By Christina Orlovsky Page, contributor
April 29, 2012 - If getting patients healthy is nurses’ first priority, keeping them safe comes in a close second. With risks like health care-associated infections (HAIs), patient falls and medication errors affecting patient safety, nurses must be frontline advocates for risk prevention. Thankfully, a number of high-tech safety checks are being put in place to ensure patient safety remains a priority for all health care professionals.
Giving hygiene a hand
According to the Centers for Disease Control and Prevention (CDC), roughly 1 in 20 hospitalized patients acquires a HAI--resulting in nearly 2 million infections in the United States each year. For health care workers, preventing many of these infections may be as simple as washing their hands. For that reason, the CDC and other health care organizations have implemented comprehensive campaigns educating health care practitioners on proper hand hygiene techniques. Still, when education isn’t enough, technology comes into play.
Biovigil LLC, an Ann Arbor, Michigan-based medical solutions company, created an integrated hand hygiene system to monitor hand hygiene compliance and prevent infection in a health care setting. Utilizing a room sensor, a base station and a badge worn by health care personnel, Biovigil detects and monitors hand-washing and automatically collects and communicates compliance data via automatic e-mail and mobile applications.
“With each room entry and exit, nurses are reminded to wash their hands,” says Brent Nibarger, Biovigil spokesperson. “Patients visually see a bright red or green status on the badge.”
This accountability and real-time monitoring has produced 95 percent-plus hand hygiene compliance in hospitals that have implemented the Biovigil system--as compared to 40 to 50 percent elsewhere.
Hand hygiene is just one part of the patient safety puzzle in hospitals that have gotten smart by using SmartRoom, a technology created at the UPMC medical system, in Pittsburgh, Penn. Centered around a 32-inch screen in the patient room, the technology detects, via ultrasound linked to caregiver badges, which caregiver enters the room--be it a nurse, nursing assistant, physician, or other member of the care team. It then displays information that is only pertinent to that provider. The caregiver views tasks that require completion and is able to document care in real time, reducing interruptions, increasing transparency between the patient and provider, and improving accuracy in the input of information.
Registered nurse Toni Morrison, who served as one of the clinical product design leads for SmartRoom, explained that one of the newest improvements to SmartRoom, which is now jointly funded by UPMC and IBM, is the implementation of hourly rounding.
“It’s a gold standard to check on patients every hour, but when using paper, it’s often a struggle to get hourly rounding implemented and audited,” Morrison says. “With SmartRoom, one of the hourly rounding tasks we’ve implemented is a Hospitality Round, which reminds frontline staff to ask patients if they’re satisfied with their environment and if they got a restful night. We’ve seen that by implementing the hourly rounding in the SmartRoom, it has led to decreased rates of patient falls and pressure ulcers.”
Additional patient safety implications of SmartRoom are INR alerts, hand hygiene trackers and infection control indicators for MRSA or C.diff., and improved documentation in the electronic medical record.
“The SmartRoom bases a lot of our actions on Lean methods, and a lot of those methods say that you don’t want to separate the information from the patient, away from the bedside,” Morrison adds. “At a bedside that doesn’t have SmartRoom, the nurse is doing charting and writing it down on a piece of paper, stepping out of the room and documenting it away from the patient. Statistics show they can get interrupted as much as 15 times an hour. By not stepping out of the room, you take the task you’re doing at the bedside and document it right there, in real time, where there’s no way you can look at any other patient’s information. It really decreases errors and directly affects patient care.”
Putting infection prevention on high alert
Finally, in order to prevent infection and protect patient safety, it’s critical that caregivers are alert to the presence of the infection in the first place. That’s where TheraDoc comes into play. A clinical surveillance software, TheraDoc collects relevant patient data from multiple hospital information sources including laboratory, pharmacy, radiology and surgery, and provides alerts to clinicians about trends, HAIs and other adverse patient events that require immediate action.
“TheraDoc helps clinicians identify changes in patients’ conditions and alerts health care providers to potential problems that need to be addressed,” says Tareta Adams, spokesperson for Hospira, the Lake Forest, Illinois-based creator of TheraDoc. “The technology helps streamline tasks and rapidly alerts nurses and other health care providers to HAIs and other adverse events, not only improving patient safety, but also helping nurses improve the quality of care at the bedside.”
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