Authors (including presenting author) :
Yip YKL,Leung SH, Chan BY,Leung KHB, Li YC
Affiliation :
Department of Family Medicine and General Out Patient Clinic, Queen Elizabeth Hospital, KCC
Introduction :
GOPCs are community based primary healthcare facilities, providing care for patients with episodic illnesses and general management of chronic conditions to a significant portion of the population. With the close relationship with the local community, in case of communicable disease outbreak hazards occur, like recent Mosquito borne diseases include Dengue fever/ Zika virus infection/ Japanese encephalitis, or even Measles, Ebola, Swine flu, Avian flu, MERS, GOPCs play a role as a gate keeper to 2nd healthcare facilities.
Objectives :
1. To prepare KCC GOPCs for rapid response to potential and emerging communicable disease in community 2. To enable communicable disease prevention, identification and control in KCC community based GOPCs for communicable disease outbreaks 3. To cope with emergency operation of designated fever clinic (DFC) and suspected case transfer during epidemic outbreaks
Methodology :
In order to cope with the unpredictable communicable disease outbreak situations, KCC GOPCs preparation including staff, resources, facilities and environment are essential. Staff Training: regular infection control trainings, infection control drills and audits assisted by IC link nurse in local GOPCs Local clinical readiness: standard practice on fever/ suspected case handling, readiness of cohort area and fever room ventilation facilities. Fever room enhancement with clinic ventilations and airflow measurement and documented to ensure clinical workplace operate within safety standards. PPE stock including Ebola PPE would be well maintained for staff use. Communication Staff communication on DFC manpower arrangement and clinical workflow. Close linkage with hospital ICNs, neighbor departments within the same premises would be necessary to cater different clinical arrangement during outbreak period. Environment: maintain a vector free clinic compound and provide mosquito repellent for outdoor duties, esp. during vector borne disease outbreaks. Patient and public education Public and staff education on outbreak situation, related sign and symptoms and prevention measures would be helpful.
Result & Outcome :
People: Mandatory infection control training covering was completed for all clinical staff in KCC GOPCs. Annual PPE audit and Ebola PPE audit, quarterly year hand hygiene audit for all professional and supporting staff are covered Fever drills are conducted annually in all GOPCs involving all staff ranks to revisit the fever case handling process and explore enhancement in infection control measures with the expert input from hospital ICNs. For designated clinics, DFC drills were conducted in all potential DFCs annually. Red list for DFC need to be prepared for staff information and contingency management and reviewed yearly. Transfer logistics of suspected cases for hospital admission has been worked out and notify all clinical staff to ensure infection prevention and control. Equipment and Resources: Functional check and regular maintenance of ventilation system and equipment are performed and properly documented. PPE stock are regularly check and reported to parent hospital. Environment Frequency and quality of pest control within clinical compounds were closely monitored Reinforced mosquito prevention measures during rain seasons Weekly environmental audit to remove sources of standing water, clean out the gutters and water drainage around clinic. Provide mosquito repellent spray to and advise on wearing long sleeves when performing outdoor duties, especially in high vegetation areas.
