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      SARS – a perspective from a school of nursing in Hong Kong

      research-article
      , PhD, RN, FRCN, , PhD, RN, FRCNA, , PhD, RN, , PhD, RN, RHV
      Journal of Clinical Nursing
      Blackwell Science Ltd
      clinical practice, health promotion, Hong Kong, infection control, nursing education, SARS

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          Abstract

          Background.  Severe acute respiratory syndrome (SARS) is a new infectious disease with significant morbidity and mortality that has had a major impact on health and health care services worldwide. Hong Kong has had a significant number of cases and deaths. Nurses, at the vanguard of the clinical health care team, have been particularly affected by it. The outbreak prompted the health authorities to implement a series of public health measures and hospital policies, including a guideline for the diagnosis and management of patients with SARS.

          Aims and objectives.  This paper aims at providing an overview of what is known about SARS and the impact it has had in Hong Kong and to highlight from the perspective of a school of nursing the major clinical, educational and public health implications.

          Conclusions.  The lack of understanding and uncertainty about the disease led to significant variation in the provision of information, contributing to the confusion and anxiety in the community. Therefore, there is a need to revise the nursing curriculum, to provide continuing education to all health care professionals, particularly with regard to infection control measures, and to revisit the range of public health policies to ensure the health of the community is protected by these policies. There also has been a reaffirmation of the importance of health promotion that highlights the importance of the partnership between nurses, health policy makers and public health personnel. It is evident that the organization and delivery of clinical practice, teaching and health promotion have to be flexible and responsive to a changing health scenario.

          Relevance to clinical practice.  Nurses must play a crucial role in the prevention, detection and containment of SARS. They will need to implement and ensure strict adherence to infection control measures and, in some circumstances, isolation and quarantine may be warranted. Attention to the psychological state of patients and family members should not be overlooked. Paramount is education of patients, families and members of the public at large.

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          Most cited references2

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          Outbreak of severe acute respiratory syndrome in Hong Kong Special Administrative Region: case report.

          To describe the outbreak of severe acute respiratory syndrome in Hong Kong. Descriptive case series. Hong Kong, Special Administrative Region, China The outbreak started with a visitor from southern China on 21 February. At the hospitals where the first cases were treated the disease spread quickly among healthcare workers, and then out into the community as family members became infected. By 1 April, 685 cases had been reported with 16 deaths. Symptoms include high fever and one or more respiratory symptoms (including cough, shortness of breath, and difficulty breathing). Changes in lung tissue suggest that part of the lung damage is due to cytokines induced by the microbial agent, which has led to empirical treatment with corticosteroids, broad spectrum antiviral agent, and antibacterial cover. There is strong evidence that a novel coronavirus is the pathogen. Precautions for droplet infection should be instituted, including the wearing of masks and rigorous disinfection and hygiene procedures. On 27 March the Department of Health announced drastic measures, including vigorous contact tracing and examination, quarantine of contacts in their homes, and closure of all schools and universities. The rapidity of the spread of the disease and the morbidity indicate that the agent responsible is highly infectious and virulent. Strict infection control measures for droplet and contact transmission by healthcare workers, a vigilant healthcare profession, and public education are essential for disease prevention.
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            Guideline on management of severe acute respiratory syndrome (SARS)

            William Ho (2003)
            Published online April 8, 2003 http://image.thelancet.com/extras/03cmt89web.pdf Severe acute respiratory syndrome (SARS) has recently been recognised as a newly emerging infectious disease that is highly contagious with significant morbidity and mortality. The first index case in Hong Kong was admitted on Feb 22, 2003. As of April 6, 842 cases have been identified in Hong Kong, with fatal complications in 22 patients. The outbreak has prompted the Hospital Authority of Hong Kong and the Department of Health to implement a series of public-health measures and hospital policies for the diagnosis and management of patients with SARS. The figures are summaries of the management flowchart in the accident and emergency department for patients with a history of definite contact with SARS patients within the past 10 days (figure 1 ) and for patients with no such definite contact (figure 2 ). Figure 1 Accident and emergency department management for person with definite contact* with person with severe acute respiratory syndrome (SARS) within past 10 days Figure 2 Accident and emergency department management for person with no definite contact* with person with severe acute respiratory syndrome (SARS) The Hong Kong Hospital Authority SARS Command Centre has been established to coordinate clinical activities, including identification and reporting of cases, implementation of infection-control measures, dissemination of information to the public, development of diagnostic tests, and assessment of treatment regimens in a cluster network of hospitals. Each hospital cluster has designated treatment centres. The Hospital Authority and the Department of Health are working collaboratively with the two universities (the Chinese University of Hong Kong and the University of Hong Kong) and with international agencies to identify the aetiological agent(s). For details of management plans for patients in the guidelines, see: http://www.ha.org.hk
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              Author and article information

              Journal
              J Clin Nurs
              J Clin Nurs
              10.1111/(ISSN)1365-2702
              JOCN
              Journal of Clinical Nursing
              Blackwell Science Ltd (Oxford, UK )
              0962-1067
              1365-2702
              16 January 2004
              February 2004
              : 13
              : 2 ( doiID: 10.1111/jcn.2004.13.issue-2 )
              : 131-135
              Affiliations
              [ 1 ]Professor of Clinical Nursing and Director, The Nethersole School of Nursing, The Chinese University of Hong Kong, China
              [ 2 ]Professor, The Nethersole School of Nursing, The Chinese University of Hong Kong, China
              [ 3 ]Professor, The Nethersole School of Nursing, The Chinese University of Hong Kong, China
              [ 4 ]Professor, The Nethersole School of Nursing, The Chinese University of Hong Kong, China
              Author notes
              [*]Professor David R Thompson 
The Nethersole School of Nursing 
The Chinese University of Hong Kong 
Hong Kong SAR 
China 
Telephone: (852) 2609 6223 
E‐mail: davidthompson@ 123456cuhk.edu.hk
              Article
              JOCN884
              10.1046/j.1365-2702.2003.00884.x
              7185828
              14723663
              0126d73d-3c05-4344-a3b2-c1c40f5d7ebc

              This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

              History
              : 16 September 2003
              : 7 October 2003
              Page count
              Figures: 0, Tables: 0, Pages: 5
              Categories
              Articles
              Clinical Nursing Issues
              Custom metadata
              2.0
              February 2004
              Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.0 mode:remove_FC converted:15.04.2020

              Nursing
              clinical practice,health promotion,hong kong,infection control,nursing education,sars
              Nursing
              clinical practice, health promotion, hong kong, infection control, nursing education, sars

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