登革热疫情下某三级综合医院动态分区管理防控模式构建及其效果

Construction and effectiveness evaluation of dynamic zoning management model in a tertiary general hospital during Dengue epidemic

  • 摘要:
    目的 探讨登革热疫情期间收治医院动态分区管理防控模式的构建路径及防控效能, 为优化院内感染控制策略提供依据。
    方法 采用回顾性分析方法, 以2024年某三级综合医院登革热疫情防控实践数据为样本, 对“分区收治-动态调配-环境协同”三位一体防控模式的应用效果进行评估。基于疫情期间实施的“核心病区-专科协同”动态分区、弹性病房扩展、分级消杀、资源实时动态调配机制及环境精准干预等感染防控优化策略, 在感染控制、资源利用、防控成本及患者结局等主要维度予以防控效能的综合评价。
    结果 通过弹性病房建设, 扩展隔离床位数占总床位数的44.13%(331/750), 其中核心病区144张占19.20%, 专科协同病区187张占24.93%, 专科协同病区的扩展使隔离收治量提升129.86%。两类病区分别收治57.27%登革热单病种患者和42.73%合并内外妇产儿专科诊疗需求隔离患者, 弹性缓冲隔离床位最低配比为6.34%(21/331), 单日最大诊治量310人, 医院感染例次发病率0、成蚊密度峰值0.13只/盏·夜、防控成本为95.22元/例、患者满意度提高1.98%(95.09 vs. 93.24)(P=0.014)。
    结论 “动态分区”模式通过三环节协同, 实现住院病区“平疫转换”快速空间弹性重构, 在有效阻断院内传播的基础上保障了多专科救治需求, 使医院在疫情暴发期兼顾防控安全底线与履行医疗服务多元化需求之中找到平衡, 能为医疗机构应对蚊媒传染病突发公共卫生事件提供标准化防控解决方案,实现院内登革热零交叉感染。

     

    Abstract:
    OBJECTIVE To explore the construction path and effectiveness of dynamic zoning management model during dengue fever pandemic, and to provide evidence for optimizing hospital-acquired infection control strategies.
    METHODS Retrospective analysis method was conducted, the practical data of dengue fever epidemic prevention and control in a tertiary general hospital in 2024 as the sample, to evaluate the application effect of the "zoned treatment-dynamic allocation-environmental coordination" trinity prevention and control model. Based on the optimized infection prevention and control strategies implemented during the epidemic, such as the "core ward-specialist collaboration" dynamic zoning, flexible ward expansion, hierarchical disinfection, real-time dynamic resource allocation mechanism, and precise environmental intervention, a comprehensive evaluation of prevention and control efficiency was conducted across key dimensions including infection control, resource utilization, prevention and control costs and patient outcomes.
    RESULTS Through the construction of flexible wards, the number of expanded isolation beds accounted for 44.13% (331/750) of the total beds, including 144 beds (19.20%) in core wards and 187 beds (24.93%) in specialist collaborative wards. The expansion of specialist collaborative wards increased the isolation admission capacity by 129.86%. The two types of wards admitted 57.27% of single-disease dengue patients and 42.73% of isolated patients with combined diagnosis and treatment needs from internal medicine, surgery, obstetrics, gynecology, and pediatrics. The minimum ratio of flexible buffer isolation beds was 6.34% (21/331), with a maximum daily treatment capacity of 310 patients. Data showed: hospital infection incidence rate was 0, peak adult mosquito density was 0.13 mosquitoes/trap·night, prevention and control cost was 95.22 yuan per case, and patient satisfaction increased by 1.98% (95.09 vs. 93.24, P=0.014).
    CONCLUSIONS The "dynamic zoning" model achieves rapid spatial elastic reconstruction of inpatient wards for "peace-epidemic conversion" through the coordination of three links. Based on effectively blocking in-hospital transmission, it ensures the needs of multi-specialty treatment, enabling the hospital to strike a balance between the bottom line of prevention and control safety and the fulfillment of diversified medical service requirements during the epidemic outbreak period. It can provide standardized prevention and control solutions for medical institutions to respond to public health emergencies of vector-borne infectious diseases, and achieve the goal of zero cross infection of hospital-acquired Dengue.

     

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