Fig. 6

Illustration of the complexity of the network including HCWs’ contacts and rooms’ visits. a An example of the different types of contacts involving a specific healthcare worker after a visit to a patient. The hand-hygiene compliance can affect both HCWs and patients, with four possible scenarios according to the use of HAS before and after the visit, as illustrated in the figure: the first line corresponds to HCW 113 using HAS before contact with a patient (green arrow from 113 towards the room) and also after the contact with the patient and before the contact with the other HCW (green arrow towards the other HCW); the second line corresponds to HCW 113 having a contact with the patient in the room without previous use of HAS (hence a risk of transmission to the patient red arrow) but using HAS after the contact with the patient and before contact with the other HCW. Lines 3 and 4 correspond to the scenarios of lines 1 and 2 respectively, but without use of HAS after the contact with the patient. b Network of all the contacts between a specific HCW (113), patients (indicated by their room number) and other HCWs during a specific day. A link between two nodes exists if the contact was observed at least once in the day; green and red links correspond to the use (or lack thereof) of HAS before the contact with the patient or between contact with patient and contact with HCW; the thickness of each link stands for the cumulative duration of the corresponding contacts. This figure integrates the information about at-risk and safe contacts of Fig. 5 a with the information about the use of HAS before the visit to the patient (i.e., the risk associated to the encounters HCW-patient). MED medical doctors; NUR nurses; NURA nurses’ aids; HKS housekeeping staff, HAS hydroalcoholic solution