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Annex 3
New coronapneumonia prevention and control technology program of medical institutions

First, the basic requirements
(1) To formulate contingency plans and work processes. Medical institutions shall, in accordance with the pathogenic characteristics of the new coronavirus, establish an early warning mechanism and formulate emergency plans and work processes in combination with the sources of infection, transmission routes, susceptible populations and medical and therapeutic conditions.

(2) To carry out full-staff training. According to the job responsibilities to determine the training content for different personnel, so that it is proficient in the prevention and control of new coronavirus infection knowledge, methods and skills, so that early detection, early reporting, early isolation, early diagnosis, early treatment, early control.

(3) Do a good job of medical personnel protection. Medical institutions shall standardize disinfection, isolation and protection work, reserve qualified quality and sufficient quantities of protective materials, and ensure that personal protection of medical personnel is in place. On the basis of strict implementation of standards for prevention, strengthen contact transmission, droplet transmission and air transmission of infection prevention and control.

(4) Pay attention to the health of medical personnel. Medical institutions should rationally allocate human resources and shift arrangements to avoid overwork of medical personnel. Active health monitoring is carried out for job characteristics and risk assessment results. Various measures are taken to ensure that medical personnel provide medical services to patients in a healthy manner.

(v) Strengthen infection monitoring. Do a good job of early warning and forecasting, strengthen the supervision and guidance of infection prevention and control work, find hidden dangers, improve in a timely manner. When a person with pneumonia with a suspected or confirmed new coronavirus infection is found, it shall be reported in a timely manner in accordance with the relevant requirements, and shall report the information within 2 hours and do a good job of disposing of it.

(6) Do a good job of cleaning and disinfection management. In accordance with the "hospital air purification management norms", strengthen the ventilation of the diagnostic environment, conditional medical institutions can carry out air disinfection, but also equipped with circulating air disinfection equipment. Strict implementation of the "medical institutions disinfection technical specifications", do a good job of diagnosis and treatment of the environment, medical equipment, patients, such as cleaning and disinfection, strict treatment of respiratory secretions, excreta, vomit, strict end-of-life disinfection.

(7) Strengthen the management of patient visits. Medical institutions should do a good job in the management of patients, to minimize the crowding of patients, in order to reduce the risk of hospital infection. When a patient with a suspected or confirmed infection with a new coronavirus is found, measures to isolate or control transmission shall be taken in accordance with the law, and medical observation and other necessary precautions shall be taken for the accompanying persons and other close contacts of the patient in accordance with the regulations. If there is no ability to treat the patient, the patient shall be referred to the medical institution with the capacity for treatment in a timely manner.

(viii) Strengthen patient education. Medical institutions should actively carry out the education of patients and their accompanying personnel to understand the protection of new coronaviruses, guide them to wash their hands correctly, cough etiquette, medical observation and home isolation.

(ix) Strengthen the management of infection outbreaks. Strict implementation of medical institutions infection prevention and control of the rules and regulations to minimize the risk of infection outbreaks. Enhance sensitivity, in the event of a suspected outbreak or outbreak of a new coronavirus infection, medical institutions must report in a timely manner in accordance with the relevant standards and procedures, start emergency plans, cooperate with the investigation and disposal work.

(10) Strengthen the management of medical waste. The medical waste generated by confirmed or suspected patients with new coronavirus infection shall be incorporated into the management of infectious medical waste and disposed of in strict accordance with the regulations of the Regulations on the Administration of Medical Waste and the Measures for the Administration of Medical Waste in Medical institutions.

Second, key department management　

(1) Fever clinic.

1. The layout and workflow of the fever clinic building shall comply with the relevant requirements such as the Technical Specification of Hospital Isolation.

2. Stay in the observation room or rescue room to strengthen ventilation, if the use of mechanical ventilation, should control the direction of air flow, from the cleaning side to the polluted side.

3. Equipped with adequate medical personnel in line with the requirements, adequate number of protective supplies, fever clinic entrance and exit should be equipped with quick-dryhand disinfectant and other hand sanitation facilities.

4. Medical personnel shall carry out standard prevention in carrying out medical treatment work. To wear a medical surgical mask or a medical protective mask properly, wash your hands or disinfect your hands before wearing a mask and after removing the mask. In and out of the fever clinic and observation ward, in strict accordance with the "medical staff wear off the protective equipment" requirements, the correct wear off protective supplies.

5. Medical personnel shall grasp the epidemiological and clinical characteristics of the new coronavirus infection, conduct patient screening in accordance with the medical norms, and take immediate isolation measures and report them in a timely manner for suspected or confirmed patients.

6. After the patient transfer out, according to the "medical institution disinfection technical specification" for final treatment.

7. Medical institutions shall provide masks and guide patients and escorts to wear them correctly.

(ii) Emergency.

1. Implement the pre-screening triage system, guide fever patients to the fever clinic, formulate and improve the transfer of seriously ill patients, treatment and treatment emergency plans and strict implementation.

2. Reasonable setting of isolation area to meet the needs of suspected or confirmed patients in-place isolation and treatment.

3. Medical personnel strictly implement preventive measures, do a good job of personal protection and treatment environment management. When implementing diagnostic measures with a high risk of exposure to infectious occupations such as emergency trachea intubation, preventive measures shall be taken in accordance with the requirements of receiving and treating confirmed patients.

4. The area should be kept well ventilated and regularly cleaned and disinfected.

5. Take effective measures such as setting up waiting areas to avoid crowd gathering.　

(3) General disease area (room).

1. Emergency isolation rooms shall be set up for the isolation and treatment of suspected or confirmed patients, and relevant work systems and processes shall be established, and adequate disinfection and protective supplies should be provided to deal with acute respiratory infections.

2. If suspected or confirmed patients are found in the area (room), initiate the relevant emergency plans and work processes, and implement timely and effective isolation, treatment and referral in accordance with the requirements of the norms.

3. Suspected or confirmed patients should be treated and cared for, restrict the access of unrelated medical personnel, in principle, do not visit;

4. Non-targeted hospitals that do not have the conditions for treatment shall be transferred in time to fixed-point hospitals with isolation and treatment capacity. Effective isolation and treatment measures are taken for patients while waiting for referral.

5. After the patient transfer out, according to the "medical institution disinfection technical specification" for its contact environment for final treatment.

(4) The area (room) for the treatment of patients with pneumonia with suspected or confirmed new coronary virus infection.

1. The layout and work flow of the building shall comply with the relevant requirements such as the Technical Specification of Hospital Isolation, and shall be equipped with protective supplies for medical personnel that meet the requirements and have a suitable number. Medical institutions that set up negative pressure disease areas (rooms) shall implement standardized management in accordance with the relevant requirements.

2. The suspected or confirmed patients should be taken timely isolation measures, suspected patients and confirmed patients should be placed separately;

3. On the basis of the implementation of standard prevention, measures such as contact isolation, droplet isolation and air isolation shall be taken. Specific measures include:　　

(1) In the isolation ward, the "hospital isolation technical specifications" "medical personnel wear off protective supplies" process, the correct implementation of hand hygiene and wear off-protection supplies.　　

(2) The procedure for medical personnel to wear protective equipment should be developed; Staff equipped with skilled infection prevention and control technology supervise the wearing of protective supplies for medical personnel to prevent pollution.　　
(3) Medical devices and nursing items such as stethoscopes, thermometers and blood pressure monitors used to treat suspected or confirmed patients shall be dedicated. If the conditions are limited, can not guarantee that medical equipment dedicated, after each use should be standardized cleaning and disinfection.

4. Serious lying patients shall be admitted to the intensive care unit or in a ward with conditions of supervision and rescue, and no other patients shall be admitted to the intensive care ward or in the ward with the conditions for supervision and rescue.

5. Strict visiting system, in principle, no escort. If the patient's critical condition and other special circumstances must be visited, the visitor must be in strict accordance with the provisions of personal protection.

6. Air purification shall be carried out in accordance with the Regulations on the Management of Air Purification in Hospitals.　　
Protection of medical personnel　

(1) Medical institutions and medical personnel shall strengthen the implementation of standard preventive measures, do a good job in the ventilation management of diagnosis and treatment areas and disease areas (rooms), strictly implement the requirements of the Medical Personnel's Hand Hygiene Code, wear medical surgical masks/medical protective masks, and, if necessary, wear latex gloves.　　

(2) Take measures such as droplet isolation, contact isolation and air isolation, and, depending on the situation, achieve the following protection.

1. When contacting the patient's blood, body fluids, secretions, excreta, vomit and contaminated substances: wear cleaning gloves, remove gloves and wash your hands.

2. May be the patient's blood, body fluids, secretions, etc. splash: wear medical protective masks, goggles, wear impermeable isolation clothing.

3. When performing aerosol-producing operations (e.g. tracheotomy, noninvasive ventilation, tracheotomy, CPR, pre-intubation, manual ventilation and bronchoscopy, etc.) for suspected or confirmed patients:

(1) Take air isolation measures;
(2) wear ingesting a medical protective mask and carry out closed performance testing;
(3) Eye protection (e.g. goggles or mask);
(4) wear long-sleeved isolation clothing that prevents the infiltration of body fluids, and wear gloves;
(5) The operation should be carried out in a well-ventilated room;
(6) The number of people in the room is limited to the minimum amount of care and support required by the patient.
(3) The protective supplies used by medical personnel shall conform to the relevant national standards.　　
(4) Medical surgical masks, medical protective masks, goggles, isolation clothing and other protective supplies shall be replaced in a timely manner when contaminated by the patient's blood, body fluids, secretions, etc.　　
(5) Proper use of protective equipment, before wearing gloves should wash hands, remove gloves or isolation clothing should immediately flow water to wash hands.
(6) Strict implementation of sharpware injury prevention measures.　　
(7) The medical devices and appliances used by each patient shall be cleaned and disinfected in accordance with the requirements of the Technical Specifications for Disinfection of Medical Institutions.　

　
Fourth, strengthen patient management　

(1) To isolate suspected or confirmed patients in a timely manner and to be guided into the quarantine area by a special person in accordance with the designated normative route.　　

(2) After the patient changes the patient's suit before entering the disease area, and the personal items and the replaced clothes are centrally disinfected and treated, they shall be stored in the designated place for unified custody by the medical institution.　

　
(3) To guide patients to choose correctly, wear masks, correctly implement cough etiquette and hand hygiene.　　

(4) Strengthen the management of patient visits or escorts.

(5) For isolated patients, in principle, their activities are limited to the isolation ward, the movement and conversion wards of patients are reduced, and if it is necessary to leave the isolation ward or isolation ward, corresponding measures, such as wearing medical surgical masks, shall be taken to prevent the patient from causing pollution to other patients and the environment.　　

(6) When a suspected or confirmed patient is discharged from hospital or transferred to a hospital, he or she shall change his clean clothes before leaving, and shall finally disinfect the contact environment according to the Technical Specification for Disinfection of Medical Institutions.　

　
(7) If a suspected or confirmed patient dies, the body shall be disposed of in a timely manner. The treatment method is: with 3000mg/L chlorine disinfectant or 0.5% peroxyacetic acid cotton ball or gauze filling the patient's mouth, nose, ears, anus and other open channels; Personal items used during the patient's hospitalization can only be taken home with the patient or family member after disinfection.

Reprinted from the website of the Health and Health Commission of the People's Republic of China

附件3
医疗机构新冠肺炎防控技术方案

一、基本要求
（一）制定应急预案和工作流程。医疗机构应当根据新型冠状病毒的病原学特点，结合传染源、传播途径、易感人群和诊疗条件等，建立预警机制，制定应急预案和工作流程。
（二）开展全员培训。依据岗位职责确定针对不同人员的培训内容，使其熟练掌握新型冠状病毒感染的防控知识、方法与技能，做到早发现、早报告、早隔离、早诊断、早治疗、早控制。
（三）做好医务人员防护。医疗机构应当规范消毒、隔离和防护工作，储备质量合格、数量充足的防护物资，确保医务人员个人防护到位。在严格落实标准预防的基础上，强化接触传播、飞沫传播和空气传播的感染防控。
（四）关注医务人员健康。医疗机构应当合理调配人力资源和班次安排，避免医务人员过度劳累。针对岗位特点和风险评估结果，开展主动健康监测。采取多种措施，保障医务人员健康地为患者提供医疗服务。
（五）加强感染监测。做好早期预警预报，加强对感染防控工作的监督与指导，发现隐患，及时改进。发现疑似或确诊新型冠状病毒感染的肺炎患者时，应当按照有关要求及时报告，并在2小时内上报信息，做好相应处置工作。
（六）做好清洁消毒管理。按照《医院空气净化管理规范》，加强诊疗环境的通风，有条件的医疗机构可进行空气消毒，也可配备循环风空气消毒设备。严格执行《医疗机构消毒技术规范》，做好诊疗环境、医疗器械、患者用物等的清洁消毒，严格患者呼吸道分泌物、排泄物、呕吐物的处理，严格终末消毒。
（七）加强患者就诊管理。医疗机构应当做好就诊患者的管理，尽量减少患者的拥挤，以减少医院感染的风险。发现疑似或确诊感染新型冠状病毒的患者时，依法采取隔离或者控制传播措施，并按照规定对患者的陪同人员和其他密切接触人员采取医学观察及其他必要的预防措施。不具备救治能力的，及时将患者转诊到具备救治能力的医疗机构诊疗。
（八）加强患者教育。医疗机构应当积极开展就诊患者及其陪同人员的教育，使其了解新型冠状病毒的防护知识，指导其正确洗手、咳嗽礼仪、医学观察和居家隔离等。
（九）加强感染暴发管理。严格落实医疗机构感染预防与控制的各项规章制度，最大限度降低感染暴发的风险。增强敏感性，一旦发生新型冠状病毒感染疑似暴发或暴发，医疗机构必须按照规定及时报告，并依据相关标准和流程，启动应急预案，配合做好调查处置工作。
（十）加强医疗废物管理。将新型冠状病毒感染确诊或疑似患者产生的医疗废物，纳入感染性医疗废物管理，严格按照《医疗废物管理条例》和《医疗卫生机构医疗废物管理办法》有关规定，进行规范处置。
二、重点部门管理　
（一）发热门诊。
1.发热门诊建筑布局和工作流程应当符合《医院隔离技术规范》等有关要求。
2.留观室或抢救室加强通风；如使用机械通风，应当控制气流方向，由清洁侧流向污染侧。
3.配备符合要求、数量充足的医务人员防护用品，发热门诊出入口应当设有速干手消毒剂等手卫生设施。
4.医务人员开展诊疗工作应当执行标准预防。要正确佩戴医用外科口罩或医用防护口罩，戴口罩前和摘口罩后应当进行洗手或手卫生消毒。进出发热门诊和留观病房，严格按照《医务人员穿脱防护用品的流程》要求，正确穿脱防护用品。
5.医务人员应当掌握新型冠状病毒感染的流行病学特点与临床特征，按照诊疗规范进行患者筛查，对疑似或确诊患者立即采取隔离措施并及时报告。
6.患者转出后按《医疗机构消毒技术规范》进行终末处理。
7.医疗机构应当为患者及陪同人员提供口罩并指导其正确佩戴。
（二）急诊。
1.落实预检分诊制度，引导发热患者至发热门诊就诊，制定并完善重症患者的转出、救治应急预案并严格执行。
2.合理设置隔离区域，满足疑似或确诊患者就地隔离和救治的需要。
3.医务人员严格执行预防措施，做好个人防护和诊疗环境的管理。实施急诊气管插管等感染性职业暴露风险较高的诊疗措施时，应当按照接治确诊患者的要求采取预防措施。
4.诊疗区域应当保持良好的通风并定时清洁消毒。
5.采取设置等候区等有效措施，避免人群聚集。　
（三）普通病区（房）。
1.应当设置应急隔离病室，用于疑似或确诊患者的隔离与救治，建立相关工作制度及流程，备有充足的应对急性呼吸道传染病的消毒和防护用品。
2.病区（房）内发现疑似或确诊患者，启动相关应急预案和工作流程，按规范要求实施及时有效隔离、救治和转诊。
3.疑似或确诊患者宜专人诊疗与护理，限制无关医务人员的出入，原则上不探视；有条件的可以安置在负压病房。
4.不具备救治条件的非定点医院，应当及时转到有隔离和救治能力的定点医院。等候转诊期间对患者采取有效的隔离和救治措施。
5.患者转出后按《医疗机构消毒技术规范》对其接触环境进行终末处理。
（四）收治疑似或确诊新型冠状病毒感染的肺炎患者的病区（房）。
1.建筑布局和工作流程应当符合《医院隔离技术规范》等有关要求，并配备符合要求、数量合适的医务人员防护用品。设置负压病区（房）的医疗机构应当按相关要求实施规范管理。
2.对疑似或确诊患者应当及时采取隔离措施，疑似患者和确诊患者应当分开安置；疑似患者进行单间隔离，经病原学确诊的患者可以同室安置。
3.在实施标准预防的基础上，采取接触隔离、飞沫隔离和空气隔离等措施。具体措施包括：　　
（1）进出隔离病房，应当严格执行《医院隔离技术规范》《医务人员穿脱防护用品的流程》，正确实施手卫生及穿脱防护用品。　　
（2）应当制定医务人员穿脱防护用品的流程；制作流程图和配置穿衣镜。配备熟练感染防控技术的人员督导医务人员防护用品的穿脱，防止污染。　　
（3）用于诊疗疑似或确诊患者的听诊器、体温计、血压计等医疗器具及护理物品应当专人专用。若条件有限，不能保障医疗器具专人专用时，每次使用后应当进行规范的清洁和消毒。
4.重症患者应当收治在重症监护病房或者具备监护和抢救条件的病室，收治重症患者的监护病房或者具备监护和抢救条件的病室不得收治其他患者。
5.严格探视制度，原则上不设陪护。若患者病情危重等特殊情况必须探视的，探视者必须严格按照规定做好个人防护。
6.按照《医院空气净化管理规范》规定，进行空气净化。　　
三、医务人员防护　
（一）医疗机构和医务人员应当强化标准预防措施的落实，做好诊区、病区（房）的通风管理，严格落实《医务人员手卫生规范》要求，佩戴医用外科口罩/医用防护口罩，必要时戴乳胶手套。　　
（二）采取飞沫隔离、接触隔离和空气隔离防护措施，根据不同情形，做到以下防护。
1.接触患者的血液、体液、分泌物、排泄物、呕吐物及污染物品时：戴清洁手套，脱手套后洗手。
2.可能受到患者血液、体液、分泌物等喷溅时：戴医用防护口罩、护目镜、穿防渗隔离衣。
3.为疑似患者或确诊患者实施可能产生气溶胶的操作（如气管插管、无创通气、气管切开，心肺复苏，插管前手动通气和支气管镜检查等）时：
（1）采取空气隔离措施；
（2）佩戴医用防护口罩，并进行密闭性能检测；
（3）眼部防护（如护目镜或面罩）；
（4）穿防体液渗入的长袖隔离衣，戴手套；
（5）操作应当在通风良好的房间内进行；
（6）房间中人数限制在患者所需护理和支持的最低数量。
（三）医务人员使用的防护用品应当符合国家有关标准。　　
（四）医用外科口罩、医用防护口罩、护目镜、隔离衣等防护用品被患者血液、体液、分泌物等污染时应当及时更换。　　
（五）正确使用防护用品，戴手套前应当洗手，脱去手套或隔离服后应当立即流动水洗手。　　
（六）严格执行锐器伤防范措施。　　
（七）每位患者用后的医疗器械、器具应当按照《医疗机构消毒技术规范》要求进行清洁与消毒。　　
四、加强患者管理　
（一）对疑似或确诊患者及时进行隔离，并按照指定规范路线由专人引导进入隔离区。　　
（二）患者进入病区前更换患者服，个人物品及换下的衣服集中消毒处理后，存放于指定地点由医疗机构统一保管。　　
（三）指导患者正确选择、佩戴口罩，正确实施咳嗽礼仪和手卫生。　　
（四）加强对患者探视或陪护人员的管理。
（五）对被隔离的患者，原则上其活动限制在隔离病房内，减少患者的移动和转换病房，若确需离开隔离病房或隔离区域时，应当采取相应措施如佩戴医用外科口罩，防止患者对其他患者和环境造成污染。　　
（六）疑似或确诊患者出院、转院时，应当更换干净衣服后方可离开，按《医疗机构消毒技术规范》对其接触环境进行终末消毒。　　
（七）疑似或确诊患者死亡的，对尸体应当及时进行处理。处理方法为：用3000mg/L的含氯消毒剂或0.5%过氧乙酸棉球或纱布填塞患者口、鼻、耳、肛门等所有开放通道；用双层布单包裹尸体，装入双层尸体袋中，由专用车辆直接送至指定地点火化。患者住院期间使用的个人物品经消毒后方可随患者或家属带回家。

转载自中华人民共和国卫生健康委员会网站