COVID-19全球流行時的契機：感染管制之轉變與創新

Turning Point during COVID-19 Pandemic: Transformation and Innovation of Infection Control in the Hospital

張雅媛(Yea-Yuan Chang) ； 顧文瑋(Wen-Wei Ku) ； 林志陵(Chih-Lin Lin) ； 陳冠仰(Kuan-Yang Chen) ； 蕭勝煌(Sheng-Huang Hsiao)

《北市醫學雜誌》 17卷4期 (2020/12) Pp. 390-401

https://doi.org/10.6200/TCMJ.202012_17(4).0004

摘要

2019年底起源於中國武漢之新型冠狀病毒COVID-19疫情，造成全球大流行。台灣經歷17年前的SARS疫情，對COVID-19及早因應並希望能防堵於境外。COVID-19風暴下，醫療體系、醫療生態及醫療行為都需快速的轉變與因應。本文簡述在台灣防疫政策下，臺北市立聯合醫院仁愛院區面對疫情四個階段的因應作為，並探討COVID-19所帶來的衝擊與創新。第一階段，經由加強入院人員監測及開設專責病房來預防COVID-19院內感染。第二階段，加強社區COVID-19監測、提升特殊單位防護、分艙分流、及非緊急醫療服務量降載來因應可能面臨之本土社區感染。第三階段因應COVID-19全球大流行，規劃重症加護病床。第四階段為如何與COVID-19長期抗戰與共舞。在目前COVID-19尚無有效藥物及疫苗之狀況下，大流行對社會及醫療體系有極大的衝擊與崩壞之可能性。仁愛院區透過各單位水平與垂直整合，根據疫情即時、滾動式調整，建立感染管制文化，守護醫院及台灣。

關鍵字

COVID-19 ； 感染管制 ； 專責病房 ； 社區監測 ； 分艙分流 ； 社交距離

並列摘要

The outbreak of novel coronavirus disease 2019 (COVID-19) was first reported by the end of 2019 in Wuhan, China, , and is currently causing a global pandemic. Taiwan had a SARS outbreak 17 years ago, which primed the Central Epidemic Command Center to respond to COVID-19 earlier and swiftly and keep the virus away from the country. Timely response and alteration of the healthcare systems, ecology and behaviors of daily are mandatory. This article briefly describes the four stages of Taipei City Hospital Renai Branch, Taiwan in response to the pandemic, and discusses the impact and innovation brought by COVID-19. At the first stage, nosocomial infection was prevented by strengthening of active surveillance of all admitted patients and setting up of quarantine wards for suspected COVID-19 cases. The second stage was to strengthen the community surveillance, enhance protection for health workers in special units, triage and compartmentalization, and reducing inpatient and outpatient number to respond to potential community outbreak. At the third stage, we expanded the capacity of intensive care units for isolation in response to the global pandemic. The fourth stage was to plan a long-term defense and ＂dance＂ with COVID-19. The COVID-19 pandemic may pound and break the society and healthcare systems with force in the absence of effective pharmaceutics and vaccines. The Renai branch adjusts the response strategy in a rolling style and establishes infection control culture to guide the hospital and the nation through horizontal and vertical integration.

並列關鍵字

COVID-19 ； infection control ； quarantine ward ； community monitoring ； triage and compartmentalization ； social distancing