Table 3.

Intervention Parameter Estimates for the Agent-Based Model

Parameter	Baseline Mean	Enhanced Mean	Ideal Mean	Sourcea
Hand hygiene
Soap and water effectivenessb		96 (90–100)		44–46
ABHR effectivenessb		29 (13–36)		34, 45
Standard room compliance
Nurse	60 (46–68)	79 (74–84)	96	47–58
Doctor	50 (40–55)	71 (57–80)	91	47–60
Visitor and caregiver	35 (20–50)	55 (50–67)	84	48, 61–67
Patient	33 (30–40)	59 (55–65)	84	63, 68–72
Fraction soap and water vs ABHR		10 (5–15)		52
C. difficile room compliance
Nurse	69c	84c	97	9, 73–75
Doctor	61c	77c	93	9, 73–75
Visitor and caregiver	50c	65c	88	9, 73–75
Patient	48c	68c	88	9, 73–75
Fraction soap and water vs ABHR	80 (70–90)	90 (80–95)	95	76
Contact precautions
Gown and glove effectivenessd	70 (60–80)	86 (80–90)	97	77–79
Healthcare worker compliance	67 (62–72)	77 (71–85)	87	9, 61, 80–84
Visitor compliance	50 (42–52)	74 (70–80)	94	61, 80, 81
Caregiver compliance	30 (15–45)	50 (42–52)	74	61, 80, 81, EO
Environmental disinfection
Daily compliance	40 (35–50)	80 (70–85)	94	85–89, EO
Terminal compliance	47 (40–50)	77 (70–82)	98	85, 90–93
Nonsporicidal effectivenessb		45 (35–50)		94, 95
Sporicidal effectivenessb		99.6		95–98
Asymptomatic screening at admission
Compliance	0	96 (92–99)	98	99, 100
PCR test sensitivity; specificity, %		93 (90–94); 97 (95–99)		101–103
Patient transfer
Intraward transfer rate	8.0 (6.1–10.1)	50% reduction	75% reduction	Internal data
Interward transfer rate	22.9 (19.9–25.9)	50% reduction	75% reduction	Internal data
Proportionate time between transfers, %	28% (time between transfer/length of stay; 25–35)			Internal data

Note. ABHR, alcohol-based hand rub; PCR, polymerase chain reaction.

^aReferences in Supplement 1 (online).

^bEffective ness at removal of spores.

^cKnown C. difficile room compliance range based on the range in standard rooms and a standard: CDI hand hygiene noncompliance ratio, 1.34.

^dEffectiveness at preventing contamination with spores.