儿童呼吸道感染高峰期病房护理弹性统筹与 靶向感控管理进展

Advances in Flexible Coordination and Targeted Infection Control for Pediatric Ward Nursing during Peaks of Respiratory Infections

摘要: 儿童呼吸道感染高峰期常伴随多病原重叠流行，致使儿科病房面临患儿激增、重症高发及护理资源挤兑等多重挑战。本文系统综述了在此高压环境下，儿科病房护理统筹与院感防控的精细化管理策略，聚焦三个核心维度：一是护理人力与病床资源的弹性统筹，通过层级排班、PDCA循环管理及家属协同参与，提升病区运转效能；二是无创呼吸支持(HFNC/CPAP)患儿的专科精细化护理，强调规范化气道清除、并发症预见性干预及基于King达标理论的集中舒适化护理；三是针对多重病原体交叉感染的靶向感控，实施以临床问题为导向的专项阻断、高危人群风险分层及护患协同的传染源隔断机制。综上，实施科学统筹与靶向感控策略，不仅能有效缓解临床高负荷运转压力，显著缩短重症患儿机械通气时间，更能大幅降低院内交叉感染率，为流行季儿科呼吸重症病房的高质量运转提供循证管理参考。

Abstract: Peaks of pediatric respiratory infections often coincide with overlapping epidemics of multiple pathogens (such as respiratory viruses and norovirus), presenting pediatric wards with multiple challenges including a surge in patient numbers, high incidence of severe cases, and strained nursing resources. This paper systematically reviews the progress in refined management strategies for nursing coordination and infection prevention and control in pediatric wards under such high-pressure conditions, focusing on three core dimensions: first, the flexible coordination of nursing staff and bed resources, which improves ward operational efficiency through tiered scheduling, PDCA cycle management, and family involvement; second, specialized and refined nursing care for children receiving non-invasive respiratory support (HFNC/CPAP), emphasizing standardized airway clearance, anticipatory intervention for complications, and centralized comfort care based on King’s goal attainment theory; and third, targeted infection control for cross-infection with multiple pathogens, implementing problem-oriented intervention strategies, risk stratification for high-risk populations, and a nurse-family collaborative mechanism for source isolation. In conclusion, the implementation of scientific coordination and targeted infection control strategies not only effectively alleviates the pressure of high clinical workloads but also significantly shortens the duration of mechanical ventilation in critically ill children and substantially reduces the rate of nosocomial cross-infection. These strategies provide evidence-based management references for the high-quality operation of pediatric respiratory wards during epidemic seasons.