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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]
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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
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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
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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