Nursing strategies for COVID‐19 prevention and control in a selected dental


Introduction

Coronavirus disease 2019 (COVID-19) is a newly identified infectious disease caused by a novel coronavirus (SARS-CoV-2). After causing a shock in China, it became a global pandemic from the spread of epidemics. The World Health Organization (WHO) announced it as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020. Through the adoption of a series of preventive and therapeutic measures, the transmission of COVID-19 was dramatically suppressed in China, and the pandemic situation has been alleviated in most provinces of China. However, the global situation has become worse as more and more countries reported COVID-19 outbreaks. According to the a report of WHO, by 7 September 2020, COVID-19 had been diagnosed in more than two hundred countries with more than 27 million people infected, and more than 880000 people had died from it. The pandemic situation was more serious in the Americas, Europe and Eastern Mediterranean regions compared with other regions. Among them, the United States, India, Brazil and Russia accounted for about 60% of infected people in the world. COVID-19 has brought great threats to the global health system, and which seriously influences the normal operation of human society.

With the emergence of emerging infectious diseases, nurses constitute a major group in the fight against infection. According to a previous study, the importance of infection control and prevention has not attracted enough attention (Nasiri et al. 2019), which is a serious threat to the health of medical and nursing staff and patients. Furthermore, applicable and effective nursing measures play a vital role in the prevention and control of pandemic situations. Because dental clinics require special working conditions, we must pay more attention to the control of nosocomial infection, and implement more professional and effective strategies to standardize the nursing work facing the challenge of COVID-19 or similar infectious diseases. Here, we report on strategies and experiences that are useful for the nursing staff of dental clinics in the prevention and control of COVID-19 during the pandemic period.

COVID-19 brings enormous challenges to the management of dental clinics

At present, it has been confirmed that respiratory droplets and close contact transmission are the main routes of COVID-19 transmission. Moreover, due to the detection of novel coronavirus in urine and faeces, environmental pollution caused by them is also a potential route of transmission (Sheervalilou et al. 2020). In addition, due to the risk of SARS-CoV-2 transmission by aerosols (van Doremalen et al. 2020; Sommerstein et al. 2020), we may be infected without protective equipment such as masks. According to current epidemiological research, COVID-19 has an incubation period of 1–14 days, and even longer in some extreme cases (Lauer et al. 2020) and there are also asymptomatic infected people (Sohrabi et al. 2020; Sun et al. 2020). In general, diversified transmission channels and long incubation period make COVID-19 a highly contagious disease, which is not conducive to the prevention and control of pandemic situations.

The specific characteristics of COVID-19 brings plenty of difficulties to the routine work of dental clinics (Meng et al. 2020). Especially in the diagnosis and treatment of oral diseases, the medical staff constantly come into close contact with patients’ saliva and blood. Moreover, in the process of operation, the use of various handpieces and ultrasonic instruments inevitably cause the spatter of saliva and blood, as well as the production of aerosols. Therefore, during the pandemic period of COVID-19, we must strictly screen patients who come to the hospital. Medical staff must have the concept that every patient may be a potential source of infection, and take the required prevention and control measures. Below are the strategies we have incorporated in our dental clinics in our hospital which will help inform the international community of medical and nursing workers as well as evidence from the international literature.

Strategies which can be implemented during routine nursing work

Personnel management

Improving personnel management system

To ensure the safety of patients and medical staff and maintain the normal operation of dental clinics, we should formulate specific regulations and measures according to superior documents and guidelines, which are conducive to the prevention and control of COVID-19. Moreover, all the staff in and out of the hospital should be checked every day, and stop working to undergo medical examination if they report with fever, cough and other related symptoms.

Personnel training for dental clinics

We need to ensure that all medical and nursing staff undergo inservice training around epidemiologic characteristics, clinical manifestations, diagnostic criteria, prevention measures and other related knowledge of COVID-19. In addition, intensive training of the occupational protective measures should be provided for nurses, such as the standard demonstration of the wearing of biochemical protective clothing. To improve learning efficiency and restrict gathering, we can participate in some online lectures and get trained in batches.

Reasonable division of labour

There are many dental chairs, complicated instruments and various disinfection and isolation measures in dental clinics in hospitals. In order to facilitate the management of daily work, especially under the situation of COVID-19, reasonable allocation of the disinfection and isolation work should be paid more attention at all levels, and which can be linked with comprehensive personal assessment.

Patient management

Reinforcing the management of consulting rooms and establishing a practical pre-examination and triage system is necessary. Studies indicate that community-wide mask wearing contributes to the control of COVID-19 (Cheng et al. 2020). Therefore, everyone who enters the dental clinic should wear a medical mask. After taking the temperature at the entrance of the clinic, the nurses collect the complete personal histories of each patient and their family members, such as a travel history to pandemic areas in the previous 14 days or more. Moreover, we need to pay attention to whether the patients have any discomfort such as cough. Except for some special circumstances, family members are not allowed to accompany patients to the clinic so as to reduce the chance of cross-infection. For patients with fever, they first get screened in the fever clinic to exclude COVID-19 and then enter a specially reserved consulting room for diagnosis and treatment. The thorough registration and data statistics of these patients to strengthen disease detection is required.

Self-protection

Basic protection

It is required that all staff who enter the consulting room and have direct contact with patients must wear masks, work caps, shoe covers and long-sleeved work clothes. Work clothes and hats should be replaced every day, and masks should be…



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