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Numerical modeling of nosocomial infection in a multi-bed ward environment
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Asante, Michael (2012) Numerical modeling of nosocomial infection in a multi-bed ward environment. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b2583339~S1
Abstract
A review on nosocomial infection has shown that there are various compelling evidence
to suggest that the role of the airborne route to infection in a multi-bed
environment cannot be ignored. Expiratory activities such as coughing, sneezes,
talking and patient-centric activities such as bed-making has been shown in literature
to generate significant quantity of infectious quanta that may become airborne
and pose an infection threat to vulnerable patients. In this study, an airborne infection
route of MRSA in the health care environment has been investigated using
both the large-eddy simulation (LES) technique and an infection modeling.
From analyzing flow field regimes in both a single room (typically found in isolation
wards) and multi-bed ward environments, it was observed that the supply
air delivered into the ventilated space produces pockets of recirculation areas near
the walls and midway of the room in the wake of the advancing ventilation outlet
bound flows, after impinging on internal surfaces such as beds. These recirculation
areas have been identified as hot spots for possible airborne infection. Furthermore,
the results suggests that the further the outlet vent is away from the inlet vent, the
more likely will be the generation of recirculation regions, which directly translate to
poor ventilation spots and that the use of curtains within the vicinity of the aerosol
generating activities increases the number of recirculation areas. The overall airflow
analysis suggest that any engineering solution designed to limit or remove the
recirculation regions from the flow regime will be an effective way of fighting cross
infections within the hospital ward environment, and as such ventilation schemes
that are optimally designed to achieve this should be encouraged and investigated.
This study has also predicted the possibility of a secondary infection in a multiward
environment using various modeling approaches. The results obtained indicated
that the posture of an infected person involved in the release of pathogens
in relation to cohorts can have a profound effect on infection rates within the ward
environment. The study of the coughing episode with the patient lying on the side
generated a unit secondary infection, whilst the same simulated episode with an
adjacent curtain in position failed to generate a secondary infection within the exposure
period. The activity of bed making was also found to generate a secondary
infection over the duration of the simulation, suggesting that bed-making can be
a potential source of infection. The particle concentration decay curves examined
in this work equally suggest that patients are at their most vulnerable state at the
initial stages of coughing/sneezes, and talking episodes where the infecting patient
assumes a directly facing posture to the susceptible.
Item Type: | Thesis (PhD) | ||||
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Subjects: | Q Science > QA Mathematics R Medicine > R Medicine (General) T Technology > TA Engineering (General). Civil engineering (General) |
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Library of Congress Subject Headings (LCSH): | Nosocomial infections -- Mathematical models, Hospitals -- Heating and ventilation -- Mathematical models, Air flow -- Mathematical models | ||||
Official Date: | July 2012 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | School of Engineering | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Chung, Yongmann M. | ||||
Sponsors: | Great Britain. Dept. of Health. Gateway Review, Estates and Facilities Division | ||||
Extent: | xix, 199 leaves : ill., charts | ||||
Language: | eng |
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