Hygiene compliance system and method

A hygiene compliance system comprising personnel tags each having a respective status indicator that may be set to a first value indicating hygiene compliance or to a second value indicating hygiene non-compliance. Monitors for target zones, e.g. patients' beds, detect the presence of the personnel tags at the target zone. Monitors for hygiene stations, e.g. washbasins, detect the presence of the tags at the hygiene stations. When the hygiene station monitor detects that a hygiene station has been used, the respective tag is set to the first value. The target zone monitor checks the status of tags detected in its target zone and may issue a warning if the status indicates hygiene non-compliance. When the person leaves the target zone, the target zone monitor changes the respective tag's status to the second value.

This application is a 35 USC 371 national phase application of International application PCT/EP2010/007607 filed Dec.14, 2010, which claims priority to Irish national application S2009/0935 filed Dec. 14, 2009, the disclosures of which are incorporated herein by reference in their entireties.

FIELD OF THE INVENTION

The present invention relates to monitoring hygiene activity.

BACKGROUND TO THE INVENTION

Hygiene activity, for example hand washing, is typically monitored by means of visual observation and manual logging of the event. To a large extent, therefore, whether or not the required hygiene standards are met depends on the diligence of the individuals involved.

It would be desirable to provide a hygiene monitoring system that is less reliant on human diligence.

SUMMARY OF THE INVENTION

A first aspect of the invention provides a hygiene compliance system comprisingat least one personnel tag for carrying by a respective person, said at least one personnel tag being associated with a respective status indicator that is settable to a first value indicating hygiene compliance or to a second value indicating hygiene non-compliance,at least one target zone monitoring apparatus for monitoring a respective target zone, said at least one target zone monitoring apparatus including means for detecting the presence of said at least one personnel tag at the respective target zone,at least one hygiene station monitoring apparatus for monitoring a respective hygiene station,wherein, upon determining that the respective hygiene station has been used, said at least one hygiene station monitoring apparatus is configured to cause the respective status indicator of the relevant personnel tag to be set to said first value,and wherein, upon determining the presence of any one of said at least one personnel tag at said respective target zone, said target zone monitoring apparatus is configured to determine the value of the respective status indicator.

A second aspect of the invention provides a method of monitoring hygiene compliance in a system comprisingat least one personnel tag for carrying by a respective person, said at least one personnel tag being associated with a respective status indicator that is settable to a first value indicating hygiene compliance or to a second value indicating hygiene non-compliance,at least one target zone monitoring apparatus for monitoring a respective target zone, said at least one target zone monitoring apparatus including means for detecting the presence of said at least one personnel tag at the respective target zone,at least one hygiene station monitoring apparatus for monitoring a respective hygiene station,said method comprising, upon determining that a hygiene station has been used, causing the respective status indicator of the respective personnel tag to be set to said first value, andupon determining the presence of any one of said at least one personnel tag at said respective target zone, determining the value of the respective status indicator.

Preferred embodiments of the invention provide a system whereby the monitoring is performed by means of a combination of four core technologies and their adoption. Component parts of the system can be adapted through the change of software/firmware for different applications. For example a hand hygiene monitoring module may be adapted to monitor activity at antibacterial dispensers and water wash stations.

In the preferred embodiment, a hygiene station monitoring apparatus for use in the system is arranged to support an ID communications channel, and comprises means for detecting presence of a person, means for counting the duration that a person remains in the hygiene station, e.g. a wash zone, preferably to a one second resolution, preferably means for storing records in a memory, preferably a volatile memory, and preferably means for communicating and downloading monitoring data to a server and/or a personnel tag.

The preferred system provides for evaluating hygiene compliance in a facility and typically comprises a plurality of target zones (i.e. locations in which individuals are required to maintain hygiene standards, e.g. a patient's bed); a plurality of hygiene stations (e.g. sinks and/or dispensers of cleaning substances); personnel tags for personnel using the system; and detectors, e.g. readers, at the stations (preferably at both the target zones and the hygiene stations) capable of detecting the presence of said personnel tags. The system may also include control means for detecting whether a personnel tag accessed at a station. Preferably, each station has a unique station identifier and each personnel tag has a unique personnel identifier, making possible the tracking of specific worker interactions. Individual stations can also bear unique identifiers.

The personnel tags conveniently comprise a machine readable sensor such as an RFID tag. The hand hygiene status of a user bearing the personnel tag is preferably stored on the personnel tag itself but can also, or alternatively, be stored on a server, e.g. central processor, linked to multiple target zones and one or more hygiene stations. The central processor may generate reports of compliance rates and hygiene activity. Such reports might be averaged for the facility or specific to individual workers. They can include the number of interactions, the number of interactions where proper hygiene was practiced, the number of interactions where proper hygiene was not practiced and/or whether proper hygiene was practiced after an interaction, e.g. at a target zone.

Preferably, the target zones include an alarm device which can provide a warning if a personnel tag having a status other than required approaches the station. The warning can be audible and/or visual. Preferably, means are provided for defining a perimeter about the station within which the personnel tag is considered present at the station. for the preferred system is capable of personnel detection, and monitoring, collecting and storing the hygiene activity. The system typically comprises a personnel detector, a monitoring and data collecting module, and means for communicating data to the server or other system component.

In preferred embodiments, a respective individual identification device, preferably includes means for recording hygiene activity events. The device includes means for storing ID information and means for communicating with other components of the system, especially said person detection device.

Advantageously, said personnel tags include a status indicator to indicate a hygiene status, e.g. a hand hygiene status, of the person bearing the tag. The status indicator may provide an audible and/or visual indication of a change in status.

Preferred systems may support other functions such a temperature monitoring, laundry temperature and cycle counts for smart uniforms.

Advantageously, the system may be used to ensure that a person performs a hand hygiene event prior to patient contact.

A third aspect of the invention provides a hygiene compliance system comprising at least one tag incorporated into a respective washable item, especially an item of clothing, said at least one tag being associated with a respective status indicator that is settable to a first value indicating hygiene compliance or to a second value indicating hygiene non-compliance, said at least one tag further including a temperature sensor that, in response to detecting a temperature above a threshold temperature, is configured to cause said status indicator to be set to said first value.

Preferably, said at least one tag includes an alarm device, preferably an audio alarm device, said at least one tag including means for activating said audio alarm device in response to determining that the respective status indicator is set to said second value.

Optionally, said at least one tag comprises means for maintaining its respective status indicator. Alternatively, said respective status indicator is maintained by a central processor.

Preferably, said at least one tag comprises a counter with which said at least one tag is configured to count the number of times said respective status indicator is set to said first value.

Preferably, said system, e.g. via at least one tag, or via said central processor, is configured to set said respective status indicator to said second value after a period of time has elapsed after having been set to said first value. Optionally, said respective status indicator is set to said second value depending on the date and/or time. To these ends, each tag may include a timer and/or a clock, especially a clock that supports a calendar.

The embedded tags are particularly suitable for use with machine washable articles such as clothing, bed linen, and towels. By way of example, the temperature threshold may be approximately 70° C.

A fourth aspect of the invention provides a method of monitoring hygiene compliance for an item, especially of washable items such as clothing, said item comprising a tag associated with a respective status indicator that is settable to a first value indicating hygiene compliance or to a second value indicating hygiene non-compliance, said tag further including a temperature sensor, said method comprising setting, in response to said temperature sensor detecting a temperature above a threshold temperature, said status indicator to said first value.

Preferred features of the invention are recited in the dependent claims.

Further advantageous aspects of the invention will be apparent to those ordinarily skilled in the art upon review of the following description of a preferred embodiment and with reference to the accompanying drawings.

DETAILED DESCRIPTION OF THE DRAWINGS

FIGS. 1A to 1Ctogether show components of a preferred hygiene compliance system embodying the invention. By way of example the system ofFIGS. 1A to 1Cis described in use as a hand hygiene compliance system in, for example, a healthcare facility.FIG. 1Ashows a person03, such as a doctor, nurse or visitor, being one of typically a plurality of users of the system who are expected to maintain a standard of hygiene which, in this example, involves cleaning their hands, e.g. in a sink or using a dispenser of disinfectant or other cleaning product. Each user is provided with a personnel tag05, which preferably incorporates, or is otherwise associated with, a unique identifying number, but may not for privacy reasons. The tag05preferably includes some form of proximity locator and/or local communication means, e.g. a wireless transceiver. For instance, in a preferred embodiment of the invention, the tag05incorporates a Radio Frequency Identification (RFID) tag/device or other transponder. The preferred tag05includes a wireless communication device (not shown) enabling the tag05to communicate with other devices in the system, as is described in more detail hereinafter. The preferred tag05includes a locating device (not shown) that allows the tag05to be detected, and preferably identified, by other devices in the system. To these ends, the tag05conveniently includes the aforesaid RFID device, but may additionally include a wireless transceiver. The tag05may be worn like a badge or otherwise carried by the user, typically in, on or incorporated into their clothing.

The system is intended to promote hygiene standards compliance in at least one but typically a plurality of target zones which, in the present example, are patient contact locations such as a hospital bed09(FIG. 2). The, or each, target zone is provided with a monitoring apparatus10, which in the present example may be referred to as a patient location module10. The monitoring apparatus10comprises and/or is in communication with one or more sensors for detecting the approach of persons03and/or the approach of the tag05. Multiple sensors and/or sensors of different types could be provided for these purposes. For instance, a passive infrared radiation (IR) sensor13, or other proximity detector capable of detecting the approach of a person may be provided along with an RFID transceiver14for reading the RFID tag05in the personnel tag05. This would allow the RFID transceiver14to remain off until the bed09is approached, i.e. until the PIR detector13detects the approach of a person, saving energy and reducing electromagnetic noise in the environment. Alternatively, the proximity detector may be omitted and the monitoring apparatus10and tag05may communicate using respective RFID devices, e.g. the RFID transceiver at the monitor10may be configured to detect and communicate with the RFID transponder in the tag05, or the RFID transponder in the tag may be configured to detect and initiate communication with the RFID device in the monitor10. The respective RFID devices may be active or passive as required. It will be understood that alternative means for allowing the monitor to detect the tag05and/or person, and to communicate with the tag05may be provided using any suitable conventional technology(ies).

In preferred embodiments, the monitoring apparatus10, by means of one or more sensor, is configured to define a detection perimeter30around the target zone, e.g. patient station, with which it is associated. In a simple form the perimeter is defined by the location of the RFID transceiver14on the station, the RFID transceiver having a range equivalent to the desired perimeter. The perimeter is preferably about one or two feet from the patient station. If it is too far it might falsely register a contact and if it is too small it might fail to register a contact. Other means for defining a perimeter such as one or more light beam detectors, e.g. PIR detector(s) or through-beam detector(s) may be provided instead or in addition. Such devices may be configured to create light beam(s) defining said perimeter which, if broken by a person approaching a patient station, allow the monitor10to detect the presence of the person. Sensors used by the monitoring apparatus10may be located separately from a controller of the monitoring apparatus (indicated as10), as appropriate, and configured to communicate with the controller.

Other machine readable tagging systems may alternatively, or in addition, be employed. RFID tags are particularly suitable for use with systems embodying the invention as they are inexpensive, can be read at a distance and some types can have data written to them and updated.

The patient contact locations, or target zones, are not limited to beds, and might for example include procedure tables, examination tables, dental chairs, gurneys and/or any location at which a health care worker is likely to come into contact with a patient, or other location where a person is expected to maintain a hygiene standard.

Referring now toFIG. 1B, the system further includes one or more hygiene station monitoring apparatus provided at respective hygiene stations, for example a hand hygiene station (such as an antimicrobial hand rub dispenser80(or dispenser of other cleansing substance) and/or hand wash station21such a sink with running water and a supply of soap or detergent for hand washing). The hygiene station monitoring apparatus01comprises detection apparatus for detecting the approach of a person03and/or a tag05, and wireless communication apparatus for communicating with the tag05of a person at the hygiene station. Conveniently, the detection and communication can be performed by an RFID transceiver24at the hygiene station apparatus01for interacting with the RFID device in the tag05. Alternatively, or in addition. the hygiene station apparatus01may be provided with one or more other sensor, e.g. a PIR detector or other proximity sensor, for detecting the presence of a person at the hygiene station, and other means (e.g. the RFID transceiver24) for communication between the hygiene station apparatus01and the tag05once a person has been detected.

Preferably, the RFID transceivers14,24, or other suitable component of the monitors01,10, are all in communication with a central data processing station26. Communication could be achieved via a hard-wired connection and/or some other form such as wireless, e.g. radio frequency (RF), communication. In an institution having, for example, a 802.11b or 802.11g or similar type of Wi-Fi based networking or communication system, the RFID transceivers14,24could communicate with the central processing station26through such network. A dedicated communication system could alternatively be provided for this purpose. Passive IR personnel detectors13can be provided at the hand hygiene stations01i. Hand hygiene stations01, especially hand rub dispensers30can be mobile and may use magnetic based passive materials.

In its basic operation, the hand hygiene compliance system employs the RFID transceivers14,24along with the personnel tags05to help ensure that a person who approaches a patient location has either washed their hands or applied an antimicrobial hand rub to reduce the chance of infecting a patient. This can be implemented in many different fashions. For example, in preferred embodiments, the system supports, in respect of each tag05, a status indicator that may be set to one of a plurality of states, e.g. “clean” or “potentially contaminated”, which indicates a hygiene status assigned to the respective tag05by the system. The status indicator, which conveniently takes the form of a data flag, may be maintained by the central processor26and/or by the respective tag05. In one implementation, the hygiene station monitor01detects a person's presence at a hand hygiene station01and then signals either to the respective tag05or to the central processor26, or to both, that the person's status should be set to “clean”. Then when that person subsequently approaches a hospital bed09the respective target zone monitor10(or more specifically the RFID transceiver14associated therewith) reads the RFID device of the tag05. If the hygiene status is directly encoded within or otherwise stored by the tag05(in particular its RFID device), the monitor10(or more specifically its RFID transceiver14) can directly obtain the hygiene status assigned to the tag05(and therefore to the person carrying the tag05) by communicating with the tag05. Alternatively, where the central processor26maintains the status indicator, the monitor10may communicate with the central processor26to determine the relevant status of the tag05. To this end, a unique ID may be associated with the tag05.

Preferably, the monitor10incorporates, or is otherwise co-operable with, a visual display49, and/or an audio output device50. The display49could be as simple as one or more colour-coded lights, preferably labelled, or more complex such an LCD panel. The monitor10is advantageously configured to operate the display49and/or audio device50when it detects the presence of a person in its target zone, and in a manner that depends on the status assigned to the tag05carried by that person. For example, when a “clean” person approaches the patient bed09, the display49may indicate the person's status by a green light or display of the status “clean” to show that the person had attended to hand hygiene prior to visiting that hospital bed09. If the status is not “clean” but i, say, “potentially contaminated”, then the monitor10generates a warning, e.g. an audio and/or visual warning via the display49and/or audio device50. Preferably, the warning may include a warning light and/or a warning message on the display49and an audio alert such as a buzzer or more preferably voice instructions to attend to hand hygiene.

In the preferred embodiment, after a person, who has been detected by the system at a target zone, e.g. bed09, leaves the target zone, the system is configured to set the respective status to a different value, for example “potentially contaminated”. This may be achieved by any suitable method. For example, the monitor10may be configured to, upon determining that the respective tag05is no longer detected at the target zone or has not been detected at the target zone for more than a threshold period, signal accordingly to the central processor26that the respective status should be changed (in cases where the status is maintained by the central processor26), or signal accordingly to the tag05that the respective status should be changed (in cases where the status is maintained by the tag05). Alternatively, in cases where the status is maintained by the tag05, the tag05may be configured to determine when it has left the target zone and to change its status accordingly. This may be achieved by, for example, the tag05determining that it is no longer in contact with the monitor10, or has not been in contact with the monitor10for longer than a threshold period.

In the present example, after leaving the patient bed09, the RFID device of the tag05has the status “potentially contaminated”. The status “potentially contaminated” may also be adopted before the tag05makes valid contact with any hand hygiene monitor01, i.e. the “potentially contaminated” state may be an initial, or default, state adopted by the system for tags05that have not been detected by a hygiene station monitor01. The status is changed to “clean” upon determination by a hand hygiene monitor01that the tag05has made valid contact with the hygiene station monitor01. The “clean” status may be effective for a specified period of time assuming there is no further contact with patient locations, after which the system may be configured to return the status to the default state, e.g. “potentially contaminated”. In more elaborate implementations, sensors such as RFID transceivers may be placed in other locations within a facility which could be possible sources of contamination and contact therewith would change a status from “clean” to “potentially contaminated”.

Optionally, the system may be configured to allow a personnel tag05to move away from a patient bed09, or other target zone, and return to that same bed09without having the status changed, e.g. from “clean” to “potentially contaminated.” This allows, for instance, the person03to move about a patient's room without having their status change, or at least the status as respect of that particular patient bed09. This may be achieved by, for example, not causing a “clean” status of the relevant tag05to change to “potentially” “contaminated” until after a period of time has expired since the monitor10has detected that the tag05has left the zone around the bed09, which period may be reset if the monitor detects that the same tag re-approaches the bed09within said period. Preferably, the “clean” status is time limited so that even if the person03re-approaches the bed09after that time limit has expired, the status registers as “potentially contaminated.” To these ends, the target monitor10, and/or the central processor26, may be provided with a timer.

Optionally, compliance rates for personnel can be tracked. The tracking can be performed on the tag05itself and/or at the central processor26. Reports can be generated and used to help personnel improve their compliance. Such reports might include the number of times such personnel approached a patient location with a status other than “clean” within a given time period. could the system may also track which patients were approached and compare tracking data against patient records to track transmission of infections within the institution. Penalties or bonus can be awarded personnel based upon compliance.

If a person03approaches a patient bed09in a condition other than “clean”, the system preferably checks whether such person then proceeds to a hand hygiene station or continues with patient contact. This check may be performed by the target monitor10by determining the period of time for which a non-clean tag05remains in the target zone, or by the tag05itself by determining the period of time for which it remains in the target zone (either or which can for example be achieved by determining the period of time for which the tag05and monitor10(or more particularly their respective RFID devices) are in contact with one another). To this end, the target monitor10, and/or the central processor26, may be provided with a timer and/or a clock. An exception in this area may be flagged with a higher priority by the system. The check may also, or alternatively, be made by comparing time at which the tag05is present at the bed09with the time of the tag's next appearance at a hand hygiene station, and possibly whether such personnel then return to the same bed09. For instance, spending more than five or ten seconds, or other threshold period, at the bed09in a state other than “clean” might constitute a violation.

Compliance at a hand hygiene station can either be assumed by presence (i.e. a valid detection of a tag05by a monitor01is taken to indicate that the person03has performed the relevant hygiene activity), or assumed by presence of the tag05for a given amount of time, and/or verified by one or more sensors at the hand hygiene station, or included in the monitor01, e.g. a sensor that detects when soap is dispensed at a hand wash station, and/or a sensor that detects when an antimicrobial hand gel, or other substance, has been dispensed at a hand rub dispenser80. Such sensors are particularly advantageous when the hand hygiene station comprises a portable dispenser80worn on the body of the user. In such cases, the respective hygiene station monitor does not need to detect the presence of the tag05since the tag05is also carried by the person. Accordingly, the hygiene station monitor may be configured to set the status of the tag's status indicator to “clean” upon determining, e.g. by means of an appropriate sensor provided on the mobile dispenser, that the dispenser has been operated. Advantageously, the hygiene station monitor still includes means for detecting the presence of the tag05so that, in an initial operation, it can detect the tag05and thereafter update the tag's status indicator depending on operation of the dispenser rather than by detection of the tag until it detects that the tag05is removed from its vicinity, e.g. when the user takes the dispenser off. Alternatively, the hygiene station monitor may broadcast a signal for updating status indicators when it determines that the dispenser has been operated, which signal may be received by any tag05that is close enough to the hygiene station monitor.

Hand hygiene procedures typically require a certain length of scrubbing at hand wash stations21and the time of water running after dispensing of the soap might also be measured for the purpose of determining compliance. A proximity sensor, especially one already used to turn on water flow, might also be polled to see if hands are in the stream of the water. Many faucets already incorporate such sensors.

Optionally, the personnel tags05may include audio and/or visual displays. For instance, the tag05might bear one or more lamps, e.g. a lamp such as an LED that is operable in more than one colour, or separate lamps91,92(FIG. 2) for each status, and optionally a beeper93, or other audio device, which emits a tone upon a change in status, or when a status other than clean is registered. Preferably, the tags05are provided with powered, or active, RFID devices which have improved communication ranges over passive RFID tags, and a common power source could power all of the features of such tags05.

In alternative embodiments, the hygiene compliance system may employ multiple detectors/monitors10throughout a facility, e.g. a building, which are configured to read and locate personnel tags05and specific events. In such a system, a person's exact location within a facility may be tracked and sensors may be activated to record specific events, such as opening a fridge, removing food and/or opening a drugs cabinet.

Optionally, the tag05can be embedded in a uniform, or other clothing. Temperature and wash cycles could similarly be monitored, incorporated e.g. by means of a temperature sensor located in, for example, clothing or textiles.

In preferred systems a tag05′ is incorporated into a respective washable item, especially an item of clothing, the tag being associated with a respective status indicator that is settable to a first value indicating hygiene compliance, e.g. denoting that the item is washed, or to a second value indicating hygiene non-compliance, e.g. denoting that the item needs washed. The tag further includes a temperature sensor that, in response to detecting a temperature above a threshold temperature, e.g. during a wash cycle in a washing machine, is configured to cause its status indicator to be set to the first value. The tag05′ may be similar to the tag05described above and so similar descriptions apply as would be apparent to the skilled person. For example, the tag05′ may comprise an RFID device, especially an RFID transponder, for communicating with, and preferably also for detection by, other components of the system, e.g. the monitors01,10. Alternatively, the tag05′ may comprise any other suitable means, e.g. wireless transceiver, to allow it to communicate with a preferably to be detected by, other components of the system.

Preferably, the tag ′05includes an alarm device, preferably an audio alarm device, the tag including means for activating the audio alarm device in response to determining that the respective status indicator is set to the second value. Optionally, the tag ′05maintains its own respective status indicator, e.g. in a local memory device or register. Alternatively, the respective status indicator is maintained by a central processor, conveniently processor26.

The tag05′ may comprise a counter with which can count the number of times it is washed, i.e. by counting the number of times its status indicator is set to the first value.

Preferably, the status indicator is set to the second value after a period of time has elapsed after having been set to the first value. Optionally, said respective status indicator is set to said second value depending on the date and/or time. To these ends, each tag may include a timer and/or a clock, especially a clock that supports a calendar.

The embedded tags are particularly suitable for use with machine washable articles such as clothing, bed linen, and towels. By way of example, the temperature threshold may be approximately 70° C.

In preferred embodiments, the tags05′ communicate with other systems components, conveniently the monitors01,10, to transfer data concerning the laundry history of the respective item in which it is embedded, e.g. the value of the respective status indicator, the value of the counter and/or one or more date(s) and/or time(s) at which the item has been washed. This allows the data to be sent to a central processor for evaluation and/or recordal.

It will be understood that, while the tag ′05is particularly suited for use with the system ofFIGS. 1A to 1C, it may alternatively be used in other systems, with or without the tag05.

The invention is not limited to the embodiments described herein, which may be modified or varied without departing from the scope of the invention.