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Validation of a Stochastic Discrete Event Model Predicting Virus Concentration on Nurse Hands

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  • Amanda M. Wilson
  • Kelly A. Reynolds
  • Marc P. Verhougstraete
  • Robert A. Canales

Abstract

Understanding healthcare viral disease transmission and the effect of infection control interventions will inform current and future infection control protocols. In this study, a model was developed to predict virus concentration on nurses’ hands using data from a bacteriophage tracer study conducted in Tucson, Arizona, in an urgent care facility. Surfaces were swabbed 2 hours, 3.5 hours, and 6 hours postseeding to measure virus spread over time. To estimate the full viral load that would have been present on hands without sampling, virus concentrations were summed across time points for 3.5‐ and 6‐hour measurements. A stochastic discrete event model was developed to predict virus concentrations on nurses’ hands, given a distribution of virus concentrations on surfaces and expected frequencies of hand‐to‐surface and orifice contacts and handwashing. Box plots and statistical hypothesis testing were used to compare the model‐predicted and experimentally measured virus concentrations on nurses’ hands. The model was validated with the experimental bacteriophage tracer data because the distribution for model‐predicted virus concentrations on hands captured all observed value ranges, and interquartile ranges for model and experimental values overlapped for all comparison time points. Wilcoxon rank sum tests showed no significant differences in distributions of model‐predicted and experimentally measured virus concentrations on hands. However, limitations in the tracer study indicate that more data are needed to instill more confidence in this validation. Next model development steps include addressing viral concentrations that would be found naturally in healthcare environments and measuring the risk reductions predicted for various infection control interventions.

Suggested Citation

  • Amanda M. Wilson & Kelly A. Reynolds & Marc P. Verhougstraete & Robert A. Canales, 2019. "Validation of a Stochastic Discrete Event Model Predicting Virus Concentration on Nurse Hands," Risk Analysis, John Wiley & Sons, vol. 39(8), pages 1812-1824, August.
  • Handle: RePEc:wly:riskan:v:39:y:2019:i:8:p:1812-1824
    DOI: 10.1111/risa.13281
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    References listed on IDEAS

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    1. Marie Laure Delignette-Muller & Christophe Dutang, 2015. "fitdistrplus : An R Package for Fitting Distributions," Post-Print hal-01616147, HAL.
    2. Timothy R. Julian & Robert A. Canales & James O. Leckie & Alexandria B. Boehm, 2009. "A Model of Exposure to Rotavirus from Nondietary Ingestion Iterated by Simulated Intermittent Contacts," Risk Analysis, John Wiley & Sons, vol. 29(5), pages 617-632, May.
    3. Delignette-Muller, Marie Laure & Dutang, Christophe, 2015. "fitdistrplus: An R Package for Fitting Distributions," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 64(i04).
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    1. Jesús Isaac Vázquez-Serrano & Rodrigo E. Peimbert-García & Leopoldo Eduardo Cárdenas-Barrón, 2021. "Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review," IJERPH, MDPI, vol. 18(22), pages 1-20, November.

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