县级疾病预防控制中心突发公共卫生事件应急能力研究

目的为了能够有效的预防及时消除和控制突发公共卫生事件中所造成的危害,使得各种突发公共卫生事件对人民群众所造成的危害减少,最大限度的来保障人民群众在突发公共卫生事件中的身体健康以及生命的安全,维护社会的正常的秩序,使江西省丰城市在突发公共卫生事件中取得有效的进步以及管理办法。方法根据《中华人民共和国传染病防治法》、《突发公共卫生事件与传染病疫情检测信息报告管理办法》、《突发公共卫生事件应急预案》等对县级疾病控制中心机构的能力进行综合的评价,分析江西省丰城市疾病控制中心机构应对突发公共卫生事件的应急能力所存在的劣势、障碍。提出加强建设江西丰城市疾病预防控制体系应对能力研究结果的建议。结果近年来,通过对于我国各县(区)突发公共卫生事件的应急系统能力调查结果发现,对于突发公共卫生事件的反应和报告的及时性,对于早期公共卫生事件的察觉,应急人员的素质和数量,以及对突发公共卫生应急事件专家库的建立,应该多与媒体方面取得合作与多加交流,器械、物资储备以及技术等这些方面的能力表现较差,所以建议江西省丰城市需要加强建设。结论通过此次研究可以发现在国内对应急事件的控制能力有益的探索,积累了很多资料,对于疾病预防控制中心中应对突然发生的公共卫生事件的能力进行研究评价,建立研究评价模型,综合评价了县(区)的疾病控制中心对突发的公共卫生事件中紧急事件的应急判断能力。     

WHO与欧盟对甲型H1N1流感防控评估报告的比较研究1

突发公共卫生事件政府应急能力评估是一项有着重要作用和重要意义的工程,也是一项全面而复杂的工程.2009年甲型H1N1流感的爆发,在让全球公共健康受到重大冲击的同时,也让世界各国重新审视突发公共卫生事件的严峻形势.如何更好地应对突发公共卫生事件,全面提升公共卫生应急管理能力,就成为全球各国共同面临的重大难题.一场危机的应对就成为了下一场危机应对能力提升的最好"教材".我们要通过危机评估,充分借鉴其他国家成功的经验和优秀的研究成果,并且在实践工作中不断探索,不断完善,实现评估工作的科学性、规范性、有效性,提高我国政府应对突发公共卫生事件的能力,在未来的应急管理中更好的保障人民生命财产安全.     

应用Delphi法构建学校传染病防控能力评价体系

目的构建学校传染病防控能力评价体系,提高综合评价学校传染病的防控能力。方法通过文献查阅和德尔菲法（Delphi）等方法筛选学校传染病防控能力的评价指标,确立各指标的权重,建立指标体系。结果15位专家的专家权威系数均数为0．90,两轮调查专家的积极系数均为1;第二轮咨询,经过对指标修改合并后,一级、二级指标协调系数分别为0．723、0．729,P值均为0．000;经过两轮专家咨询,指标体系筛选出9项一级指标、24项二级指标。结论Delphi专家咨询法是构建学校传染病防控能力评价指标体系的有效方法,并将为进一步建立学校传染病防控能力量化评价方法奠定基础。     

茂名市疾病预防控制机构应急能力的调查

目的了解茂名市疾病预防控制机构突发公共卫生事件应急反应能力建设状况。方法用问卷方法对茂名市级及各县（市、区）级7所疾病预防控制机构进行应急能力调查。结果各级疾病预防控制机构针对不同突发公共卫生事件已做好预案和应急准备，应急体系初步形成。市疾病预防控制中心应急能力较强，基层疾病预防控制机构应急能力亟需提高。结论突发公共卫生事件应急能力建设是长期的任务．需各级疾病预防控制机构不懈努力：应加强专业技术人员特别是基层疾病预防控制机构的应急意识和现场处詈能力培训．     

应用PPRR模式构建医院突发疫情应对能力评价指标体系

目的 探讨以危机管理PPRR模式为基础构建医院突发疫情应对能力.方法 应用PPRR模式,采用文献研究法、头脑风暴法等,初拟医院突发疫情应对能力评价指标体系,运用德尔菲法进行两轮专家函询,采用Excel 2019、SPSS 25.0软件对函询数据进行处理,计算专家积极系数、专家协调系数、专家权威系数以及各项指标的重要性均...     

重庆市2004—2007年突发公共卫生事件分析

目的对重庆市2004—2007年报告的突发公共卫生事件进行分析，以加强对突发公共卫生事件的预防和应急处理。方法应用描述流行病学方法，分析事件特征。结果全市4年报告突发公共卫生事件478起，发病19884例，死亡56例；渝东南地区多发，时间分布基本呈双高峰：传染病事件占80．98％．学校事件占78．87％；事件平均报告时间3．44d，平均处理时间46．72d。结论突发公共卫生事件的发生与地区经济文化水平密切相关；应提高对乙、丙类传染病和非法定传染病事件的重视程度；学校卫生工作有待进一步加强：突发公共卫生事件报告管理体系有待进一步理顺。     

紧急救援备灾护士在集体食物中毒病人救治中作用的探讨

目的：探讨备灾护士在突发性公共卫生事件紧急医疗救援中作用、地位。方法：通过急诊科同一天短时内接诊2起大批量食物中毒病人的紧急抢救,对护理部制定的应急预案、备灾护士的救护能力进行现场的检查考核。结果：应急预案和备灾护士在成功抢救大批量病人过程中,发挥着至关重要作用．是病人生命安全有力保障。结论：经过严格筛选、考核、培训、培养的紧急救援备灾护士和慎密的应急预案,是有效应对突发性公共事件的良好路径,值得推广借鉴。     

骨科专科护士核心能力评价指标体系的构建

目的通过专家问卷咨询和调查,构建适用于我国骨科专科护士的核心能力评价指标体系。方法通过前期文献检索法和专家访谈,初步形成了骨科专科护士核心能力评价指标体系的框架和条目初稿,之后选择北京、天津、上海、山西、四川等6省市三级医院中,从事骨科临床护理、骨科护理教育、护理管理、护理研究等方面的专家,依据德尔菲法经过两轮的专家咨询、调查和探讨,整合专家建议,最终构建了骨科专科护士核心能力评价指标体系和各级指标条目的内容。结果运用以上研究方法,最终确立骨科专科护士核心能力评价指标体系具有6个维度的核心能力,既一级指标,其中包括专业态度、专业实践能力、批判性思维能力、护理管理能力、交流沟通能力和专业发展能力。在该体系中的6个一级指标条目下包括21个二级指标条目和65个三级指标条目。两轮咨询的专家积极系数分别为0.90、0.94,专家权威系数0.87、0.86,协调系数为0.247~0.263。通过数据显示专家对指标条目的意见趋于一致且对所设置的指标条目认同程度高。结论通过一系列系统和科学的研究方法,建立了骨科专科护士核心能力评价指标体系,该体系可以为骨科专科护士的考核、评价提供全面的、可量化的指标,并对今后骨科专科护士的培养有指导意义。     

医疗机构医疗器械不良事件监测系统评价模型研究

目的设计医疗机构医疗器械不良事件监测系统评判模型,对医疗器械不良事件监测系统进行的全面、科学的评价,为国家管理部门实施对医疗机构的考核提供科学的方法。方法使用德尔菲法确立指标权重,使用系统分析法建立医疗器械不良事件监测系统的综合评价体系,使用模糊综合评判方法建立数学模型。结果本研究建立的评价模型适合作为评价工具,为国家管理部门在考核、评价医疗机构医疗器械不良事件监测系统方面提供科学的指导方法。结论综合评价体系中的评价指标、指标权重等数据应在实际应用中持续地改进和完善。     

重视批量伤员医院救治应急预案

批量伤员常由突发公共卫生事件造成。应急预案是医院针对各种突发公共卫生事件,在院外和院内对个体或群体伤员实施及时有效的救援措施,以挽救生命、减轻损害为目的而制订的行动计划。本文结合笔者参与2015年1月30日一起高速公路交通事故批量伤员医院内救援情况,阐述了批量伤员医院救治应急预案目前的现状、制订与演练过程中相关技术细节,以期有助于提高医院救治批量伤员能力。     

Preparing health professions students for terrorism, disaster, and public health emergencies: core competencies.

The recent increased threat of terrorism, coupled with the ever-present dangers posed by natural disasters and public health emergencies, clearly support the need to incorporate bioterrorism preparedness and emergency response material into the curricula of every health professions school in the nation. A main barrier to health care preparedness in this country is a lack of coordination across the spectrum of public health and health care communities and disciplines. Ensuring a unified and coordinated approach to preparedness requires that benchmarks and standards be consistent across health care disciplines and public health, with the most basic level being education of health professions students. Educational competencies establish the foundation that enables graduates to meet occupational competencies. However, educational needs for students differ from the needs of practitioners. In addition, there must be a clear connection between departments of public health and all other health care entities to ensure proper preparedness. The authors describe both a process and a list of core competencies for teaching emergency preparedness to students in the health care professions, developed in 2003 and 2004 by a team of experts from the four health professions schools of Columbia University in New York City. These competencies are directly applicable to medical, dental, nursing, and public health students. They can also easily be adapted to other health care disciplines, so long as differences in levels of proficiency and the need for clinical competency are taken into consideration.     

Usefulness of simulated cases for assessing pandemic influenza preparedness plans

To evaluate compliance with preparedness plans, actors simulating avian influenza attended various hospital emergency departments and public health centres during the last quarter of 2007. Most centres (89%) did not respond correctly. The useful information obtained was sent to the medical and administrative staff who were responsible for the preparedness plans. Awareness of these errors and their rectification can lead to improvements in the response to any case of influenza with pandemic potential and in the capacity to combat any other emergent or re-emergent community infection.     

Laboratory preparedness and response with a focus on arboviruses in Europe

BackgroundThe global health burden of arboviruses is continuously rising, which results in increasing pressure on local and (inter)national laboratory infrastructures. Timely and accurate diagnosis of cases is one of the main pillars for public health and clinical responses to an arbovirus emergence.Aims and sourcesThis narrative review aims to summarize recent advances and to identify needs in laboratory preparedness and response activities, with a focus on viruses transmitted by arthropods in Europe. The review is based on evidence extracted from PubMed searches, Public Health and clinical laboratory experiences from the authors and the authors' opinions substantiated by peer-reviewed scientific literature.ContentWe illustrate the importance of inter-epidemic laboratory preparedness activities to ensure adequate Public Health and clinical responses. We describe the status of arbovirus endemicity and emergence in Europe thereby highlighting the need for preparedness for these viruses. We discuss the components and pitfalls of an adequate laboratory preparedness and response and the broader context of the current landscape of international research, clinical and laboratory preparedness networks. The complexity of arbovirus laboratory preparedness and response is described.ImplicationsOutbreak preparedness plans need to look beyond national reference laboratories, to include first-line responding onsite hospital laboratories and plans for strengthening of such local capacity and capability as required depending on the nature of the outbreak. In particular, the diagnosis of arbovirus infections is complicated by the existence of geographic overlap of circulation of numerous arboviruses, the overlap in clinical manifestation between many arboviruses and other aetiologies and the existence of cross-reactivity between related arboviruses in serology testing. Inter-epidemic preparedness activities need strong national and international networks addressing these issues. However, the current mushrooming of European preparedness networks requires governance to bring the European preparedness and response to a next level.     

Emergency preparedness: addressing a residency training gap.

As the importance of physician involvement and leadership in crisis preparedness is recognized, the literature suggests that few physicians are adequately trained to practice effectively in a large-scale crisis situation. A logical method for addressing the emergency preparedness training deficiency identified across several medical specialties is to include disaster and emergency preparedness training in residency curricula.In this article, the authors outline the development and implementation of an emergency preparedness curriculum for the Johns Hopkins General Preventive Medicine Residency (JHGPMR) from 2004 to 2006. The curriculum consists of two components. The first was developed for the academic year in the JHGPMR and includes didactic lectures, practical exercises to apply new knowledge, and an opportunity to integrate the knowledge and skills in a real-world exercise. The second, developed for the practicum year of the residency, includes Web-based lectures and online content and culminates in a tabletop preparedness exercise. Topics for both components include weapons of mass destruction, risk communication and personal preparedness, aspects of local emergency response planning, and mental health and psychological aspects of terrorism.On the basis of the emergency preparedness training gap that has been identified in the literature, and the success of the three-year experience in implementing a preparedness training curriculum in the JHGPMR, the authors recommend incorporation of competency-based emergency preparedness training for residencies of all specialties, and offer insights into how the described curriculum could be adapted for use in other residency settings.     

Responding to disasters: academic medical centers' responsibilities and opportunities.

Disaster preparedness and disaster response should be a capability of all academic health centers. The authors explore the potential role and impact of academic medical centers (AMC)s in disaster response. The National Disaster Medical System and the evolution of disaster medical assistance teams (DMAT) are described, and the experience at one AMC with DMAT is reviewed. The recent deployment of a DMAT sponsored by an AMC to the Hurricane Katrina disaster is described, and the experience is used to illustrate the opportunities and challenges of future disaster medical training, research, and practice at AMCs. AMCs are encouraged to identify an appropriate academic unit to house and nurture disaster-preparedness activities, participate in education programs for health professionals and the public, and perform research on disaster epidemiology and response. Networks of AMCs offer the potential of acting as a critical resource for those AMCs stricken by a disaster and for communities needing the infusion of highly trained and motivated health care providers. The Association of American Medical Colleges can play a critical role in assisting and coordinating AMC networks through its relationship with all AMCs and the federal government and by increasing the awareness of medical educators and researchers about this important, emerging area of medical knowledge.     

A short medical school course on responding to bioterrorism and other disasters.

The events of 9/11 highlighted the limitations of the United States health care system in responding to large-scale public health emergencies. The key for an effective response to any mass casualty event is preparedness; thus, the education of medical students has become a priority. The Association of American Medical Colleges (AAMC) recommended that the nation's medical schools should thoroughly educate students about the public health and emergency services systems to ensure coordinated responses to weapons of mass destruction or other public health threats. In response, The Texas A&M University System Health Science Center College of Medicine, partnering with the Defense Institute for Medical Operations (DIMO), developed a one-week block of required (but not graded) instruction, the "Leadership Course in Disaster Response," first given in 2003-04 to 72 second-year students and taught by six military experts from DIMO. The course goal is to (1) educate students on resources available for regional disaster response; (2) define principles of resource management in disaster response; (3) identify specific agents associated with bioterrorism; and (4) understand the psychosocial aspects of disasters. The course was well received, and the 2004-05 session was improved, based on student and faculty feedback. The authors describe the details of the course (specifically, how the course was tailored to fit the AAMC guidelines), changes in students' knowledge and attitudes, and how the course was improved.     

Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study

BackgroundIn Korea, the actual distribution of cardiac rehabilitation (CR) to the clinical field is insufficient due to the many barriers for cardiovascular patients to participate in CR. Community-based CR is a useful alternative to overcome these obstacles. Through a nationwide survey, we investigated the possibility of regional medical and public health management institutes which can be in charge of community-based CR in Korea.MethodsThe questionnaires on recognition of CR and current available resources in health-related institutions were developed with reference to the CR evaluation tools of York University and the International Council of Cardiovascular Prevention and Rehabilitation. The questionnaires were sent to regional public and private medical institutions and public health management institutions.ResultsIn total, 2,267 questionnaires were sent to 1,186 institutions. There were 241 and 242 responses from 173 and 179 regional private and public medical institutions, respectively. And a total of 244 responses were gathered from 180 public health management institutions. Although many institutions were equipped with the necessary facilities for exercise training, there were few patient-monitoring systems during exercise. Most institutions were aware of the need for CR, but were burdened with the cost of establishing personnel and facilities to operate CR.ConclusionMost regional medical, and public health management institutions in Korea are unprepared for the implementation of community-based CR programs. To encourage the utilization of such, there should be efforts to establish a national consensus.     

Anaphylaxis: evidence-based long-term risk reduction in the community

Anaphylaxis occurs frequently in the community, and it can be fatal in community settings. Risk assessment and risk reduction should ideally be coordinated by an allergy/immunology specialist and focus on: (1) prevention of subsequent anaphylaxis episodes, (2) emergency preparedness, and (3) anaphylaxis education. Preventive strategies should include trigger avoidance, specific preventive measures, and optimal management of comorbidities. Despite best efforts to avoid anaphylaxis triggers they can be encountered inadvertently, and anaphylaxis episodes can and do recur. Risk reduction therefore also focuses on emergency preparedness: carrying self-injectable epinephrine, having a personalized Anaphylaxis Emergency Action Plan, and wearing accurate medical identification. Anaphylaxis education should involve not only at-risk individuals and their families, but also health care professionals and the general public.