Hand Hygiene is Gamified with RTLS in Hospitals

Published: September 4, 2024
  • Kontakt.io is offering its hand hygiene solution with rewards offered for compliance so that healthcare workers treat handwashing similar to exercising with fitness trackers.
  • Several hospitals are testing the system with IR and Bluetooth Low Energy (BLE) to identify whether or not nurses or staff members wash hands when they enter a patient’s room.

While RTLS technology helps healthcare companies manage their assets, improve efficiency and protect workers under duress, one of the technology’s other features has gotten less traction: hand hygiene.

In fact, a variety of solutions has helped hospitals tracking when workers sanitize their hands, before and after meeting with patients, but they aren’t at the forefront of many company’s technology priorities.

Kontakt.io is offering to change that with a solution that it says can be easily deployed, especially if the infrastructure is already in place for more common applications. One key feature of the Hand Hygiene solution is that healthcare workers may actually enjoy using it, said Rom Eizenberg, Kontakt.io’s chief revenue officer. Since it began to be piloted in several hospitals, it has tracked hand washing events, alerted users before an infection could be transmitted, and workers have expressed positive reactions to it.

The solution leverages Bluetooth Low Energy (BLE), and IR sensors in patient rooms, identifies when a nurse doesn’t wash their hands, and lets them know, while also gamifying the experience— offering rewards when hand washing takes place regularly.

History of Lower Prioritization Among RTLS Features

Hand hygiene as an isolated use case has seen limited adoption over the years, Eizenberg noted. The people who care most about this application are typically a small infection disease prevention division that doesn’t generate revenue.

And for healthcare workers, those deploying such systems can be thought of as the enforcers related to hand washing behavior.  “But they have a very important role,” Eizenberg said. “They save lives.”

Technology that can encourage proper hand hygiene practices enables proper compliance for regulatory bodies like the non-profit healthcare standards group Joint Commission, and can lower insurance costs, not to mention avoiding the high financial and reputational cost of responding to a hospital-based infection.

“[Often,] there’s no ROI behind the infectious disease prevention technology— it’s just too expensive and too complex and the problem is not big enough,” said Eizenberg.

Such solutions can require very precise location data to work properly, he added, to identify each time someone enters and leaves a room, even when traveling fast—such as busy nurses often do. That means deploying a system with room-level accuracy—something that isn’t always required for other applications such as asset management.

Kontakt.io Offers a Solution

The solution Kontakt.io offers is designed to capture room-level location accuracy within seconds. It consists of a battery powered IR sensor installed on the ceiling of each room, and BLE sensors built into hand sanitizer stations in those same room. Healthcare workers wear a BLE-based badge with a unique ID typically linked to that individual’s identity.

When they enter a room where the IR sensor is transmitting, the badge receives that signal which prompts it to send a Bluetooth response. That transmission is received by the BLE radio in the hand washing station and the patient room gateway. The beacon in that station can determine how close the badge is to it, thereby calculating whether the worker came in close proximity, presumably to wash their hands.

If the badge is detected in a room and does not approach the handwashing station within a specific amount of time, the badge receives a prompt to gently vibrate. At the same time, the sanitization dispenser lights up.

The sound and vibration are both designed to be subtle, said Eizenberg, so that if someone enters a patient room and doesn’t wash their hands within 20 seconds, the vibration of the badge is what he calls “a gentle, digital tap on the shoulder.”

“We want to make sure that we remind you so you could do the right thing, but also do it in a nonobtrusive way,” he explained.

Gamification to Provide Incentive

Typically, healthcare providers need to wash or sanitize their hands hundreds of times a day, based on the many patient visits, and need to wash both before and after each visit.

One of the reasons many don’t meet those expectations is the time and hassle it takes from a busy job. “Washing your hands is not necessarily something we enjoy — we felt that the engagement between the goals of infectious disease prevention and the goals of the nurse have to be bridged and for that we wanted to gamify hand hygiene,” said Eizenberg.

The idea was to offer a system with competition and rewards, similar to the fitness trackers many use to incentivize exercise.

Competition at Work

With the app, individuals are identified only by an ID number. They can then view their results throughout the day to view their performance in real time, or at the end of a week, even to can compete against their peers. All ID numbers are anonymized. “We don’t expose names,” Eizenberg said.

The chief nurse within each department, hospital management, and infectious disease officials can view the results per departments or of all nurses, and display the results on leaderboards.

Each time someone meets the monthly goal for handwashing, the system generates a Starbucks coupon. They receive the coupon in the app and can redeem it at the café in their hospital or elsewhere. The team opted for a Starbucks coupon because many hospitals host the business in their facility.

By providing a reward for complying with hand hygiene rules, Eizenberg said, “the nurses feel that they have been seen and valued, in that hand hygiene is not something forced on them but something that they participate in— it creates an upside for them.”

Tracking the Hand Hygiene Dispensers

Another feature of the solution is tracking the conditions of the hygiene or soap dispenser itself. One often overlooked issue that could reduce hand washing behavior by nurses is the fact that the dispensers stop working or run out of fluid.

Kontakt.io included what it calls its fleet management feature to track the fill level and battery health of each smart dispenser.

Sensors on the dispenser can detect both low battery and low fill levels, and they then send that data back to the server via Bluetooth. Hospital staff can thereby proactively monitor the dispensers, identify challenges before they become a failure, and address it by changing the battery or refilling the dispenser.

Contact Tracing

The system enables hospitals to trace back where a worker has been in the case of them contracting an infectious disease as well.

The system doesn’t identify transmissions between two badges of people who may have been in contact, but rather, where that worker has been. They can then link the data to others detected at that site at the same time.

An example would be this: A user requests “show me all the patient rooms a specific nurse visited since 2 pm yesterday, and show me all the staff members that shared the same room with that nurse for at least 20 seconds.” The software would then produce a list of individuals who could have been at risk.

Aiming For Fast Deployment

Kontakt.io reports that it can install IR, patient room gateways and dispensers in patient rooms for a 220 bed hospital in about two weeks. If a hospital is already using the Kontakt.io solution for applications like asset management, the process is simpler and the necessary dispensers and any additional IR devices can be in place in a few days.

Piloting of the hand hygiene solution is now underway at several U.S. facilities and should be finished in Q4, company officials reported.

The technology firm has been measuring participation, how many logins to the app per nurse per day, as well as how much time nurses spent on the app and whether they used the coupons.

“All in all we’re seeing good adoption, so the nurses love it,” he said.

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About the Author: Claire Swedberg