the procedures for the treatment of fever sentinel sites: after patients enter the sentinel site, they must first go through the five processes of pre-examination and triage, re-testing of body temperature, information registration, inquiry of medical history, and inquiry of performance, and ensure Closed-loop management, for patients with epidemiological history, clinical manifestations and examination results that meet or partially meet the diagnostic criteria for infectious diseases such as new coronary pneumonia or suspected patients who need further diagnosis, the receiving physician will guide them to the sentinel observation area for on-site isolation And report immediately; contact 120 or a special vehicle in time, transfer to the fever clinic designated by the district health committee, and make a referral and record. After the referral, disinfect the sentinel clinic and related areas.
The Shanghai Municipal Health Commission requires that fever sentinel clinics should have independent air conditioning and ventilation systems and should be equipped with senior physicians with certain clinical experience. For fever caused by unknown causes, or beyond the capacity of community diagnosis and treatment, the community health service center will refer patients to the nearest regional medical center for fever diagnosis and treatment. According to the plan, during the epidemic of infectious diseases, persons with fever of unknown origin should be registered, reported, handled and transferred in accordance with relevant regulations.
https://www.bjnews.com.cn/detail/160739350215064.html