A True Security Blanket

The new generation of electronic security systems is designed for pediatrics

Anti-abduction systems are now a common feature at birthing units and obstetric departments in hospitals nationwide. Over the last decade, facilities have opted to safeguard newborns with this specialized technology that provides protection to each infant.

In fact, it's become so common that mothers-to-be and their families now look for this technology when choosing a birthing hospital.

Influenced by the trend toward individual patient protection in the obstetric department, pediatric departments have been adopting similar technology.

Unfortunately, these systems have been inappropriately designed around the needs of obstetric departments, which are substantially different from pediatric departments, both in terms of the threat they are trying to defend against and the nature of their patient population.

Pediatrics Face More Risks

In the world of obstetrics, the security threat facing patients is singular and easily defined—abduction by a stranger. Since the danger is almost always external, building defenses against this threat is a straightforward step.

Things aren't quite so clear for pediatrics. The risks facing pediatric patients are multiple and vary considerably by patient.

Patients up to six months of age face the same risk of stranger abduction as newborns in the obstetrics department. According to the National Center for Missing and Exploited Children, 14 percent of the 126 infant abductions from hospitals between 1983 and March 2009 occurred in the pediatric department.

However, the NCMEC only records statistics on infant abduction by a stranger. This excludes children over six months of age and all family-related incidents.

There is no organization that specifically tracks abductions of older children from hospitals, whether by a family member or a stranger. However, the Office of Juvenile Justice and Delinquency Prevention, an arm of the Department of Justice, estimates that 17,000 kidnappings of individuals under 18 were reported to police in 2006. In half of these cases, the perpetrator was a family member. For children under 12, a family member was involved 70 percent of the time.

It is impossible to say how many of these crimes occurred in hospitals, but these numbers are enough to convince most hospitals that the threat is real.

Diverse Patients

The different security risks faced by pediatric departments are a reflection of the diverse patient population. This is another factor that makes infant protection technology an awkward fit for pediatrics.

The most obvious difference is in the range of patient ages. Obstetric departments deal only with newborns. A pediatric patient also could be a newborn, an 18 year old or any age in between. Infant protection systems are not designed to fit these older patients, who can easily pull them off. With most systems, this could lead to nuisance alarms, since they detect any attempt to tamper with the tag.

Another factor that sets pediatrics apart from obstetrics is the fact that these patients are sick. Pediatric patients may need to be transported frequently to other parts of the hospital for medical procedures. This poses two security problems: They have to pass outside the safe area, and for many medical procedures, the electronic tag must be removed.

A more Flexible Solution

These factors have led to the development of a system designed specifically for protecting pediatric patients: the Pedz system from Stanley Healthcare Solutions. After consulting with users of its Hugs infant protection system, Stanley built the Pedz system to give hospitals the flexibility they need for a pediatric application.

"It was really pressure from hospitals that pushed the development of this product," said Kevin Smith, product manager for patient security at Stanley Healthcare Solutions. "We just knew that we could build something better for pediatric users."

The Pedz system works very much like its sister product, the Hugs system. Every patient requiring protection wears an RFID tag on the wrist or ankle. Exit points from the pediatric department are equipped with door monitor devices that emit a low frequency field around the exit. When a protected patient approaches an exit, the tag detects this field and transmits its unique ID number and the exit location to the system.

The band is held in place by a clamp, which allows the curious young patient to safely tug on the tag or twist it without causing an alarm. Yet, any malicious attempt to detach the band or cut through it will immediately result in an alarm.

A special removal key enables staff members to remove a patient's tag for a medical procedure. When the patient returns, the tag is reattached with the same band. The transport is initiated in the system software, where the nurse informs the system that the tag is being removed from the patient temporarily. Afterward, the system automatically resumes monitoring the child.

The system also moves away from the "one-size-fits-all" model of infant protection and acknowledges that each patient has different requirements. Depending on the age and risk profile of the patient, the facility can choose to allow the patient to travel outside the department unescorted. This permission can be restricted to specific exits and times of the day, with automatic notification if the patient doesn't return.

The system makes it easier to keep tabs on the flow of patients in the department. The software records exactly when a patient left, which staff member authorized the departure and when they returned. Users can add their own notes to record custom information. This feature has proven so useful that early adopters of the system are actually using it as their main patient census tool.

A Common Platform

From an integration point of view, the Pedz system also is an easier fit than earlier electronic banding solutions. It shares a common platform with the Hugs system and Stanley Healthcare Solutions' new patient protection system, which helps hospitals supervise agitated patients.

Door monitors, receivers and other network devices all use Echelon Corp.'s LonWorks protocol, a widely used network technology for mission-critical applications. The devices all are connected to a single server. The server supports the various applications, feeding data to multiple client computers running specific application software. Each department sees only the client application designed for its clinical needs.

Adding a new application involves simply incorporating devices and tags and installing client applications on departmental computers. Devices also can be shared between different applications—a practical option for smaller hospitals, where obstetrics and pediatrics are combined or adjacent to each other.

For larger facilities where departments are spread apart, network devices can be connected to the server PC via a LonWorks-to-Ethernet device that piggybacks on an existing LAN, saving time and money on installation.

This article originally appeared in the June 2009 issue of Security Today.

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