RTLS tags: Security friend or infection-prevention foe?

Infection-control guidance from the Society for Healthcare Epidemiology includes disinfecting or replacing items such as lanyards, identification tags, cellphones and pagers if they come into contact with patients.

By Dr. Ari Naim / Special to Healthcare Facilities Today
October 16, 2018

Preventing the spread of healthcare-associated infections (HAIs) is an ongoing challenge for hospitals and other healthcare facilities. According to the Centers for Disease Control (CDC), HAIs affect five to ten percent of hospitalized patients in the U.S. every year, resulting in 99,000 deaths and an estimated $20 billion in healthcare costs.

The most common causes of HAIs are associated with central lines, indwelling urinary catheters, surgical sites and ventilators. However, HAIs have also been traced to the transfer of microorganisms from non-clinical surfaces. That’s why infection-control guidance from the Society for Healthcare Epidemiology includes disinfecting or replacing items such as lanyards, identification tags, cellphones and pagers if they come into contact with patients.

Consider the potential problems associated with Real-Time Location System (RTLS) tags. While location services can help hospitals contain infectious outbreaks by tracking interactions between patients and assets or equipment with which patients come into contact, they can also be exposed to and harbor pathogens, making them a source of cross-contamination that can lead to infections. That’s why it’s important to choose the right RTLS tags for any application. Fully enclosed tags without seams or screw holes are typically the wisest choice for reducing the spread of infections.

RTLS technology explained

Real-Time Location Systems are used to automatically identify and locate assets, patients, and staff in real time. RTLS solutions consist of various tags and badges, location engines, receivers (Wi-Fi, Bluetooth, Ultra-High Frequency, etc.) readers and exciters (infrared, ultrasound, low frequency) as well as other components like servers, middleware and end-user software. The latest RTLS tags are lightweight and small, which make them easy to attach to equipment or people for convenient tracking of critical assets, personnel and patients.

RTLS in hospitals

Hospitals use RTLS in a variety of ways. They are most often utilized to enhance security by tracking the locations of patients, staff and equipment. They give those responsible for maintaining equipment increased visibility into equipment location, status and inventory levels. In some cases, the phone can be used as a tag. The RTLS can communicate with the phone and even be used for wayfinding by connecting to a downloadable app to help patients and visitors find campus services like cafeterias and clinics, pinpoint their parking location, or receive notifications of gift shop hours. Not only do RTLS tags improve operating efficiency, they also free staff to spend more time caring for patients. Patient tags are also useful in protecting patient safety by ensuring that at-risk patients cannot wander into restricted areas or preventing the possibility that an infant is abducted.

RTLS technologies play a role in controlling infectious outbreaks by providing real-time tracking of medical equipment and patients. Location technologies and applications can document the usage, cleaning and storage cycles of medical equipment, which helps hospitals make sure that all assets are cleaned and sanitized before returning to work. For example, RTLS can identify the time at which a specific endoscope or infusion pump was removed from storage, the route it traveled through the hospital, when it was delivered to a patient or treatment room, the time it left the treatment room, and when it was delivered back to the soiled utility room. That data can be used to send out alerts to at-risk parties, schedule immediate sanitization of soiled equipment, limit further spread of infection and avoid non-essential reprocessing or damage to equipment.

Tags also can be used to track a patient’s or caregiver’s movement and contacts within the facility. In the event of an infectious outbreak, it is important to be able to trace every person or entity that has potentially come in contact with the risk. RTLS tags collect data that can be used retroactively to track the spread of disease within the facility.

What to look for in an RTLS tag

When selecting RTLS tags for use in a hospital or other healthcare setting, it’s crucial to consider the potential for microbial transmission when the tag is transferred from person to person, or item to item. In some use cases, there may be no risk of microbial transmission. While in others, the risk may be higher.

Match the risk of microbial transmission to the tag type. Some tags are used once and then discarded, eliminating the potential for microbial transmission. This may be expensive, if the tag is not designed for single use. Other tags are re-used and therefore carry a higher risk for germ transmission, especially when they come into contact with patients’ bodily fluids and microorganisms.

Reusable patient tags need to be cleaned, sterilized and disinfected, and they need to stand up to harsh cleaning formulas and processes such as high-pressure washing without compromising the integrity of their batteries and other internal components. For these reasons, reusable patient and certain asset tags must be fully waterproof and capable of full immersion in cleaning solution. Smooth plastic tags with no seams, screw holes, or crevices are optimal. Although ultrasonic welding of traditional tag form factors may also acceptable for healthcare settings. Ideally, all patient tags should be constructed of clear plastic so that any fluid ingress in damaged tags can be easily detected and the tag taken out of service.

Gaining staff buy-in

The collective and ultimate goals of RTLS technologies are to improve patient care through reduced infections, increased safety and improved hospital efficiencies. To achieve that goal, it is critical to communicate with and educate staff about the importance of RTLS tags and how they work so that they become widely accepted throughout the organization and are selected, used and cleaned properly.

Dr. Ari Naim is CEO of CenTrak. He helped design, develop and launch more than 30 successful consumer electronic products for original equipment manufacturers (OEMs). 

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Topic Area: Infection Control

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