Int J Med Inform - A novel method for inferring RFID tag reader recordings into clinical events.

Tópicos

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Resumo

CKGROUND: Nosocomial infections (NIs) are among the important indicators used for evaluating patients' safety and hospital performance during accreditation of hospitals. NI rate is higher in Intensive Care Units (ICUs) than in the general wards because patients require intense care involving both invasive and non-invasive clinical procedures. The emergence of Superbugs is motivating health providers to enhance infection control measures. Contact behavior between health caregivers and patients is one of the main causes of cross infections. In this technology driven era remote monitoring of patients and caregivers in the hospital setting can be performed reliably, and thus is in demand. Proximity sensing using radio frequency identification (RFID) technology can be helpful in capturing and keeping track on all contact history between health caregivers and patients for example.OBJECTIVES: This study intended to extend the use of proximity sensing of radio frequency identification technology by proposing a model for inferring RFID tag reader recordings into clinical events. The aims of the study are twofold. The first aim is to set up a Contact History Inferential Model (CHIM) between health caregivers and patients. The second is to verify CHIM with real-time observation done at the ICU ward.METHOD: A pre-study was conducted followed by two study phases. During the pre-study proximity sensing of RFID was tested, and deployment of the RFID in the Clinical Skill Center in one of the medical centers in Taiwan was done. We simulated clinical events and developed CHIM using variables such as duration of time, frequency, and identity (tag) numbers assigned to caregivers. All clinical proximity events are classified into close-in events, contact events and invasive events. During the first phase three observers were recruited to do real time recordings of all clinical events in the Clinical Skill Center with the deployed automated RFID interaction recording system. The observations were used to verify the CHIM recordings. In second phase the first author conducted 40 h of participatory observation in the ICU, and observed values that were used as golden standard to validate CHIM.RESULTS: There were a total of 193 events to validate the CHIM in the second phase. The sensitivity, specificity, and accuracy of close-in events were 73.8%, 83.8%, and 81.6%; contact events were 81.4%, 78.8%, and 80.7%; and invasive events were 90.9%, 98.0%, and 97.5% respectively.CONCLUSION: The results of the study indicated that proximity sensing of the RFID detects proximity events effectively, and the CHIM can infer proximity events accurately. RFID technology can be used for recording complete clinical contact history between caregivers and patients thus assisting in tracing cause of NIs. Since this model could infer the ICU activities accurately, we are convinced that the CHIM can also be applied in other wards and can be used for additional purposes.

Resumo Limpo

ckground nosocomi infect nis among import indic use evalu patient safeti hospit perform accredit hospit ni rate higher intens care unit icus general ward patient requir intens care involv invas noninvas clinic procedur emerg superbug motiv health provid enhanc infect control measur contact behavior health caregiv patient one main caus cross infect technolog driven era remot monitor patient caregiv hospit set can perform reliabl thus demand proxim sens use radio frequenc identif rfid technolog can help captur keep track contact histori health caregiv patient exampleobject studi intend extend use proxim sens radio frequenc identif technolog propos model infer rfid tag reader record clinic event aim studi twofold first aim set contact histori inferenti model chim health caregiv patient second verifi chim realtim observ done icu wardmethod prestudi conduct follow two studi phase prestudi proxim sens rfid test deploy rfid clinic skill center one medic center taiwan done simul clinic event develop chim use variabl durat time frequenc ident tag number assign caregiv clinic proxim event classifi closein event contact event invas event first phase three observ recruit real time record clinic event clinic skill center deploy autom rfid interact record system observ use verifi chim record second phase first author conduct h participatori observ icu observ valu use golden standard valid chimresult total event valid chim second phase sensit specif accuraci closein event contact event invas event respectivelyconclus result studi indic proxim sens rfid detect proxim event effect chim can infer proxim event accur rfid technolog can use record complet clinic contact histori caregiv patient thus assist trace caus nis sinc model infer icu activ accur convinc chim can also appli ward can use addit purpos

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