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Shi X, Cai YT, Cai X, Wen XL, Wang JY, Ma WC, Shen J, Wu JX, Liu HY, Sun J, He PQ, Lin Y, Zhao DY, Li PQ. Management and implementation strategies of pre-screening triage in children during coronavirus disease 2019 pandemic in Guangzhou, China. World J Clin Cases 2021; 9:2731-2738. [PMID: 33969056 PMCID: PMC8058678 DOI: 10.12998/wjcc.v9.i12.2731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/28/2020] [Accepted: 03/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Emerging infectious diseases are a constant threat to the public’s health and health care systems around the world. Coronavirus disease 2019 (COVID-2019), which was defined by the World Health Organization as pandemic, has rapidly emerged as a global health threat. Outbreak evolution and prevention of international implications require substantial flexibility of frontline health care facilities in their response.
AIM To explore the effect of the implementation and management strategy of pre-screening triage in children during COVID-19.
METHODS The standardized triage screening procedures included a standardized triage screening questionnaire, setup of pre-screening triage station, multi-point temperature monitoring, extensive screenings, and two-way protection. In order to ensure the implementation of the pre-screening triage, the prevention and control management strategies included training, emergency exercise, and staff protection. Statistical analysis was performed on the data from all the children hospitalized from January 20, 2020 to March 20, 2020 at solstice during the pandemic period. Data were obtained from questionnaires and electronic medical record systems.
RESULTS A total of 17561 children, including 2652 who met the criteria for screening, 192 suspected cases, and two confirmed cases without omission, were screened from January 20, 2020 to March 20, 2020 at solstice during the pandemic period. There was zero transmission of the infection to any medical staff.
CONCLUSION The effective strategies for pre-screening triage have an essential role in the prevention and control of hospital infection.
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Affiliation(s)
- Xuan Shi
- Department of Pediatric Emergency, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Yu-Tao Cai
- Outpatient Department of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Xian Cai
- Emergency General Ward, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Xiu-Lan Wen
- Department of Nursing, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Jing-Yan Wang
- Department of Pediatric Emergency, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Wen-Cheng Ma
- Department of Pediatric Emergency, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Jun Shen
- Department of Disease Control and Prevention, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Jin-Xia Wu
- Department of Pediatric Emergency, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Hai-Yan Liu
- Outpatient Department of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Jing Sun
- Emergency General Ward, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Pei-Qin He
- Department of Pediatric Emergency, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Yan Lin
- Department of Nursing, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Dan-Yang Zhao
- Department of Disease Control and Prevention, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Pei-Qing Li
- Department of Pediatric Emergency, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
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Schwedhelm MM, Herstein JJ, Watson SM, Mead AL, Maddalena L, Liston DD, Hewlett AL. Can You Catch It? Lessons Learned and Modification of ED Triage Symptom- and Travel-Screening Strategy. J Emerg Nurs 2020; 46:932-940. [PMID: 32340737 PMCID: PMC7160057 DOI: 10.1016/j.jen.2020.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction Efficient identification and isolation of patients with communicable diseases limits exposure to health care workers, other patients, and visitors. In August 2014, our team developed and implemented an algorithm to triage suspected cases of Ebola virus disease in a midwestern United States emergency department and outpatient clinics based on patient travel history and symptoms. Here, we present the lessons learned and modifications to update the tool. Methods Two strategies were developed and utilized to properly identify, isolate, and inform on patients with suspected highly hazardous communicable diseases: 1) a robust electronic symptom and travel screen with decision support tools in the electronic medical record, and 2) the availability of workflow protocols for Ebola virus disease, Middle East Respiratory Syndrome (MERS), and coronavirus 2019 (COVID-19) once a person under investigation is identified. After action reports provided opportunities to modify the algorithm and improve the identification and isolation processes. Results Since our screening and travel electronic medical record inception 5 years ago, modifications changed iteratively to further enhance the screening process. Since 2018, staff have identified 5 patients at risk for MERS; in all cases, identification occurred during the check-in process. Exposure investigations in the emergency department decreased significantly after algorithm implementation in January 2019, from 30 in 2018 to 0 in 2019. Discussion Although highly hazardous communicable diseases like Ebola virus disease and MERS are of concern due to their mortality rates and limited treatment options, these same concepts may be applied to the early identification and isolation of patients suspected of having more common communicable diseases like measles and influenza, emphasizing the importance of protocol-based screening in the healthcare environment.
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