Decision 1226/QD-BYT 2022 promulgating the Guidelines on adjusting a number of provisions on screening, testing and distributing the flow of patients with suspected SARS-CoV-2 infection, and receiving, treating COVID-19 patients in medical examination and

DECISION

On promulgating the Guidelines on adjusting a number of provisions on screening, testing and distributing the flow of patients with suspected SARS-CoV-2 infection, and receiving, treating COVID-19 patients in medical examination and treatment establishments

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THE MINISTER OF HEALTH

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

Pursuant to the 2009 Law on Medical Examination and Treatment;

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

Pursuant to the Government's Resolution No. 38/NQ-CP dated March 17, 2022, promulgating the COVID-19 prevention and control program;

At the proposal of the Director of the Medical Services Administration under the Ministry of Health.

DECIDES:

Article 1. To promulgate the Guidelines on adjusting a number of provisions on screening, testing and distributing the flow of patients with suspected SARS-CoV-2 infection, and receiving, treating COVID-19 patients in medical examination and treatment establishments (hereinafter collectively referred to as hospitals). To be specific:

1. Guidance on screening and distributing the flow of persons with suspected SARS-CoV-2 infection in hospitals:

a) Viewpoints

If there is a person who is infected with COVID-19 while being treated for other diseases in a hospital, it will cause many difficulties for the treatment; so, it is necessary to organize a screening, distributing patient flow, testing, detecting and treating COVID-19 cases as soon as possible. Departments, where severe and high-risk patients are treated, should minimize the SARS-CoV-2 infection. Leaders of hospitals should effectively organize the screening for early detection of persons with suspected SARS-CoV-2 infection, especially at departments with high risk where the first aid and priority treatment for reduction of deaths related to COVID-19 are centralized.

b) Principles

- People with suspected SARS-CoV-2 infection should be undergone screening and early detection to avoid infection or prevent other diseases from getting more severe, especially patients in high-risk groups, or in intensive care, haemodialysis (artificial kidney) and postoperation units. Persons infected with SARS-CoV-2 must be examined and treated separately from others who are not infected with SARS-CoV-2.

- Based on general guidelines of the Ministry of Health, the hospitals shall actively formulate, update and maintain the procedures for receipt, screening, distribution of patient flow, medical examination, testing, treatment and hospital transfer applicable to COVID-19 patients according to the flexible direction, cutting administrative procedures and creating favorable conditions for the people to access to healthcare services.

- Based on the professional scope, available infrastructure, human conditions, physical foundations, hospitals shall study and design the convenient and reasonable procedures on the principle of minimizing the risk of SARS-CoV-2 infection.

c) Screening and distribution of patient flow

Applicable to public and private hospitals with one or many gates.

At the gates of receiving patients, a signboard of “Way for patients suffering cough, fever, runny nose, sore throat, chest pain, dyspnoea, myalgia and loss of taste” must be placed.

Such signboards may contain other contents such as other symptoms, hotlines, etc.; and lights for a clear view at night.

After the signboard, there must be an instruction on the area for COVID-19 screening (or department/unit of infectious diseases of the hospital assigned to carry out the screening and examination). The screening areas must be equipped with means of transport such as stretchers and wheelchairs for patients showing signs of acute respiratory infection, with hygiene instructions, such means must be disinfected after each use.

For a large-scale hospital with a large area or other specialized characteristics, the hospital may establish and organize the screening right at the hospital gate or a number of its departments/centers or blocks according to general principles.

d) Complying with anti-pandemic measures

- Hospitals must require and instruct patients and visitors to wear face masks and disinfect their hands.

- Body temperature measurement and keeping a safe distance shall actively be regulated by the hospitals according to their physical foundations and the number of patients and visitors to the hospitals.

Screening areas must be well ventilated and equipped with adequate means of controlling infection, hand hygiene, bags, barrels and means; the management of wastes and environmental hygiene shall comply with regulations.

2. Guidance on testing persons with suspected SARS-CoV-2 infection in hospitals:

a) SARS-CoV-2 testing (by techniques to detect cases of SARS-CoV-2 infection) shall be conducted for people visiting hospitals for medical examination, in-patients and health staff in case of showing symptoms of COVID-19 infection such as cough, fever, runny nose, sore throat, chest pain, dyspnoea, myalgia and loss of taste or smell, and other abnormal symptoms after COVID-19 screening.

b) Hospitals shall focus on assessing the risk and detecting symptoms of COVID-19 infection to designate testing for patients before performing surgery, patients in high-risk departments such as intensive care, stroke, haemodialysis (artificial kidney), postoperation departments and other patients at professional requirements on the principles of protecting people at high risk, minimizing infection.

c) Other persons, including Caregivers, persons providing services for hospitals, customers of hospitals, students and visitors who show symptoms of COVID-19 infection as mentioned above must actively go to the COVID-19 screening areas and comply with health staff’s instructions and indications.

3. Guidance and receiving and treating COVID-19 patients in medical examination and treatment establishments:

a) Organization of areas where COVID-19 patients are treated

- COVID-19 treatment may be carried out in infectious disease departments; or patient rooms or COVID-19 treatment zones in a clinical department or a clinical inter-department; or a newly established COVID-19 treatment in a medical examination and treatment.

- Patient rooms or areas for first aid and treatment of serve COVID-19 patients or those who are in critical condition must be arranged in intensive care units.

b) Heads of medical examination and treatment establishments shall, based on conditions of physical foundations, departments and divisions in medical examination and treatment establishments, arrange COVID-19 treatment areas for COVID-19 patients who visit establishments for medical examination or who are detected during their medical visit in establishments according to one or a number of methods mentioned at Point a of this Section. Hospital transfer shall be carried out for severe COVID-19 patients or those who are in critical conditions beyond the establishments’ professional capacity according to current regulations, or instructions of Departments of Health of provinces and centrally-run cities.

Article 2. This Decision takes effect on the signing and issuance date, and replaces:

1. Official Dispatch No. 1385/BCDQG dated March 19, 2020, of the National Steering Committee for COVID-19 Prevention and Control, on prevention and control of the respiratory disease caused by a new strain of Coronavirus, regarding the withdrawal of experience on the distribution of flow of, and isolation of people with suspected respiratory disease infection at health establishments and report of implementation images.

2. Chapter 4 (screening and patient flow distribution) in the Minister of Health’s Decision No. 3088/QD-BYT dated July 16, 2020, on safe criteria for hospitals for prevention and control of COVID-19 and acute respiratory diseases.

3. Provisions on flow distribution, receipt, screening and isolation of infected or suspected people in the Guidance on prevention and control of SARS-CoV-2 infection in medical examination and treatment establishments promulgated together with the Minister of Health's Decision No. 5188/QD-BYT dated December 14, 2020.

4. Section 2 (subjects of application) and Clause b Section 3 (testing methods) of the Ministry of Health’s Official Dispatch No. 5028/BYT-KHTC dated June 23, 2021.

Article 3.  Chief of the Ministry Office; Chief inspector of the Ministry; Directors of Departments and Agencies of the Ministry of Health; Heads of the Steering Committees for COVID-19 Prevention and Control of provinces and cities; Directors of hospitals and institutes affiliated to the Ministry of Health; Directors of Departments of Health of provinces and centrally-run cities, heads of medical divisions of all sectors shall implement this Decision./.