Note: Descriptions are shown in the official language in which they were submitted.
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REAL-TIME METHOD AND SYSTEM FOR MONITORING HYGIENE COMPLIANCE
WITHIN A TRACKING ENVIRONMENT UTILIZING VARIOUS TIMERS
TECHNICAL FIELD
[0001] This invention relates to real-time methods and systems for
monitoring hygiene
compliance within a tracking environment such as a clinical environment. At
least one embodiment
of the invention relates to methods and systems for determining hand hygiene
status and providing
event notifications within a tracking environment and tags and dispenser
sensors for use therein.
Such methods and systems are provided to sense and locate tag-wearing persons
in front of a hand
hygiene cleaning agent dispenser and associate actuation of the dispenser with
the sensing event,
providing notifications if the subject is deemed "non-compliant" based on time
delays or interaction
with another subject without having completed appropriate actuation of the
dispenser within a
tracking environment.
BACKGROUND
[0002] U.S. Patent No. 5,202,666 discloses an automated device used to
remind employees
to wash their hands after toileting. Sensors are worn on credit card sized
badges and mounted in
bathroom ceilings and attached to soap dispensers and sinks. When an employee
enters the
bathroom, the ceiling unit sensor activates a blinking light on the badge. The
light is deactivated
once the employee pumps the soap dispenser and stands in front of the siffl(
for at least 15 seconds.
[0003] U.S. Patent No. 5,945,910 discloses a hand washing and monitoring
system that uses
a sensor that signals the dispensation of a cleaning agent from a dispenser. A
dual mode monitoring
and reporting module includes an input element, an output element, a processor
and memory. The
module accepts data identifying an employee, receives a signal indicating
dispensation of the
cleaning agent and stores compliance data records.
[0004] U.S. Patent No. 5,812,059 discloses a method and system for
enhancing hygiene. An
activating device is located outside a work area, a hand cleaning station is
located near the work
area, and a deactivating device is associated with the hand cleaning station.
Upon leaving a food
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handling area, an indicator worn by a worker is activated when the worker is
near the activating
device. The indicator is deactivated only when it is determined that the
worker has used the hand
cleaning station.
[0005] Acquisition of infection by hospital patients is a serious
healthcare problem. The
Center for Disease Control, the World Health Organization and other health
care organizations and
agencies encourage healthcare workers to practice proper hand hygiene to
reduce the transmission of
pathogens via hands. Recommended procedures include the decontamination of the
hands prior to
direct patient contact, prior to invasive non-surgical procedures, prior to
gloving, after contact with
body fluid, mucous membranes, non-intact skin and wound dressings, intact skin
and inanimate
objects near patients. These procedures apply in hospital settings, doctor's
offices, and anywhere
where these personnel come into contact with patients. In some instances,
application of an
antimicrobial preparation to the hands is substituted for a hand washing. In
any event, the goal is to
reduce the microbe load on the healthcare provider's hands and prevent
contamination of either the
patients or healthcare providers.
[0006] Systems have been developed for monitoring the actions of workers.
One such
system includes badges worn by workers that are capable of transmitting or
receiving information.
As discussed in U.S. Patent No. 6,236,317, workers are provided with badges
that detect entry into
an area that may be unsanitary and alert the workers to this fact. If a worker
subsequently washes
his hands or activates a disposable glove dispenser following such exposure,
the alerting function of
the badge is deactivated. If appropriate action is not taken by a worker, a
violation is recorded by
the badge or a system controller.
[0007] U.S. Patent No. 6,882,278 describes another system that monitors
compliance with
recommended hand washing practices. The system includes a hand washing
detector and an event
detector such as a motion detector that detects an event such as a person
entering or leaving a room.
A control unit determines whether a person has washed his hands within a
predetermined time
period before entering the room.
[0008] U.S. Patent No. 6,727,818 and 6,975,231 disclose other systems for
promoting
hygienic practices. The '818 patent discloses a system that tracks the
movements of healthcare
workers throughout the facility and within a patient's room. The healthcare
workers are provided
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with badges that transmit ID information to sensors located in the hallways
and rooms of the facility,
which in turn transmit location information to a master station. ID
information is also transmitted to
wash siffl( sensors to indicate whether the healthcare worker has washed his
hands. If the healthcare
worker enters a patient contact zone in the patient's room without having
complied with the required
hand washing procedure, an alert is provided by the healthcare worker's badge
and/or other alerting
devices located on the patient's bed or in the patient's room. A time delay
may be employed before a
warning alert is provided so that an alert is not triggered by a healthcare
worker who is only briefly
in the patient contact zone.
[0009] The '231 patent discloses a system employing sets of detectors
located just outside
and within a patient's room. These detectors are actuated sequentially as a
person enters the room
and the time between their actuation is monitored in determining whether a
person has entered the
room. A determination is made as to whether the person has washed his hands
within a
predetermined period of time, and a warning signal is generated if the hands
have not been washed
within the set period.
[0010] As described above, it is difficult to determine the compliance
rate of staff which
have had interactions within infectious patients. One prior art system records
these interactions so
that late discovery of infections can be investigated, cross-contamination can
be tracked and those
who come into contact with known contamination can easily be recalled. A
software package
includes several reports, including a compliance report, which can be used to
analyze the movement
of people or items, thereby enabling one to track the spread of contagions.
The compliance report
demonstrates compliance with hygiene rules by displaying both successful and
unsuccessful
compliance. For instance, successful compliance can be represented by a staff
member entering a
designated "clean" zone (wash room) after entering a contaminated zone
(patient room).
[0011] The following U.S. patent documents are related to the present
invention: 6,392,546;
7,242,307; 7,423,533; 2008/0001763; 2008/0107636; 2008/0218351; and
2009/0091458.
[0012] The following U.S. patents are also related to the present
invention: 4,868,859;
4,906,853; 5,017,794; 5,027,314; 5,027,383; 5,119,104; 5,131,019; 5,276,496;
5,355,222;
5,387,993; 5,548,637; 5,572,195; 6,104,295; 6,154,139; 6,462,656; 6,838,992;
7,286,057;
7,372,367; 7,375,640; 7,411,511; 7,443,305; 7,482,936; and 7,537,030.
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[0013] Referring now to Figures 1 and 2, there is illustrated a prior art
real-time tracking
apparatus for locating subjects (i.e., persons and objects) in a tracking
environment. In general, the
apparatus is a combined infrared and radio frequency locating system which is
adapted for use not
only in medical applications, but also in non-medical applications. The
apparatus is a fully
automatic data collection system which provides real-time location information
of personnel or
equipment (i.e., subjects). Typically, information is collected using an in-
ceiling and/or in-wall
receiver network connected with common telephone-type wire to make accurate
decisions and
execute the appropriate responses. Typically, the components of the apparatus
are relatively simple
and modular. The apparatus and its components are specifically described in
U.S. Patent Nos.
6,154,139 and 6,838,992 which are hereby incorporated by reference in their
entirety herein.
[0014] There are a number of drawbacks to current hand hygiene compliance
systems,
including: (1) lack of real-time location knowledge; (2) expensive specialized
dispenser equipment;
(3) deployment difficulty and expense to maintain; (4) specialized training
requirements; and (5) an
inability to leverage existing communication infrastructure.
SUMMARY
[0015] An object of the present disclosure is to provide an improved real-
time method and
system for monitoring hygiene compliance in a tracking environment such as a
clinical environment.
[0016] Another object of at least one embodiment of the present
disclosure is to provide a
method and system to determine hand hygiene status that does not require
expensive specialized
dispenser equipment; is simple and inexpensive to deploy and maintain;
requires no special training
for clinical staff; and that leverages common, pre-existing communication
infrastructure, when
possible.
[0017] Yet another object of at least one embodiment of the present
disclosure is to provide a
method and system to determine hand hygiene status in a clinical environment
and provide real-time
compliance or non-compliance notification as well as historical analysis of
recorded hygiene
procedures through use of real-time locating apparatus.
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[0018] In carrying out the above object and other objects of the present
disclosure, in one
embodiment a real-time method of monitoring hygiene compliance within a
tracking environment
provided by real-time tracking apparatus is provided. Auto-ID personnel tags
are associated with
personnel whose hygiene compliance is desired to track locations of the
personnel within the
environment. Each of the personnel tags is capable of transmitting a wireless
signal including ID
information unique to its associated personnel tag. Personnel location
information is generated
based on the locations of the personnel tags within the environment. The
method includes
associating an auto-ID dispenser tag with each cleaning agent dispenser
located within the tracking
environment. Each of the dispenser tags is capable of transmitting a wireless
signal including ID
information. The method further includes sensing a state change which
indicates activation of a
particular dispenser. The method still further includes scanning a region
about the activated
dispenser for a first period of time in response to the state change to
receive a wireless signal
including its associated ID information transmitted by a personnel tag
detected within the region.
The method further includes utilizing the dispenser tag associated with the
activated dispenser to
transmit at least one wireless signal including information which identifies
the detected personnel
tag. The method still further includes assigning a status of hygiene compliant
to the person
associated with the detected personnel tag based on the signal transmitted by
the dispenser tag.
[0019] The environment may be a clinical environment and the personnel
may be givers of
care to patients. An auto-ID patient tag is associated with each patient to
track locations of patients
within the environment. Patient location information based on the locations of
the patient tags
within the environment is generated. The method may further include recording
the caregiver and
patient location information and the status of the caregivers.
[0020] The method may further include assigning a status of hygiene non-
compliant to the
person associated with the detected personnel tag when either the detected
personnel tag enters a
hygiene non-compliant zone or a second period of time elapses following
activation of the dispenser.
[0021] According to another embodiment, a real-time computer implemented
method of
monitoring hygiene compliance of personnel within a tracking environment is
provided by a real-
time tracking apparatus. Auto-ID personnel tags are associated with personnel
in the tracking
environment. Each personnel tag is capable of transmitting a wireless signal
including ID
information unique to its associated personnel tag. The tracking environment
has a dispenser
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capable of dispensing a cleaning agent for hand washing. The method includes
assigning a status of
hygiene-compliant to a person associated with one of the personnel tags based
on a first transceiver
associated with the dispenser (i) sensing activation of the dispenser
indicating a handwashing event,
and (ii) receiving a first wireless signal that includes the ID information
transmitted by the personnel
tag. The method further includes starting a timer in response to the
activation of the dispenser. The
method further includes changing the status of hygiene-compliant to a status
of hygiene-
noncompliant based on (i) the timer timing out, and (ii) subsequently, a
second wireless signal being
received by a second transceiver associated with a passageway that
communicates a patient location
area with a common area, the second wireless signal including the ID
information transmitted by the
personnel tag indicating the personnel being in or around the passageway.
[0022] The status of the personnel may be changed from hygiene-compliant
to hygiene-
noncompliant based on the second transceiver associated with the passageway
receiving the second
wireless signal after the timer has timed out.
[0023] The dispenser and first transceiver may be located outside the
patient location area.
The method may further include associating a third transceiver with a second
dispenser located
inside the patient location area.
[0024] The method may further include starting a second timer in response
to activation of
the second dispenser.
[0025] The two timers may be calibratible such that they are capable of
timing out after
different lengths of time. Changing, setting, altering, or otherwise
calibrating the timer may be
accomplished via a user interface, for example.
[0026] The dispenser and the first transceiver may be located outside the
patient location
area. The method may further include assigning a status of hygiene-
noncompliant to the person
associated with the detected personnel tag based on the personnel entering the
patient location area
through the passageway subsequent to the timer timing out.
[0027] The dispenser and first transceiver may be located inside of the
patient location area.
The method may further include associating a third transceiver with a second
dispenser located
outside the patient location area.
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[0028] The method may further include starting a second timer in response
to activation of
the second dispenser.
[0029] The method may further include assigning a status of hygiene-
noncompliant to the
person associated with the detected personnel tag based on the personnel
exiting the patient location
area through the passageway subsequent to the timer timing out.
[0030] According to another embodiment, a real-time computer implemented
method of
monitoring hygiene compliance of personnel within a tracking environment
provided by a real-time
tracking apparatus is provided. The auto-ID personnel tags are associated with
personnel in the
tracking environment. Each personnel tag is capable of transmitting a wireless
signal including ID
information unique to its associated personnel tag. The tracking environment
has a dispenser
capable of dispensing a cleaning agent for hand washing. The method includes
starting a timer
based on a first wireless signal being received by a first transceiver
associated with a passageway
that communicates a patient location area with a common area. The first
wireless signal includes the
ID information transmitted by the personnel tag, indicating the personnel
being in or around the
passageway. The method further includes assigning a status of hygiene-
noncompliant based on the
timer timing out without or prior to a second transceiver associated with the
dispenser (i) sensing
activation of the dispenser and (ii) receiving a second wireless signal that
includes the ID
information transmitted by the personnel tag.
[0031] The (i) sensing activation of the dispenser and the (ii) receiving
a second wireless
signal by the second transceiver may indicates a handwashing event by the
personnel associated with
the personnel tag.
[0032] The dispenser may be inside the patient location area. The step of
starting may
include starting the timer based on the first wireless signal being received
by the first transceiver
when the personnel enters the patient location area. The step of assigning may
include assigning a
status of hygiene-noncompliant based on the timer timing out after the
personnel enters the patient
location area prior to any subsequent handwashing event by the personnel.
[0033] The dispenser may be outside the patient location area. The step
of starting may
include starting the timer based on the first wireless signal being received
by the first transceiver
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when the personnel exits the patient location area. The step of assigning may
include assigning a
status of hygiene-noncompliant based on the timer timing out after the
personnel exits the patient
location area prior to any subsequent handwashing event by the personnel.
[0034] The timer and any other timers may be individually calibratible
such that individual
personnel may program or set the timer to time out at different lengths of
time.
[0035] The method may also include assigning a status of hygiene-
compliant based on, prior
to the timer timing out, the second transceiver sensing activation of the
dispenser and receiving the
second wireless signal including the ID information transmitted by the
personnel tag.
[0036] The method may further include starting a second timer in response
to the activation
of the dispenser, wherein the second timer is calibratible such that it is
enabled to differ in time from
the first timer.
[0037] The second transceiver may be mounted to an existing dispenser.
Alternatively, the
second transceiver may be specifically incorporated into a handwashing unit to
be installed in whole.
[0038] According to another embodiment, changing the status of hygiene-
compliant to a
status of hygiene-noncompliant may be based on either (i) at least one of the
personnel
entering/exiting the patient location area subsequent to the first timer
timing out since the previous
handwashing event, or (ii) the second timer timing out since the personnel
entered/exited the patient
location area without activating the dispenser.
[0039] According to another embodiment, a method may include associating
a first timer
with a first transceiver in a dispenser that starts in response to activation
of the dispenser. The
method may further include associating a second timer with a second
transceiver that starts in
response to detection of personnel entering/exiting a patient location area.
The transceiver may be
placed within or near a passageway connecting the patient location area with a
common area. The
method may include assigning a status of hygiene-compliant to a person
associated with one of the
personnel tags based on the first transceiver (i) sensing activation of the
dispenser indicating a
handwashing event, and (ii) receiving a first wireless signal that includes
the ID information
transmitted by the personnel tag. The method may include changing the status
of hygiene-compliant
to a status of hygiene-noncompliant based either (i) the personnel
entering/exiting the patient
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location area subsequent to the first timer timing out since the previous
handwashing event, or (ii)
the second timer timing out since the personnel entered/exited the patient
location area without
activating the dispenser.
[0040] The methods may include performing an action based on the status
of the person.
[0041] The action may include an audio or video alert.
[0042] The alert may be a video alert comprising a text or graphical
alert.
[0043] The step of scanning may include the step of scanning a delimited
zone in front of the
dispenser to detect the personnel tag.
[0044] The hygiene may be hand hygiene and the cleaning agent may be a
hand cleaning
agent. The hand cleaning agent may be a hand sanitizer comprising alcohol, or
a liquid or foam soap
without alcohol. The timer that begins following activation of a first
dispenser may be greater than
or less than another timer that begins following activation of a second
dispenser, which may be
different than another timer that begins following detection of personnel in
or near a passageway
connecting the patient location area with the common area. The second
dispenser may have a
different hand cleaning agent associated therewith than the first dispenser
such that the second
period of time varies between dispensers having different hand cleaning agents
associated therewith.
[0045] The state change indicating a handwashing event may be a switch
state change.
[0046] The state change may indicate motion or vibration associated with
activation of the
dispenser.
[0047] The method may further include displaying, via a user interface, a
prompt enabling a
user to set individual timers associated with corresponding dispensers located
in various locations,
dispensers located inside of patient care rooms, dispensers located outside of
patient care rooms, and
dispensers having different hand cleaning agents associated therewith. Timers
can also be set for
sensors or transceivers on or around an entrance/exit of the patient care area
such that personnel ID
from the ID tags can be detected as entering/exiting a room. The prompt
enables a user to set a timer
that begins following activation of a dispenser located inside a patient care
room, a different timer
that begins following activation of a dispenser located outside the patient
care room, and a different
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timer that begins upon the personnel entering/exiting the patient location
area. A status of hygiene
non-compliant may be assigned at different times after the activations of the
respective dispensers or
entering/exiting the patient location area. The prompt may also enable a user
to set a period of time
for a dispenser with a first cleaning agent associated therewith and a
different period of time for a
dispenser with a second cleaning agent associated therewith.
[0048] Further in carrying out the above object and other objects of the
present invention, a
real-time system for monitoring hygiene compliance within a tracking
environment provided by a
real-time tracking apparatus is provided. Auto-ID personnel tags are
associated with personnel
whose hygiene compliance is desired to track locations of the personnel within
the environment.
Each of the personnel tags is capable of transmitting a wireless signal
including ID information tag.
Personnel location information is generated based on the locations of the
personnel tags within the
environment. The system includes an auto-ID dispenser tag associated with each
cleaning agent
dispenser located within the tracking environment. Each of the dispenser tags
being capable of
transmitting a wireless signal including ID information. The system further
includes a dispenser
sensor configured to sense state change which indicates activation of a
particular dispenser located
within the tracking environment. The system still further includes a receiver
associated with each of
the sensors and configured to scan a region about the activated dispenser for
a first period of time in
response to the state change and to receive a wireless signal including its
associated ID information
transmitted by a personnel tag detected within the region. A dispenser tag
associated with the
activated dispenser transmits at least one wireless signal including
information which identifies the
detected personnel tag. The system still further includes apparatus configured
to assign a status of
hygiene complaint to the person associated with the detected personnel tag
based on the signal
transmitted by the dispenser tag.
[0049] The environment may be a clinical environment and the personnel
may be givers of
care to patients. An auto-ID patient tag is associated with each patient in
the clinical environment to
track locations of patients within the environment. Patient location
information based on the
locations of the patient tags within the environment may be generated. The
caregiver and patient
location information and the status of the caregiver may be recorded in a data
repository.
[0050] The system may further include an apparatus for assigning a status
of hygiene non-
compliant to the person associated with the detected personnel tag when either
the detected
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personnel tag enters a hygiene non-compliant zone or a second period of time
elapses following
activation of the dispenser.
[0051] A timer may begin when the detected personnel tag enters/exits a
hygiene non-
compliant zone. The hygiene non-compliant zone may include at least one of a
patient room, a
localized area about the patient, a patient care area, a contamination zone, a
bathroom, a hallway and
the like.
[0052] The system may further include an apparatus for assigning a status
of hygiene non-
compliant to the person associated with the detected personnel tag when the
detected personnel tag
enters the hygiene non-compliant zone and remains there until a third period
of time elapses without
a subsequent handwashing event. The third period of time may begin when the
detected personnel
tag enters the non-compliant zone.
[0053] The system may further include an apparatus configured to perform
an action based
on the status of the person.
[0054] The receiver may scan a delimited zone in front of the dispenser
to detect the
personnel tag.
[0055] The action may include an audio or video alert.
[0056] The alert may be a video alert comprising a text or graphical
alert.
[0057] The state change may be a switch state change.
[0058] The state change may indicate motion or vibration associated with
activation of the
dispenser.
[0059] The hygiene may be hand hygiene and the cleaning agent may be a
hand cleaning
agent. The hand cleaning agent may be a hand sanitizer comprising alcohol, or
a liquid or foam soap
without alcohol.
[0060] Each of the dispenser tags may include a receiver so that each of
the dispenser tags
comprises a transceiver.
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[0061] The above object and other objects, features, and advantages of
the present invention
are readily apparent from the following detailed description of the best mode
for carrying out the
invention when taken in connection with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0062] FIGURE 1 is a schematic overview diagram illustrating a prior art
method and
apparatus for locating subjects within a clinical environment;
[0063] FIGURE 2 is a schematic block diagram specifically illustrating a
prior art auto-ID
tag useful with the method and apparatus of Figure 1;
[0064] FIGURE 3 is a diagram similar to the diagram of Figure 1 but
illustrating a method
and system of at least one embodiment of the present invention;
[0065] FIGURE 4 is a view, taken along lines A-A of Figure 3, of an
infrared receiver within
a typical field of view;
[0066] FIGURE 5 is a view, taken along lines B-B of Figure 3, of an
infrared receiver within
a reduced field of view;
[0067] FIGURE 6 is a diagram similar to the diagram of Figure 2 but
specifically illustrating
an auto-ID dispenser tag useful with at least one embodiment of a method and
system of the present
invention;
[0068] FIGURE 7 is a view of a typical report that can be generated by
using at least one
embodiment of the present invention;
[0069] FIGURE 8 is a view of a possible text alert that can be generated
and displayed using
at least one embodiment of the present invention;
[0070] FIGURE 9 is a view of a dashboard type graphical indicator that
can be generated and
displayed using at least one embodiment of the present invention;
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[0071] FIGURE 10 is a view of a user interface displaying a prompt
enabling a user to set
and control various timers associated with various dispensers using at least
one embodiment of the
present invention; and
[0072] FIGURES 11(a)-(d) are views of various handwashing activity
accomplished by the
caregiver and subject to the various timers amongst respective handwashing
dispensers.
DETAILED DESCRIPTION
[0073] Referring now to the drawing figures, there is illustrated a real-
time tracking system,
generally indicated at 10, which may also be used to capture hand hygiene
events as performed by
subjects identified as caregivers and to determine compliant or non-compliant
interactions of
caregivers with subjects identified as patients. Referring specifically to
Figures 3 and 6, the system
is comprised of tags 12 (worn by subjects or attached to objects) which emit
infrared (i.e., IR)
signals 14 which are captured by infrared receivers 20 common to the tracking
system and a
specialized transceiver 6 that upon activation of dispenser 5 reads an IR
signal 14 from a caregiver
badge, adds a data element which identifies the caregiver badge to its own
identifying data element
and transmits a qualified badge signal 15 which includes the two identifying
data elements via an IR
emitter 18 or RF transmitter 17. However, it is to be understood that the
transducer 6 could transmit
multiple signals to provide the necessary information.
[0074] Typically, the maximum effective line-of-sight range of such
infrared signals 14 is
about a twenty meter diameter 23 with the receiver of Figure 4. To achieve
higher granularity within
the system 10, the infrared receiver 20 may have its field of view reduced to
as little as a one meter
diameter 27 by introducing a restrictor 25 in the IR sensor 20 (i.e., Figure
5). The tags 12 may also
transmit radio frequency (i.e., RF) signals 53 which are received by an RF
receiver 26. The radio
frequency signal 53 emitted by the antennas 16 are received by an antenna 24
of a radio frequency
receiver 26 having a range of approximately forty meters 28 in all directions.
Typically, information
is collected using an in-ceiling and/or in-wall serial network 22 that
terminates at the
microprocessor-based collector 30.
[0075] The IR receiver 20 is stationary and its location is known. The
dispenser 5 may or
may not be stationary. Tags 12 are worn by mobile subjects and transmit unique
IDs 14 which allow
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the tracking system 10 to associate unique subject identifiers (such as
physician, nurse or patient) to
each individual tag 12. With this association, when IR signals 14 are received
by an IR receiver 20
or dispenser transceiver 6, the tracking system 10 identifies the tag(s) 12
(and hence the subject or
subjects) relative to the location of the IR receiver. The tracking system 10
aggregates the unique
IDs received from the tags 12 enabling the system 10 to identify when one or
more unique IDs are
present at a particular location (represented by an IR sensor 20). The
tracking system 10 also
calculates the amount of time that has passed since last receipt of each IR
signal 14 at an IR sensor
20 or specialized transceiver 6.
[0076] Since it is important that certain tag-wearing subjects identified
as givers of care (i.e.,
caregivers) to patients perform a hand cleansing event prior to interacting
with other tag-wearing
subjects identified as patients, the tracking system recognizes when a subject
with a caregiver tag 18
activates the dispenser 5 to deliver hand cleaning agent. To accomplish this,
an IR receiver 7 of the
transceiver or tag 6 scans the area directly in front of the dispenser 5 when
it is activated to detect an
IR transmission 14 from the tag 12. The microprocessor-based controller 19 of
the specialized
transceiver 6 adds a data element which identifies the caregiver tag to its
own identifying data
element and transmits a modified badge signal 15 including the two identifying
data elements via an
IR emitter 18 or RF transmitter 17.
[0077] The specialized transceiver or badge 6 of each dispenser begins
operating when it
senses a state change in its trigger circuit. The state change may be
indicated in a variety of ways as
indicated in Figure 6. The most straightforward activation method is to
install a micro switch 31 into
the dispenser 5 in such a way as to have the dispenser's activating paddle
depress the switch to signal
the state change when it is delivering cleaning agent. In another form, the
specialized transceiver 6
may be activated by either an internal or external motion switch 32 that
signals a state change upon
sensing dispenser motion during the dispense event. Finally, when attached to
an automated,
powered dispenser the specialized transceiver 6 may receive the state change
from the circuitry
installed to govern the dispenser's operation.
[0078] In another embodiment, the transceivers or receivers may be part
of a real-time
locating system (RTLS) in which the transceivers or receivers cooperate with
or include sensors that
automatically identify and track the location of the personnel tags 12. In an
RTLS system, the
activation of the dispenser or entering/exiting a patient location area may be
indicated due to the
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location of a particular personnel tag 12 being within a given proximity
(e.g., three feet) of the
transceiver or receiver. A compliance event can therefore be indicated by the
location of the
personnel in relation to the dispensers rather than a physical activation of
the dispenser itself.
[0079] In any embodiment, the badge/tag can be mounted inside, outside,
in or on the
dispenser in any fashion that would allow accurate detection of activation of
the dispenser. Upon
activation of the dispenser, the transceiver in the badge/tag communicates
with the collector via a
wireless or wired network to store information indicating a "handwashing
compliance" event.
[0080] The tracking system 10 logs the status of the compliance event 9
(Figure 7) associated
with the modified badge signal 15 representative of the caregiver tag 33 as
"compliant" and
continues to monitor the unique ID received from the tag 12 for conditions
that would relegate the
caregiver tag 33 subject's status 9 from "compliant" to the default "non-
compliant" state. Such
conditions include (1) the passage of time, whereby after a predetermined
interval, the status of the
tag 12 (or the subject wearing the tag) is set to non-compliant or (2) the tag
12 is next detected by an
IR receiver 20 in a zone wherein subjects are automatically designated "non-
compliant". Other
conditions exist, as will be discussed.
[0081] The status of "compliant" or "non-compliant" may remain with the
caregiver tag 33
until a condition causing a change in status is detected. For example, if a
caregiver enters a patient
room for only a brief moment, rather than merely delaying a warning indicating
the absence of a
hygiene-compliant status, the caregiver tag 33 will not change status to
hygiene non-compliant until
after a period of time elapses after entering the patient room.
[0082] With regard to caregiver and patient interactions, a caregiver
subject 33 having
completed a hand hygiene event will interact with the patient subject 34 as
one would expect. When
a caregiver subject 33 interacts with a patient subject 34 the IDs of
caregiver and patient tags 12, the
time, the location and the compliance status 9 is recorded in an appropriate
database.
[0083] Actions are taken in near real time to alert non-compliant
caregivers of their status
and reward status compliant caregivers. These actions typically consist of
audio and/or visual alerts
on a portable device carried by the caregiver, a nearby computer workstation
or other appliance
capable of status 9 notification.
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[0084] An example of possible alerts are shown in Figures 8 and 9. Figure
8 illustrates a text
alert that can be sent to devices such as an alphanumeric pager carried by the
caregiver or a
computer workstation in the immediate vicinity of the caregiver. Figure 9
illustrates a dashboard
type indicator that can be displayed at the central nurse's station for any
given care unit.
[0085] The database is subsequently mined for management reporting, a
representative
sample of which can be seen in Figure 7. This report is used to reward
conscientious caregivers or to
counsel / change the behavior of less conscientious caregivers. The data can
be used to compare
infection rates for various diseases to actual hand hygiene compliance rates
and aid root-cause
analysis/research.
[0086] Figure 10 illustrates a user interface according to one
embodiment. The user interface
may be displayed on a monitor or the like and visually and/or audibly
communicates information
regarding the system 10. The user interface displays a prompt allowing a user
to set and control the
timers associated with various tags on multiple dispensers or tags or
transceivers located in or near
the doors or passages that connect the patient location area with the common
area. The timers can
be individually set to any partial-second or partial-minute interval.
[0087] For example, the user is able to set the "Enter Timer" for
dispensers within a patient
care area, indicating a time value in which, after a handwashing event takes
place within the patient
care area, hygiene compliance remains with the caregiver. Upon the time value
being exceeded, the
tag associated with the caregiver is given a hygiene non-compliant status
until another handwashing
event occurs. The user is also able to set an "Exit Timer" for dispensers
located outside of the
patient care area. This time value may differ from the "Enter Timer" and
indicates a time value in
which, after a handwashing event takes place outside of the patient care area,
hygiene compliance
remains with the caregiver while outside of the patient care area.
[0088] A "Claim Timer" may be set that indicates the minimum amount of
time that a
caregiver must be either inside or outside of the patient care area to trigger
any change to hygiene
non-compliant. For example, the Claim Timer may be set to 7 seconds. If a
caregiver is hygiene-
compliant and enters a patient room for a time less than 7 seconds, the
caregiver may not be assigned
a status of non-compliant. However, if the caregiver remains in the patient
room for a time
exceeding the 7-second Claim Timer, (i) the caregiver may be assigned a status
of non-compliant, or
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(ii) another timer may begin in which, upon exceeding that timer without
accomplishing a
handwashing event, the caregiver is assigned a status of non-compliant.
[0089] The user may also set "Inside HW" and "Outside HW" timers. These
timers indicate
the amount of time that the user will, regardless of other events, remain
hygiene compliant after
activation of a dispenser either when entering (Inside HW) or exiting (Outside
HW) a patient care
room. These timers correspond with an estimated time it takes for a caregiver
to accomplish a full
handwashing event. For example, when using an alcohol-based gel hand
sanitizer, it may take a full
60 seconds to wipe hands entirely clean and dry, as opposed to 45 seconds when
using soap and
water. Following an activation of a dispenser and before the Inside/Outside HW
timer has been
exceeded, a caregiver can remain hygiene-compliant even while traveling from
room to room.
[0090] Another timer may be provided in which the timer indicates the
amount of time that
the caregiver is allowed to remain assigned hygiene-compliant upon entering a
patient care area,
assuming the caregiver was already assigned hygiene-compliant when entering
the patient care area.
Similarly, another timer indicates the amount of time that the caregiver is
allowed to remain assigned
hygiene-compliant upon exiting the patient care area, assuming the caregiver
was already assigned
hygiene-compliant when exiting the patient care area.
[0091] A "Special HW" timer may be set indicating the amount of time that
the caregiver is
allowed to remain assigned hygiene-compliant when exiting or entering a
patient care area if the
assignment of hygiene-compliant was last given at a handwashing event in a
"special location." The
special location may be, for example, a dispenser in the caregiver's office.
[0092] It should be understood that other timers can be individually
calibrated or set or
controlled such that the relationship between the activation of the dispensers
is individually timed
according to the caregiver facility's needs. For example, the user interface
may also allow a user to
set a timer for one type of dispenser (e.g., alcohol-based hand sanitizer) and
a different time for a
different type of dispenser (e.g., liquid soap dispenser). This may be useful
if one type of dispenser
(e.g., alcohol-based hand sanitizer) prolongs the cleanliness of a caregiver's
hands when compared
to another type of dispenser (e.g., liquid soap). Timers associated with a
transceiver at or near the
entrance/exit or the patient location area can also be similarly calibrated.
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[0093] It should also be understood that the user can set each of the
above-described timers
individually and separately. A micro-managed approach to each dispenser
throughout the facility is
thus provided. The timers may begin when communication is made to the
associated transceiver. A
time limit for the timer may be commanded in the microprocessor within the
badge/tag associated
with its respective dispenser or entrance/exit. Alternatively, the timer may
partially or entirely run
by the computer and database (shown in Figure 3) that is separate from the
individual transceivers.
[0094] Figures 11(a)-(b) illustrate two scenarios in which a caregiver
enters a patient location
area such as a patient care room 60. In Figure 11(a), the caregiver first
activates a dispenser 62
located outside of the patient care room. The transceiver in or around the
dispenser 62 senses the
activation of the dispenser 62 and scans to receive a wireless signal send
from the personnel badge
33 that includes corresponding ID information. Activation of the dispenser
also activates a first
timer (e.g., 45 seconds) in which the caregiver can enter the patient care
room 60 and remain flagged
as "hygiene-compliant" without having to activate another dispenser, such as
dispenser 64 located
within the patient care room. This timer may start for the caregiver when
activating any dispenser at
any location. For example, the caregiver may activate the dispenser 62 in the
hallway outside of the
patient care room 60. Upon activation of the dispenser 62, the first timer
begins and is calibrated to
time out or reach a time threshold after 45 seconds. Upon entering the patient
care room 60 at any
time before the timer times up, a transceiver 63 located on, above or near the
doorway of the patient
care room 60 detects the caregiver entering the patient care room 60 via
interaction with the
caregiver tag 33. The transceiver 63 may be located, for example, in the
ceiling above the doorway
into the patient room 60. The transceiver 63 should be disposed in a region in
which detection of
personnel entering or exiting a passageway between the patient location are 60
and a common area
outside of the patient location area. Once the caregiver has entered the
patient care room 60, the
caregiver will not be flagged as "noncompliant." Noncompliance will not be
flagged at least until a
secondary timer (indicating how long the caregiver is in the patient care room
without a subsequent
handwashing event) has elapsed. The secondary timer can be set to be a
different time limit than the
first timer. Alternatively, if the transceiver determines that the caregiver
enters the patient care room
60 after the timer times up, the transceiver sends a signal to the database
and the caregiver will be
flagged as "hygiene-noncompliant" upon the transceiver 63 detecting the
caregiver entering the
patient care room 60.
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[0095] Figure 11(b) illustrates a situation in which the caregiver enters
the patient care room
60, for example, after the time prescribed by the first timer (e.g., 45
seconds) has elapsed since the
last handwashing event. Alternatively, the embodiment of Figure 11(b) may be
regardless of initial
hygiene-compliant status prior to entering the patient location area 60. In
this scenario, upon the
transceiver 63 sensing entry into the patient care room, a second timer
starts. This timer can have a
different time limit (e.g., 15 seconds) than the first timer of the dispenser
62. The caregiver will be
flagged as "hygiene-compliant" if the caregiver activates a dispenser 64
within the limits of the
second timer after entering the patient care room 60. If the caregiver is in
the care room for a time
longer than the second timer without activating the dispenser 64, the
caregiver will be flagged as
"hygiene-noncompliant."
[0096] In a system in which the timers of both Figures 11(a) and 11(b)
are utilized, a
caregiver will be flagged as "hygiene-noncompliant" if the caregiver enters
the patient room 60 after
the first timer times up (e.g., 45 seconds since the last hand washing event),
and/or if the caregiver
does not activate the dispenser 64 within the patient room prior to the second
timer timing up (e.g.,
15 seconds after entering the patient room). This provides additional accuracy
to determine whether
a caregiver is indeed hygiene compliant when interacting with patients.
[0097] Figures 11(c)-(d) illustrate two scenarios in which the caregiver
exits the patient
location area or patient care room 60. In Figure 11(c), the caregiver first
activates a dispenser 64
before leaving the patient care room 60. Once the dispenser 64 is activated, a
first timer begins (e.g.,
45 seconds) during which the caregiver may leave the patient room 60 and
remain flagged as
"hygiene-compliant." After expiration of the first timer without leaving the
patient care room 60,
the caregiver may be flagged as "hygiene-noncompliant." The status of hygiene-
noncompliant may
be assigned either based on the expiration of the timer, or based on the
personnel exiting the patient
location area 60 as determined by receiving the wireless signal from the
personnel badge 33 via
transceiver 63.
[0098] Figure 11(d) illustrates a situation in which the caregiver exits
the patient care room
60 without first activating the dispenser 64 within the room. Alternatively,
the embodiment of
Figure 11(d) may be regardless of initial hygiene-compliant status prior to
exiting the patient
location area 60. Upon exiting the patient care room 60, a second timer starts
that can have a
different time limit (e.g., 15 seconds) than the first timer. Unless the
caregiver activates a dispenser
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62 (or another dispenser) outside of the patient care room 60 within the time
prescribed by the
second timer, the caregiver will be flagged as "hygiene-noncompliant."
[0099] In a system in which the timers of both Figures 11(c) and 11(d)
are utilized, a
caregiver will be flagged as "hygiene-noncompliant" if the caregiver exits the
patient room 60 after a
time exceeding the first time (e.g., 45 seconds since the last hand washing
event), and/or if the
caregiver does not activate a dispenser within a second time after exiting the
room (e.g., 15 seconds
after exiting the patient room). This provides additional accuracy to
determine whether a caregiver
is indeed hygiene compliant when interacting with patients.
[0100] Systems incorporating the timers as illustrated in Figures 11(a)-
(d) ensure proper
hygiene compliance not only when entering a patient care room, but also when
exiting the room.
This ensures a handwashing event has taken place both before and after
interaction with the patient
to inhibit the patient from being exposed to the external environment as well
as to inhibit the
environment of the patient from being passed through the caregiving facility.
[0101] As explained above, it should also be understood that there may be
a threshold timer
that must be exceeded without handwashing or entering/exiting the room prior
to the first and second
timers being activated. This threshold timer may be a relative small amount of
time (e.g., 5 seconds)
and accounts for situations in which caregivers are merely walking by a
patient room or merely
opening the door to assess the situation within the room. If the caregiver is
not by the patient care
room for a time exceeding this threshold amount of time, the remaining timers
are not activated and
the caregiver will retain his/her compliance status.
[0102] In summary, at least one embodiment of the present invention
provides a method for
determining hand hygiene compliance status within a tracking environment. The
method includes
providing a real-time locating tag, which emits infrared (IR) and radio
frequency (RF) signals that
are received by ceiling-mounted sensors, for each subject whose hand hygiene
status must be known.
The data associated with each tag includes the subject's ID and a default
hygiene compliance status
of "non-compliant". The provision of this tag in a tracking environment allows
the real-time
tracking system to associate unique tag data with a particular location. The
method further includes
adding a battery-powered IR receiver and IR or RF transmitting device (i.e.,
transceiver) to each
hand cleaning agent dispenser that, upon activation, scans the IR receiver
spectrum in front of the
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dispenser for a valid real-time locating caregiver tag for a short, preset
interval. If the IR receiver
device detects a value ID from a real-time locating tag, then the IR receiver
adds an identifying data
element to the ID detected and received from the locating tag and retransmits
the modified ID to the
tracking system through an IR or RF signal.
[0103] At least one embodiment of the present invention also provides a
system for real-time
compliance or non-compliance notification and recording of hygiene status at
the time of patient
care. The system includes the aforementioned real-time locating tag in a
tracking environment
which also provides for the continual monitoring of the data record associated
with each subject's
unique ID tag. All interaction events among subjects with tag IDs possessing a
hand hygiene status
of either "compliant" or "non-compliant" and subjects with tag IDs identifying
the subject as a
patient will be recorded within the tracking system. Appropriate,
predetermined actions will be
initiated based on the "compliant" or "non-compliant" status of the former
subject in relation to his
location, time and/or interaction with a tag-wearing subject identified as a
patient. The tracking
environment, or the area in which sensors are available to receive tag ID
data, can be programmed to
delineate certain areas as "non-patient care" or "patient care" areas.
[0104] Hand hygiene status of tag-wearing subjects will be "non-
compliant" as the default
state. The default state changes to "compliant" only when the tag ID is
detected by the receiver of
the transceiver attached to the cleaning agent dispenser. The hand hygiene
"compliant" status may
remain in effect until (1) sufficient time has passed according to a pre-set
timeout, and/or (2) the
subject enters a predetermined "non-patient care" area, and/or (3) the subject
enters a "hygiene non-
compliant" area and remains there for a period of time exceeding a threshold.
Tag-wearing subjects
in a "non-compliant" state attempting to provide care to another tag-wearing
subject (identified as a
patient in the tracking system) will receive an alert designed to allow the
tag-wearing subject
(caregiver) to perform corrective action, or a hand hygiene event, prior to
continuing interaction with
the patient. Further, a tag-wearing subject possessing a hand hygiene
"compliant" status in patient
care areas will receive an alert if the time interval between the hand hygiene
compliance event and
patient care event exceeds the predetermined value.
[0105] While embodiments of the invention have been illustrated and
described, it is not
intended that these embodiments illustrate and describe all possible forms of
the invention. Rather,
the words used in the specification are words of description rather than
limitation, and it is
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understood that various changes may be made without departing from the spirit
and scope of the
invention.
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