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Global Clinical Networking to Optimize the Clinical Management of High-Consequence Infectious Diseases. 全球临床网络优化高发传染病的临床管理。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 DOI: 10.1089/hs.2024.0067
Jocelyn J Herstein,Jake Dunning,Poh Lian Lim,Christian Herzog,Lauren M Sauer
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引用次数: 0
Evaluation of an Electrochemiluminescence Assay for the Rapid Detection of Ricin Toxin. 评估用于快速检测蓖麻毒素的电化学发光测定法。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 DOI: 10.1089/hs.2023.0160
Gowri Manickam, Christine A Pillai, Nagarajan Thirunavukkarasu, Segaran P Pillai, Julie R Avila, David Hodge, Kevin Anderson, Shashi Sharma

In this article, we detail a comprehensive laboratory evaluation of an immunoassay for the rapid detection of ricin using the Meso Scale Diagnostics Sector PR2 Model 1800. For the assay evaluation, we used inclusivity, exclusivity, and informational panels comprised of extracts of 35 near-neighbor plant cultivar-extracts, 66 lectins, 26 white powders, 16 closely related toxins and proteins/toxoids, and a pool of 30 BioWatch filter extracts. The results show that the Meso Scale Diagnostics ricin detection assay exhibits good sensitivity and specificity with a limit of detection of 1.2 ng/mL. However, the dynamic range of the assay for the quantitation of ricin was limited. We observed a hook effect at higher ricin concentrations, which can lead to potential false negative results. A modification of the assay protocol that incorporates extra wash steps can decrease the hook effect and the potential for false negative results.

在这篇文章中,我们详细介绍了使用 Meso Scale Diagnostics Sector PR2 1800 型快速检测蓖麻毒素的免疫测定的综合实验室评估。在检测评估中,我们使用了由 35 种近缘植物栽培种提取物、66 种凝集素、26 种白粉、16 种密切相关的毒素和蛋白质/类毒素以及 30 种 BioWatch 过滤器提取物组成的包容性、排他性和信息面板。结果表明,Meso Scale Diagnostics 的蓖麻毒素检测化验具有良好的灵敏度和特异性,检测限为 1.2 纳克/毫升。但是,该检测方法定量蓖麻毒素的动态范围有限。在蓖麻毒素浓度较高时,我们观察到钩状效应,这可能导致假阴性结果。修改化验方案,加入额外的洗涤步骤,可以减少钩状效应和出现假阴性结果的可能性。
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引用次数: 0
Improving Safety and Comfort of Healthcare Workers Caring for Patients With High-Consequence Infectious Diseases in a High-Level Isolation Unit Using Innovative Approaches. 利用创新方法改善医护人员在高级别隔离病房护理高危传染病患者时的安全性和舒适性。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-25 DOI: 10.1089/hs.2023.0147
Luca N Zweers, Manon Tingen-Wieland, Edmée Bowles, Jacqueline van Tricht, Jos Velers, Alma Tostmann, Chantal P Rovers

Patients with high-consequence infectious diseases (HCIDs) require high-quality care by specially trained staff in a high-level isolation unit (HLIU) that follows strict infection prevention and control (IPC) measures. Caring for patients with (suspected) HCID is challenging, mainly because of the strict personal protective equipment (PPE) and IPC protocols healthcare workers (HCW) must adhere to for protection. The Radboud University Medical Center, located in Nijmegen, the Netherlands, has been a dedicated HLIU facility since 2008. A newly built HLIU opened in May 2022, and encouraged us to review the existing PPE selection, IPC protocols, and HCID training program to improve safety and comfort for HCWs working in the HLIU. Based on a systematic search through (inter)national HCID PPE guidelines and semistructured interviews with end users, we selected an improved, more comfortable set of PPE. Additionally, we developed a more concise and easier-to-use patient care process flow and implemented a new teaching strategy. The new way of working was tested in October 2022 when the first 2 patients with suspected HCID were admitted to our unit. We used surveys to evaluate the experiences of HCWs involved in this care to further improve the workflow of the unit. When optimizing safety and comfort for HCWs, it is important to consider (inter)national guidelines as well as user preferences. By systematically evaluating recent experiences of patient admission to the HLIU and then adjusting protocols and training, we can ensure that the quality of provided healthcare and the safety of HCWs working in the HLIU remains high.

高致病性传染病(HCID)患者需要在高级隔离病房(HLIU)中由经过专门培训的人员提供高质量的护理,并严格遵守感染预防和控制(IPC)措施。护理(疑似)HCID 患者具有挑战性,这主要是因为医护人员(HCW)必须遵守严格的个人防护设备(PPE)和 IPC 协议,以提供保护。位于荷兰奈梅亨的拉德布德大学医疗中心自 2008 年以来一直是专门的 HLIU 机构。新建的 HLIU 于 2022 年 5 月投入使用,这促使我们重新审视现有的个人防护设备选择、IPC 协议和 HCID 培训计划,以提高在 HLIU 工作的医护人员的安全性和舒适度。我们系统地搜索了各国的 HCID 个人防护设备指南,并与最终用户进行了半结构式访谈,在此基础上,我们选择了一套经过改进的、更舒适的个人防护设备。此外,我们还开发了更简洁、更易用的病人护理流程,并实施了新的教学策略。新的工作方式于 2022 年 10 月进行了测试,当时我们科室接收了首批 2 名疑似 HCID 患者。我们通过调查评估了参与该护理工作的医护人员的经验,以进一步改进科室的工作流程。在优化医护人员的安全性和舒适度时,必须考虑(国际)国家指导方针以及用户的偏好。通过系统地评估最近病人进入重症监护室的经历,然后调整协议和培训,我们可以确保所提供的医疗服务质量以及在重症监护室工作的高危护理人员的安全。
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引用次数: 0
Frontline Leadership: Nurses in Special Pathogens Preparedness and Response. 前线领导:前线领导:特殊病原体防范和应对中的护士。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-06-03 DOI: 10.1089/hs.2023.0149
Jade B Flinn, Christa L Arguinchona, Angela Vasa, Sharon Vanairsdale Carrasco, Iris Agreiter, Stefan Boxnick, Benjamin Stadtmann, Patricia Ann Tennill
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引用次数: 0
Feasibility Assessment of a Novel Isolation Care Tent in Uganda During the 2022 Sudan ebolavirus Outbreak. 2022 年苏丹伊波拉病毒爆发期间乌干达新型隔离护理帐篷的可行性评估。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI: 10.1089/hs.2023.0177
M Jana Broadhurst, Rodgers R Ayebare, David M Brett-Major, Sean M Carroll, Jacob Lacore, Alexander D Laskey, James V Lawler, Patricia Lord, Ruben M Vazquez, Peter Waitt, Mohammed Lamorde

This case study describes a feasibility assessment of a novel isolation care tent used in health facilities in Uganda during the 2022 Sudan ebolavirus outbreak. The Isolation System for Treatment and Agile Response to High-Risk Infections Model 1B (ISTARI 1B) is a single-occupancy, portable, negative-pressure isolation tent designed for the safe delivery of standard care to patients with a communicable disease, including Ebola disease (Sudan). At the request of the Uganda Ministry of Health, the Makerere University Infectious Diseases Institute and University of Nebraska Medical Center partnered to evaluate 7 health facilities across 4 districts in Uganda for infrastructure, case management, and infection prevention and control (IPC) capacity relevant to isolation care and ISTARI 1B use. A 3-day workshop was held with IPC leaders to provide familiarization and hands-on experience with the ISTARI 1B, delineate appropriate use scenarios in Ugandan healthcare settings, contextualize ISTARI 1B use in case management and IPC workflows, develop a framework for site assessment and implementation readiness, and consider ongoing monitoring, assessment, and intervention tools. Workshop participants performed a comprehensive site assessment and mock deployment of the ISTARI 1B. In this case study, we describe lessons learned from health facility assessments and workshop outcomes and offer recommendations to support successful ISTARI 1B implementation. Use scenarios and implementation strategies were identified across facility levels, including tools for site assessment, training, risk communication, and ongoing quality and safety monitoring.

本案例研究描述了对 2022 年苏丹埃博拉病毒爆发期间乌干达卫生机构使用的新型隔离护理帐篷的可行性评估。高危感染治疗和敏捷反应隔离系统 1B 型(ISTARI 1B)是一种单人、便携式负压隔离帐篷,设计用于为包括埃博拉病毒在内的传染病(苏丹)患者安全提供标准护理。应乌干达卫生部的要求,马凯雷雷大学传染病研究所与内布拉斯加大学医学中心合作,对乌干达 4 个地区的 7 家医疗机构的基础设施、病例管理以及与隔离护理和 ISTARI 1B 使用相关的感染预防和控制 (IPC) 能力进行了评估。与 IPC 领导者一起举办了为期 3 天的研讨会,让他们熟悉 ISTARI 1B 并亲身体验其操作,确定在乌干达医疗机构中的适当使用场景,了解 ISTARI 1B 在病例管理和 IPC 工作流程中的使用情况,制定现场评估和实施准备框架,并考虑持续监控、评估和干预工具。研讨会与会者对现场进行了全面评估,并模拟部署了 ISTARI 1B。在本案例研究中,我们介绍了从医疗机构评估和研讨会成果中吸取的经验教训,并提出了支持成功实施 ISTARI 1B 的建议。我们确定了各级医疗机构的使用方案和实施策略,包括现场评估、培训、风险沟通以及持续质量和安全监测工具。
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引用次数: 0
Transport of Patients With High-Consequence Infectious Diseases: Development of European Capacity in Norway. 高危传染病患者的转运:在挪威发展欧洲能力。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI: 10.1089/hs.2023.0153
Arne B Brantsæter, Andreas E Hansen, Andreas Gisholt Gustavsen, Vidar Stensvåg, Hege Anita Aastrøm, Fridtjof Heyerdahl, Per Magne Tveitane, Espen Rostrup Nakstad

Infection of Western aid workers with Ebola virus disease during the 2014-2016 West African outbreak demonstrated the need for medical evacuation to high-level isolation units in Europe and the United States. In Norway, an ad hoc preparedness team was established for aeromedical evacuation in case of need. In October 2014, this team transported an infected aid worker from the military section of Oslo Airport to Oslo University Hospital. To maintain and strengthen the capacity for domestic ambulance transport on the ground and in the air, the Norwegian Medical Emergency Response Team for High Consequence Infectious Diseases (in Norway known as "Nasjonalt medisinsk utrykningsteam for høyrisikosmitte"), or NORTH, was established as a permanent service in 2017. Recognizing the expertise of this domestic team, Norway was subsequently entrusted with the task of enhancing the European aeromedical transport capacity for high-consequence infectious diseases and establishing the Norwegian rescEU Jet Air Ambulance for Transport of Highly Infectious Patients, or NOJAHIP, in 2022. In this case study, we present experiences and lessons learned from these 2 services and discuss how they can be further developed.

在 2014-2016 年西非疫情爆发期间,西方援助人员感染了埃博拉病毒疾病,这表明有必要向欧洲和美国的高级隔离单位进行医疗后送。挪威成立了一个特设准备小组,以便在需要时进行航空医疗后送。2014 年 10 月,该小组将一名受感染的援助人员从奥斯陆机场军事区送往奥斯陆大学医院。为了保持和加强国内地面和空中救护运输的能力,2017 年成立了挪威高后果传染病医疗应急小组(在挪威称为 "Nasjonalt medisinsk utrykningsteam for høyrisikosmitte"),简称 NORTH,作为一项长期服务。挪威认识到这支国内团队的专业能力,随后受托加强欧洲高危传染病的航空医疗转运能力,并于2022年成立了用于转运高危传染病患者的挪威救援欧盟喷气式空中救护队(Norwegian rescEU Jet Air Ambulance for Transport of Highly Infectious Patients),简称NOJAHIP。在本案例研究中,我们将介绍这两项服务的经验和教训,并讨论如何进一步发展这两项服务。
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引用次数: 0
Using Video-Reflexive Methods to Develop a Provider Down Protocol for the New South Wales Biocontainment Center. 使用视频反思方法为新南威尔士生物安全中心制定 "提供商停机协议"。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-08-12 DOI: 10.1089/hs.2023.0165
Mary Wyer, Su-Yin Hor, Patricia E Ferguson, Arwen Morath, Ruth Barratt, Catherine M Priestley, Alice Polak, Gwendolyn L Gilbert

The New South Wales Biocontainment Centre is a statewide referral facility for patients with high-consequence infectious disease (HCID). The facility collaborates with researchers to adapt existing HCID procedures such as donning and doffing of personal protective equipment (PPE). However, information on how to respond safely to collapse of a healthcare provider in full PPE within a contaminated zone is scarce. To address this gap, we adapted Nebraska Medicine's "provider down" protocol on paper and then simulated and video recorded the process, iteratively, in the facility. Clinicians analyzed the recordings collaboratively in researcher-facilitated reflexive discussions. Our primary aim was to ascertain how to maintain optimal infection prevention and control while providing urgent care for the healthcare provider. We tested participants' suggested modifications, in repeated video recorded simulations, until consensus on optimal practice was achieved. Our secondary aim was to assess the utility of video-reflexive methods to enhance clinicians' awareness and understanding of infection prevention and control in a rare and complex scenario. Six adaptations and simulations were discussed in video-reflexive sessions before consensus was reached; the final version of the protocol differed considerably from the first. Viewing footage of simulations in situ enabled participants to (1) identify infection and occupational risks not identified on paper or during verbal postsimulation debriefs and (2) test alternative perspectives on safe procedure. Video-reflexivity enables context-sensitive and consensus-building codesign of policies and procedures, critical to protocol development in a new unit. It contributes to a culture of teamwork, preparedness, and confidence before, rather than in the heat of, a crisis.

新南威尔士生物封闭中心是全州范围内的高危传染病 (HCID) 患者转诊机构。该机构与研究人员合作,调整现有的 HCID 程序,例如穿脱个人防护设备 (PPE)。然而,关于如何安全应对在污染区中穿着全套个人防护设备的医护人员倒地的信息却很少。为了填补这一空白,我们在纸上改编了内布拉斯加州医学会的 "医护人员倒地 "协议,然后在医疗机构中反复模拟并录制了这一过程。临床医生在研究人员主持的反思性讨论中共同分析了录像。我们的主要目的是确定如何在为医疗服务提供者提供紧急护理的同时保持最佳的感染预防和控制效果。我们在反复录制的模拟视频中测试参与者提出的修改建议,直到就最佳做法达成共识。我们的第二个目的是评估视频反思法在罕见的复杂场景中提高临床医生对感染预防和控制的认识和理解的效用。在达成共识之前,我们在视频反思会议上讨论了六种改编和模拟方案;方案的最终版本与第一版有很大不同。通过观看现场模拟的录像,参与者能够:(1)识别纸面上或模拟后口头汇报中未识别的感染和职业风险;(2)检验对安全程序的其他看法。通过视频反思,可以对政策和程序的设计进行背景敏感性分析并达成共识,这对新单位的规程制定至关重要。它有助于在危机发生之前,而不是在危急关头,形成一种团队合作、有备无患和充满信心的文化。
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引用次数: 0
Twenty Years of International Research on First Aid: A Bibliometric Visualization of Scientific Outputs. 国际急救研究二十年:科学成果的文献计量可视化。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-10-04 DOI: 10.1089/hs.2023.0188
Alexei A Birkun

Although first aid research is a wide-ranging and diverse field within medical science, so far no attempts have been made to provide a holistic view of international scientific outputs in the first aid domain. To determine strategic directions for conducting future studies, it is important to understand the status of the research, including its frontiers and blind spots. This study explored the global landscape of first aid research using bibliometric visualization analysis of relevant literature published within the last 20 years. The search yielded a total of 2,057 relevant papers. There was a trend of increasing annual numbers of publications throughout the 20 year period. The following topics were identified as the mainstream directions of first aid research: cross-sectional studies on attitudes and knowledge of first aid; cardiac arrest and cardiopulmonary resuscitation; bleeding and hemorrhage control; burns, scalds, and their management; envenomations and their management; and systematic evaluation of the scientific evidence. Evidence evaluation is one of the main frontiers of first aid research. Studies concerning first aid for the most common and deadliest diseases, including myocardial infarction and stroke, are not in the scope of contemporary international first aid research. Considering that effective implementation of first aid can reduce morbidity and mortality, it is advisable to advance research on first aid management of major emergencies that are the most common potentially avoidable causes of death.

尽管急救研究是医学科学中的一个广泛而多样的领域,但迄今为止,还没有人尝试对急救领域的国际科学成果进行全面审视。为了确定未来研究的战略方向,了解研究现状,包括其前沿和盲点非常重要。本研究通过对过去 20 年间发表的相关文献进行文献计量学可视化分析,探索了全球急救研究的现状。搜索共获得 2,057 篇相关论文。在这 20 年间,每年发表的论文数量呈上升趋势。以下主题被确定为急救研究的主流方向:关于急救态度和知识的横断面研究;心脏骤停和心肺复苏;出血和出血控制;烧伤、烫伤及其处理;中毒及其处理;以及科学证据的系统评估。证据评估是急救研究的主要前沿之一。有关心肌梗塞和中风等最常见、最致命疾病的急救研究不属于当代国际急救研究的范围。考虑到有效实施急救可以降低发病率和死亡率,我们建议推进对重大突发事件的急救管理研究,因为这些事件是最常见的、有可能避免的死亡原因。
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引用次数: 0
The Importance of Networks and Relationships: Leveraging the Biocontainment Unit Leadership Workgroup for Special Pathogen Outbreak Response. 网络和关系的重要性:利用生物安全单位领导工作组应对特殊病原体爆发。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-22 DOI: 10.1089/hs.2023.0151
Caroline C Persson, Christa Arguinchona, Sophia Y Shea, Lauren M Sauer

Developing and sustaining relationships and networks before an emergency occurs is crucial. The Biocontainment Unit Leadership Workgroup is a consortium of the 13 Regional Emerging Special Pathogen Treatment Centers in the United States. Established in 2017, the volunteer-based workgroup is composed of operational leaders dedicated to maintaining readiness for special pathogen care. Monthly meetings focus on addressing operational challenges, sharing best practices, and brainstorming solutions to common problems. Task forces are leveraged to tackle more complex issues that are identified as priorities. In 2022, members of the workgroup were harnessed for response efforts related to mpox, Sudan ebolavirus, and Marburg virus disease. The weekly Outbreak Readiness call is a shared effort between the Biocontainment Unit Leadership Workgroup and the Special Pathogens Research Network of the National Emerging Special Pathogens Training and Education Center. Call participants included leaders of the Regional Emerging Special Pathogen Treatment Centers and federal partners who shared weekly updates on operational readiness of units, case counts, laboratory capacity, available medical countermeasures, and other pertinent information. The routine exchange of real-time information enabled learning and collegial sharing of experiences, highlighted the experience of the network to federal partners, and provided situational awareness of special pathogen outbreaks across the country. The consortium enabled this rapid convening of partners to meet an urgent need for special pathogen response. The weekly Outbreak Readiness call is a communication model and scalable framework that serves both domestic preparedness efforts and international efforts should the need for a collaborative global response arise. In this case study, we describe the framework and experience of this partnership, along with the structure of rapid deployment for group convening.

在紧急情况发生之前发展和维持关系与网络至关重要。生物安全单位领导工作组是由美国 13 个地区新兴特殊病原体治疗中心组成的联盟。该工作组成立于 2017 年,以志愿者为基础,由致力于保持特殊病原体治疗准备就绪的业务领导人组成。每月举行的会议侧重于应对运营挑战、分享最佳实践和集思广益解决常见问题。工作组被用来解决被确定为优先事项的更复杂的问题。2022 年,工作组的成员被用于应对与麻疹、苏丹伊波拉病毒和马尔堡病毒病有关的工作。每周的疫情准备电话会议是生物安全单位领导工作组与国家新发特殊病原体培训和教育中心的特殊病原体研究网络共同开展的一项工作。电话会议的参与者包括地区新发特殊病原体治疗中心的领导和联邦合作伙伴,他们每周都会分享有关单位的运行准备情况、病例数量、实验室能力、可用的医疗对策和其他相关信息的最新情况。例行的实时信息交流促进了学习和经验共享,向联邦合作伙伴强调了网络的经验,并提供了对全国特殊病原体爆发的态势感知。该联盟能够迅速召集合作伙伴,以满足特殊病原体应对的迫切需要。每周一次的疫情准备呼叫是一种沟通模式和可扩展的框架,既可服务于国内的准备工作,也可在需要全球合作应对时服务于国际工作。在本案例研究中,我们将介绍这种合作关系的框架和经验,以及快速部署小组召集的结构。
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引用次数: 0
High-Level Isolation: A Landscape Analysis of Global Capabilities and Opportunities to Advance the Field. 高水平隔离:对全球能力和推动该领域发展的机遇的分析。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-08-05 DOI: 10.1089/hs.2023.0181
Jocelyn J Herstein, Joseph Lukowski, Wael ElRayes, John J Lowe, Aneesh K Mehta, Vikramjit Mukherjee, Katie L Stern, Sharon Vanairsdale Carrasco, Angela Vasa, Sami Vasistha, Lauren M Sauer

High-level isolation units (HLIUs) have been established by countries to provide safe and optimal medical care for patients with high-consequence infectious diseases. We aimed to identify global high-level isolation capabilities and determine gaps and priorities of global HLIUs, using a multiple method approach that included a systematic review of published and gray literature and a review of Joint External Evaluations and Global Health Security Index reports from 112 countries. A follow-up electronic survey was distributed to identified HLIUs. The landscape analysis found 44 previously designated/self-described HLIUs in 19 countries. An additional 33 countries had potential HLIUs; however, there were not enough details on capabilities to determine if they fit the HLIU definition. An electronic survey was distributed to 36 HLIUs to validate landscape analysis findings and to understand challenges, best practices, and priorities for increased networking with a global HLIU cohort; 31 (86%) HLIUs responded. Responses revealed an additional 30 confirmed HLIUs that were not identified in the landscape analysis. To our knowledge, this was the first mapping and the largest ever survey of global HLIUs. Survey findings identified major gaps in visibility of HLIUs: while our landscape analysis initially identified 44 units, the survey unveiled an additional 30 HLIUs that had not been previously identified or confirmed. The lack of formalized regional or global coordinating organizations exacerbates these visibility gaps. The unique characteristics and capabilities of these facilities, coupled with the likelihood these units serve as core components of national health security plans, provides an opportunity for increased connection and networking to advance the field of high-level isolation and address identified gaps in coordination, build an evidence base for HLIU approaches, and inform HLIU definitions and key components.

各国建立高级别隔离单位(HLIU)的目的是为高危传染病患者提供安全和最佳的医疗护理。我们采用多种方法,包括对已发表的文献和灰色文献进行系统回顾,以及对 112 个国家的联合外部评估和全球健康安全指数报告进行回顾,旨在确定全球高级别隔离能力,并确定全球高级别隔离单位的差距和优先事项。还向已确定的高级别医疗保险单位分发了后续电子调查表。情况分析发现,在 19 个国家中有 44 个先前指定/自述的高危重点单位。另有 33 个国家有潜在的高风险独立单位,但没有足够的能力细节来确定它们是否符合高风险独立单位的定义。向 36 个高地独立单位分发了电子调查表,以验证前景分析结果,并了解与全球高地独立单位群组加强联网所面临的挑战、最佳实践和优先事项;31 个(86%)高地独立单位做出了回应。答复显示,另有 30 个已确认的高阶层人士联谊单位在情况分析中没有发现。据我们所知,这是首次对全球高阶层人士联谊单位进行摸底调查,也是有史以来规模最大的一次调查。调查结果显示,高地小岛屿的知名度存在重大差距:虽然我们的景观分析初步确定了 44 个小岛屿,但调查发现还有 30 个高地小岛屿此前未被确定或确认。缺乏正式的地区或全球协调组织加剧了这些能见度差距。这些设施的独特性和能力,加上这些单位有可能成为国家卫生安全计划的核心组成部分,为加强联系和联网提供了机会,以推动高级隔离领域的发展,解决协调方面的差距,为高级隔离单位方法建立证据基础,并为高级隔离单位的定义和关键组成部分提供信息。
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