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Wardipedia – 50. Electronic access

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Introduction

There is considerable controversy about what to do about enabling patients to have appropriate access to their bedroom and the outside world, while minimising risks. There is a totally simple solution – patients having fobs, wristbands, swipe-cards or the equivalent electronic device.

These can be programmed for individuals’ rooms, the ward door, garden door, kitchen etc. And the terrific thing is that the system is being successfully used, and that this positive experience is available for others to share.

Although most of the focus is, understandably, on protecting patients from leaving the ward if there is a particular level of risk, there are additional benefits of electronic door control for patients’ bedrooms. These can also be achieved by non-electronic locks but this can involve having to ask staff to do this. And it’s cool to have a bit of electronic kit when in hospital.

More substantial than the coolness, patients need:

  • privacy from other patients when their in their bedroom. (Marion once barricaded herself in her room to achieve this, not a proud moment in her life.)
  • to feel safe in their bedroom
  • their property to be safe in the bedroom, and not to feel anxious about whether it’s going to be safe. (The City 128 Study of Observation and Outcomes on Acute Psychiatric Wards looked at the problem of ‘inter-patient petty theft’ “which caused considerable anxiety and irritation”.)
  • minimum hassle (i.e waiting for staff to open a locked door)
  • minimum humiliation in front of visitors

Options

Electronic access control optional

There are three types of authenticating information:

  • something the user knows, e.g. a password, pass-phrase or PIN
  • something the user has, such as smart card
  • something the user is, such as fingerprint, verified by biometric measurement

Electronic kit options

  • magnetic stripe
  • bar code
  • card-swipe
  • contact and contactless smart cards
  • fobs (key-ring, wrist)
  • fancy biometric technologies include fingerprint, facial recognition, iris recognition, retinal scan, voice, and hand geometry.
  • Some readers may have additional features such as LCD and function buttons for data collection purposes, camera/speaker/microphone for intercom, and smart card read/write support.

Ward examples

  • Ward has combined finger-print and code entry system.
  • There’s a fantastic system of patients having small alarms on their key fobs, not just for safety reasons but also for times when they aren’t able to move to get help, so it’s seen more as a ‘nurse call’ system than one for personal protection. In the year that they’ve been in use, they’ve never been inappropriately used. Similarly, no patient has responded negatively to having an alarm on their fob.
  • All patients have a fob wrist band. These can be programmed depending on what access patient is permitted to have (based on risk). For example, they may have access to their own bedroom but cannot unlock the main ward door. This is reviewed regularly – with the intention to increase access when appropriate.
  • Patients report feeling positively independent as they don’t have to wait for staff to grant access.

 

Categories: Involvement, Wardipedia
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