Quyết định 1226/QĐ-BYT 2022 điều chỉnh sàng lọc xét nghiệm người nghi nhiễm SARS CoV 2

DECISION

ON GUIDELINES FOR AMENDMENTS TO REGULATIONS ON SCREENING, TRIAGE, AND TESTING OF SUSPECTED COVID-19 PATIENTS AND ADMISSION OF COVID-19 PATIENTS TO HEALTH FACILITIES

THE MINISTER OF HEALTH

Pursuant to the Law on Prevention and Control of Infectious Diseases 2007;

Pursuant to the Law on Medical Examination and Treatment 2009;

Pursuant to Government's Decree No. 75/2017/ND-CP dated June 20, 2017 on functions, tasks, powers and organizational structure of the Ministry of Health;

Pursuant to Resolution No. 38/NQ-CP dated March 17, 2022 of the Government on promulgation of Program on prevention and control of COVID-19 pandemic;

At request of Director of Department of Medical Examination and Treatment Management, the Ministry of Health.

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Article 1. To promulgate guidelines for amendments to regulations on screening, triage, and testing of suspected Covid-19 patients and admission of Covid-19 patients to health facilities (hereinafter referred to as hospitals), in specific:

1. Guidelines for screening and triage of suspected Covid-19 patients in hospitals:

a) Main point of view

In the hospital, if people who are being treated for other diseases have COVID-19, that will cause many difficulties for treatment, so it is necessary to organize screening, triage, testing, identification and treatment of those patients soon.  Departments that admit seriously ill and high-risk patients need to minimize the spread of SARS-CoV-2. Hospital leaders need to well organize screening and early identification of people suspected of being infected with SARS-CoV-2, especially in high-risk departments, and focus on first aid and treatment with priority given to reducing deaths related to COVID-19.

b) Principles

- People with suspected signs of SARS-CoV-2 infection should be screened and identified early to avoid infection and aggravation of other diseases, especially patients in high-risk groups, in the intensive care unit, dialysis (artificial kidney) and in postoperative period. People who are found to be infected with SARS-CoV-2 should be examined and treated separately from those who are not infected.

- Based on the general guidance of the Ministry of Health, the hospital shall, on their own initiative, build, update and maintain the process of welcoming, screening, triaging, giving medical examination, testing, and referral for people with COVID-19 in a way that flexibility is enhanced, administrative procedures are reduced, and people are enable to access health services.

- Based on the scope of expertise, human conditions, facilities, infrastructure, and existing structures, the hospital researches and designs a convenient and reasonable process on the principle of minimizing the risk of infection of SARS-CoV-2.

c) Screening and triage

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At the entries that receive patients, the following sign is put up:

"This way is for people with cough, fever, runny nose, sore throat, chest tightness, shortness of breath, body aches, loss of taste and smell."

The sign may have other contents such as other symptoms, hotline number, etc. The sign is electrically-lighted so that it can be seen clearly at night.

Behind the sign, there should be a direction to the COVID-19 screening area (or to the infectious disease department/unit of the hospital assigned to screen).  The screening area has transportation facilities such as stretchers and wheelchairs for patients with symptoms of acute respiratory infection, has a clear cleaning and disinfection process after each use.

In case of special hospitals that have large scale, large premises or other specific reasons, the hospitals can set up and organize patient screening at the hospital gate or at some departments/centers, the hospital blocks following the general principles.

d) Follow the pandemic safety protocols

- The hospital has instructions for people entering the hospital to wear masks and disinfect their hands.

- The measurement of body temperature, distance maintenance are proactively regulated by the hospital and implemented appropriately, based on the conditions of the premises and facilities and the number of people coming to the hospital.

The screening areas are well ventilated, fully provided with facilities for infection control and hand cleaning, bags, bins, and vehicles, and waste management and environmental sanitation according to applicable regulations”.

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a) Test the following people for SARS-CoV-2 (by given techniques to identify SARS-CoV-2 infection): patients who seek medical care at the hospital, inpatients, health workers if suspected of COVID-19 such as cough, fever, runny nose, sore throat, chest tightness, difficulty breathing, body aches, loss of taste, smell and other related abnormal symptoms after COVID-19 screening.

b) The hospital focuses on risk assessment and identifying suspicious signs of COVID-19 to order testing of patients before surgery, patients in high-risk departments such as intensive care, stroke, dialysis (artificial kidney), in postoperative period and other patients according to professional requirements on the principle of protecting high-risk patients, minimizing infection.

c) Other people such as: people taking care of patients, people providing services to hospitals, people coming to work with the hospital, students, and visitors; if they have suspicious signs of COVID-19 as above, they need to take the initiative to go to the COVID-19 screening area and follow the instructions of the health workers.

3. Guidelines for admitting and treating people with COVID-19 in medical examination and treatment facilities:

a) How to organize the treatment area for COVID-19 patients

- The COVID-19 treatment area is located at one of the following:  the infectious disease department; or arrange a COVID-19 ward or treatment area in a clinical or inter-clinical department; or set up a COVID-19 treatment area in a medical facility.

- At the intensive care unit:  arrange a ward or area for emergency and treatment of severe and critical COVID-19 patients.

b) The head of medical examination and treatment facility shall, based on its conditions of physical facilities, departments and rooms, arrange a COVID-19 treatment area for COVID-19 patients upon their arrival or during medical examination and treatment at the facility in one or several ways mentioned at Point a of this Section.  Refer severe and critical COVID-19 patients to higher-level facilities when it exceeds their professional capacity according to applicable regulations or under the guidance of the Departments of Health of the provinces and centrally-affiliated cities.

Article 2. This Decision comes into effect from the day of signing, promulgation and supersedes certain contents and documents below:

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2. Supersede Chapter 4 (screening and triage) in Decision No. 3088/QD-BYT dated July 16, 2020 of the Minister of Health, promulgating the “Set of criteria for hospitals for prevention and control of COVID-19 and acute respiratory infections”.

3. Supersede the regulations on triage, receipt, screening and isolation of people infected or suspected of being infected with SARS-CoV-2 in the Guidelines for the prevention and control of SARS-CoV-2 infection in medical examination and treatment facilities issued under Decision No. 5188/QD-BYT dated December 14, 2020 of the Minister of Health.

4. Supersede Section 2 (regulated entities) and Clause b, Section 3 (testing methods) in Official Letter No. 5028/BYT-KHTC dated June 23, 2021 of the Ministry of Health.

Article 3. The Chief of the Ministry Office; the Ministerial Chief Inspector; Directors of Departments affiliated to the Ministry of Health; Head of the Steering Committee for COVID-19 prevention and control of the provinces and cities; Directors of hospitals and institutes under the Ministry of Health; Directors of Health Departments of provinces and centrally affiliated cities; The Chief Health Officer shall implement this Decision./.

PP. MINISTER
DEPUTY MINISTER




Nguyen Truong Son