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Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors.

Isella L, Romano M, Barrat A, Cattuto C, Colizza V, Van den Broeck W, Gesualdo F, Pandolfi E, Ravà L, Rizzo C, Tozzi AE - PLoS ONE (2011)

Bottom Line: The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found.The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies.Proximity-sensing technology should be considered as a valuable tool for measuring such patterns and evaluating nosocomial prevention strategies in specific settings.

View Article: PubMed Central - PubMed

Affiliation: Complex Networks and Systems Group, Institute for Scientific Interchange Foundation, Torino, Italy.

ABSTRACT

Background: Nosocomial infections place a substantial burden on health care systems and represent one of the major issues in current public health, requiring notable efforts for its prevention. Understanding the dynamics of infection transmission in a hospital setting is essential for tailoring interventions and predicting the spread among individuals. Mathematical models need to be informed with accurate data on contacts among individuals.

Methods and findings: We used wearable active Radio-Frequency Identification Devices (RFID) to detect face-to-face contacts among individuals with a spatial resolution of about 1.5 meters, and a time resolution of 20 seconds. The study was conducted in a general pediatrics hospital ward, during a one-week period, and included 119 participants, with 51 health care workers, 37 patients, and 31 caregivers. Nearly 16,000 contacts were recorded during the study period, with a median of approximately 20 contacts per participants per day. Overall, 25% of the contacts involved a ward assistant, 23% a nurse, 22% a patient, 22% a caregiver, and 8% a physician. The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found. In the setting under study, caregivers do not represent a significant potential for infection spread to a large number of individuals, as their interactions mainly involve the corresponding patient. Nurses would deserve priority in prevention strategies due to their central role in the potential propagation paths of infections.

Conclusions: Our study shows the feasibility of accurate and reproducible measures of the pattern of contacts in a hospital setting. The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies. Proximity-sensing technology should be considered as a valuable tool for measuring such patterns and evaluating nosocomial prevention strategies in specific settings.

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Related in: MedlinePlus

Schematic representation of detected contacts among 2 nurses (N1, N2) and 3 patients (P1, P2, P3) and corresponding measured quantities.Each individual is represented by a node and a link corresponds to a contact established between two individuals. The width of the link is a measure of the duration of the contact, also indicated explicitly in terms of minutes. Multiple links can occur between two individuals, as highlighted in the pair N1-P1, indicating a contact of frequency larger than 1. The quantities introduced in the Materials and Methods section are calculated for the pair of individuals N1 and P1. The pair established one contact  with frequency equal to two  for a total duration of six minutes . By taking into account all interactions, individual N1 has established three contacts , two of which were distinct contacts , for a total duration of contacts equal to seven minutes .
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pone-0017144-g001: Schematic representation of detected contacts among 2 nurses (N1, N2) and 3 patients (P1, P2, P3) and corresponding measured quantities.Each individual is represented by a node and a link corresponds to a contact established between two individuals. The width of the link is a measure of the duration of the contact, also indicated explicitly in terms of minutes. Multiple links can occur between two individuals, as highlighted in the pair N1-P1, indicating a contact of frequency larger than 1. The quantities introduced in the Materials and Methods section are calculated for the pair of individuals N1 and P1. The pair established one contact with frequency equal to two for a total duration of six minutes . By taking into account all interactions, individual N1 has established three contacts , two of which were distinct contacts , for a total duration of contacts equal to seven minutes .

Mentions: In the following, unless otherwise stated, all measures are normalized on a 24-hour (daily) interval, e.g., all cumulative times in contact are divided by the duration of the study expressed in days (8 days). Figure 1 provides an example on how the above quantities are computed for a schematic sequence of contact data, where the individuals i and j belong to two different classes, nurses (N) and patients (P).


Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors.

Isella L, Romano M, Barrat A, Cattuto C, Colizza V, Van den Broeck W, Gesualdo F, Pandolfi E, Ravà L, Rizzo C, Tozzi AE - PLoS ONE (2011)

Schematic representation of detected contacts among 2 nurses (N1, N2) and 3 patients (P1, P2, P3) and corresponding measured quantities.Each individual is represented by a node and a link corresponds to a contact established between two individuals. The width of the link is a measure of the duration of the contact, also indicated explicitly in terms of minutes. Multiple links can occur between two individuals, as highlighted in the pair N1-P1, indicating a contact of frequency larger than 1. The quantities introduced in the Materials and Methods section are calculated for the pair of individuals N1 and P1. The pair established one contact  with frequency equal to two  for a total duration of six minutes . By taking into account all interactions, individual N1 has established three contacts , two of which were distinct contacts , for a total duration of contacts equal to seven minutes .
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3046133&req=5

pone-0017144-g001: Schematic representation of detected contacts among 2 nurses (N1, N2) and 3 patients (P1, P2, P3) and corresponding measured quantities.Each individual is represented by a node and a link corresponds to a contact established between two individuals. The width of the link is a measure of the duration of the contact, also indicated explicitly in terms of minutes. Multiple links can occur between two individuals, as highlighted in the pair N1-P1, indicating a contact of frequency larger than 1. The quantities introduced in the Materials and Methods section are calculated for the pair of individuals N1 and P1. The pair established one contact with frequency equal to two for a total duration of six minutes . By taking into account all interactions, individual N1 has established three contacts , two of which were distinct contacts , for a total duration of contacts equal to seven minutes .
Mentions: In the following, unless otherwise stated, all measures are normalized on a 24-hour (daily) interval, e.g., all cumulative times in contact are divided by the duration of the study expressed in days (8 days). Figure 1 provides an example on how the above quantities are computed for a schematic sequence of contact data, where the individuals i and j belong to two different classes, nurses (N) and patients (P).

Bottom Line: The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found.The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies.Proximity-sensing technology should be considered as a valuable tool for measuring such patterns and evaluating nosocomial prevention strategies in specific settings.

View Article: PubMed Central - PubMed

Affiliation: Complex Networks and Systems Group, Institute for Scientific Interchange Foundation, Torino, Italy.

ABSTRACT

Background: Nosocomial infections place a substantial burden on health care systems and represent one of the major issues in current public health, requiring notable efforts for its prevention. Understanding the dynamics of infection transmission in a hospital setting is essential for tailoring interventions and predicting the spread among individuals. Mathematical models need to be informed with accurate data on contacts among individuals.

Methods and findings: We used wearable active Radio-Frequency Identification Devices (RFID) to detect face-to-face contacts among individuals with a spatial resolution of about 1.5 meters, and a time resolution of 20 seconds. The study was conducted in a general pediatrics hospital ward, during a one-week period, and included 119 participants, with 51 health care workers, 37 patients, and 31 caregivers. Nearly 16,000 contacts were recorded during the study period, with a median of approximately 20 contacts per participants per day. Overall, 25% of the contacts involved a ward assistant, 23% a nurse, 22% a patient, 22% a caregiver, and 8% a physician. The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found. In the setting under study, caregivers do not represent a significant potential for infection spread to a large number of individuals, as their interactions mainly involve the corresponding patient. Nurses would deserve priority in prevention strategies due to their central role in the potential propagation paths of infections.

Conclusions: Our study shows the feasibility of accurate and reproducible measures of the pattern of contacts in a hospital setting. The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies. Proximity-sensing technology should be considered as a valuable tool for measuring such patterns and evaluating nosocomial prevention strategies in specific settings.

Show MeSH
Related in: MedlinePlus