title: Using sensor networks to study the effect of peripatetic healthcare workers on the spread of hospital-associated infections.
abstract: BACKGROUND
  Super-spreading events, in which an individual with measurably high connectivity is responsible for infecting a large number of people, have been observed. Our goal is to determine the impact of hand hygiene noncompliance among peripatetic (eg, highly mobile or highly connected) healthcare workers compared with less-connected workers.
  
  
  METHODS
  We used a mote-based sensor network to record contacts among healthcare workers and patients in a 20-bed intensive care unit. The data collected from this network form the basis for an agent-based simulation to model the spread of nosocomial pathogens with various transmission probabilities. We identified the most- and least-connected healthcare workers. We then compared the effects of hand hygiene noncompliance as a function of connectedness.
  
  
  RESULTS
  The data confirm the presence of peripatetic healthcare workers. Also, agent-based simulations using our real contact network data confirm that the average number of infected patients was significantly higher when the most connected healthcare worker did not practice hand hygiene and significantly lower when the least connected healthcare workers were noncompliant.
  
  
  CONCLUSIONS
  Heterogeneity in healthcare worker contact patterns dramatically affects disease diffusion. Our findings should inform future infection control interventions and encourage the application of social network analysis to study disease transmission in healthcare settings.
authors.affiliation: Department of Computer Science, College of Public Health, University of Iowa, Iowa City, Iowa 52242, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hornbeck
authors.forename: David
authors.initials: D
authors.lastname: Naylor
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Segre
authors.forename: Geb
authors.initials: G
authors.lastname: Thomas
authors.forename: Ted
authors.initials: T
authors.lastname: Herman
authors.forename: Philip M
authors.initials: PM
authors.lastname: Polgreen
mesh_terms: D003198:Computer Simulation; D016358:Contact Tracing / Q000295:instrumentation / Q000379:methods*; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission*; D006235:Hand Disinfection / Q000592:standards*; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D017053:Infection Control; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D008962:Models, Theoretical