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美国一家四级医疗中心医护人员的社交混合模式:一项前瞻性观察研究。

Social mixing patterns of United States healthcare personnel at a quaternary health center: a prospective observational study.

作者信息

Pischel Lauren, Aguolu Obianuju G, Ahmed Noureen, Campbell Melissa M, Borg Ryan, Duckwall Chelsea, Willebrand Kathryn, Zaleski Agnieska, Paintsil Elliott E, Muenker M Catherine, Malik Amyn A, Kiti Moses C, Warren Joshua L, Jenness Samuel M, Lopman Ben A, Belsky Justin, Martinello Richard A, Yildirim Inci, Ko Albert I, Omer Saad B

机构信息

Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.

Yale Institute for Global Health, New Haven, CT, USA.

出版信息

Infect Control Hosp Epidemiol. 2025 Jan 30;46(3):1-9. doi: 10.1017/ice.2024.234.

Abstract

BACKGROUND

Understanding healthcare personnel's (HCP) contact patterns are important to mitigate healthcare-associated infectious disease transmission. Little is known about how HCP contact patterns change over time or during outbreaks such as the COVID-19 pandemic.

METHODS

This study in a large United States healthcare system examined the social contact patterns of HCP via standardized social contact diaries. HCP were enrolled from October 2020 to June 2022. Participants completed monthly surveys of social contacts during a representative working day. In June 2022, participants completed a 2-day individual-level contact diary. Regression models estimated the association between contact rates and job type. We generated age-stratified contact matrices.

RESULTS

Three-hundred and sixty HCP enrolled, 157 completed one or more monthly contact diaries and 88 completed the intensive 2-day diary. In the monthly contact diaries, the median daily contacts were 15 (interquartile range (IQR) 8-20), this increased slightly during the study (slope-estimate 0.004, p-value 0.016). For individual-level contact diaries, 88 HCP reported 2,550 contacts over 2 days. HCP were 2.8 times more likely to contact other HCP (n = 1,592 contacts) than patients (n = 570 contacts). Rehabilitation/transport staff, diagnostic imaging technologists, doctors, nurses, mid-level, and laboratory personnel had higher contacts compared with the lowest contact group (Nursing aids). Contact matrices concentrated in working-age populations.

CONCLUSIONS

HCP contacts concentrate in their work environment, primarily with other HCP. Their contacts remained stable over time even during large changes to societal contact patterns during the COVID-19 pandemic. This stability is critical for designing outbreak and pandemic responses.

摘要

背景

了解医护人员(HCP)的接触模式对于减少医疗相关传染病传播至关重要。对于医护人员的接触模式如何随时间变化或在诸如新冠疫情等疫情期间如何变化,我们知之甚少。

方法

本研究在美国一个大型医疗系统中,通过标准化的社会接触日记来研究医护人员的社会接触模式。医护人员于2020年10月至2022年6月招募。参与者在一个具有代表性的工作日完成每月的社会接触调查。2022年6月,参与者完成了一份为期2天的个人层面接触日记。回归模型估计了接触率与工作类型之间的关联。我们生成了按年龄分层的接触矩阵。

结果

360名医护人员参与研究,157人完成了一份或多份月度接触日记,88人完成了为期2天的密集日记。在月度接触日记中,每日接触的中位数为15次(四分位间距(IQR)8 - 20),在研究期间略有增加(斜率估计值0.004,p值0.016)。对于个人层面接触日记,88名医护人员在2天内报告了2550次接触。医护人员与其他医护人员接触(n = 1592次接触)的可能性是与患者接触(n = 570次接触)的2.8倍。与接触最少的群体(护理辅助人员)相比,康复/运输人员、诊断成像技术人员、医生、护士、中级人员和实验室人员的接触更多。接触矩阵集中在工作年龄人群。

结论

医护人员的接触集中在工作环境中,主要是与其他医护人员接触。即使在新冠疫情期间社会接触模式发生巨大变化的情况下,他们的接触随时间保持稳定。这种稳定性对于设计疫情应对措施至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2ac/11883655/987356610861/S0899823X24002344_fig1.jpg

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