Tuesday, August 1, 2017

Mobile-Device Management, Part 3

Investing in an asset is accompanied by the need to protect the asset. Mobile phones and tablets are small and may be misplaced or stolen. An employee may drop it in his/her pocket and forget to turn it in at the end of the shift and take it home.  

Theft is an issue in medical facilities, as in the instance of the Texas Veterans Affairs Hospitals, which discovered last year that $6.2 million in taxpayer-purchased items were lost or stolen. Items ranged from cell phones to a John Deere tractor. Santa Clara Valley Medical Center, San Jose, CA, partially supported by tax dollars, reported 383 items, valued at nearly $12 million, missing between 2010 to 2014. United Memorial Medical Center in Batavia, NY, reported more than $50,000 of stolen equipment, which later turned up for sale on eBay. Much of such theft is due to insider wrong-doing.

Searching for lost or misplaced items is costly, too. A survey by Nursing Times found that more than one third of nurses spend at least an hour searching for equipment during an average hospital shift, and another hour is spent helping other departments to find items, translating to approximately 40 hours per month spent by nurses wasting expensive time looking for lost equipment.

Lost or stolen devices can result in a breach of protected health information. An online article from Bitglass, “Device Theft Dominates Healthcare Data Breaches,” refers to their 2014 Healthcare Breach Report, which analyzed healthcare data breaches from the previous 3 years. The report noted that 68 percent of breaches since 2010 occurred because devices were lost or stolen. In contrast, only 23 percent of breaches were due to hacking. The report found that more than 76% of all records breached were the result of loss or theft. Also of note, the report stated that healthcare data is 50 times more valuable than credit-card information on the black market.

The Bitglass article said that almost one-half of all data breaches reported in the U.S. are healthcare-related. Nat Kausik, CEO of Bitglass, was quoted as saying, “While major hacking events more commonly make headlines, our research shows that unprotected data on lost or stolen devices represents the majority of breach activity in healthcare. . . . This reaffirms the need for healthcare organizations to reevaluate their security and compliance strategies.”

The U.S. Department of Human Health and Services frowns on breaches of unsecured protected health information to the extent that penalties are imposed. The HIPAA Breach Notification Rule requires HIPAA-covered entities and their business associates to notify individuals affected by the breach, as well as the Secretary, and, in certain circumstances, the media. In addition are the legal repercussions and expenses. No medical facility wants that kind of attention or added costs.

An example is the case of the Catholic Health Care Services (CHCS) of the Archdiocese of Philadelphia, which provided management and information-technology services as a business associate to six skilled nursing facilities. Theft of a single CHCS mobile device compromised protected health information of more than 400 nursing-home residents. The U.S. Department of Health and Human Services Office for Civil Rights determined that CHCS had no policies in place for addressing the removal of mobile devices containing protected health information from its facility or what to do in the event of a security incident. It was an expensive lesson. The CHCS settled potential HIPPA violations to the tune of $650,000.

Clearly, many millions of dollars are lost each year on stolen or misplaced equipment and related consequences. It is imperative that a system be put in place to protect valuable assets, to protect confidential data, and to tighten security controls.

Seal Shield’s ElectroClave uses radio-frequency identification (RFID) for tracking and auditing to help prevent asset loss and theft, providing better control over inventory. The RFID tags integrate with nearly any existing ultra-high frequency RFID network, ranging from 902 to 928 MHz, providing faster data-transfer rates and reliable performance for electronic-asset surveillance and device management. Also available are Ultra-Slim Tags, passive RFID tags that are well-suited for small electronic devices and stick to a variety of materials. Tags are unobtrusive, preserving the device’s original form. The RFID component captures oversight data automatically and makes it available to clinicians, management, and information-technology staff via the cloud.

Tagged assets can track who checked out the device and can track where the devices are at any given time. Alerts can notify when devices are not in location compliance. ElectroClave RFID system can prevent data breaches, and concomitant HIPPA fines, by shutting down the device and wiping it clean of data if a device is determined to be out of its location assignment. Workflows and notifications can be customized in the ElectroClave™ management portal to send a push notification to a device/user that he/she is out of location compliance. If the device does not come back into location compliance, data can be wiped off the device remotely.

Leaving your facility’s mobile devices unprotected is a dangerous, perhaps very costly, risk. Call Seal Shield, 87-SEAL-SHIELD (877-325-7443), and let one of our experts advise you on how to protect your investment today.

Susan Cantrell, ELS 
Infection Control Corner
Contributor Writer

Friday, May 5, 2017

WHO SAVE LIVES: Clean Your Hands 2017

Fight antimicrobial resistance with proper hand hygiene

Beginning in 2009, the World Health Organization (WHO) launched the annual SAVE LIVES: Clean Your Hands campaign, aiming to raise global awareness of the importance of hand hygiene in health care and to bring people together in support of improving hang hygiene globally. Read on to see the global challenges we face, and how you can do your part!

Antimicrobial Resistance and Hand Hygiene: A Global Challenge

Antimicrobial resistance (AMR) is one of today’s most complex and threatening global health challenges – The World Bank has warned that it could cause as much damage to the economy as the 2008 financial crisis.  AMR threatens to reverse the progress made against infectious diseases since the second half of the 19th Century and is on the rise in every region of the world.

Antibiotics are losing effectiveness after decades of use (and overuse) in human medicine and food production, and few replacement products are on the horizon – our world is moving towards a post-antibiotic era, where common infections will once again turn deadly.  Health interventions such as organ transplants, chemotherapy, and pre-term infant care will become increasingly difficult (or even too dangerous) to undertake if current trends continue.

Hand hygiene is the best way to combat antibiotic resistance, and serves as the cornerstone of any effective infection control and prevention plan.

Everyone at every level can help to influence safer, quality health care through infection prevention. One of the first steps through WHO’s campaign is to ensure that all health facilities sign up. You can also learn other ways to spread the word and get involved with the campaign here!

Did you know that 80% of all infections are spread by hands?

According to The Centers for Disease Control and Prevention, Hospital-acquired infections (HAIs) are a leading cause of death in the U.S. health care arena, with an overall estimated annual incidence of 1.7 million cases and 100,000 deaths.  This results in an annual spend of excess health care costs for U.S. hospitals of $28.4 billion to $45 billion.

WHO estimates that 1 in 10 patients contract an infection while receiving care, and up to 32% of surgical patients get a post-op infection (of which up to 51% are antibiotic resistant).  This is a huge number, when you consider that over 313 million people undergo surgery each year – that’s twice the number of babies born in the world!

In recognition that proper hand hygiene is the first line of defense for infection prevention, U.S. hospitals spend over $160 million each year to prevent unforeseen infections. Below is a breakdown of annual hand hygiene costs, based on a 450-bed U.S. hospital, according to the American Hospital Association (AHA) and the World Health Organization (WHO):

Even with all of the awareness and investments, however, statistics surrounding hand hygiene practices are still sobering. WHO found that 61% of health care workers don’t clean their hands at the right moment, and for surgical staff it’s 1 in 2.  

What is the proper procedure for hand hygiene?

The World Health Organization (WHO) has many resources on proper hand hygiene procedures to help you:

Hand hygiene challenges in modern health care

Hand hygiene alone isn’t enough in modern health care – there is a multitude of evidence now supporting that the environment plays a role in disease transmission and how we pick up pathogens at the same level by touching the environment as we do by touching the patient.

William Rutala, PhD, MPH, CIC, of the University of North Carolina, Chapel Hill stated "There is increasing evidence to support the contribution of the environment to disease transmission, and that we pick up pathogens at the same level by touching the environment as we do by touching the patient. Unless we inactivate or remove these microbes, they are going to be present in a patient room for a long time. Just entering a room previously occupied by a MRSA, VRE or C. difficile patient significantly increases the risk of contracting that pathogen.”

But how many health care facilities are using mobile devices?

Becker’s Health care recently published a study citing that 59% of respondents reported that their hospitals have a “bring your own device” program.  Smartphone usage in hospitals has increased steadily since 2012, with 77% of respondents reporting that their organizations support smartphone usage.

In the Fall of 2016, the American Academy of Pediatrics (AAP) published their Infectious Diseases, Volume 19, Issue 2 that examined the increase of mobile device usage in health care and the problems associated with it, reporting the 87% of physicians use a smartphone or tablet in the workplace, and 90% use mobile device apps to access drug information.  Our current digital era has been largely integrated into modern health care, as it allows for streamlining communication and documentation regarding patient care, including the full spectrum of devices including cell phones, notebooks/tablets, laptops, pagers, handheld dictation devices, and computers/workstations on wheels (COW). 

How do these devices infect health care workers?

According to AAP, an estimated 70-100% of health care workers’ (HCWs) mobile devices are contaminated with microbes, of which 9-25% sampled across different settings were contaminated with pathogens known to cause HAIs.

Approximately 50% of HCWs admitted to using mobile devices during physical contact with patients, a practice that is known to increase device contamination. Over 50% of HCWs are then carrying these devices in and out of patient rooms, therefore transporting pathogens across an entire facility at an alarming rate.

Knowing that these devices pose a threat – are they being cleaned?

The general answer here is no.  A survey in a Michigan hospital (cited by AAP) revealed that 17% of physicians never cleaned their mobile devices, and 46% only cleaned them monthly or yearly. According to a similar study in the UK, only 8% of physicians cleaned their mobile phones.

Furthermore, practicing hand hygiene in association with mobile device usage is not currently common practice, as a study in Barbados showed that 97% of HCWs did not wash their hands before or after using their mobile device.

These devices must be considered an extension of the patient/health care environment, and proper handling and disinfection of such devices is imperative to facility’s infection control and infection prevention plans. 

Further statistics and citations on the problem of mobile devices negating hand hygiene practices

  • A study demonstrating how hospital staff members pick up pathogens from mobile phones after thoroughly washing their hands, concluding that mobile phones act as a reservoir for microorganisms. Before touching the mobile phones, the disinfected hands showed no appreciable pathogen levels. After touching mobile phones, bacterial contamination on hands increased to 93.7% (same rate as phones). 
  • Samples from the hands of 200 HCWs and 200 mobile phones were cultured. 94.5% of phones demonstrated evidence of bacterial contamination with different types of bacteria. The gram negative strains were isolated from mobile phones of 31.3% and the ceftazidime resistant strain from the hands were 39.5%. S. aureus strains isolated from mobile phones of 52% and those strains isolated from hands of 37.7% were methicillin resistant. Distributions of the isolated microorganisms from mobile phones were similar to hands isolates. Mobile phones used by HCWs in daily practice may be a source of nosocomial infections in hospitals.
  • Sampling was conducted over a 3-day period on devices at 2 large medical centers. 53 out of 204 (25.9%) swabs yielded at least 1 pathogen; Gram-positive organisms were cultured from nearly all devices (93.4%; 99/106) and Gram-negative organisms were found on 21.7% (23/106). As with other fomites, these devices represent a potential reservoir for the transmission of pathogens.
  • Genetically identical isolates were detected from mobile phones and their user and multiple users, which is consistent with mobile phones serving as reservoirs of infection in the health care environment. These findings reinforce the need for hand hygiene prior to patient contact as the most effective intervention for preventing health care–associated infections.
  • During the period from August-September 2010, 221 mobile phones and palms and fingers of nursing staff in 23 general wards of a university hospital were sampled for bacterial contamination. 
    • Of the 221 mobile phones used by nurses, 16 (7.2%) were contaminated with S aureus, of which 5 (2.3%) isolates were MRSA. Of the 5 mobile phones contaminated with MRSA, S aureus was isolated from 55 (24.9%) of the 221 nurses' palm or fingers, of which 13 (5.9%) nurses were positive for MRSA.
    • Of the 23 wards in the hospital, MRSA was detected in the palms or fingers of nurses assigned to 8 wards.
  • Surface contamination of mobile phones likely occurs when these devices are used with bare hands or gloved hands after contact with a patient.
  • Although it is known that hand hygiene is the cornerstone of preventing health care–associated infection, data in this study suggests that contact with contaminated mobile phones after handwashing can recontaminate palms or fingers.
  • Research showed that tens of thousands of microbes live on each square inch of mobile devices.
  • Microbiologists say that the combination of constant handling with the heat generated by the phones creates a prime breeding ground for many microorganisms that are normally found on the skin. There is a close relationship between the emission of electromagnetic radiation and the microbial load on the mobile phones. Bacteria absorbing electro-magnetic energy from cell phones also emit these electromagnetic radiations which again form a conducive medium for their growth. Hence cell phones are rightly called as technological petridishes for thousands of worms. And the Micro-organisms can be transferred from person to person or from inanimate objects (such as stethoscopes, bronchoscopes, pagers, ballpoint pens, hospital charts, computer keyboards, mobile phones and fixed telephones) to hands and vice versa.

So what is the solution to the threat of mobile devices in undoing proper hand hygiene practices?

Luckily Seal Shield is dedicated to Preventing Infections and Saving Lives, and recognizes the issue of modern technology usage in health care.  We’ve come up with the solution to help health care facilities support the implementation of mobile device plans, while effectively combating the pathogens they may carry in the process.

Mobile Device Disinfection and Management Made Simple

Meet the ElectroClave™, an all-encompassing solution to mobile device management and disinfection, with superior technology to also provide hospitals peace of mind over their investments. 
  • The LED UV-C disinfection process of the ElectroClave™ destroys bacteria and viruses in just minutes on the entire surface of the device, achieving a 99.99% pathogen kill on all sides of the device (360° disinfection).  While disinfecting, the ElectroClave™ also charges the device and syncs to the management portal.
  • RFID tracking system and cloud-based management portal allows for complete oversight of the facility’s mobile environment, from both an infection control and infection prevention perspective, as well as IT and asset management.
Learn more about the ElectroClave as the solution for mobile device disinfection and management:
Mobile devices aren’t the only source of modern technology in health care that can transmit infections and negate your best efforts at hand hygiene practices.  Computer keyboards, mice, monitors, touch-screens, and other patient monitoring devices can all pose a threat, and Seal Shield has multiple product lines to help prevent devices from spreading pathogens and serving as a modern ‘trojan horse’ in health care facilities.

As our world advances – in both medicine and technology – the need for new technology and ways to combat the spread of infections is paramount, and Seal Shield has its finger on the pulse of this issue. Reach out to us today to see how we can help you do your part!

Wednesday, February 15, 2017

Mobile Device Management: Part 2

One of the most important features of Seal Shield’s ElectroClave™ UV Disinfection and Mobile Device Manager is its ability to disinfect mobile devices and generate reports verifying user adherence to mobile-device disinfection policies. There are a few other providers of MDM, but no others are designed specifically for use in the healthcare arena, and no others offer disinfection of mobile devices. With CMS penalties in place for certain healthcare-acquired infections, infection prevention has never been more important. Seal Shield’s ElectroClave can help to keep down cross-transmission of pathogens causing healthcare-acquired infections and subsequent penalties.

Scientific literature clearly links mobile electronic devices with transmission of healthcare-acquired infection and encourages healthcare facilities to have a system for cleaning them in place. In a published scientific study, Kirkby and Biggs (Cell phones in the neonatal intensive care unit: how to eliminate unwanted germs. Adv Neonatal Care. 2016;Dec;16[6]:404-409) found that “Microbial surface contamination was evident on every phone tested before disinfecting. All phones were substantially less contaminated after disinfection. A standardized cleaning process  . . .  reduced the amount of germs and potential transmission of nosocomial pathogens within the NICU. The simple exercise illustrated the importance of cell phone hygiene in a high-risk population.”

A study by Haun et al (Healthcare personnel attire and devices as fomites: a systematic review. Infect Control Hosp Epidemiol. 2016 Nov;37[11]:1367-1373) examined transmission of pathogens via objects including mobile electronic devices, noting that such devices may harbor pathogens and contribute to risk of cross-transmission.

In another study (Contamination of healthcare workers' mobile phones by epidemic viruses. Clin Microbiol Infect. 2016 May;22[5]:456.e1-6), Pillet et al evaluated the presence of metapneumovirus, respiratory syncytial virus, influenza viruses, rotavirus (RV), and norovirus on mobiles phones used by HCWs in four adult and pediatric departments of a university hospital. Virus RNA were detected on 39 percent of mobile phones tested. The study concluded that mobile phones “routinely used in hospital, even during care, can host virus RNA, especially RV [respiratory syncytial virus]. Promotion of frequent hand hygiene before and after [mobile phone] use, along with frequent cleaning of [mobile phones], should be encouraged.”

Seal Shield’s ElectroClave™ UV Disinfection and Mobile Device Manager takes a mere 13 minutes to charge and disinfect mobile devices. ElectroClave’s 360° fail-safe disinfection has a 99.9999% pathogen kill rate. Notifications will alert if the process has not been completed correctly; for example, if John Doe did not close the door to the ElectroClave cabinet, a notification will alert to the fact, recording date and time, and will advise whether the problem was resolved. A disinfection audit reports on status of individuals’ mobile devices, noting check-in and check-out times, and whether the device was disinfected before use. Infection-control compliance policies are fully customizable.

Mobile devices are disinfected at the end of each shift. As the tablet or mobile phone is charging, it is also being disinfected. Results confirming disinfection status are displayed on the cabinet and are available on the cloud. The devices are then ready for the next shift. When a nurse swipes his or her badge to check out a tablet, cell phone, or PDA, the device is tied to them via the cloud. Should the nurse manager get a report from the infection preventionist indicating an outbreak, all devices easily could be called in for disinfection. Between disinfection cycles, HCWs may want to use Seal Shield’s sleeve for mobile devices for further protection. Seal Shield has you covered, one way or another.

Susan Cantrell, ELS 
Infection Control Corner
Contributor Writer

Other articles in this series:
Mobile Device Management: Part 1

Other articles by this author:
Antimicrobial Resistance: Part 1
Antimicrobial Resistance: Part 2 
Antimicrobial Resistance: Part 3 

Thursday, February 9, 2017

Mobile Device Management: Part 1

How does your facility manage the mobile devices in use by employees?

If you don’t already know the answer to this question, it is an area you will need to explore, probably sooner rather than later. Health care is becoming more and more dependent on touch devices to manage the workflow. Many healthcare facilities and organizations are already moving away from desktop computers to mobile tablets and mobile telephones for information management. Mobile devices allow charting information to be at the HCW’s fingertips, wherever the nurse is. Healthcare workers (HCWs) are always on the move; for greater efficiency and productivity, their devices need to be on the move with them.

The trend toward mobile devices must be accompanied by a strategy for managing them. Mobile-device management (MDM) is both an information-technology (IT) and clinician concern, with areas that overlap. The IT department may be responsible for security of corporate mobile devices, maintenance of devices, and control of inventory. They also may be responsible for the MDM budget. The HCWs’ concerns are centered on how they make use of the mobile devices in their work; for example, how do they disinfect phones and tablets without ruining them? How will disinfection procedures be enforced? Both HCWs and IT are concerned with how mobile devices are accessed and returned by users and with how multiple devices are kept ready for use. If the devices are not charged when they are needed, they are useless. If someone forgets to turn the mobile device in at the end of their shift, what happens next? If the devices are not accounted for and stored securely in a designated place until needed, that presents another problem for HCWs and IT alike. The buck has to stop somewhere, so one of the big decisions in MDM is who is ultimately responsible for which aspects of MDM.

This is just a sampling of points to consider when determining a strategy for MDM. It is such a new area, chances are many people don’t even know the questions to ask to arrive at the answers they need. A system for MDM requires forethought, vision, planning, and the right equipment. It also is an investment of precious medical-facility financial resources. Before you invest in an MDM system, let Seal Shield advise you. It’s a complicated undertaking, but Seal Shield can simplify it for you, because they have already done the research and implementation.

Seal Shield’s ElectroClave™ UV Disinfection and MobileDevice Manager automates MDM. At the heart of ElectroClave™ is the web-based MDM Portal. All of ElectroClave’s functions are tied to the cloud, for complete oversight by both IT and clinicians, and it can be accomplished with any device. The MDM Portal is an indispensable tool for managing workflows and setting up rules. Other critical features include smart charging, to prolong the life of the battery; RFID device tracking, so that anyone with oversight always knows where the mobile device is and which user has it in their possession, whether something is wrong with the device, and whether it needs updates or charging; LED UV-C 360° disinfection; and custom workflow. Unlike any other MDM system, ElectroClave™ UV Disinfection and Mobile Device is imaged specifically for health care. It is scalable to the needs of the facility. Another huge advantage is that ElectroClave™ is not device-specific; it is configurable to any device, make, and model. All of this and more is accomplished with a secure, locking, particulate- and dust-free cabinet about the size of a mini-fridge. The ElectroClave™ UV Disinfection and Mobile Device Manager can hold four tablets or twelve mobile phones or PDAs.

In our next blog, we will talk more in depth about the singular feature that sets Seal Shield’s ElectroClave™ UV Disinfection and Mobile Device Manager apart from other MDM systems, making it ideal for use in health care. No other MDM offers disinfection of its mobile devices, a critical need for mobile devices used in health care.

Susan Cantrell, ELS 
Infection Control Corner
Contributor Writer