新型冠状病毒肺炎儿童定点医院管理经验分享

Management experience of a designated hospital for children with coronavirus disease 2019

摘要:

新型冠状病毒肺炎（简称“新冠肺炎”）全球性疫情给传统医疗模式带来巨大挑战。2022年3~5月，上海新冠肺炎流行期间，由于Omicron变异株传染性强、容易免疫逃逸发生疫苗突破性感染，儿童病例数骤增。儿童新冠肺炎定点医院的设立，在儿童专科医院和方舱医院之间起到承上启下的关键作用。自2022年4月7日至6月2日，上海交通大学医学院附属仁济医院（南部院区）儿童新冠肺炎病例定点医院共收治871例儿童新冠肺炎病例，其中3岁以下儿童568例（65.2%），轻型/普通型病例870例（99.9%），1例重型病例。该文报告该定点医院对儿童新冠肺炎病例的管理经验，主要包括：构建病例入院流程，强化以多学科为基础的规范化诊疗，优化重症管理预警和救治系统，实施以家庭为中心的“亲子”护理策略，落实“一人一策”中医中药治疗方案，优化出院流程、加强床位周转，严格全轨迹防控、降低院内感染风险，构建结构化病历系统、借助信息平台、适应病例大流量工作模式，开展科学研究、分析诊疗经验等。

Abstract:

The global pandemic of coronavirus disease 2019 (COVID-19) has brought great challenges to the traditional medical model. During the outbreak of COVID-19 in Shanghai, China, from March to May, 2022, there was a significant increase in the number of pediatric cases due to high transmissibility, immune escape, and vaccine breakthrough capacity of Omicron variants. The designated hospitals for children with COVID-19 served as a connecting link between children's specialized hospitals and mobile cabin hospitals. From April 7 to June 2, 2022, a total of 871 children with COVID-19 were admitted to Renji Hospital, Shanghai Jiao Tong University School of Medicine (South Branch), a designated hospital for children with COVID-19. Among these patients, 568 (65.2%) were children under 3 years old, 870 (99.9%) were mild or moderate, and 1 was severe. This article reports the experience in the management of pediatric cases in this designated hospital, which included the following aspects: establishing an optimal case-admission process; strengthening multidisciplinary standardized diagnosis and treatment; optimizing the management, warning, and rescue system for severe COVID-19; implementing family-centered nursing care; formulating an individualized traditional Chinese medicine treatment regimen; optimizing the discharge process and strengthening bed turnover; implementing strict whole-process control to reduce the risk of nosocomial infection; constructing a structured medical record system and using information platforms to adapt to the work mode of large-volume cases; conducting scientific research and sharing the experience in diagnosis and treatment.