Department of Emergency Medicine, Emory University, Atlanta, Georgia, United States of America.
PLoS One. 2013 Aug 21;8(8):e70854. doi: 10.1371/journal.pone.0070854. eCollection 2013.
Infectious individuals in an emergency department (ED) bring substantial risks of cross infection. Data about the complex social and spatial structure of interpersonal contacts in the ED will aid construction of biologically plausible transmission risk models that can guide cross infection control.
We sought to determine the number and duration of contacts among patients and staff in a large, busy ED. This prospective study was conducted between 1 July 2009 and 30 June 2010. Two 12-hour shifts per week were randomly selected for study. The study was conducted in the ED of an urban hospital. There were 81 shifts in the planned random sample of 104 (78%) with usable contact data, during which there were 9183 patient encounters. Of these, 6062 (66%) were approached to participate, of which 4732 (78%) agreed. Over the course of the year, 88 staff members participated (84%). A radiofrequency identification (RFID) system was installed and the ED divided into 89 distinct zones structured so copresence of two individuals in any zone implied a very high probability of contact <1 meter apart in space. During study observation periods, patients and staff were given RFID tags to wear. Contact events were recorded. These were further broken down with respect to the nature of the contacts, i.e., patient with patient, patient with staff, and staff with staff. 293,171 contact events were recorded, with a median of 22 contact events and 9 contacts with distinct individuals per participant per shift. Staff-staff interactions were more numerous and longer than patient-patient or patient-staff interactions.
We used RFID to quantify contacts between patients and staff in a busy ED. These results are useful for studies of the spread of infections. By understanding contact patterns most important in potential transmission, more effective prevention strategies may be implemented.
急诊科（ED）中的传染性个体带来了严重的交叉感染风险。有关 ED 中人际接触复杂的社会和空间结构的数据将有助于构建具有生物学合理性的传播风险模型，从而指导交叉感染控制。
我们旨在确定大型繁忙 ED 中患者和工作人员之间的接触人数和持续时间。这是一项前瞻性研究，于 2009 年 7 月 1 日至 2010 年 6 月 30 日进行。每周随机选择两个 12 小时的班次进行研究。该研究在城市医院的急诊科进行。在计划的 104 个随机样本中有 81 个班次（78%）有可用的接触数据，在此期间有 9183 次患者就诊。其中，有 6062 名（66%）患者被邀请参与，其中 4732 名（78%）同意。在这一年中，有 88 名工作人员参与（84%）。安装了射频识别（RFID）系统，并将 ED 分为 89 个不同的区域，这些区域的结构使得两个人同时出现在任何一个区域都意味着两人之间的距离非常近，几乎没有空间间隔。在研究观察期间，给患者和工作人员佩戴 RFID 标签。记录接触事件。根据接触的性质（即患者与患者、患者与工作人员以及工作人员与工作人员）进一步对其进行细分。记录了 293171 次接触事件，每个参与者每个班次的中位数为 22 次接触和 9 次与不同个体的接触。工作人员与工作人员的互动比患者与患者或患者与工作人员的互动更多且持续时间更长。
我们使用 RFID 量化了繁忙 ED 中患者和工作人员之间的接触。这些结果可用于研究感染的传播。通过了解潜在传播中最重要的接触模式，可以实施更有效的预防策略。
