Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Wong PM, Wong KP
Affiliation :
Nursing Service Division
Introduction :
The safety and security of neonates & infant in hospitals is one of the most common concern over the world. In Hong Kong Hospital Authority (HA), Sentinel Event - Infant Abduction shall be reported if patient, aged 12 months or below, is discharged to wrong family or infant abduction or taken away from hospital without prior notice. Preventive measures, e.g. 24 hours CCTV in common corridor for identifying the visitors, access and exit control of the visitor manually, and security tags with wristband holder for alerting the staffs when baby is near exit were commonly implemented in different HA hospitals.
Objectives :
Reviewing the limitation and concerns of existing preventive measures, Hong Kong Children’s Hospital (HKCH) implemented a newly innovated Baby Tagging System (BTS) to enhance the safety and security of patients in Neonatal Intensive Care Unit (NICU).
Methodology :
Real time security tagging system, location tracking, unique tag design for different size neonates & infants and allowing user customization were the four main characteristics of the BTS in HKCH. Active RFID technology was adopted with two-way communication between 72 installed readers and baby tags by detecting motion vector and response time for ensuring the tags location and tracking. Baby tags would submit the signal every 0.15 seconds to the readers actively and continuously for real time tags identification. Soft hospital-graded silicon c-ring was designed as reusable, rechargeable, water resistance and comfortable to our patients. The unique imprinted identifier and build-in sensor of the tag allowed tracking and detecting tampering action. Integrating with HA HL-7 system was to ensure simplified registration workflow and to show the correct patient with bed number on display panel. The alarm design and system algorithm, user interface layout of the display panel at nurse stations and the customized mobile app design of the handheld for facilitating clinical workflow. Launching the system in HKCH, a number of coordination, cooperation, discussion, modification & rectification required with multidisciplinary teams including P&MM, Administration, Supporting Security, Facility Management, Hospital Information Technology (IT) and HAHO IT, Electrical and Mechanical Services Department (EMSD), clinical users, parents & carers and suppliers. Throughout all the professional efforts with over 20 review and discussion meetings, at least 9 different types of drills and pilot tests were performed and passed, such as IT production drill, EMC interference test, system loading and stress test, water submerge test, technical and compliance test, multiple scenario tests, user pilot and acceptance tests.
Result & Outcome :
After a two-week education session in July, 2023, the system was fully operated on 25 July, 2023. BTS in HKCH was awarded a Bronze Medal in the Asia Exhibition of Innovations and Inventions Hong Kong on 8 December, 2023. To engage staff and for continuous quality improvement, an online staff satisfaction survey was performed from 22 Nov to 20 Dec, 2023. Target questions were focusing on Hardware operation (e.g. Display panels & Handheld devices), consumables quality (e.g. Baby Tags & Straps), effectiveness of training and supplier support, disinfection, accuracy, connectivity and stability of system. 54 samples were received, including 37 nurses, 13 patient care assistance, 2 clerical staffs and 2 doctors. Common concerns were the consumable quality - strap decolorization (50%), accuracy of real time location and tracking (40%) and sensitivity of hardware (29%). 66% of senior nurses, working in NICU for more than 5 years, reflected concerns on clinical workflow. According to the results, nursing focus group interviews on 7 March, 2024 and 13 March, 2024 was held. Small group training and workshop about workflow enhancement will be organized in 2Q, 2024. Alarm log from system server and the quality of hardware & consumables will be kept continuous monitoring.
