Design, Implementation, and Field Testing of a Privacy-Aware Compliance Tracking System for Bedside Care in Nursing Homes

摘要

Lower back musculoskeletal disorders are pervasive in workplaces. In the United States alone, the total cost of such injuries exceed $100 billion a year. The lower-back injury rate in the healthcare sector is one of the highest among all industry sectors. A main risk factor for lower-back injuries is the use of improper body mechanics when doing lifting and pulling activities. In healthcare venues, nursing homes in particular, nursing assistants are on the front line to take care of patients. Even in places where ceiling-mounted lifting equipment is installed, they are still required to handle the patient for bedside care, such as sliding the sling underneath the patient, scooping up the patient, putting on compression socks, etc. To help nursing assistants get into the habit of using proper body mechanics, we designed and implemented a privacy-aware compliance tracking system (PACTS). PACTS can track a nursing assistant for possible violation of proper body mechanics while doing bedside care and provide realtime feedback via a smart wearable device such as a smart watch worn by the nursing assistant. The system was deployed in a local nursing home for an 80-day field study in six rooms with seven participating nursing assistants. The test exposed several issues with the original design of the system. The primary issue is how to balance the privacy requirement and the usability of the system. Over-emphasizing the former would negatively impact the latter. This issue is partially resolved with a leasing mechanism where the system would automatically register a nursing assistant within the lease period once she or he has manually registered with the system.