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Educate employees about the risks of using robotics


November 1, 2009

Confirm that all employees who work with robotics have received proper education about the use and maintenance of the machines, as well as any related dangers. Otherwise, the lapse could spell potential compliance trouble with The Joint Commission’s rules for worker safety and egress routes and with OSHA’s bloodborne pathogens standard (1910.1030).

More hospitals are investing in robotics for patient care, including telemedicine-based devices that transmit information and physician-driven machines that perform surgeries, according to a white paper published in June by the ECRI Institute, an independent healthcare research firm in Plymouth Meeting, PA.

Two further applications are cropping up:

  • Machines that roam halls, executing tasks such as taking soiled linen away, restocking crash carts, and toting pallets of other supplies
  • Fixed-location machines that improve a department’s efficiency by tasks such as filling prescriptions in the pharmacy or processing specimens in the clinical laboratory

These robotic applications are becoming smaller, cheaper, more efficient, and easier to use, says Jim Keller, vice president for health technology evaluation and safety at the ECRI Institute.

“You’ll see a lot more of this over the next several years,” Keller says.

If your facility has a new robotic addition or one planned for the near future, assess the safety risks and update policies and procedures. Such foresight will help minimize potential employee injuries down the road and shore up possible compliance holes with The Joint Commission.

Proper instruction ensures safety

In a surgical setting, user training for proper setup and operation is key to utilizing surgical robots safely. Not doing so can decrease the amount of procedures staff members perform in one day and also make procedures take longer, thus exposing patients and employees to unnecessary risks such as bleeding, complications associated with anesthesia, or infections.

“We’ve heard from a number of hospitals who have jumped the gun earlier than they should have on robotic equipment in the OR, such as the da Vinci–type system,” Keller says. “It can be a fairly involved technology to use. Staff that aren’t using that equipment on a regular basis can have issues with proficiency.”

In the lab, improper cleaning and handling of parts and patient fluid samples can lead to employee exposures to bloodborne pathogens that might present OSHA violations. Training employees on manufacturer-written maintenance and upkeep procedures as well as dealing with day-to-day cleaning helps prevents these problems.

Regarding maintenance, employee users typically don’t go beyond daily upkeep and cleaning. Many hospital robots are serviced by the manufacturers, and others will assign maintenance to biomedical engineers and independent service organizations, Keller says.

Hall-roaming robots rely on sensors

Hall-roaming robots can be a boon to daily life at a hospital. The Ohio State University Medical Center (OSUMC) in Columbus put 46 of these assistants in service several years ago across four buildings.

These L-shaped transporters are 4 ft. wide, 5 ft. long, and 6 ft. tall. They pick up cargo in carts, travel slowly, beep to alert people of their presence, and stop when their laser-beam “bumpers” detect people in front or behind. They also can speak eight different messages, announcing actions or requesting assistance.

Carl Story, director of distribution services at OSUMC, says the robots are used mostly to take away carts of soiled laundry but can also help deliver patient meals and supplies. “They can stop on a dime, so when those bumpers are tripped, they do stop immediately,” Story says, adding that someone can halt each vehicle manually by pushing a red safety stop button.

The ECRI Institute’s medical device problem reporting system hasn’t received any instances of hall-roamers such as those in use at OSUMC knocking into people or causing similar accidents, Keller says. That , he adds, might be attributable to the relatively small number of units being used in hospitals at this time.

Over time, the robots’ sensors may become dirty, possibly affecting their performance, he says. If your hospital has such mobile robots in service, identify routine maintenance checks needed to ensure that the sensors work properly.

Be wary of Joint Commission rules for keeping egress corridors clear of clutter and impediments under standard LS.02.01.20, element of performance 13.

Hall-roaming robots may violate the standard if they sit stationary for more than 30 minutes, similar to wheeled carts, Keller says.

Choose judiciously where to park and charge these robots.

Other ways to bolster worker well-being

Keller and Story offer the following additional pointers for promoting safety with hospital robotics:

  • Define needs first. It can be tempting to buy a cutting-edge piece of technology, but making sure the device fits your facility’s needs might lead to a different choice that will work out better in the long run.
  • Minimize human contact. OSUMC’s hall-roaming assistants run in their own elevators, are serviced by automatic cart washers, and use their own tracks between buildings, Story says. Minimizing human interaction lowers employee hazards.
  • Think about the environment. If your hospital plans to purchase transporters like the ones at OSUMC, double-check that they can navigate your buildings. Avoid making the machines take tight turns, and if they carry heavy materials such as wet laundry, automate loading and unloading as much as possible to prevent potential back injuries to employees.
  • Give the learning curve time. Make sure your procurement contracts with manufacturers require that a machine’s users have adequate training and opportunities to get comfortable using the device. Contracts should also include provisions for refresher training.
  • Try video-based education. OSUMC produced safety videos demonstrating its hall-roaming robots, helping fill in a safety hole that Keller sees at other facilities.

“A lot of hospitals don’t spend enough time on training for complex technologies. At most, they may have a brief orientation session at installation,” Keller says. “Per diem workers and the people who were sick that day don’t get that training. If no refresher or update training is provided, they will miss training altogether.”

Also, workers who participate in orientation may forget much of what was learned without refreshers.

Join us now on Twitter

We’re now sending updates via the Twitter social networking site (www.twitter.com/hospitalsafety).

For those unfamiliar with Twitter, the site allows users to post short 140-character updates—known as “tweets”—about what they’re doing.

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We’ve already found Twitter to be a useful tool to bring news to you rather than you having to search it out every day.

Recent tweets from us include updates on Environmental Protection Regulation revisions, news from The Joint Commission, and how one hospital used Twitter during a flood response.

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