Practice of closed-loop group nursing model in the makeshift intensive care unit for coronavirus disease 2019_West China Medical Journal

Authors：

FENG Mei ¹ ,  LI Ka ² , ZHU Jing ¹ , WAN Qijing ³ , SONG Zhifang ¹

1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Fever Ward 4, Wuhan Red Cross Hospital, Wuhan, Hubei 430000, P. R. China;

Corresponding author：

LI Ka, Email: lika127@126.com

Keywords：

Closed-loop group nursing model; Coronavirus disease 2019; Makeshift intensive care unit; Management practice

DOI：

10.7507/1002-0179.202003022

Video：

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Objective To explore the effect of closed-loop group nursing model on the makeshift intensive care unit (ICU) in a hospital specialized for coronavirus disease 2019 (COVID-19).Methods Several fever wards had been shifted into ICUs and ran by the first medical team from Sichuan Province from January 30th to March 19th, 2020. Closed-loop group nursing model was utilized. The nursing model activated the nurses in management by empowerment and nursing group establishment. To ensure standard of care, measures were carried out in this model, namely, improving the physical work environment, nurse training, optimizing composition of nursing manpower, fine and standardized management of medical resources, “double-chain” medical supply system, “3S” management on first aid kit, protecting patient safety and dignity, and developing emergency nursing workforce deployment plan.Results The implementation of closed-loop group nursing model showed good results in treating severe to critically ill COVID-19 patients regardless of shortages in nursing workforce and facilities. The rescue work was carried out successfully in the makeshift ICUs. All the nurses showed great teamwork and were really involved in the management of the wards. Conclusions As the current ICUs were not adequate for the increasing number of critically ill patients during the epidemic, it was unavoidable to transform other wards into ICUs. Closed-loop group nursing model was utilized to break the hierarchy. As a result, all nurses were empowered to participate in nursing management and their potential was fully inspired. Furthermore, this working model presented a clear working framework in multidisciplinary teamwork in a limited time, which also provided patients with dignity and safety.

Citation： FENG Mei, LI Ka, ZHU Jing, WAN Qijing, SONG Zhifang. Practice of closed-loop group nursing model in the makeshift intensive care unit for coronavirus disease 2019. West China Medical Journal, 2020, 35(9): 1030-1034. doi: 10.7507/1002-0179.202003022 Copy

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1. 国家卫生健康委办公厅. 新型冠状病毒感染的肺炎诊疗方案(试行第五版修正版). (2020-02-08)[2020-03-07]. http://www.nhc.gov.cn/yzygj/s7653p/202002/d4b895337e19445f8d728fcaf1e3e13a/files/ab6bec7f93e64e7f998d802991203cd6.pdf.
2. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 2020, 382(8): 727-733.
3. 国家卫生健康委员会. 新型冠状病毒感染的肺炎纳入法定传染病管理. (2020-01-20)[2019-03-03]. http://www.nhc.gov.cn/jkj/s7915/202001/e4e2d5e6f01147e0a8df3f6701d49f33.shtml.
4. World Health Organization. WHO declares coronavirus outbreak a global health emergency. (2020-01-30)[2020-03-03]. https://www.statnews.com/2020/01/30/who-declares-coronavirus-outbreak-a-global-health-emergency/.
5. 国家卫生健康委办公厅. 新型冠状病毒感染的肺炎诊疗方案(试行第六版). (2020-02-18)[2020-03-07]. http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2/files/b218cfeb1bc54639af227f922bf6b817.pdf.
6. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 2020, 395(10223): 514-523.
7. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus, infected pneumonia. N Engl J Med, 2020, 382(13): 1199-1207.
8. 李星梅, 张翠萍, 郭建新. 成组护理管理模式的应用对比研究. 解放军护理杂志, 2009, 26(8A): 67-68.
9. 谢娥. 闭环管理模式在护理隐患排查处理中的应用. 护理实践与研究, 2016, 13(15): 104-106.
10. 倪忠, 秦浩, 李洁, 等. 新型冠状病毒肺炎患者经鼻高流量氧疗使用管理专家共识. 中国呼吸与危重监护杂志, 2020, 19(2): 120-124.
11. 葛慧青, 代冰, 徐培峰, 等. 新型冠状病毒肺炎患者呼吸机使用感染管理专家共识. 中国呼吸与危重监护杂志, 2020, 19(2): 116-119.
12. 罗红, 张晗. 俯卧位通气的细节与实施. 中华结核和呼吸杂志, 2016, 39(9): 666-668.
13. 廖浩, 宋景春. 重症加强治疗病房危重患者俯卧位通气垫的研制与使用. 中国呼吸与危重监护杂志, 2020, 19(1): 78-80.
14. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected: Interim Guidance. (2020-01-12)[2020-03-03]. https://apps.who.int/iris/handle/10665/178529?locale=en.
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16. 刘于, 汪晖, 陈军华, 等. 突发新型冠状病毒肺炎疫情的护理人力及物力应急管理. 中华护理杂志, 2020, 55(3): 343-346.
17. 夏晴晴. 闭环反馈控制模式在精神科护理管理中的应用. 中医药管理杂志, 2018, 26(18): 132-133.
18. 杨梅. 正反馈闭环管理系统在泌尿外科护理中的应用. 中医药管理杂志, 2017, 25(1): 181-182.

West China Medical Journal

Practice of closed-loop group nursing model in the makeshift intensive care unit for coronavirus disease 2019

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