Use of a Real-Time Locating System for Contact Tracing of Health Care Workers During the COVID-19 Pandemic at an Infectious Disease Center in Singapore: Validation Study
Use of a Real-Time Locating System for Contact Tracing of Health Care Workers During the COVID-19 Pandemic at an Infectious Disease Center in Singapore: Validation Study
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DOI：
10.2196/19437
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发表时间：
2020-05-26
影响因子：
7.4
通讯作者：
Chow, Angela
中科院分区：
文献类型：
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作者：
Ho, Hanley J.;Zhang, Zoe Xiaozhu;Chow, Angela
背景：2020年初，冠状病毒病(新冠肺炎)出现，并通过社区和医院传播传播。有效追踪潜在接触者对于预防和控制医疗机构中的传染病暴发至关重要。目的：本研究旨在通过实时定位系统和查阅新加坡新冠肺炎应急指定医院的电子病历，评估接触者追踪在新冠肺炎大流行期间的比较有效性。方法：在为期两天的研究期间，确定所有住院的新冠肺炎患者、他们的病房位置和每个病房的医护人员名单，以确定新冠肺炎患者和医护人员之间的潜在接触总数。评估了通过EMR审查、基于RTLS的接触者追踪以及两种方法的组合确定的工作人员与患者接触的数量。结果：在796例潜在的医护人员-患者接触者中，104例(13.1%)同时被RTLS和EMR识别，54例(6.8%)被RTLS单独识别，99例(12.4%)被单独EMR识别，539例(67.7%)未被两种方法识别。与自我报告的接触者相比，EMR综述的敏感性为47.2%，特异性为77.9%，而RTLS的敏感性为72.2%，特异性为87.7%。通过RTLS或EMR确定的所有接触者的敏感性最高(敏感性77.8%，特异性73.4%)。结论：基于RTLS的接触者追踪的敏感性和特异性均高于EMR回顾。这两种方法的结合为快速接触者追踪提供了最佳性能，尽管仍有必要对RTLS进行技术调整，并提高用户对佩戴RTLS标签的遵从性。
Background: In early 2020, coronavirus disease (COVID-19) emerged and spread by community and nosocomial transmission. Effective contact tracing of potentially exposed health care workers is crucial for the prevention and control of infectious disease outbreaks in the health care setting.Objective: This study aimed to evaluate the comparative effectiveness of contact tracing during the COVID-19 pandemic through the real-time locating system (RTLS) and review of the electronic medical record (EMR) at the designated hospital for COVID-19 response in Singapore.Methods: Over a 2-day study period, all admitted patients with COVID-19, their ward locations, and the health care workers rostered to each ward were identified to determine the total number of potential contacts between patients with COVID-19 and health care workers. The numbers of staff-patient contacts determined by EMR reviews, RTLS based contact tracing, and a combination of both methods were evaluated. The use of EMR-based and RTLS-based contact tracing methods was further validated by comparing their sensitivity and specificity against self-reported staff-patient contacts by health care workers.Results: Of 796 potential staff-patient contacts (between 17 patients and 162 staff members), 104 (13.1%) were identified by both the RTLS and EMR, 54 (6.8%) by the RTLS alone, and 99 (12.4%) by the EMR alone; 539 (67.7%) were not identified through either method. Compared to self-reported contacts, EMR reviews had a sensitivity of 47.2% and a specificity of 77.9%, while the RTLS had a sensitivity of 72.2% and a specificity of 87.7%. The highest sensitivity was obtained by including all contacts identified by either the RTLS or the EMR (sensitivity 77.8%, specificity 73.4%).Conclusions: RTLS-based contact tracing showed higher sensitivity and specificity than EMR review. Integration of both methods provided the best performance for rapid contact tracing, although technical adjustments to the RTLS and increasing user compliance with wearing of RTLS tags remain necessary.