某區域教學醫院附設護理之家流感群聚之經驗分享

A Study on Influenza A Cluster Infection in an Attached Nursing Home Ward of Regional Teaching Hospital

南部某區域教學醫院附設護理之家2015年9月初於發生A型流感群聚感染，共計19位出現上呼吸道感染（住民12位、員工包含照服員2位、護理師1位、實習護生4位計共7位），A型流感陽性的住民9位（75%）、員工2位（28.6%）。本次群聚事件經驗再次強調應落實感染措施作為，包含：（1）人員管理：執行手部衛生、配戴口罩、員工健康監測、照護政策；（2）住民管理：住民健康監測、啟動住民防護措施、分區收治、就地隔離、暫停團體活動、訪客管制；（3）環境管理：病室分區清消、清潔用具分區消毒，以漂白水500 PPM（1:100）執行環境清消；（4）預防性抗病毒藥劑同步施用。整體事件追蹤到9月22日無論住民或員工均無新增發生，透過積極介入感染管制措施，使得流感群聚獲得有效控制及提供臨床實務上運作。

An outbreak of influenza A virus infection occurred in a nursing home attached to a regional teaching hospital in southern Taiwan from September 4 to September 12, 2015. A total of 19 nasopharyngeal specimens from 12 residents and seven crews were collected for the rapid influenza antigen test, out of which seven residents and two crews demonstrated positive results. The investigation revealed that work colleagues were not sufficiently vigilant. Patients often entered emergency rooms, underwent rehabilitation and acute medical treatments; therefore, were easily exposed to the threat of influenza virus infection. In addition, beds were placed in a closed environment and the isolation bed could not be adjusted in time, which resulted in influenza clusters. In response to this outbreak, immediate interventions, including triage and isolation measures, use of antiviral agents, antiviral prophylactic measures, environment cleaning, and hand hygiene were implemented. There were no more cases on the 10th day after the interventions. Successful control of the outbreak was achieved with such immediate interventions.