Infection control strategies of medical institutions in response to COVID-19.

PREFACE

The government of Taiwan has taken a proactive approach in responding to the COVID‐19 pandemic, with only 393 confirmed cases and 6 deaths so far, most of which have been people returning from overseas.1, 2 Here, we would like to share the experience of our contingency team of Kaohsiung Municipal Siaogang Hospital which we hope will be useful for other medical institutions.

The latest information

We implemented the government's epidemic prevention policy, including tracking travel history through National Health Insurance cards and mask rationing into the hospital access control system. This was achieved through patient education by using graphic design (posters), dynamic images (video), social media (Facebook, Line, YouTube), the hospital's official website, hospital halls, elevators, and other places (Figure 1). The information is updated daily in real time, to prompt the public and staff to comply with the latest epidemic prevention measures in the hospital, and remind them of the importance of implementing personal health management and protection.

FIGURE 1

The posters of latest information

All wards monitor people accompanying the patients: Wearing masks/temperature measurement/hand washing/travel, occupation, contact and cluster history

Masks.

Washing hands.

Travel, occupation, contact and cluster (TOCC).

Implementation method:

After admission, the nurse in charge will investigate the TOCC of the patient and those accompanying the patient and record the data.

When the people accompanying the patient change, the nurse on duty will assist in re‐establishing the TOCC.

Audit:

The unit's head nurse checks daily whether the TOCC has been registered.

The head nurse on duty checks the completeness of the TOCC record of each unit of the hospital on a daily basis, including whether the registration of the address is correct.

Measure body temperature: The nursing station measures the temperature of the people accompanying the patient once a day during the day shift. The night shift tracks whether the people accompanying the patient have a fever or upper respiratory tract symptoms, and records these data in the nursing record. The unit's head nurse checks whether the temperature of the accompanying people has been actually registered.

Education and training of caregivers in Kaohsiung Municipal Siaogang Hospital

In order to ensure that the care workers have correct knowledge on the prevention of severe special infectious pneumonia, the “Management Practices for Care Workers” were formulated in accordance with the announcement of the Ministry of Health and Welfare in February 2020. Kaohsiung Municipal Siaogang Hospital designed a training course according to these specifications to educate all care workers, including self‐employed, native, and foreign workers. The training course allows caregivers to complete the “Form of Self‐Assessment of Care Literacy” and protective education before taking care of patients. We also provide multilanguage education and training versions including Chinese, English, Thai, Vietnamese, and Indonesian versions so that caregivers can better understand the content of education and training.

Education and training

The care attendant can complete the education training by using the website (https://youtu.be/lg77s3iZDXE) or by QR code. The care attendant can also review the class repeatedly to increase familiarity. The training focuses on:

Recognize and understand the symptoms of severe special infectious pneumonia.

Recognize and understand notice and cooperation policies for home quarantine and home isolation for potential cases of serious special infectious pneumonia.

Recognize and understand the correct method and timing of hand washing.

Recognize and understand the correct method and timing of wearing masks.

Management measures

The details of each care attendant will be registered. Their TOCC information will be recorded in the system so that it can be tracked in order to provide a reference for the Health Bureau for future epidemic investigations.

In order to understand the effectiveness of the education and training program for the care attendants, the nursing station randomly checks the correctness of wearing masks and washing hands of three people every day. If anyone fails the assessment, nursing staff will teach him or her until the procedure is correctly being performed.

Formulate work specifications for caregivers to prevent cross infection, such as:

During service time, the care attendant should take responsibility for attending to the patient, and should not leave the care area of the patient. In addition, it is forbidden to gather and chat in other wards, corridors, stairwells, and so on.

The care attendant should not go to the hospital to care for patients during home isolation or home quarantine.

If the care attendant has a fever, respiratory symptoms or other physical discomfort, they should temporarily suspend patient service.

The care attendant must fill in the “Form of Self‐Assessment of Care Literacy,” and sign and write the evaluation date on the form for any new care cases.

We hope that our experience will be helpful for other medical institutions.

CONFLICT OF INTEREST

The authors declare no potential conflict of interest.