基于循证实践指南的新型冠状病毒肺炎患者隔离病区环境表面清洁与消毒流程的构建

目的 构建新型冠状病毒肺炎（COVID-19）确诊患者隔离病区的环境表面清洁与消毒流程,为隔离病区护理人员开展清洁与消毒工作提供参考,从而保障隔离病区的物表清洁与消毒质量。方法 通过检索全球COVID-19防控相关的循证实践指南,以AGREE II（Appraisal of Guidelines for Research and Evaluation II）评价工具进行严格评价及指南的筛选,通过开展德尔菲专家咨询及调查利益相关者即清洁与消毒岗护士对流程落实的认同度及观点反馈,最终通过小组会议形成隔离病区环境表面清洁与消毒流程。结果 研究共纳入12篇指南,通过2轮德尔菲专家咨询结合对清洁与消毒岗护士的调查结果,形成6大步骤40条具体内容及备注（评估计划与组织、人员准备与培训、物资准备与提供、实施清洁与消毒、医废处理与整理、监控反馈与改进）的COVID-19确诊患者隔离病区物表清洁与消毒流程。结论 基于循证实践指南构建的COVID-19确诊患者隔离病区环境表面清洁与消毒流程可为疫情中防止医务人员和患者的交叉感染、降低院内传播风险提供护理管理策略,为同质化落实清洁与消毒措施、保证隔离病区的清洁与消毒质量提供工作依据。

Construction of Cleaning and Disinfection Process in Isolated Units for COVID-19 Patients Based on Evidence-based Practice Guidelines

Objective To construct a cleaning and disinfection process in isolated units for COVID-19 patients, and to provide reference for nursing staff in isolated units to ensure the quality of cleaning and disinfection. Methods Evidence-based practice guidelines of global COVID-19 prevention and control were retrieved and the AGREEII (Appraisal of Guidelines for Research and Evaluation II) evaluation tool was used to evaluate and screen the guidelines. Through Delphi expert consultation and survey on the attitude toward and reaction of the implementation of the process among sterilization nurses, the cleaning and disinfection process in the isolated wards was finally formed through group meeting. Results Twelve guidelines were included in the study. Through two rounds of Delphi expert consultation, combined with the survey of sterilization nurses, the final process consisted of 6 steps in general and 40 specific items and remarks of the cleaning and disinfection process (evaluation plan and organization, personnel preparation and training, material preparation and delivery, cleaning and detoxification, management and arrangement of medical waste, and monitoring feedback and improvement.) Conclusion Evidence-based cleaning and disinfection process in isolated units for COVID-19 patients would provide nursing management strategies for preventing cross infection between medical staff and patients and reducing the risk of no socomial infections during the epidemic period, and it would provide basis for homogenizing the implementation of cleaning and disinfection measures and ensuring the cleaning and disinfection qualities in the isolated wards.