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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

Contact number and duration per role (A: ward assistants; D: Doctor; N: Nurse; P: Patients; C: Caregiver).The plots show the median values per participant in each class of: the number of contacts  (panel A), the number of distinct contacts  (panel B), the cumulative time in contact  (panel C). All quantities for a given class are computed on the contacts established by participants in that class with any other participant. Data are normalized to a 24-hour interval.
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pone-0017144-g002: Contact number and duration per role (A: ward assistants; D: Doctor; N: Nurse; P: Patients; C: Caregiver).The plots show the median values per participant in each class of: the number of contacts (panel A), the number of distinct contacts (panel B), the cumulative time in contact (panel C). All quantities for a given class are computed on the contacts established by participants in that class with any other participant. Data are normalized to a 24-hour interval.

Mentions: The daily median number of contacts per individual, shown in Figure 2A, is highest among ward assistants, and it is much higher than the values observed for other classes (the second largest value is 45.5 contacts established by an average nurse, compared to 99.5 contacts in the ward assistant case). This pattern is explained by the organization of the staff duties, as ward assistants are requested mainly to clean up, to transport patients, and to distribute food, and they mostly work in pairs. Figure 2B reports the daily median number of distinct contacts that participants of a given class establish with any other participant, showing that health-care workers are involved in interactions with a larger number of distinct individuals, typically 3–5 distinct contacts, whereas patients and caregivers mostly interact with a single person, with high frequency. In addition to the number and the frequency of contacts, the RFID infrastructure enables the accurate measurement of the duration of contacts between individuals, providing a more detailed characterization of proximity events, which is generally hard to achieve by using traditional survey methodologies. Figure 2C shows the cumulative time in contact, , spent by individuals belonging to each of the roles. This quantity is highly heterogeneous, ranging, daily, from a few minutes for physicians up to approximately one hour for ward assistants.


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)

Contact number and duration per role (A: ward assistants; D: Doctor; N: Nurse; P: Patients; C: Caregiver).The plots show the median values per participant in each class of: the number of contacts  (panel A), the number of distinct contacts  (panel B), the cumulative time in contact  (panel C). All quantities for a given class are computed on the contacts established by participants in that class with any other participant. Data are normalized to a 24-hour interval.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0017144-g002: Contact number and duration per role (A: ward assistants; D: Doctor; N: Nurse; P: Patients; C: Caregiver).The plots show the median values per participant in each class of: the number of contacts (panel A), the number of distinct contacts (panel B), the cumulative time in contact (panel C). All quantities for a given class are computed on the contacts established by participants in that class with any other participant. Data are normalized to a 24-hour interval.
Mentions: The daily median number of contacts per individual, shown in Figure 2A, is highest among ward assistants, and it is much higher than the values observed for other classes (the second largest value is 45.5 contacts established by an average nurse, compared to 99.5 contacts in the ward assistant case). This pattern is explained by the organization of the staff duties, as ward assistants are requested mainly to clean up, to transport patients, and to distribute food, and they mostly work in pairs. Figure 2B reports the daily median number of distinct contacts that participants of a given class establish with any other participant, showing that health-care workers are involved in interactions with a larger number of distinct individuals, typically 3–5 distinct contacts, whereas patients and caregivers mostly interact with a single person, with high frequency. In addition to the number and the frequency of contacts, the RFID infrastructure enables the accurate measurement of the duration of contacts between individuals, providing a more detailed characterization of proximity events, which is generally hard to achieve by using traditional survey methodologies. Figure 2C shows the cumulative time in contact, , spent by individuals belonging to each of the roles. This quantity is highly heterogeneous, ranging, daily, from a few minutes for physicians up to approximately one hour for ward assistants.

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