Objective: To construct a training program on emergency response ability for all staff in emergency medical wards under COVID-19 epidemic, and to evaluate its clinical effect. Methods: A targeted training program for emergency response ability of all staff in the emergency medical ward was established through literature review, brain storming and online conference discussion. The scheme includes seven modules: training system, training plan, training outline, training course, teaching team, training materials and teaching evaluation. For medical staff, other staff (nursing workers, work attendance, cleaning), patients and family members of different categories of personnel, advanced version, basic version and popular science version are designed respectively, and the training content closely fitted the needs of epidemic prevention and skills required in different groups. During the period from April 5 to May 10, 2022, the training program was conducted to train the emergency response ability in all staff,and effect was evaluated using questionnaires invstigation before and after training, oral questions, operation assessment and on-site inspection, and the incidence of clinical actual infection was monitered. Results: The score after traning on response ability to infectious disease emergencies in medical staff( 161.27±14.13) was higher than before the training (143.38±23.10) (P<0.05). After the training, the qualified rate of "hand hygiene" and "wearing and taking off isolation clothes" in nursing workers, cleaning workers and work attendance increased from 62.5% (before the training) to 100.0%, and the qualified rate of oral question answering increased from 50.0% (before the training) to 87.5%. The correct wearing rate of masks for patients and their families increased from 66.1% to 89.3%, and the standard rate of hand hygiene increased from 75.0% to 92.0%. The score on satisfaction was (16.36±2.03), which indicates that all staff had a good experience of participating in the training process. There were no case of novel coronavirus infection. Conclusions: Under the background of COVID-19 epidemic, the whole staff-emergency capacity training program established in this study is reasonable and feasible, which can effectively improve the emergency capacity of personnel, urge everyone to participate in nosocomial infection prevention and control, and ensure the normal epidemic control in the ward.

新型冠状病毒(新冠)奥密克戎变异株感染疫情在上海蔓延,面对重大传染病疫情,为保障上海市民正常就医,我院急诊科采取一系列措施积极应对,快速反应.从平时"常态管理模式"切换为"应急管理模式",从"人员"设置、物资"申领"、"运输"、"存储"、"发放"5个方面调整管理策略,通过设置物资保障岗位、应用信息化物资管理系统、划分物流运输"三区"、设立二级库房管理和落实精准化物资管控共5项具体措施的实施.实现科学、有效、规范的物资管理,确保疫情时期急诊科物资保障工作顺利进行,为进一步规划和完善突发公共事件中应急物资的储备、运输、调配管理体系提供参考和依据,促进提高急诊科应对突发公共卫生事件的应急能力.

目的 构建急诊护士创伤救治核心能力评价指标和培训课程,为进一步开展急诊护士创伤救治临床实践培训提供依据.方法 基于文献回顾和半结构式访谈结果,设计急诊护士创伤救治核心能力评价指标与培训课程咨询问卷,采用德尔菲法选取15名专家进行2轮咨询,确定急诊护士创伤救护核心能力和培训课程构架.结果 2轮专家咨询问卷有效回收率分别为100％和86.67％,专家的权威系数为0.85,肯德尔和谐系数分别为0.389、0.268 (P＜0.05).构建的急诊护士创伤救治核心能力共有6项一级指标(专业态度、创伤救治专业能力、评判性思维能力、创伤救治管理能力、沟通协调能力和专业发展能力)、21项二级指标和47项三级指标.核心能力各维度指标权重系数为:一级指标0.149～0.187;二级指标0.041～0.053;三级指标0.019～0.023.该指标体系的总体Cronbach's α系数为0.964,内容效度指数S-CVI/UA和S-CVI/Ave均为0.948.培训课程包含理论课、workshop、情景模拟、小组讨论、考核共计26学时.培训课程各条目权重系数为0.037～0.043,Cronbach's α系数为0.950,内容效度指数-CVI/UA和S-CVI/Ave均为0.988.结论 构建的急诊护士创伤救治核心能力评价指标体系科学、可靠、完整;培训课程突出创伤救治护理特色,满足核心能力要求,培训方式和考核方法多样,能为进一步开展急诊护士创伤救治的临床实践培训提供参考依据.

总结新冠肺炎疫情下急诊输液室的疫情防控管理策略,内容包括输液室建筑布局调整、通道管理、设置应急隔离区,严格落实医院感控措施、人员管理制度、人力资源管理制度、物资管理制度,进行护理流程再造(包括针对核酸结果异常人员,建立"输液室→发热急诊→定点医院"转诊机制以及疫情期间急诊急救→输液室→抢救室"联动机制)和护理人文关怀.切实做好疫情期间急诊输液室的防控管理工作,保障了急诊输液室运转良好,自2022年3月以来,本输液室无重大医疗纠纷及护理差错事故,医护人员零感染.

目的 自行设计密闭式胆汁回输装置并评估其临床应用效果.方法 自行设计密闭式胆汁回输装置,选择2015年9月—2017年10月本院急诊重症监护室胆源性重症急性胰腺炎患者21例,采用自行设计的密闭式胆汁回输装置联合肠内营养同步收集回输,并进行效果评价.结果 胆汁回输后患者实验室营养指标改善,发生营养管阻塞1例.无误吸、导管滑脱及移位等不良事件发生.医护人员未发生职业暴露.结论 新型胆汁回输装置安全实用,提高疾病治疗效果,提升工作效率,值得推广应用.