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Mapping Patient-Nurse Interactions Could Minimize Infections

Marianne Aiello, for HealthLeaders Media, October 28, 2013

"Most people think of transmission as being primarily a contact-driven problem, but they are not likely to be familiar with social network analysis and how it could be leveraged to provide insight to this very significant problem," says Sean Barnes, Ph.D., Assistant Professor at University of Maryland's Robert H. Smith School of Business. "By thinking about the structure of interactions between people in a hospital, you can start to devise alternative ways of preventing transmission."

And they did. Barnes and his fellow researchers found that there is a strong correlation of a "sparse, social network structure" with low infection transmission rates.

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These findings call on hospital leaders to take a deeper look at how their staff – primarily, nurses – are interacting with patients, and to determine a way for the highest risk patients to come into contact with fewer workers. Barnes has three staffing practices that hospitals might consider.

1. Hire more nurses.
This strategy is simplest in terms of complexity, if not in terms of feasibility, Barnes says. "By limiting the number of patients each nurse comes into contact with, transmission can be limited significantly."

2. Create a strategy for patient sharing.
This practice tasks hospital leadership with deciding on a strategy for healthcare workers to cover one another's patients in a way that limits the connectivity of the contact network.

Barnes and his colleagues recommend two approaches for doing so: paired sharing (i.e. the buddy system) and revolving sharing (i.e. a circular sharing system).

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2 comments on "Mapping Patient-Nurse Interactions Could Minimize Infections"


Daniel Juckette RN, CCRN (12/12/2013 at 10:11 AM)
What about a " turn team" where unit staff alternate in teaming up to go through the unit and turn every patient. Management is enamoured with this idea to reduce skin breakdown. I see it as a way to insure that every staff member touches every patient multiple times during the day. If one staff member becomes contaminated by poor technique or contacts a patient with an undiagnosed infection, it guarantees that infection will be transported to every patient.

Mary Ann Toennisson (11/7/2013 at 2:15 PM)
I think that we also need to consider everyone that moves around in the hospital as causes of infection. How about the transporter that moves a patient from the surgical unit and then picks up a patient from orthopedics. Or the Physical therapist that goes from floor to floor doing gait training. Infections are not just spread in one unit, but throughout the building.