Clinical Nurse Specialist Impact on COVID-19 Preparation at a Military Treatment Facility.

PURPOSE: The COVID-19 pandemic has significantly challenged healthcare organizations across the globe, forcing innovation, resourcefulness, and flexibility. The purpose of this article is to describe the impact of clinical nurse specialist practice on COVID-19 preparation at a military hospital. ENVIRONMENT OF CARE CHANGES: The pandemic required facilities to develop expansion plans to facilitate a potential surge of COVID-19 patients. Clinical nurse specialists collaborated to develop a plan to expand care capacity and streamline testing while designating specific critical care and medical-surgical areas for COVID-19 patients. STAFFING CONSIDERATIONS: To capitalize on the expanded bed capacity, clinical nurse specialists identified and trained outpatient nursing staff to serve as nurse extenders. DISCUSSION: Early in the pandemic, a lack of strong evidence-based interventions to mitigate transmission and treatment necessitated the development of innovative solutions. The clinical nurse specialist team established designated transport routes for COVID-19 patients, leveraged technology to improve methods of care, and cultivated a culture of innovation by providing on-the-spot meaningful recognition to staff. CONCLUSION: As leaders in healthcare, clinical nurse specialists are change agents that work to maintain high-quality, safe patient care even during a global pandemic.

Small but nimble: measures taken to face the COVID-19 pandemic in small French military hospitals.

OBJECTIVES: To describe a complete panel of actions of the Service de Santé des Armées (SSA) (ie, French Military Health Service) that together contributed to prevent French health system saturation during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN: Observational retrospective study. METHODS: Actions taken by military practitioners in the Parisian military hospitals, which contained 500 beds, to fight COVID-19 were listed and described. RESULTS: The Parisian military hospitals were fully reorganized to offer 147% more intensive care unit beds and took care of 665 inpatients with COVID-19 while continuing their core mission of war-wounded military care. A strategy to prioritize the use of medicine and medical devices was designed to avoid shortages. Field intensive care unit deployment and airborne collective medical evacuation by the SSA's MoRPHEE system avoided hospital saturation. CONCLUSIONS: Key facets of this achievement were interunit collaboration, esprit de corps, and health workers' adaptability. Small hospitals can provide a coherent answer to the COVID-19 pandemic, as long as they organize and prioritize the patients' care.

Prevention of Pruritis following Spinal Morphine for Scheduled Cesarean Birth.

BACKGROUND: Intrathecal morphine provides effective analgesia after cesarean birth, yet up to 90% of women who receive it experience excessive itching, an undesirable dose-dependent effect. Pruritis may increase nursing workload, delay breastfeeding, and decrease patient satisfaction. When 0.1 mg spinal morphine is given, pruritis is markedly reduced while analgesia is preserved. PURPOSE: The purpose of this project was to determine possible causes and solutions for pruritus after cesarean birth. METHODS: Anesthesia providers were educated and encouraged to limit spinal morphine to 0.1 mg as a strategy to prevent pruritus. In a repeated measures design, the rate of treatment-required pruritus and opioid consumption were measured 24 hours after surgery. The project included an evaluation of 30 medical records before and 30 medical records after the project intervention. RESULTS: Preintervention rate of treatment-required pruritis was 37%, all received spinal morphine ≥ 1.5 mg. Postintervention rate of treatment-required pruritis was 13% and 57% after spinal morphine 0.1 mg and 0.2 mg, respectively. Opioid consumption was similar between groups. CLINICAL IMPLICATIONS: Mother-baby nurses can have an impact on the practice of anesthesia providers by advocating for evidence-based dosing of intrathecal morphine to reduce the incidence of pruritis while maintaining effective analgesia for women after cesarean birth.

Establishing a 130-Bed Field Intensive Care Unit to Prepare for COVID-19 in 7 Days in Bahrain Military Hospital.

This article reports the establishment of an isolated, fully functional field intensive care unit (FICU) unit equipped with all necessary critical care facilities as a part of the national pre-emptive preparedness to treat an unexpected surge outbreak of coronavirus disease 2019 (COVID-19) patients in Bahrain. One floor of an existing car parking structure was converted into a 130-bed FICU set-up by the in-house project implementation team comprised of multidisciplinary departments. The setting was a military hospital in the Kingdom of Bahrain, and the car park was on the hospital premises. The FICU contained a 112-bed fully equipped ICU and an 18-bed step-down ICU, and was built in 7 d to cater to the intensive care of COVID-19 patients in Bahrain.

Oficiais enfermeiros no hospital militar no ano de 1995 / Oficiales enfermeros en el hospital militar en el año de 1995 / Nursing officers at the military hospital in the year of 1995

Resumo Objetivo analisar a lotação e distribuição da primeira turma de oficiais enfermeiros, ao término do Curso de Formação de Oficiais, com a patente de 2º Tenente, no Hospital Central da Polícia Militar do Estado do Rio de Janeiro, em 1995. Método estudo histórico em fontes documentais escritas e orais produzidas por meio de 19 entrevistas, sendo 18 oficiais enfermeiros e um civil. Os conceitos de poder simbólico e capital de Pierre Bourdieu consubstanciaram a análise dos achados. Resultados a classificação obtida no curso de formação de oficiais e a experiência profissional, embora com menor peso, foram preponderantes na distribuição nos setores do hospital. Considerações finais e implicações para prática os critérios de antiguidade da vida militar influenciaram na configuração da equipe de enfermagem no hospital militar. Destaca-se que a ocupação das chefias pelos oficiais enfermeiros foi determinada pelo capital incorporado no estágio probatório, o qual foi institucionalizado pela patente.

Resumen Objetivo analizar la capacidad y la distribución de la primera clase de oficiales enfermeros al término del Curso de Formación de Oficiales, con el grado de 2º Teniente, en el Hospital Central da Polícia Militar do Estado do Rio de Janeiro, en 1995. Método estudio histórico en fuentes de documentos escritos y orales producidos a través de 19 entrevistas, 18 de las cuales fueron enfermeras y una civil. Los conceptos de poder simbólico y capital de Pierre Bourdieu fundamentaron el análisis de los hallazgos. Resultados la clasificación obtenida en el curso de formación para oficiales y la experiencia profesional predominaron en la distribución en los sectores hospitalarios, aunque con menor peso. Conclusión e implicaciones para práctica los criterios de antigüedad en la vida militar influyeron en la configuración del equipo de enfermería. Se destaca que la ocupación de los comandos por oficiales enfermeros fue determinada por el capital incorporado en la etapa probatoria, institucionalizada por el grado.

Abstract Objective to analyze the capacity and distribution of the first class of nurse officers, at the end of the Officer Training Course, with the rank of 2nd Lieutenant, at the Hospital Central da Polícia Militar of the State of Rio de Janeiro, in 1995. Method historical study in written and oral documentary sources produced through 19 interviews, of which 18 are nurse officers and one civilian. Pierre Bourdieu's concepts of symbolic power and capital substantiated the analysis of the findings. Results the classification obtained in the training course for officers and professional experience, although with less weight, were preponderant for the distribution in the hospital sectors. Final considerations and implications for practice the criteria of seniority in military life influenced the configuration of the nursing team at the military hospital. It is noteworthy that the occupation of the heads by the nurse officers was determined by the capital incorporated in the probationary period, which was institutionalized by the patent.

[SARS-CoV-2: the experience of the Legouest armed forces teaching hospital]. / Sars-CoV-2 : le vécu de l'hôpital d'instruction des armées Legouest.

The Legouest military training hospital is one of the eight hospitals of the armed forces health service. Situated in the Grand-Est region, one of the regions most affected by the COVID-19 epidemic in spring, it had to reorganise itself within a few days with its regional and national partners. While continuing to support forces sent abroad, to overseas territories or located in the East of France, the armed forces hospital had three major missions: the support of other military hospital facilities, the continued care of non-COVID patients and the care of patients affected by COVID-19 requiring non-intensive hospital care.

[Students from military schools providing support to hospitals]. / Les élèves des écoles militaires de santé en renfort des hôpitaux.

The health crisis in France has led military and health authorities to call on military student nurses and military medicine and pharmacy students. Students from the military health schools of Lyon-Bron provided reinforcements to the eight French military training hospitals, as well as to the field intensive care hospital deployed in Mulhouse. An original experience for the trainee health professionals, in service of the nation, and which required operational expertise, technical and cognitive skills and empathy in the face of a poorly controlled infection risk.

[COVID-19 unit hospitalization and family isolation: the value of a family information cell]. / Hospitalisation en unité Covid-19 et isolement familial : intérêt d'une cellule d'information aux familles.

This worldwide health crisis forced hospitals to adapt their activities to this new confinement environment. Innovation was required to maintain a social bound between cohorting service's patients and their families, to guarantee a dedicated listening time and prevent as much as possible from the isolation due to this COVID-19 unusual situation. With that aim, the army training hospital Legouest created an information and support listening cell dedicated to COVID-19 hospitalized patients' families. It also provided several tablets for creating a patient and family digital gate.

Improving Readiness: Preventive Maintenance of the Human Operating System that Drives Readiness and Lethality.

Improving the readiness and lethality of the U.S. fighting forces has always been a key priority, and it received renewed emphasis in the National Defense Authorization Act of 2017. A major rearrangement of the Defense Health Agency and the Military Health System is ongoing with this emphasis. Although revising features to improve our military health service is essential, the health, well-being, and readiness of our people will also rely on the culture created at the Command level where soldiers, sailors, airmen and civilians operate daily. In alignment with our military health care community and in support of our renewed emphasis on warfighting readiness, USS Missouri began a journey to address foundational mindset that drives the core behaviors, training, and procedures of the submarine force and Naval Nuclear Propulsion Principles leading to enhanced readiness, resilience, and accountability.

Leading the Military Health System Transformation: From Military Treatment Facility to Market Construct.

The transition of authority to manage and administer all DoD Medical Treatment Facilities from the Military Department Services to the Defense Health Agency is an extremely complex challenge involving multiple stakeholders and systems in an effort to achieve greater force readiness while reducing cost. Womack Army Medical Center at Fort Bragg served as the U.S. Army's sole prototype for the initial phase of the transition of authority. Starting with a foundational shift to an organizational outward mindset was essential in building effective relationships to exercise Mission Command at echelon to manage risks to mission during this period of uncertainty and ambiguity. This shift in mindset set the conditions for mobilizing Army Doctrine, elicited, and invited collaborative behaviors, and resulted in the improved organizational performance accomplished with velocity to successfully lead the transformation to Defense Health Agency.

Análisis de casos clínicos del área de Oftalmología atendidos mediante el Servicio de Telemedicina del Hospital Central de la Defensa Gómez Ulla durante los años 2017, 2018 y 2019 / Analysis of clinical cases in the Oftalmology area attended by the Telemedicine Service of the Hospital Central de la Defensa «Gómez Ulla» during the years 2017, 2018 and 2019

ANTECEDENTES Y OBJETIVOS: Evaluación de casos clínicos de Oftalmología atendidos mediante el Servicio de Telemedicina del Hospital Central de la Defensa Gómez Ulla en 2017, 2018 y 2019 estudiando edad, sexo, empleo, antecedentes oftalmológicos, tiempo de respuesta, pruebas, diagnóstico, tratamientos, evacuaciones, medio de comunicación y lugar. MATERIAL Y MÉTODOS: Estudio observacional retrospectivo de los 37 casos clínicos de la base de datos del Servicio de Telemedicina. RESULTADOS: La especialidad de oftalmología está entre las 10 más demandadas y las solicitudes aumentan cada año. La patología con mayor prevalencia es traumatismo en la conjuntiva o excoriación corneal por accidentes. En un 65% fue posible el tratamiento en la misión gracias a las indicaciones del oftalmólogo. El personal desplegado carecía de los fármacos necesarios en al menos 6 casos. En algunos pacientes se encontraron antecedentes oftalmológicos que podían ser causa de la enfermedad que aconteció. CONCLUSIONES: Sería aconsejable una mayor protección ocular dado que la mayoría de los casos consisten en accidentes traumáticos y salpicaduras. Convendría llevar a cabo exámenes exhaustivos pre-misión revisando antecedentes que puedan desencadenar problemas en misiones. Sería recomendable proveer a cualquier sanitario desplegado los medicamentos recogidos en este trabajo que han sido recomendados por los oftalmólogos. El Servicio de Telemedicina ha hecho posible que los especialistas del área de Oftalmología hayan brindado un valioso apoyo al personal sanitario desplegado en un amplio abanico de ubicaciones remotas. Además de evitar evacuaciones médicas innecesarias, dicho servicio facilita evacuaciones apropiadas que de otro modo podrían haberse retrasado

BACKGROUND AND OBJECTIVES: Evaluation of Ophthalmology clinical cases attended to by the Telemedicine Service of the Central Defense Hospital Gómez Ulla in 2017, 2018 and 2019, studying age, sex, employment, ophthalmological history, response time, tests, diagnosis, treatments, evacuations, media and place. MATERIAL AND METHODS: Retrospective observational study of the 37 clinical cases from the database of the Telemedicine Service. RESULTS: Ophthalmology is among the 10 most highly demanded specialities and requests are increasing every year. The pathology with the highest prevalence is conjunctival injury or corneal abrasion due to accidents. In 65% of the cases, thanks to the ophthalmologist's instructions, treatment within the mission was possible. The deployed health staff lacked the necessary medication in at least 6 cases. A history of ophthalmological diseases was found in some patients, which could be the cause of the disease that was observed. CONCLUSIONS: Greater eye protection would be advisable, since the majority of cases consist of traumatic accidents and splashes. Extensive pre-mission reviews should be conducted by reviewing possible issues that may trigger mission problems. It would be advisable to equip all deployed healthcare staff with the necessary medications that were identified in this work, which have been recommended by ophthalmologists. The Telemedicine Service has made it possible for specialists in the area of Ophthalmology to provide valuable support to deployed healthcare staff in a wide range of remote locations. In addition to avoiding unnecessary medical evacuations, this service facilitates appropriate evacuations that might otherwise may have been delayed

Asistencia en cuidados críticos de una unidad de Sanidad Militar dentro del hospital de campaña en la Institución Ferial de Madrid durante la crisis SARS-CoV-2 / Assistance of a Military Health Unit deployed in «Institucion Ferial de Madrid» field hospital during SARS-CoV-2 crisis

INTRODUCCIÓN: Durante la pandemia por coronavirus SARS-CoV-2 que afectó a España durante la primavera del año 2020, muchos de los hospitales se colapsaron por la afluencia de estos pacientes. Por este motivo se desplegó en la Institución Ferial de Madrid (IFEMA) un hospital de campaña. La única unidad de críticos de este hospital fue militar. La unidad responsable de su montaje, mantenimiento y repliegue fue la Unidad Médica Aérea de Apoyo al Despliegue (UMAAD) de Madrid perteneciente al Ejército del Aire. OBJETIVO: Describir la asistencia médica prestada en la unidad de críticos de IFEMA. MATERIAL Y MÉTODOS: Estudio descriptivo prospectivo realizado del 19 de marzo al 30 de abril de 2020. Se consiguió la autorización militar de la Dirección de Sanidad del Ejército del Aire para la realización del estudio. RESULTADOS: Durante el periodo de estudio 25 pacientes ingresaron en la unidad durante la Operación «Balmis». La mayoría fueron varones y de raza hispana, el motivo de ingreso fue por neumonía por SARS-CoV-2. Se aisló la vía aérea en el 88% de los pacientes. Las principales complicaciones fueron trombosis, hemorragia e hipertensión, falleciendo tres pacientes durante la realización del estudio. CONCLUSIÓN: La experiencia adquirida en este despliegue, demuestra, una vez más, la importancia de los apoyos que la Sanidad Militar puede prestar a la Sanidad Civil en el que el componente sanitario de la gestión de crisis en territorio nacional

INTRODUCTION: During the coronavirus SARS-CoV-2 pandemic that affected Spain in spring of 2020, many of hospitals were collapsed by these patients. For this reason, a field hospital was deployed at the «Institución Ferial de Madrid» (IFEMA). The only critical unit of this field hospital was military. The unit responsible for its deployment, maintenance and withdrawal was UMAAD (Madrid Deployment Support Air Medical Unit belonging to the Air Force). OBJECTIVE: To describe medical assistance provided in the IFEMA critical unit. MATERIAL AND METHODS: Prospective descriptive study carried out from March 19 to April 30, 2020. The pertinent military authorization (Air Force Health Service Director) was obtained to carry out the study. RESULTS: During the study time, 25 critically ill patients were admitted. Most of them were male and Hispanic race. SARS-CoV-2 pneumonia was the reason for hospital admission. Airway was performed in 88% of patients. Principal complications were thrombosis, hemorrhage and hypertension. Three patients died during this research paper. CONCLUSION: The experience acquired in this deployment demonstrates, once again, the importance of the support that Military Health can provide to Civil Health in the component of crisis management in national territory

Actuación del Hospital General de la Defensa en Zaragoza durante la pandemia ocasionada por el nuevo coronavirus SARS-CoV-19 / Performance of the General Defense Hospital in Zaragoza during the pandemic caused by the new SARS-CoV-19 coronavirus

La pandemia provocada por el virus SARS-CoV-2 ha supuesto una verdadera tragedia sanitaria a nivel mundial, generando graves consecuencias de morbimortalidad, especialmente en personas mayores. El Hospital General de la Defensa (HGDZ) ha participado en la Operación Balmis de las Fuerzas Armadas (FAS) para combatir esta pandemia. Esto ha exigido al HGDZ una gran flexibilidad y capacidad de adaptación para afrontar la gran demanda de ingreso de pacientes infectados por este virus. Para ello, ha Implantado un conjunto creciente de medidas centradas en reforzar la respuesta en el ámbito de la salud y reducir las tasas de contagio

The pandemic caused by the SARS-CoV-2 virus has been a true health tragedy worldwide, generating serious consequences of morbidity and mortality, especially in older people. The General Defense Hospital (HGDZ) has participated in Operation Balmis of the Armed Forces (FAS) to fight against this pandemic. It has required HGDZ great flexibility and adaptability to face the high demand for admission of patients infected with this virus. To this aim, it has implemented a growing set of measures focused on strengthening the response in the health field and reducing contagion rates

Challenges of implementing the accreditation model in military and university hospitals in Iran: a qualitative study.

BACKGROUND: The aim of this study was to present challenges of implementing the accreditation model in university and military hospitals in Iran. METHODS: In this qualitative study, purposive sampling was used to select hospital managers and implementers of the model working in 3 hospitals affiliated to Kerman University of Medical Sciences and in 3 military hospitals in Kerman, Iran. A total of 39 participants were interviewed, and semi-structured questionnaires and thematic analysis were used for data collection and analysis, respectively. RESULTS: In this study, 5 major codes and 17 subcodes were identified: (1) perspectives on accreditation model with 5 subcodes: a difficult and time-consuming model, less attention to the patient, accreditation as a way of money acquisition, not being cost-effective, and accreditation means incorrect documentation; (2) absence of appropriate executive policy, with 3 subcodes: lack of financial funds and personnel, disregarding local conditions in implementation and evaluation, and absence of the principle of unity of command; (3) training problems of the accreditation model, with 2 subcodes: absence of proper training and incoordination of training and evaluation; (4) human resources problems, with 3 subcodes: no profit for nonphysician personnel, heavy workload of the personnel, and physicians' nonparticipation; (5) evaluation problems, with 4 subcodes: no precise and comprehensive evaluation, inconformity of authorities' perspectives on evaluation, considerable change in evaluation criteria, and excessive reliance on certificates. CONCLUSIONS: This study provided useful data on the challenges of implementing hospitals' accreditation, which can be used by health policymakers to revise and modify accreditation procedures in Iran and other countries with similar conditions. The accreditation model is comprehensive and has been implemented to improve the quality of services and patients' safety. The basic philosophy of hospital accreditation did not fully comply with the underlying conditions of the hospitals. The hospital staff considered accreditation as the ultimate goal rather than a means for achieving quality of service. The Ministry of Health and Medical Education performed accreditation hastily for all Iranian hospitals, while the hospitals were not prepared and equipped to implement the accreditation model.

Sanidad Militar ante la crisis de la COVID-19 / Military Health in the face of the COVID-19

No disponible

El Hospital Central de la Defensa en la crisis de la COVID-19 / The Spanish Central Defense Hospital in COVID-19 Crisis

En este trabajo se exponen los cambios efectuados en el Hospital Central de la Defensa durante la crisis de la COVID-19. Se efectúa una descripción de las capacidades previas al comienzo de la pandemia, y como se han adaptado los diferentes departamentos, el servicio de Urgencias, las plantas de hospitalización y la Unidad de Cuidados Intensivos a una situación nueva, y de súbita aparición. Así mismo, se exponen los apoyos logísticos recibidos, tanto desde el punto de vista de recursos humanos y materiales

In this paper, we present the changes made at the Central Defense Hospital «Gomez Ulla» to face the COVID-19 crisis. A description on the available capabilities prior to the pandemic outbreak is made, and how they had to adapt to a suddenly established new situation, regarding departments such as Emergency, Hospitalization and Intensive Care Units. Support received, both in personal and material resources will also be mentioned

Organización de la cuarentena hospitalaria en los evacuados de Wuhan al inicio de la pandemia de COVID-19 / Hospital organization quarantine in Wuhan evacuees at the start of the COVID-19 pandemic

INTRODUCCIÓN: El 31 de diciembre de 2019, la Organización Mundial de la Salud fue informada de un grupo de casos de neumonía de etiología desconocida detectados en la ciudad de Wuhan (China). El 30 de enero de 2020, se declaró el brote de nCoV-2019 (posteriormente SARS-CoV-2) como una emergencia de salud pública de preocupación internacional. En este contexto, algunos países occidentales, decidieron evacuar a sus ciudadanos. OBJETIVOS: En este artículo se describe el planteamiento llevado a cabo en el caso de las personas evacuadas desde Wuhan a su llegada a España. MATERIAL Y MÉTODO: Se recopiló información sobre los criterios para seleccionar las instalaciones y el personal, el número de casos en cuarentena, la estrategia de control de infección, la duración de la cuarentena, la monitorización clínica y otros aspectos relevantes. RESULTADOS: Las autoridades sanitarias españolas seleccionaron el Hospital Central de Defensa Gómez Ulla para realizar una cuarentena hospitalaria. Veintiuna personas fueron trasladadas de Wuhan a Madrid, incluidos dos niños. Los médicos de medicina preventiva y enfermedades infecciosas fueron seleccionados para dirigir y asistir la vigilancia. Las visitas fueron autorizadas siguiendo un protocolo establecido. CONCLUSIONES: Este es el primer informe sobre cuarentena hospitalaria para SARS-CoV-2, diseñado específicamente para repatriados. La cuarentena hospitalaria podría ser un método útil para casos seleccionados de enfermedades altamente contagiosas. Sin embargo, se necesita un buen soporte de recursos e instalaciones, selección de personal experimentado y protocolos revisados

INTRODUCTION: On December 31, 2019, the World Health Organization was informed of a group of cases of pneumonia of unknown etiology detected in the city of Wuhan (China). On January 30, 2020, the nCoV-2019 outbreak (later SARS-CoV-2) was declared a public health emergency of international concern. In this context, some western countries decided to evacuate their citizens. AIM: This article describes the approach taken in the case of people evacuated from Wuhan upon arrival in Spain. METHODS: Information was collected on the criteria for selecting facilities and personnel, the number of quarantine cases, the infection control strategy, the duration of quarantine, clinical monitoring, and other relevant aspects. RESULTS: The Spanish health authorities selected the Gómez Ulla Central Defense Hospital to carry out a hospital quarantine. Twenty-one people were transferred from Wuhan to Madrid, including two children. Preventive medicine and infectious disease physicians were selected to direct and assist surveillance. The visits were authorized following an established protocol. CONCLUSIONS: This is the first hospital quarantine report for SARS-CoV-2, designed specifically for returnees. Hospitalarian quarantine could be a useful method for selected cases of highly contagious diseases. However, good resource and facility support, selection of experienced staff, and revised protocols are required

Papel de la sección de Enfermedades Infecciosas en la pandemia de COVID-19 en el Hospital Central de la Defensa / Role of infectious Diseases unit during COVID-19 pandemic in Central Defense Hospital

El Hospital Central de la Defensa «Gómez Ulla» (HCDGU) ha tenido un papel de especial relevancia durante la pandemia COVID-19 en España. En este artículo nos centraremos en el papel de la sección de Infecciosas del HCDGU en sus cuatro fases: la preparación previa a la pandemia, la atención de la cuarentena de los compatriotas repatriados de Wuhan, China el 31 de enero de 2020, la atención hospitalaria inicial de los primeros casos en marzo de 2020 y la transformación de dicha atención en un modelo multidisciplinar basado en el modelo de los programas de optimización del tratamiento antimicrobiano (PROA). Así mismo, se analizan las lecciones aprendidas con propuestas de mejora

Central Defense Hospital «Gómez Ulla» (HCDGU) has played a particularly important role during the COVID-19 pandemic in Spain. In this article we will focus on the role of the Infectious Diseases unit of the HCDGU during its four phases: pre-pandemic preparation, the attention of the quarantine of Spaniard returnees from Wuhan, China on 31 January 2020, the initial hospital care of the first COVID-19 cases in March 2020 and the transformation of such care into a multidisciplinary model based on the antimicrobial stewardship model. Lessons learned and proposals for improvement are also discussed