傳染病防治醫療網東區應變醫院之院內感染應變及防疫任務作為

Responses to a Nosocomial Infection and Other Epidemic Prevention Tasks in the Communicable Disease Control Medical Network Strain Hospital in Eastern Taiwan

本院於2022年4月爆發院內群聚感染，隨即擴大執行全院員工普篩核酸檢測；此時已衍伸二個群聚感染事件：1.護理之家二樓、三樓住民；2.護理之家工作人員、一樓門診區以及其他院區員工。依據疾病管制署及其東區管制中心之應變處置會議建議：立即執行原地隔離治療及分流照護、營運立即降載、環境清消、動線管制、維持社交距離、全面停止新入院及停止探病、改視通訊診療、三日內完成確診長者抗病毒藥物、迅速擴充專責病房照護空間、照護人力妥適安排，啟動人力短缺應變計劃，專案申請確診者照顧確診者模式、積極推動員工及長者接種COVID-19疫苗，第一波院内群聚感染於二週內有效獲得控制，總計171人感染。當院內員工及病人再發生第二波及第三波小規模院內感染時，依循前例防疫經驗，修訂防疫管制逐步開放目標，在醫療與防疫並重下，滾動式調整因應策略，採取該單位或病室管控及隔離措施，提升整體照護量能，小規模的院内群聚事件很快就得到控制。

A nosocomial outbreak occurred in our hospital in April, 2022, and then expanded an implementation of Polymerase chain reaction (PCR) screening for all staff in the hospital; subsequential two cluster infection incidents were found: (1) 96% of residents of the nursing home; (2) related families and staffs, the outpatient area on the first floor of the same area, and other hospital staffs. According to the recommendations of the contingency meeting of the CDC and the East Management Center, in-situ isolation and care were proceed immediately, medical load reducing, cleaning up of the environment and other infection control measurements were also performed. All the infected residents of the nursing home were provided for antiviral drugs within three days. Properly arrange nursing manpower, start Manpower shortage contingency plan was triggered. The first wave of nosocomial cluster infections was effectively controlled within two weeks, and total 171 people were infected. When the second wave and the third wave of small-scale nosocomial infections occurred again, all the situations could be well handled. During the difficult time, many epidemic prevention tasks were also performed that were worth to be described in this article.