Promulgation Date: 2020-1-22 Title: 国家卫生健康委办公厅关于印发医疗机构内新型冠状病毒感染预防与控制技术指南（第一版）的通知 Document Number:国卫办医函〔2020〕65 号 Expiration date: Promulgating Entities:General Office of the National Health Commission Source of text: http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml
To the health commissions of each province, autonomous region, directly-governed municipality, and of the Xinjiang production and construction corps.
In order to further perform well novel coronavirus infection prevention and control work, to effectively reduce the risk of transmission within medical establishments, and to ensure the quality and safety of medical treatment, this commission arranged for and formulated the "Technical Guide for Medical Establishments in the Prevention and Control of the Transmission of the Novel Coronavirus (1st Edition). We now print and circulate it to you and ask that local health administration departments at all levels appoint specific people to be responsible for the infection prevention and control work of medical establishments within your respective jurisdictions, and lower, to the greatest possible extent, the risk of the transmission of the novel coronavirus within medical establishments. Meanwhile, please report the details of the responsible persons of provincial-level health administration departments, including name, contact telephone number, division, and position, to the Commission’s Medical Administration and Regulation Bureau before 10 o’clock on 23 January 2020.
Contact: Bureau for Medical Administration; Zhang Wenbao, Wang Manli
General Office of the National Health Commission
January 22, 2020
(Information disclosure type: Proactive Disclosure)
Technical Guide for Medical Establishments in the Prevention and Control of the Transmission of the Novel Coronavirus (1st Edition)
This technical guide is specially drafted to further complete efforts to prevent and control the spread of the novel coronavirus, to effectively reduce the risk of transmitting the coronavirus in medical establishments, and to regulate the conduct of medical personnel.
I. Basic Requirements
(1) Draft emergency response plans and work procedures. Medical establishments shall strictly implement the "Notice on Further Strengthening Efforts on the Prevention and Control of Infection in Medical Establishments" (GuoWeiBanYiHan (2019) No. 480), and are to establish early warning mechanisms, emergency response plans, and work procedures, based on factors such as the novel form coronavirus's pathogenic features, sources of infection and transmission, vulnerable populations and treatment requirements,
(2) Train all personnel. Designate training material for different personnel based on their post and duties, especially giving key training to medical personnel in high-risk departments such as fever clinics, internal medicine clinics, pediatrics clinics, emergency rooms, ICUs, and respiratory wards, familiarizing them with knowledge, methods, and techniques on prevention and control of infection by the novel coronavirus, so that it is discovered, reported, quarantined, diagnosed, treated, and controlled early on.
(3) Protect medical personnel. Medical establishments should standardize disinfection, isolation and protection work and have in reserve ample protective materials that meet quality standards, such as disinfectant products and surgical masks, medical masks, isolation gowns, eye protection and other protective equipment, to ensure that the personal protection of medical personnel is as it should be. On top of strict application of standard precautions, strengthen the prevention and control of contact transmission, droplet transmission and airborne transmission. Correct selection and wearing of face masks and hand hygiene are key measures in the prevention and control of contagion.
(4) Pay attention to the health of medical personnel. Medical establishments should make reasonable arrangements in deploying human resources and organising shifts to avoid health workers becoming overly tired. They should provide nutritious meals to strengthen the immunity of health workers. Aimed at the specifics of different posts and the results of risk assessments, carry out active health monitoring including for body temperature and respiratory system symptoms etc. They should adopt multiple different measures to ensure that health workers are able to healthily provide medical services for patients.
(5) Strengthen monitoring of contagion. Carry out early warning and forecasting to good effect, strengthen supervision and guidance of infection prevention and control work, detect hidden dangers, and promptly make improvements. On discovering suspected or diagnosed novel coronavirus pneumonia patients, report promptly in accordance with relevant requirements and, within two hours, report the details upwards, and make the necessary work arrangements.
(6) Manage cleaning and disinfecting. In accordance with the Hospital Air Purification Management Guidelines, strengthen ventilation of diagnosis and treatment environments; medical establishments with the conditions to do so can carry out air disinfection, and recirculating air disinfection equipment can be installed. Strictly implement the Technical Guidelines for Medical Establishment Disinfection, ensure the correct cleaning and disinfection of diagnosis and treatment environments (air, surfaces, floors etc), medical instruments, articles used by patients, etc.; ensure strict handling of patient respiratory secretions, excretions, and vomit; and strictly carry out terminal disinfection.
(7) Strengthen management of patient treatment visits. Medical establishments should ensure proper management of consulting patients and do their best to reduce patient crowding to reduce the risk of hospital infection. On discovering patients suspected or diagnosed as infected with novel coronavirus, in accordance with law adopt isolation or transmission control measures and, according to regulations, adopt medical observation and other necessary preventative measures vis-à-vis persons accompanying such patients and others who have come into close contact with them. Those that do not have the capacity to offer treatment, should promptly refer patients to medical establishments that do have the capacity for treatment.
(8) Strengthen education of patients. Medical establishments should actively undertake to educate consulting patients and persons accompanying them, to help them become informed about protecting against novel coronavirus, guiding them as to correct hand-washing, cough etiquette, medical observation, home isolation and so on.
(9) Strengthen management of infection outbreaks. Strictly implement each item of in the regulatory framework to prevent and control infection in medical establishments, reducing the risk of an outbreak as much as possible. Strengthen sensitivity; as soon as suspected cases of novel coronavirus infection break out or once they have broken out, medical institutions must promptly report on them in accordance with regulations and, according to the relevant standards and procedures, set in motion emergency plans, and cooperate in ensuring work to investigate and handle cases is done effectively.
(10) Strengthen management of medical waste. Bring medical waste produced by patients diagnosed with or suspected as being infected with novel coronavirus under management for infectious medical waste, and carry out standard-compliant handling strictly in accordance with the related stipulations in the Regulations on Medical Waste Management and the Measures on the Management of Medical Waste by Medical and Health-Care Institutions.
II. Administration of Key departments
(1) Fever clinics.
1. The building arrangements and work procedures for fever clinics should be in keeping with the related requirements found in the Technical Guidelines for Hospital Isolation etc.
2. Observation rooms and emergency rooms should strengthen ventilation; if machine ventilation is being used, the direction of airflow should be controlled, from clean to contaminated.
3. Equip with ample numbers of requirement-compliant protective articles for medical personnel; fever clinic entrances and exits should install hand hygiene facilities such as alcohol-based hand rubs.
4. Medical personnel carrying out diagnosis and treatment work should implement standard protective measures. They should wear correctly surgical masks or medical protective masks; before putting on and after taking off a mask, hands should be washed or a hand hygiene disinfectant rub should be used. On entering and exiting fever clinics and observation wards, correctly put on or remove protective items strictly in accordance with the Procedures for Medical Personnel on the Wearing and Removal of Protective Items (see appended document).
5.Medical personnel should have a grasp of the particular epidemiological and clinical characteristics of novel coronavirus infection, undertake patient screening in accordance with diagnosis and treatment standards, and immediately adopt isolation measures for patients suspected or diagnosed and promptly report.
6. Once patients have been transferred conduct terminal handling in accordance with the Technical Guidelines on Disinfection in Medical Establishments.
7. Medical establishments should provide face masks for patients and those accompanying them, and guide them as to how to wear them correctly.
(2) Emergency rooms.
1. Implement pre-examination and triage systems, guide patients with fever to be seen in fever clinics and draw up and improve emergency plans for transfer and emergency care for patients with severe symptoms, and strictly implement them.
2. Set up reasonable isolation areas to meet the needs for on-site isolation and treatment of suspected and confirmed patients.
3. Medical personnel should strictly implement prevention measures; ensure personal protection and diagnosis and treatment environments are correctly managed. When implementing diagnosis and treatment measures, such as emergency endotracheal intubation, for which the occupational exposure to infection risk is relatively high, (medical personnel) should adopt prevention measures according to the requirements for treating patients with confirmed diagnoses.
4. Diagnosis and treatment areas shall be well ventilated and regularly cleaned and disinfected.
5. Employ effective measures is setting up waiting areas and so forth, to avoid concentrating groups of people.
(3) General wards (rooms).
1. Emergency isolation rooms should be put in place and used for the isolation and emergency treatment of suspected or diagnosed patients; the related work systems and processes should be established, and sufficient disinfectant and protective articles should be prepared for responding to acute respiratory tract infections.
(4) Wards (rooms) for patient with pneumonia suspected or diagnosed as being infected with the novel corona virus.
III. Protection of Medical Personnel
(6) Strictly implement measures for preventing injuries from sharps.
IV. Strengthening Patient Management.
（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。
Attachment: Procedures for Medical Personnel Wearing and Removing Protective Gear
I. Procedures for Medical Personnel Putting on Protective Gear to Enter Quarantine Zones
II. Procedures for Medical Personnel Removing Protective Gear on Leaving Quarantine Zones