Electronic sensors for assessing interactions between healthcare workers and patients under airborne precautions.
BACKGROUND
Direct observation has been widely used to assess interactions between healthcare workers (HCWs) and patients but is time-consuming and feasible only over short periods. We used a Radio Frequency Identification Device (RFID) system to automatically measure HCW-patient interactions.


METHODS
We equipped 50 patient rooms with fixed sensors and 111 HCW volunteers with mobile sensors in two clinical wards of two hospitals. For 3 months, we recorded all interactions between HCWs and 54 patients under airborne precautions for suspected (n = 40) or confirmed (n = 14) tuberculosis. Number and duration of HCW entries into patient rooms were collected daily. Concomitantly, we directly observed room entries and interviewed HCWs to evaluate their self-perception of the number and duration of contacts with tuberculosis patients.


RESULTS
After signal reconstruction, 5490 interactions were recorded between 82 HCWs and 54 tuberculosis patients during 404 days of airborne isolation. Median (interquartile range) interaction duration was 2.1 (0.8-4.4) min overall, 2.3 (0.8-5.0) in the mornings, 1.8 (0.8-3.7) in the afternoons, and 2.0 (0.7-4.3) at night (P<10(-4)). Number of interactions/day/HCW was 3.0 (1.0-6.0) and total daily duration was 7.6 (2.4-22.5) min. Durations estimated from 28 direct observations and 26 interviews were not significantly different from those recorded by the network.


CONCLUSIONS
The RFID was well accepted by HCWs. This original technique holds promise for accurately and continuously measuring interactions between HCWs and patients, as a less resource-consuming substitute for direct observation. The results could be used to model the transmission of significant pathogens. HCW perceptions of interactions with patients accurately reflected reality.
Infection Control Unit, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. jean-christophe.lucet@bch.aphp.fr
Jean-Christophe
JC
Lucet
Cédric
C
Laouenan
Guillaume
G
Chelius
Nicolas
N
Veziris
Didier
D
Lepelletier
Adrien
A
Friggeri
Dominique
D
Abiteboul
Elisabeth
E
Bouvet
France
F
Mentre
Eric
E
Fleury
D000328:Adult; D003428:Cross Infection; D005260:Female; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms