RFID tags are being deployed at the University of Miami to report when doctors and nurses wash their hands, and let them know if their fingernails aren't clean. In contrast to previously-suggested systems involving chemical sniffers, the RFID-based technology being used in Miami just monitors when a doctor or nurse is near a bed …
If that's what it takes
I normally would rant about the invasion of personal space yadda yadda, but this seems to be sensible. Doctors and nurses have to comply -- THEY ae the cause of so much infection, and that's the bottom line. I'd be happy if tannoy, bells, whistles, flashing lights and big pointy hands from the sky all pointed to the dirty dog who thought he or she was somehow too special to do the basics to prevent spreading bugs.
Danger Will Robinson !!!
"assuming doctors don't mind the whole ward knowing of their lax attitude to hand hygiene".
Presumably it's based upon hoping that doctors do mind, and if embarrassing them in public is what it takes after all else has failed then that seems fair enough. However, it does seem fair to use a tiered warning system, a discrete beep to warn the doctor first so they can rectify their mistake or over-sight before it becomes a danger, or when a system failure hasn't logged use of the hygiene facilities.
Making false claims in a very public manner which brings a professional's reputation into disrepute opens the door to a defamation action for slander. I wonder how they deal with that aspect of things ?
It will be interesting to see the results of this after a while, see if this does actually make a difference to infection and fatality rates in the hospital, as compared with before they implemented the new process.
If that's what it takes - I agree
It looks as if everything else has been tried. Given all the training they get it is almost unbelievable to me that doctors and nurses don't wash their hands, but there it is and if this is the only solution, so be it.
This just goes to show that surveillance can be useful sometimes. Not that it makes the case for ID cards. In this case, the surveillance isn't security theatre. It is highly targeted: no mission creep, no unnecessary information, no information out of the control of the people targeted.
It is a good idea. Quite invasive but I think its good. But what I think would be better is that while the doctor is in range of the bed but not the dispenser the tag knows hes dealing with a patient. If he walks out of range the tag bleeps to tell him to wash his hands you dirty mofo.
Re If that's what it takes
I'm pretty much with Hollerith. I literally hate any spying/anti-privacy application but this one seems right. I'm too well informed about hygiene habits in hospitals so that I avoid them (hospitals not hygiene!) whenever somehow possible.
But, it doesn't stop with doctors and nurses for there is a cleaning service as well. When you think they cleaned the toilet after someone dropped his/her infested crap, think again. If it looks clean (i.e. no visible skid marks) they regard it as clean. Those cleaners usually do not really care whether they clean some public shit hole, a cheap hotel or a hospital. It's not that I want to pick on cleaners. It's just that you need to use some UV test kit to educate cleaning staff and fire those who are resistant to learning. This should also happen to the medical staff.
... my 2p
I generally agree with a system like this, but Jason Bloomberg's comment is valid. A tiered warning would be much better, maybe 3-tier (discrete buzz from pager, beep from pager, announcement over tanoy). This helps counter errors in the system, and simple lapses in concentration by over worked hospital staff.
Also, Evil Auditor makes a good point. Cleaners in hospitals are just like cleaners everywhere, when cleanliness in a hospital needs to be taken much more seriously. They should be better trained, better equipped, and better paid. This would both encourage and allow cleaners in hospitals to take pride in their work, and punishments for not doing so would have to be fairly harsh too.
But will this sort of thing happen over here, in our NHS? We all know the answer...
I like the tiered response idea, but after the discrete chime/loud beep sequence, could we just jump straight to a jolt of electricity? ...maybe from a wallet-sized device in the trouser pocket, or something similar for the non-trouser-wearing members of the medical profession?
After all, we wouldn't want to harm their reputations by having "Have you washed lately, Dr. xxxx?" booming over the PA system, would we?
abd the follow-up?
Yes, once the study iether proves this works or not....
So...the other only thing is an appropriate level of punishment for doctors or nurses who ignore warnings, don't wash, and infect their patients. Fines, loss of pay, removal from floor...? Suggestions?
She knows all about punishment.
Clarification about the Miami Hand Hygiene Project
All of your comments and questions are great. I am the marketing manager for the systems integrator who provided this solution to the UM-JMH Center for Patient Safety. I have answered a few of your questions and concerns below.
Jason Bloomberg: it does seem fair to use a tiered warning system, a discrete beep to warn the doctor first so they can rectify their mistake or over-sight before it becomes a danger, or when a system failure hasn't logged use of the hygiene facilities.
This is all being tested currently. The system is cabable of issuing an audible and/or visible alert through virtually any electronic system. Miami is testing the audible alert, vibration to the pager and flashing light options.
Jason Bloomberg: Making false claims in a very public manner which brings a professional's reputation into disrepute opens the door to a defamation action for slander. I wonder how they deal with that aspect of things ?
This has been considered. Rest assured that the Center required a 100 percent accuracy threshold. Stay tuned to my blog for the results. Also, this is being tested in one small area right now. It is not announced to an entire ward -- just within the room to gently remind the clinician to wash his/her hand BEFORE an adverse event occurs. As stated before, we are also testing other methods of alerting staff if they forget to wash their hands before approaching a patient.
zerofool2005: But what I think would be better is that while the doctor is in range of the bed but not the dispenser the tag knows hes dealing with a patient. If he walks out of range the tag bleeps to tell him to wash his hands you dirty mofo.
You will be happy to know that the system does in fact do this. Again, you are welcome to visit our site and see the short flash demo showing how the system works. The flash demo can be viewed at http://www.dynamicrfidsolutions.com/solutions/preventing_HAIs.php.
I would be happy to provide more information to interested parties upon request. You may email me at email@example.com with questions or if you are considering testing such a system in your health care facility.
Cut and paste www.DynamicRFIDSolutions.com/Blog
There are details and a flash demo showing how the system works on our site. I would encourage anyone interested to subscribe to the blog, as updates will be posted there first when the data are available from this study/pilot.
I am happy to provide more information to interested parties upon request. You may email me at firstname.lastname@example.org with questions or if you are considering testing such a system in your health care facility.
Thank you for discussing your thoughts on this. Feel free to comment on our blog as well.
Dynamic Computer Corporation
Farmington Hills, MI USA
It's a shame that the people most qualified to know about the deadly effects of bacteria and the importance of clean hands need such measures. But if they do, then go for it! Shame the filthy sods into caring about who they kill with their dirty hands!
Visitors are worse
From my experience of hospital and recently ICU, the worst offenders are visitors - visiting their ill loved ones, walking right past hand disinfectors and spreading their outside crap all over the intensive care units! All doctors and nurses were keeping themselves clean every time they passed the handwashers. These visitors could bring in infections enough to kill people who had just had say brain surgery. I shouted at one couple who walked past me without washing their hands, they washed their hands then but there isn't anyone employed to stand there and stop these idiots just wandering in.... And why should the NHS pay for someone to stand there to tell idiot visitors to clean their hands? Selfish bastards should be euthanised. The doctors and nurses seemed very aware of cleanliness and the risks of infection.
this idea has more merit and capability to be extended
RFID's could be incorporated into surgical instruments too, along with temperature sensors, perhaps. How many stories have you read where tired docs have left bits of surgical stuff inside folk (a lot here in the UK over the years, although recently I haven't seen any) and stitched them back up? This would save the NHS/insurers a lot money in avoided lawsuits. Prevention is better than cure/lawsuits.
@AC-09:22 GMT -Selfish bastards should be euthanised
If we can do it cleanly.
@ visitors are worse
It's this kind of stuff that should be blasted over the tannoy. A recorded message every few minutes and dispensers outside entrances. Maybe sensors could be put in the dispensers to activate the recorded message. That way no one gets in without cleaning their hands first. Obviously, this assumes that folk aren't allergic to the hand cleaning stuff.
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