Using RTLS in the Fight Against Infection: Wheelchairs

STOP THE ROLLING EPIDEMIC OF HAIs:  Using RTLS in the fight against infection

One of the biggest culprits in the spread of hospital-acquired infections (HAI) may be the wheelchair.

Wheelchairs “get sick” this way.  An infected patient needs to go to radiology, but the transporter assigned to take her is not told that she has an infection and superbugs hop onto the wheelchair for the ride.

But, since the transporter was not aware the patient was infected, he doesn’t perform the special “clean” required to rid the wheelchair of the germs.

Now the chair becomes a rolling epidemic, since it will be handed off to the next transporter for another patient trip, and another, and another and on and on.

How often does this happen? Hospitals don’t keep statistics about “inadvertent” exposures, but the anecdotal evidence is startling.

Because most infection control alerts are done manually and take a significant amount of time, transporters and EVS personnel often don’t get word that they are entering an isolated room. This exposure happens several times a week in some hospitals.  What is far worse is the fact that contagion, which once was concentrated in the ICU, has been moving into the general wards with an ever increasing presence.

Documenting and designating isolation rooms were the biggest challenges for Methodist Healthcare System of Antonio, TX when it came to preventing the spread of infection. Susan Kilgore, RN, vice president of patient management, says lack of communication led to the breakdown [see 3:36 minute video titled “Patient Care Infection Control“].

“Often in the hospital setting, we are good at communicating in a silo, and we often forget that other people need to know specific data about a patient,” she says.

So the eight-hospital system made infection control one of its top priorities.  Methodist integrated TeleTracking’s Capacity Management Suite™ with its ADT system to track every patient move, call up patient histories and monitor bed availability.  Alerts were automated to all personnel with a need to know, including housekeeping and transportation, who receive electronic notification when isolation is declared.

Methodist took infection control one step further by including a field for isolation in its bed request system.  Placement personnel must indicate an infection attribute in the system or indicate “none” in order for the placement request to go through. This assures that infection status is addressed by all admissions personnel throughout the hospital.

But, what about that wheelchair?

Methodist is implementing TeleTracking’s RTLS (real-time locating system) to track all moveable medical devices, including that rolling epidemic. Now they’ll be able to determine which wheelchair went where with whom and which transporter took them there.

Unfortunately, Methodist is one of the few hospitals to undertake such action. “You need buy-in from the top down,” Ms. Kilgore says. “We had reluctance when we decided to put a full-stop on patient placement before infection attributes were defined, but when we made the senior leaders and nursing directors aware of the impact, they supported our decision.”

A smart move when you consider that HAIs cost U.S. hospitals $45 billion per year, according to the Centers for Disease Control (CDC), and that the average HAI patient is in the hospital 20.6 days versus the national LOS average of 4.5 days. Stunning numbers in light of health care reform initiatives to lower LOS.

Still, some hospital administrators don’t get it. The most stunning statistic involving HAIs came from a recent survey by the Association for Professionals in Infection Control and Epidemiology (APIC). The association’s membership reported that only 30 percent of their hospitals’ top executives were willing to budget for preventive measures.

Why on earth would that be the case? Any ideas?