Authors:
Sinjit Mukherjee,Soumya Sonalika,DOI NO:
https://doi.org/10.26782/jmcms.2025.06.00012Keywords:
Chlorhexidine Bathing,Healthcare Delivery,Hospital-Acquired Infections (HAIs),Infection Control Patient Safety,Multidrug-Resistant Organisms (MDROs),Nurse-led Interventions,Personal Protective Equipment (PPE),Susceptible-Infected-Recovered (SIR),Abstract
Hospital-acquired infections (HAIs), or nosocomial infections, compromise patient safety and the provision of care worldwide. With their extensive patient contact, nurses are key to HAIs transmission and prevention. This article employs a mathematical simulation of HAI dynamics for 60 days in a theoretical 1,000-person hospital ward using a modified Susceptible-Infected-Recovered (SIR) model, with and without nurse interventions such as hand hygiene, patient isolation, personal protective equipment (PPE) use, and environmental disinfection. Enhanced advancements, including the incorporation of genomic and epidemiological data, enhance the model's ability to track transmission clusters, particularly in the case of multidrug-resistant organisms (MDROs) such as MRSA (Illingworth et al., 2022). The simulation demonstrates that nurse interventions reduce infection rate by over 70%, retarding peak and lowering total cases (from ~830 to ~240). Findings are congruent with observations comparing interventions such as chlorhexidine bathing (Climo et al., 2016). Through model assumptions, e.g., asymptomatic transmission, this article offers a concrete basis for hospital decision-making, emphasizing evidence-based nursing and interprofessional infection control practices.Refference:
I. Anderson, Roy M., and Robert M. May. Infectious Diseases of Humans: Dynamics and Control. Oxford UP, 1991.
II. Allegranzi, Benedetta, et al. “Burden of Endemic Health-Care-Associated Infection in Developing Countries: Systematic Review and Meta-Analysis.” The Lancet, vol. 377, no. 9761, 2011, pp. 228–241. ScienceDirect. 10.1016/S0140-6736(10)61458-4.
III. Beggs, Clive B., et al. “Potential for Airborne Transmission of Infection in the Waiting Areas of Healthcare Premises: Stochastic Analysis Using a Monte Carlo Model.” BMC Infectious Diseases, vol. 8, 2008, article no. 247. BioMed Central. 10.1186/1471-2334-8-247.
IV. Butcher, J. C. Numerical Methods for Ordinary Differential Equations. Wiley, 2016.
V. Climo, Michael W., et al. “A Re-analysis of the STAR*ICU Trial Using Mathematical Modeling.” Open Forum Infectious Diseases, vol. 3, no. 4, 2016, ofw247. 10.1093/ofid/ofw247.
VI. Donskey, Curtis J. “Does Improving Surface Cleaning and Disinfection Reduce Health Care–Associated Infections?” American Journal of Infection Control, vol. 41, no. 5 Suppl., 2013, pp. S12–S19. 10.1016/j.ajic.2012.12.010.
VII. Harbarth, Stephan, Hugo Sax, and Petra Gastmeier. “The Preventable Proportion of Nosocomial Infections: An Overview of Published Reports.” Journal of Hospital Infection, vol. 54, no. 4, 2003, pp. 258–266. 10.1016/S0195-6701(03)00150-6.
VIII. Hethcote, Herbert W. “The Mathematics of Infectious Diseases.” SIAM Review, vol. 42, no. 4, 2000, pp. 599–653. JSTOR. 10.1137/S0036144500371907.
IX. Ho, C., et al. “Evaluating the BUGG Trial with Mathematical Models.” Journal of Hospital Infection, vol. 96, no. 3, 2017, pp. 231–237. 10.1016/j.jhin.2017.03.011.
X. Illingworth, C. J. R., et al. “Transmission of SARS-CoV-2 in a UK National Health Service Trust: A Genomic and Epidemiological Analysis.” Nature Communications, vol. 13, no. 1, 2022, article no. 28291. 10.1038/s41467-022-28291-y.
XI. Kermack, W. O., and A. G. McKendrick. “A Contribution to the Mathematical Theory of Epidemics.” Proceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences, vol. 115, no. 772, 1927, pp. 700–721. 10.1098/rspa.1927.0118.
XII. Larson, Elaine L., et al. “Effect of an Automated Hand Hygiene Reminder System on Health Care–Acquired Infections: A 4-Year Quality Improvement Study.” American Journal of Infection Control, vol. 42, no. 10, 2014, pp. 978–982. 10.1016/j.ajic.2014.06.030.
XIII. Lee, Bruce Y., et al. “Modeling the Spread of Methicillin-Resistant Staphylococcus aureus (MRSA) Outbreaks throughout the Hospitals in Orange County, California.” Infection Control & Hospital Epidemiology, vol. 32, no. 6, 2011, pp. 562–572. Cambridge UP. 10.1086/660011.
XIV. McBryde, Emma S., et al. “A Risk-Based Model for Infection Control and Surveillance of Hospital-Acquired Infections.” Infection Control & Hospital Epidemiology, vol. 25, no. 10, 2004, pp. 792–797. 10.1086/502488.
XV. Pittet, Didier, and John M. Boyce. “Hand Hygiene and Patient Care: Pursuing the Semmelweis Legacy.” The Lancet Infectious Diseases, vol. 1, no. 1, 2001, pp. 9–20. 10.1016/S1473-3099(09)70295-6.
XVI. Rabie, Tamer, and V. Curtis. “Handwashing and Risk of Respiratory Infections: A Quantitative Systematic Review.” Tropical Medicine & International Health, vol. 11, no. 3, 2006, pp. 258–267. 10.1111/j.1365-3156.2006.01568.x.
XVII. Smith, D. R. M., et al. “Improving Mathematical Modeling of Interventions to Prevent Healthcare-Associated Infections by Interrupting Transmission of Pathogens.” PLoS ONE, vol. 17, no. 3, 2022, e0264344. 10.1371/journal.pone.0264344.
XVIII. Stiller, Andreas, et al. “Relationship between Hospital Ward Design and Healthcare-Associated Infection Rates: A Systematic Review and Meta-Analysis.” Antimicrobial Resistance and Infection Control, vol. 5, 2016, article no. 51. Springer Open. 10.1186/s13756-016-0148-1.
XIX. Temime, L., et al. “Impact of Hand Hygiene Compliance on Nosocomial Infection Rates: A Modeling Approach.” Infection Control & Hospital Epidemiology, vol. 30, no. 8, 2009, pp. 751–758. 10.1086/598672.
XX. Toth, D. J. A., et al. “Forecasting Multidrug-Resistant Organism Emergence: Challenges and Opportunities.” Emerging Infectious Diseases, vol. 29, no. 4, 2023, pp. 677–685. 10.3201/eid2904.221552.
XXI. World Health Organization. Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level. World Health Organization, 2016, https://www.who.int/publications/i/item/9789241549929.
XXII. Yassi, Annalee, et al. “Protecting the Faces of Health Care Workers: Knowledge Gaps and Research Priorities for Effective Protection Against Occupationally-Acquired Respiratory Infectious Diseases.” International Journal of Environmental Research and Public Health, vol. 8, no. 12, 2011, pp. 314–319. 10.3390/ijerph8010314.