This week has been an exciting one as we have started implementing trackers in our first run of trials. With this study, we are exploring the capabilities of the AeroScout sensors and MobileView software. Specifically, we want to determine the resolution of the sensors, extent and specificity of the history and report features, potential roles for buttons on the trackers, and potential logic algorithms between trackers. This will illustrate the technology’s utility if installed in the NICU. It is our hope that this study will highlight areas where the technology can be improved and built upon to develop a useful and customized tool for the NICU. We are hoping to visually depict these improvements/customizations in a mock-up display system that could be used as a planning tool until it can fully sync with positioning sensors.
Monday, February 9th at 7:45 am, the sensors went live in the NICU. From that point, we began tracking the locations of 5 physicians for each shift, the charge nurse and assistant charge nurse for each shift, the ultrasound machine, a Storzscope which aids in intubating, and 5 isolettes. The outgoing charge nurse and assistant charge nurse have passed along their sensors during their meeting with the incoming charge nurse at 6:45 in the morning and evening. Each attending physician responsible for a team passes his or her sensor to the nurse practitioner responsible for that group of babies over night. The sensors are then returned to the attending physician the following morning before rounding begins. The sensors on the isolettes and equipment will remain on until the completion of the study.
At the beginning of the study, we encountered reluctance from one of the head physicians. He expressed concerns as to the legal implications inherent in tracking systems in a high-risk environment such as the NICU; namely, he was concerned about what data was being collected, where it was being stored, who had access to it, and if the study received IRB approval. He opted out of our trial, but his concerns have given us a lot to think about as far as security and privacy issues that come with tracking systems such as the one we are trying to implement. Fortunately, the head of neonatology has given us full approval to use the trackers in the NICU due to the more qualitative nature of our study and all other employees have complied, allowing for the tracking of four out of the five physician teams responsible for the NICU. Below is a screenshot of MobileView showing the sensors on the floor of the NICU.
Although we have only been tracking for a short time, we have already observed both promising and troublesome events. Firstly, all staff have been compliant and the tags have been consistently reporting at the preset frequencies. No dead zones have been observed and staff compliance has allowed for uninterrupted tracking. On the other hand, the trackers have periodically been displayed on the wrong floor due to a low spatial resolution. For example, a physician was reported to be a floor above the NICU for less than 30 seconds, an event which we confirmed not to have happened. The display system also shows the isolettes in their pods but does not have the resolution to show which room they are in. This could be solved by using ultrasound exciters, a technology that is currently beyond the financial capabilities of our project. Issues such as this will be addressed in a systems requirement document and model display system.
Throughout the sensor implementation process, we have continued shadowing to see how logic algorithms embedded in the sensors or button presses on the sensors can aid in operating efficiency. For example, button presses could potentially be used to identify when and how long a patient has been seen on rounds. Whatever the function, we are hoping this trial will elucidate the most helpful use of the button and logic tools.