Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-30T16:27:33.387Z Has data issue: false hasContentIssue false
  • English
  • Français

Improving physical distancing among healthcare workers in a pediatric intensive care unit

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  14 December 2021

Anna C. Sick-Samuels Open the ORCID record for Anna C. Sick-Samuels [Opens in a new window] ,
Sara Cosgrove ,
Clare Rock ,
Alejandra Salinas Open the ORCID record for Alejandra Salinas [Opens in a new window] ,
Opeyemi Oladapo-Shittu Open the ORCID record for Opeyemi Oladapo-Shittu [Opens in a new window] ,
Ayse P. Gurses ,
Briana Vecchio-Pagan ,
Patience Osei Open the ORCID record for Patience Osei [Opens in a new window] ,
Yea-Jen Hsu  and
Ron Jacak Open the ORCID record for Ron Jacak [Opens in a new window]
...Show all authors
Anna C. Sick-Samuels*
Affiliation:
Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland
Sara Cosgrove
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Clare Rock
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Alejandra Salinas
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Opeyemi Oladapo-Shittu
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Ayse P. Gurses
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland
Briana Vecchio-Pagan
Affiliation:
Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland
Patience Osei
Affiliation:
Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland
Yea-Jen Hsu
Affiliation:
Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland
Ron Jacak
Affiliation:
Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland
Kristina K. Zudock
Affiliation:
Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland
Kianna M. Blount
Affiliation:
Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland
Kenneth V. Bowden
Affiliation:
Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland
Sara Keller
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
Author for correspondence: Anna C. Sick-Samuels, E-mail: asick1@jhmi.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Healthcare workers (HCWs) not adhering to physical distancing recommendations is a risk factor for acquisition of severe acute respiratory coronavirus virus 2 (SARS-CoV-2). The study objective was to assess the impact of interventions to improve HCW physical distancing on actual distance between HCWs in a real-life setting.

Methods:

HCWs voluntarily wore proximity beacons to measure the number and intensity of physical distancing interactions between each other in a pediatric intensive care unit. We compared interactions before and after implementing a bundle of interventions including changes to the layout of workstations, cognitive aids, and individual feedback from wearable proximity beacons.

Results:

Overall, we recorded 10,788 interactions within 6 feet (∼2 m) and lasting >5 seconds. The number of HCWs wearing beacons fluctuated daily and increased over the study period. On average, 13 beacons were worn daily (32% of possible staff; range, 2–32 per day). We recorded 3,218 interactions before the interventions and 7,570 interactions after the interventions began. Using regression analysis accounting for the maximum number of potential interactions if all staff had worn beacons on a given day, there was a 1% decline in the number of interactions per possible interactions in the postintervention period (incident rate ratio, 0.99; 95% confidence interval, 0.98–1.00; P = .02) with fewer interactions occurring at nursing stations, in workrooms and during morning rounds.

Conclusions:

Using quantitative data from wearable proximity beacons, we found an overall small decline in interactions within 6 feet between HCWs in a busy intensive care unit after a multifaceted bundle of interventions was implemented to improve physical distancing.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 12 , December 2022 , pp. 1790 - 1795
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Social distancing—keep a safe distance to slow the spread. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html. Updated 2020. Accessed June 30, 2021.Google Scholar
COVID-19: physical distancing. World Health Organization website. https://www.who.int/westernpacific/emergencies/covid-19/information/physical-distancing. Accessed July 2, 2021.Google Scholar
Schneider, S, Piening, B, Nouri-Pasovsky, PA, Krüger, AC, Gastmeier, P, Aghdassi, SJS. SARS-coronavirus-2 cases in healthcare workers may not regularly originate from patient care: lessons from a university hospital on the underestimated risk of healthcare worker to healthcare worker transmission. Antimicrob Resist Infect Control 2020;9:192.Google Scholar
Çelebi, G, Pişkin, N, Çelik Bekleviç, A, et al. Specific risk factors for SARS-CoV-2 transmission among healthcare workers in a university hospital. Am J Infect Control 2020;48:1225–1230.Google ScholarPubMed
Keller, SC, Pau, S, Salinas, AB, et al. Barriers to physical distancing among healthcare workers on an academic hospital unit during the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol 2021. doi:10.1017/ice.2021.154.CrossRefGoogle Scholar
Bian, S, Zhou, B, Lukowicz, P. Social distance monitor with a wearable magnetic field proximity sensor. Sensors (Basel) 2020;20(18). doi: 10.3390/s20185101.CrossRefGoogle ScholarPubMed
van Niekerk, JM, Stein, A, Doting, MHE, Lokate, M, Braakman-Jansen, LMA, van Gemert-Pijnen, JEWC. A spatiotemporal simulation study on the transmission of harmful microorganisms through connected healthcare workers in a hospital ward setting. BMC Infect Dis 2021;21:260.Google Scholar
Machens, A, Gesualdo, F, Rizzo, C, Tozzi, AE, Barrat, A, Cattuto, C. An infectious disease model on empirical networks of human contact: bridging the gap between dynamic network data and contact matrices. BMC Infect Dis 2013;13:185.CrossRefGoogle ScholarPubMed
Isella, L, Romano, M, Barrat, A, et al. Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors. PLoS One 2011;6:e17144.CrossRefGoogle Scholar
Vanhems, P, Barrat, A, Cattuto, C, et al. Estimating potential infection transmission routes in hospital wards using wearable proximity sensors. PLoS One 2013;8:e73970.CrossRefGoogle ScholarPubMed
Barrat, A, Cattuto, C, Tozzi, AE, Vanhems, P, Voirin, N. Measuring contact patterns with wearable sensors: methods, data characteristics and applications to data-driven simulations of infectious diseases. Clin Microbiol Infect 2014;20:10–16.Google Scholar
Keller, SC, Salinas, AB, Oladapo-Shittu, O, et al. The case for wearable proximity devices to inform physical distancing among healthcare workers. JAMIA Open 2021. doi: 10.1093/jamiaopen/ooab095.CrossRefGoogle ScholarPubMed
Parmasad, V, Keating, JA, Carayon, P, Safdar, N. Physical distancing for care delivery in healthcare settings: considerations and consequences. Am J Infect Control 2020. doi: 10.1016/j.ajic.2020.12.014.Google ScholarPubMed
Fuller, C, Michie, S, Savage, J, et al. The Feedback Intervention Trial (FIT)—improving hand-hygiene compliance in UK healthcare workers: a stepped wedge cluster randomised controlled trial. PLoS One 2012;7:e41617.CrossRefGoogle ScholarPubMed
Coronavirus. Maryland Department of Health website. https://coronavirus.maryland.gov/. Accessed June 30, 2021.Google Scholar
Xie, A, Woods-Hill, CZ, Berenholtz, SM, Milstone, AM. Use of human factors and ergonomics to disseminate healthcare quality improvement programs. Qual Manag Health Care 2019;28:117–118.CrossRefGoogle Scholar
Pronovost, P, Weast, B, Rosenstein, B, et al. Implementing and validating a comprehensive unit-based safety program. J Patient Saf 2005;1:33–40.Google Scholar
Public health guidance for community-related exposure. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html. Updated 2020. Accessed June 30, 2021.Google Scholar
Murthy, BP. Disparities in COVID-19 vaccination coverage between urban and rural counties—United States, December 14, 2020. Morb Mortal Wkly Rep 2021;70:759–764.CrossRefGoogle Scholar
Understanding vaccination progress. Johns Hopkins Coronavirus Resource Center website. https://coronavirus.jhu.edu/vaccines/us-states. Accessed July 19, 2021.Google Scholar
COVID data tracker. Centers for Disease Control and Prevention website. https://covid.cdc.gov/covid-data-tracker. Updated 2020. Accessed July 19, 2021.Google Scholar
Supplementary material: Image

Sick-Samuels et al. supplementary material

Sick-Samuels et al. supplementary material 1

Download Sick-Samuels et al. supplementary material(Image)
Image 17.1 KB
Supplementary material: Image

Sick-Samuels et al. supplementary material

Sick-Samuels et al. supplementary material 2

Download Sick-Samuels et al. supplementary material(Image)
Image 102.9 KB