Database.

Background
COVID-19 has changed the way hospitals manage infections and how healthcare workers (HCWs) carry out their activities. The pandemic has taught us how safety, hygiene and work schedules should be implemented. After the pandemic, a substantial body of research has examined the managerial capacities of health systems, national prevention programmes, and crisis-response strategies.
Objective
The aim of this study is to determine the most critical risk management measures in the context of COVID-19 pandemic, with a focus both prevention and post-factum control measures.
Methodology
We conducted a study using a questionnaire previously validated by the World Health Organization, adapted to identify the key organisational measures for preventing and controlling infections during interactions with patients infected with COVID-19 virus. The setting for the study was the “Sf. Ioan cel Nou” County Emergency Hospital, Suceava, Romania. A total of 312 responses were collected between 10.10.2020 and 19.03.2021. The study complied with two ethical protocols, data were analysed using 21.0 version of the Statistical Package for the Social Sciences software.
Results
Statistical analysis identified four constructs grouping the measures – technical, organisational, human resources, and others, all aimed at preventing the spread of SARS-CoV-2 within and beyond the hospital. In our vision, these four main resulted constructs could be conceptualised similarly to a security system, which aims protects an “asset” from a threat by applying several layers that gradually reduce risk to near zero. Specifically, the first layer involves managing exposure risk by separating contaminated from uncontaminated areas; the second comprises general preventive measures for healthcare workers operating in contaminated areas; the third layer addresses staff attendance and workplace organisation, and the fourth focuses on risks perceived and manifested at the individual level.
Conclusion
Exposure risk assessment and management follow a logic similar to that of a security system designed to protect an “asset” from a threat. In our case, the health of the HCWs was at risk due to their interactions with COVID-19 patients at “Sf. Ioan cel Nou” County Emergency Hospital, Suceava, Romania. Hypothesis testing indicated that all implemented measures contributed significantly to pandemic management, although a functional exposure risk management system requires effective risk reduction across all 4 layers. Given the validity of the second hypothesis – that preventive measures were generally applied at the hospital – we can conclude that HCWs and managers may primarily focus on this type of preventive measure, mainly addressing the second layer alone. This imbalance risks diverting managerial attention and resources toward the second layer at the expense of the other three.

背景
新冠疫情（COVID-19）改变了医院的感染管理模式，以及医护人员（healthcare workers, HCWs）的日常工作开展方式。这场大流行让我们明确了安全防护、卫生规范与工作排班的落地要求。疫情过后，已有大量研究对卫生系统的管理能力、国家预防方案以及危机应对策略展开了探讨。

研究目的
本研究旨在明确新冠疫情（COVID-19）背景下最为关键的风险管理措施，重点覆盖预防与事后防控两类手段。

研究方法
本研究采用经世界卫生组织（World Health Organization）预先验证的问卷开展，该问卷经适配调整后，用于识别与新冠病毒（COVID-19）感染患者接触过程中，感染防控的核心组织措施。本研究的实施场所为罗马尼亚苏恰瓦市的「Sf. Ioan cel Nou」县急救医院。研究共收集了2020年10月10日至2021年3月19日期间的312份回复。本研究符合两项伦理规范，数据采用社会科学统计软件包（Statistical Package for the Social Sciences, SPSS）21.0版本进行分析。

研究结果
统计分析将防控措施归纳为四大构念：技术类、组织类、人力资源类及其他类，所有措施均旨在遏制严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）在医院内部及外部的传播。本研究认为，这四大核心构念可类比为一套安防系统：通过多层级防护逐步将风险降至近乎为零，以此保护某一“资产”免受威胁。具体而言，第一层级通过划分污染区与非污染区来管控暴露风险；第二层级针对在污染区工作的医护人员制定通用防护措施；第三层级聚焦员工出勤与工作场所组织管理；第四层级则关注个体层面感知并显现的风险。

研究结论
暴露风险评估与管理的逻辑，与为保护“资产”免受威胁而设计的安防系统高度相似。在本研究场景中，罗马尼亚苏恰瓦市「Sf. Ioan cel Nou」县急救医院的医护人员因与新冠患者接触，其健康面临风险。假设检验结果显示，所有已实施的措施均对疫情防控起到了显著作用，但一套高效的暴露风险管理系统需要在全部四个层级上开展有效的风险消减工作。结合第二项假设的有效性（即该医院普遍落实了预防措施），我们可以得出结论：医护人员与管理人员可优先聚焦此类预防措施，仅针对第二层级开展工作。这种失衡状态可能导致管理注意力与资源向第二层级倾斜，而牺牲其他三个层级的建设。