Nursing Home San Giulio in Beregazzo

CHALLENGE

The Nursing Home San Giulio in Beregazzo is a geriatric rehabilitation clinic with 93 beds, accredited and authorized by the Lombardy Regional Authority, and it is part of the Laetitia group, which has 25 active facilities in North Italy.

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Reflecting the group’s general strategy, the management of the facility has approved a highly detailed project to ensure high standards of quality and comfort – and in particular to improve security and risk prevention for the patients.

The problems that the project aims to solve are:

  • the need to control the patients’ nocturnal movements, in order to prevent falls and possible fractures
  • the need to avoid free access to unauthorized places
  • the need to prevent any breakout by patients suffering from degenerative mental diseases
  • improving the efficiency of assistance to patients
  • improving the efficiency and reducing stress levels of health workers during night shiftsn
  • the adaptation to ministerial regulations and recommendations in force or in the process of ratification

SURE project: security and prevention of the risk to the patient

SOLUTION

Italtel has joined the SURE project (UWB Sensors for Risk Management), sponsored by the Lombardy Regional Authority.
The purpose of the project is to develop a sensors network for healthcare, based on UWB (Ultra Wide Band) technology, in order to identify and locate, in real time, patients, medical staff, visitors and medical devices (such as defibrillators, infusion pumps, stretchers) so as to obtain a secure care-process management.

Italtel's role comprises the following activities:
1
Defining functional and architectural specifications
2
System Integration
3
Support to project management activities
4
Dissemination
The implemented system enables a precise and unambiguous localization of patients, medical staff, visitors and electronic medical devices. Through the integration with the Hospital Information System, each patient is associated with the healthcare process he/she has been following. All patients are provided with a device (TAG) with which they are constantly monitored while being moved by the nursing staff.
Particular attention has been paid to the management of the TAG device (bracelet or necklace), taking into account the need to conceal it or adapt it to the patient’s personality. Patients themselves have contributed to the creation of a « portatag » in order to improve the object’s acceptance levels.

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In the event of a medical emergency, patients can – wherever they are – draw the attention of nursing/assistance staffs by pressing a button on the TAG.
The automatic generation of an alarm will signal the patient’s possible unconsciousness – due, for example, to a fall – or if the patient happens to be in unsuitable places or tries to break out from the facility, thereby enabling the medical/nursing staff to intervene promptly and take charge of the patient.
The system also allows for the monitoring of patients in order to prevent falls and fractures during night shifts within the facility.

BENEFITS

The project has brought the Nursing Home numerous economic advantages, as well as several efficiency- and process-related benefits, in particular:

  • Improving the effectiveness of patient care in terms of service quality and promptness:
    • reducing fracture rates resulting from autonomous nocturnal movements
    • detecting some escape attempts by patients with dementia
    • improving the efficiency of the nursing staff by 20%
  • process improvement, in terms of monitoring certain processes (Patient’s Care Scheme, Emergency Management and Prevention, Organizational Process Management)
  • reducing stress levels among night shift workers
  • streamlining and accelerating intervention procedures, reducing and preventing clinical risks, with a concomitant improvement of the patient experience.

Finally, both the patients’ relatives and the patients themselves have shown interest in the project, due to a « feeling » of greater safety, customization and humanization in the service, but also due to the patient’s centrality with respect to his/her clinical and health path.

TECHNICAL DETAILS

The project was implemented in the reception area and in one of the facility’s wings.

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Each patient in this particular wing was provided with an RFID TAG which allows their identification and location in real time.
Health workers were equipped with multimedia equipment that allows them to be constantly informed about the movements and possible emergencies occurred.
Healthcare professionals were given a 5-hour training, which has enabled them to use the system without difficulty.
At a technological level, the solution consists of three basic components:
1. active tags, in the form of a bracelet or badge, associated with patients, visitors or medical staff, which transmit UWB (Ultra Wide Band) pulses used to determine their respective position

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2. sensors or receivers, located in the hospital area and mounted on fixed structures, which receive, evaluate and process signals transmitted by the TAGs
3. a software platform to aggregate such positional data and to present, analyze and communicate information to users and management applications.
The data is made available through a management console with a user-friendly graphical interface.
The console is web-based so it can be accessed once users authenticate their credentials whether on fixed locations or via or tablet/smartphone.
The use of a wireless UWB infrastructure provides high localization precision (15-30 centimeters against 5-10 meters in the case of Wi-Fi).

CONCLUSION

The SURE system therefore provides real time automatic monitoring of risk patients, to prevent their exit from the facility, by triggering an automatic alarm (e.g. a text message sent to the operator’s device); it also provides access control and the monitoring of the patient’s nocturnal movements, signaling those that take place beyond a three-meter perimeter from the bed, in order to prevent any falls.

A crucial factor in the project’s success was Italtel’s ability to engage immediately with all relevant parties, involving not only administrative and clinical staffs but also IT and design teams, which resulted in an effective, global and constructive partnership. Process analysts, health professionals and the IT team have shown great availability.

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