Meghan Piccinin is a third-year medical student at Michigan State University’s College of Osteopathic Medicine. Prior to moving to Michigan in 2015, Meghan completed her Bachelors of Medical Science with a double major in Medical Cell Biology & Pharmacology as well as a Masters of Science in Pathology at the University of Western Ontario. Throughout her studies, Meghan has been involved in biomedical research, with a particular interest in the integration of technology into healthcare settings. Outside of school, Meghan’s pastimes include skiing, mountain biking and aerial silks.
As a medical student, much of my career will be spent in hospitals. The primary intention of hospitals is to provide an environment for the medical and surgical management of sick patients. It seems intuitive that one should never leave a hospital in a worse state than they entered it in. While hospitals are typically considered institutions of healing, I have seen first-hand, many instances of hospital-acquired, or nosocomial, illnesses. From devastating pneumonias to delirium-inducing urinary tract infections to noxious Clostridium difficile colitis, nosocomial infections are unfortunately commonplace and often carry a grave prognosis. While the risk of developing significant disease for healthy employees remains comparatively low, hospitalized patients often have multiple comorbidities that decimate their body’s protective defenses, rendering them immunocompromised. The development of otherwise relatively minor infections in this population can result in significant avoidable morbidity and mortality. The
problem is an economic one as well, with healthcare-associated infections accounting for up to $45 billion in additional medical spending per annum.
In the case of nosocomial infections, hospitals are well-aware that an ounce of prevention is worth far more than a pound of cure. To combat this scourge on the healthcare system, hospitals have implemented a great number of workplace safety measures to limit disease transmission, with varying levels of success. Despite these interventions, nosocomial infections still run rampant throughout inpatient communities. These diseases are often transmitted between patients by healthcare workers inadvertently transporting pathogenic microorganisms throughout the hospital. The paramount importance of proper hand hygiene is well-known by healthcare workers, but compliance with handwashing recommendations often remains lacking in the hospital setting. Many campaigns have promoted handwashing with positive outcomes on patient safety and infection rates, but the habits, and thus the benefits, are often short-lived. One study has shown that awareness of being observed led to improved physician adherence to hand-washing standards. This raises the question – how can we cost-effectively monitor physician hand-washing habits?
One such monitoring method that has recently become economically and technologically feasible is the utilization of radiofrequency identification (RFID), similar to the chips used to track runners in a marathon. Passive RFID tags could be incorporated into the hospital badges of healthcare workers with RFID readers built into sinks, recording the interval RFID tags spend in proximity to the reader. This would allow for the quantity and duration of hand-washing episodes to be recorded on a per-person basis. This system can allow healthcare workers to compare their practices with that of their colleagues to encourage better hand-washing stewardship among the low performers. Detailed analytics could also be generated to identify individuals or departments that demonstrate exemplary hand hygiene for rewards and those with poor compliance for remediation. While the initial cost involved in establishing such a program remains relatively high, many studies have already supported the cost-effectiveness of RFID technology in other healthcare applications. Given the benefits of proper hand hygiene has both economically and on the individual patient-level, such an investment appears to be a viable avenue for enhancing patient safety in our healthcare system.