加強版防疫專責旅館隔離個案返家之關懷

The Care Plan of the Enhanced Anti-Epidemic Hotel Isolation Cases after Returning Home

2021年5月台灣爆發COVID-19社區感染，5月11日起4天內北市累計336例確診，醫療量能嚴重超出負荷。本院2021年5月奉市府指示接管北部2家防疫專責旅館，與臺北市政府共同創設「加強版防疫專責旅館」，提供快篩陽性的無症狀或輕症民眾入住。在醫院治療者，出院返家會接受出院準備服務的關懷及追蹤。但面對新興傳染病的個案，首次以入住防疫旅館的型態收住，當個案解除隔離返家後的自主健康管理或是居家環境消毒等感管措施，尚無相關管道或權責單位關注。臺北市立聯合醫院中興院區於2021年6月開始接手2家加強版防疫專責旅館，由醫師、護理師、藥師等醫療團隊進駐。以個案管理的全人照護運作模式，離所返家後亦進行電話關懷訪視，提供持續性照護服務。於2021年5月14日-2021年7月13日期間，共入住防疫旅館557人，平均年齡46歲，最長者91歲、最小為2歲；入住時有症狀者349人（62.6%）；自我照顧能力良好503位（90.3%）；平均入住隔離為9天。返家1周內進行電話關懷，在病情上有509人（91.4%）是穩定的，14.9%仍有殘存症狀。在居家環境部分僅有38.9%及42.6%能夠正確稀釋漂白水消毒環境及執行衛浴清消。顯示居家環境清消的正確性及遵從性上仍有待加強。建議應加強宣導及落實居家環境的防護措施，才能避免家戶感染及阻斷社區傳播的風險。

In May 2021, 336 cases of COVID-19 infection were confirmed in Taipei City in four days since May 11, and the medical capacity was severely overloaded. In May 2021, under the instruction of the Taipei municipal government, our hospital took over the two anti-epidemic hotels in northern Taiwan, and together with the Taipei Municipal Government, we created the ''Enhanced Anti-epidemic Hotel'' to provide accommodation for asymptomatic or mild symptoms patients who tested positive in rapid screening. For those who are treated in the hospital, they will receive discharge care and follow up from discharge preparation service when they return home. However, for emerging infectious diseases, admission to this type of anti-epidemic hotel is a novel attempt. When the case is released from isolation to return home, issues including independent health management or home environment disinfection and other infection management measures emerged, but there is no relevant channel or authority concerned. The Taipei City Hospital Zhongxing Branch will take over two Enhanced Anti-epidemic Hotel in June 2021, with a medical team of doctors, nurses, and pharmacists on site. The whole-person care operation model is based on case management, and telephone care will be conducted after the patients return home to provide continuous care services. During the period from May 14, 2021 to July 13, 2021, a total of 557 people were admitted in the Enhanced Anti-epidemic Hotel, with an average age of 46 years, the oldest being 91 years old and the youngest 2 years old; 349 people (62.6%) had symptoms at the time of admission; 503 people (90.3%) were able to take care of themselves; and the average length of stay was 9 days. Telephone care within one week of returning home, and 509 (91.4%) were stable in condition, and 14.9% still had residual symptoms. In the home environment, only 38.9% and 42.6% were able to properly dilute bleach to disinfect the environment and perform sanitary cleaning and disinfection. It showed that the accuracy and compliance of home environment cleaning and disinfection were still needed to be strengthened. It is suggested that the promotion and implementation of protective measures in the home environment should be strengthened to reduce the risk of household infection and block community transmission.