臺北榮民總醫院婦產部對COVID-19疫情的感染管制措施與成效

COVID-19 control measures and their effectiveness in the Department of Obstetrics and Gynecology, Taipei Veterans General Hospital

目標：新型冠狀病毒全球大流行，需有由中央到醫院、院級到各科部的多層級全面防疫措施，以兼顧防疫與照顧品質。本案旨在探討臺北榮民總醫院婦產部採行的感染管制措施與成效。方法：針對高風險個案、新生兒運送、親職教室、訪客眾多四個防疫問題點，研擬及早鑑別風險、減少嬰兒暴觸感染機會、採行替代方案、採行訪客管理四個策略，制定執行措施，於待產室、產房、手術室及普通病房落實執行。結果：2020年全年共照顧16位高危險個案，無確診案例、無院內感染發生，2020年1月到6月純母乳哺餵率44.8％，較往年同期增加1.3～1.5％，親子同室率7.7％，相較去年同期無改變，依期別產前親職教室準媽媽出席率4.4％、4.7％，相較去年無明顯變化；準爸爸出席率1.8％、1.6％，相較去年下降0.7～1.1％；這些比較均無統計上顯著差異。結論：疫情期間調整照護模式，純母乳哺餵率及親子同室率未受影響。顯現防疫限制下，仍可維持醫療品質。

Objectives: The coronavirus disease (COVID-19) pandemic requires multilevel comprehensive epidemic prevention measures from the central government to hospitals and from hospitals to departments in order to control it. The aim of this study was to assess the effectiveness of infection control measures implemented by the Department of Obstetrics and Gynecology, Taipei Veterans General Hospital. Methods: Strategies were developed to deal with high-risk cases, newborn transportation, parental classes, and visits and companions. These strategies included early risk identification, infant exposure reduction, alternative health education tactics, and visitor management. Results: In 2020, 16 high-risk patients received care at our department. No confirmed COVID-19 cases and nosocomial infections were noted. Exclusive breastfeeding rate during the period of January to June 2020 was 44.8%, an increase of 1.3% and 1.5% over the same period in 2019 and 2018, respectively. The rooming-in rate was 7.7%, similar to that (7.5%) of the same period in 2019. Session-specific attendance rates in prenatal parenting classes were 4.4% for second semester and 4.7% for third semester expectant mothers; there was no significant change compared with the 2019 rates (4.5% and 4.6%). The attendance rate of expectant fathers was 1.8% for the second semester and 1.6% for the third semester, a decrease of 0.7% and 1.1%, respectively, compared with the 2019 rates. However, these differences were not statistically significant. Conclusions: The infection control measures implemented for early risk identification, infant exposure reduction, alternative prenatal parenting education, and visitor management were effective as no COVID-19 case occurred and the quality of patient care and treatment was maintained.