Facing complicated developments of the COVID-19 epidemic, based on the new requirements and guidelines of the National Steering Committee, the Ministry of Health, the City Steering Committee, the Department of Health has updated a new version. Activities to be implemented in hospitals through “Recommendation of disease prevention activities in the hospital so that the hospital does not become a COVID-19 infection site during an outbreak re ”(version 3.0).

Recommendation of prevention activities in the hospital so that the hospital does not become a place of COVID-19 infection during the outbreak of the disease (Version 3.0)

  1. Implement synchronous disease prevention and control measures in the hospital so that the hospital does not become a place of COVID-19 infection and reduces the risk of cross-contamination of other infections in the hospital. each officer, officer and employee in all departments and rooms of the hospital. Organize the evaluation and re-evaluation of the hospital's achievement according to the “Hospital Criteria for safe and prevent COVID-19 and acute respiratory infections” (according to Decision No. 3088 / QD-BYT dated 16 July 2020 of the Minister of Health) helps guide the hospital to identify priority issues for safe medical examination and treatment, prevention of infection for patients and health workers. Strengthen the inspection and supervision of compliance of medical staff in departments and rooms throughout the hospital on hospital safety criteria.


  1. Perform 24/7 medical screening and check-ups at all entrances of the hospital, apply for everyone to the hospital, ensure that each person must wear a mask, measure body temperature, and clean hand and perform medical declaration, marking the person who has been screened. Content of medical declaration should be regularly updated to suit the new situation of disease developments and in accordance with regulations. Promote the application of information technology in medical declaration. To deploy a screening clinic near the entrance or hall near the place where the medical declaration is made, separate from other departments and rooms; the isolation area (if any) is located near the screening room, ensuring ventilation and separation from other departments of the hospital. Arrange a temporary isolation chamber near the screening room if the hospital does not have an isolation ward.


  1. Review and reorganize the clinics at the examination department to organize the streamlined flow of patients to ensure that patients with fever and respiratory symptoms are immediately separated from other patients. from when to register. Review and take measures to ensure maximum safety and prevent infection for all high-risk patients, especially the elderly and those with underlying medical conditions. Thoroughly screen all patients being treated in clinical departments, perform isolation in separate areas and indicate early testing of SARS-CoV-2 according to regulations.


  1. Immediately transfer the patient to the quarantine area if there are signs of suspicion or having an epidemiological factor related to COVID-19, take samples and transfer samples to a hospital authorized to perform SARS-CoV- 2. Arrange each patient to a separate room while waiting for the test result, if the result is positive, send the patient to one of the hospitals assigned to receive treatment. Carry out disinfection and cleaning of the chamber as soon as the patient leaves the isolation ward. If the hospital does not have an isolation ward, let the patient stay in a temporary isolation ward while waiting for procedures to be transferred to the hospital assigned to accept it for testing, monitoring and treatment.


  1. Set up a screening emergency room at the Emergency Department of the hospital, separate from the rest of the Emergency Department. The screening emergency room is the first receiving place for all patients transferred to the Emergency Department, ensuring that all emergencies after first aid or emergency resuscitation are carefully screened. risk factors associated with COVID-19 or influenza syndrome or a suspected viral severe acute respiratory infection and sampling as prescribed when indicated, only refer the patient to the Emergency Department when suspicion of COVID-19 has been ruled out. Make sure the medical staff on duty at the emergency room screen and use personal protective equipment in accordance with the regulations. Carry out disinfection and cleaning of emergency screening rooms right after the patient leaves. Perform comprehensive patient care in emergency and intensive care units.


  1. Strengthen screening and indication of testing for SARS-CoV-2 for patients who visit or are being treated in medical facilities with symptoms of influenza syndrome or an active acute respiratory infection rapid, viral pneumonia (according to City Center for Disease Control Guidelines). Special attention should be paid to clusters of cases (from 02 cases in the same household or in the same classroom or in the same office, ...) or for the elderly, people with chronic diseases. In unclear cases, please contact the City Center for Disease Control or the end-line hospitals assigned by the Ministry of Health for advice. The general and specialized hospitals are encouraged to deploy RT-PCR testing to find SARS-CoV-2 to proactively propose to the Ministry of Health for evaluation and recognition of eligibility for implementation.


  1. When receiving a patient who is a foreigner, or a Vietnamese from abroad or from a province or city with epidemic outbreaks, transferred back for further treatment because of different diseases must be tested for SARS-CoV -2, take care and monitor the patient in the hospital's isolation ward in accordance with regulations. Perform spot sampling, X-ray and bed ultrasound when indicated for inpatient cases with suspected COVID-19 symptoms or flu symptoms or Severe acute viral respiratory tract infections to limit the risk of cross-contamination with other departments in the hospital. The higher level hospitals give priority to receiving serious patients transferred by the lower levels, and minimize the usual cases of medical examination that the lower levels can perform.


  1. Perform spacing in areas where people often gather in the hospital, take measures to maintain a minimum distance of 1m between the patient, the patient's relative, and the hospital staff. Ensure a well-ventilated environment in the patient rooms. Do not organize family members to visit patients, minimize family members taking care of the sick. Carry out the dispensing of drugs for treatment of chronic diseases for a longer time, not exceeding 03 months. Maintaining the operation of "hand hygiene stations" at the examination department and other departments and rooms in the hospital, with solutions to encourage patients, their relatives, and hospital staff to regularly wash or disinfect their hands . If the hospital has a boarding house dedicated to the patient's relatives, ensuring hygiene, ventilation, providing adequate hand sanitizer solutions, regularly checking the compliance with masking, keeping a minimum distance, promptly detect new cases of disease for isolation and monitoring. Deployment of medical examination by appointment time, speeding up the progress and diversifying forms of non-cash hospital fee payment


  1. Ensure adequate supply of personal protective equipment for all medical staff directly involved in medical examination and treatment or performing sub-clinical techniques, directly caring for and treating suspected patients. have frequent suspicion of COVID-19 or manifestations of influenza syndrome or suspected viral severe acute respiratory infection. Ensure hospital staff use the correct personal protective equipment in each specific situation according to the guidance of the Ministry of Health and the recommendations of the World Health Organization (Rational use of personal protective equipment for Corona virus disease 2019 (COVID-19) -WHO, 02/27/2020).


  1. Deploy negative pressure isolation chambers in resuscitation departments or isolators of hospitals assigned to receive and treat patients with COVID-19. Preferred use of a negative pressure isolation chamber for SARS-CoV-2 positive cases requiring respiratory assistance or surgical intervention or an aerosol-generating procedure. Newly installed negative pressure chambers must be checked and accepted based on technical criteria issued by the Science and Technology Council of the Department of Health (pending specific instructions from the Ministry of Health). Deploying maintenance and maintenance of the negative pressure chamber in accordance with regulations.


  1. Strengthen health management solutions for hospital staff, hospital goods supply staff (pharmaceuticals, chemicals, consumables, stationery, ...) and employees of the public. The company contracts with the hospital to provide services for patients (cafeteria, nutrition, security, parking, industrial hygiene ...). All must make a medical report before entering the hospital, must be trained and re-trained on the basics of infection control, and prevention of COVID-19 infection, must be equipped with facilities. Appropriate personal protection when dealing with sick people, their relatives and hospital staff, must be monitored continuously, if there is fever or respiratory symptoms, report immediately to the staff in charge. medical facilities are assigned by the hospital to isolate, test and treat promptly.


  1. Training and retraining on infection control, reception, screening and enrollment procedures for patients with suspected COVID-19 and other issues related to COVID-19 epidemic prevention for all staff depending on the position of work. Particularly, doctors and nurses must be trained to update the instructions on diagnosis and treatment of acute respiratory infections caused by the SARS-CoV-2 virus issued by the Ministry of Health, and encourage professional organizations to update. The various clinical forms of the COVID-19 epidemic are published in valuable scientific journals. Carry out communication in the hospital about the responsibility of each citizen for COVID-19 epidemic prevention and control such as installing Bluezone, nCoVi applications on smartphones.


  1. Consolidate the hospital's information technology infrastructure to promote and maintain online meetings, online briefings and remote consultation. There is a plan to arrange workforce to work in shifts with fixed personnel, the crews do not come in direct contact with each other to prevent cross-contamination occurring and must be isolated from the medical system according to regulations; mobilize doctors from other departments to support the Infectious Department (when needed) to help ensure rest and recovery for doctors of the Infectious Department. Supervise all health-care workers with influenza syndrome, acute respiratory infections, pay special attention to those who have been cared for and have been in contact with sick people with flu syndrome or severe acute respiratory infections. virus for 14 days before symptoms appear.


  1. When a person with COVID-19 is found in the department or room of a hospital or someone in contact with someone with COVID-19 (who is not a patient), the hospital director must issue a decision to establish Isolation areas, for faculty, room and interdisciplinary scale, to make a list of all contacts to perform the isolation and diagnostic tests as prescribed, and to report urgently to the Department of Medicine Health Center and the City's Center for Disease Control. Actively coordinate with district health centers in the area to disinfect the entire departments and related departments in accordance with regulations before operating again.


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