To Send Or Not To Send - The Carrier Question

To Send or Not To Send That Item?

When was the last time you found a peanut butter and jelly sandwich in your pneumatic tube system carrier? Hopefully never, although you may be surprised at some of the unusual, and inappropriate, items that have been sent soaring through hospital tube systems since they were invented before the turn of the century.

Much has changed in hospital material transport since then, not only in the engineering of pneumatic tube systems but also in the safeguards used to prevent improper use of the carriers.

Still, there are reports of all kinds of odd items being sent through tube system carriers, many of which can result in a biological hazard threat. In all our years of maintaining pneumatic tube systems, here are a few of the peculiar things we’ve heard were sent, often unsuccessfully, through the tube system. Imagine opening your carrier to find:

• Blood and gore:
  Blood vials loose in a carrier can easily break. This creates a biohazard, not only for those handling the carrier but, lacking a special bag or insert liner, it can leak into the tube network and cleaning nightmare.
• Sticky medicine mess: 
  An employee popped a loose bottle of cough syrup into a carrier and sent it through the tube system. What resulted was a sticky mess as it traveled through the high speed tube system.
• Odorous urine leakage: 
  Nobody likes to imagine this kind of a mess. Untrained employees have been known to pop a urine specimen into an unprotected carrier and let it rip. Once again we have both a hazardous material leak and a stinky mess at the other end.
• Glitter explosion: 
  Someone with a packet of glitter thought it would be festive to pour it into a carrier. Often an employee isn’t familiar with the forces that go into tube transfer. The carrier moves up to 20-25 feet per second which means things get shaken up in transfer! This is why training is so important.
• Melted ice cream: 
  It's not just food that can melt which should be avoided. We have heard of snacks, sandwiches, and other food items being sent that never should have been put in a carrier. In addition to contaminating the carrier, any leakage brings an instant health and liability risk.
• Unidentified powder puff: 
  Was it an explosive, a cleaning product, or just a healthcare worker's mistake? In one situation, a carrier arrived at a station full of white powder it immediately prompted emergency protocols. Law enforcement had to be informed and the tube system was immediately deactivated while the carrier was sent out for testing. A nervous staff was immobilized in the process, costing the hospital time, money, and service to patients.
• Shaken soda: 
  An employee noticed that a large bottle of soda would fit perfectly inside a pneumatic tube carrier and was curious what would happen when the person on the other end opened it. What happened was an explosion instantly contaminated everything around it.
• Cellphone: 
  Even with a protection plan, phones are not meant to be sent via a powerful pneumatic tube system. An individual’s cell phone was put in the carrier, along with a vial of liquid substance. The liquid broke free, not only ruining the phone but creating an instant biohazard.
• Pillow: 
  Once the tube system door is opened the suction is activated. Any item, pillows included, can instantly be sucked up through the tube. This kind of mistake can cost the hospital a tremendous amount in down time, deploying runners instead of the tube system, and getting repairs lined up. You don’t want to be held responsible for this kind of issue! Once again, training is the answer here.
• Personal Items: Any number of other unauthorized and biohazardous items can, in the wrong hands, be put into carriers and sent through the tube system.

Pneumatic tube system carrier leaks are time consuming and expensive to resolve.

While a few of these may seem funny or harmless, they compromise critical hospital infrastructure. When an unauthorized or improperly packaged substance is sent through a pneumatic tube system, the results can be not only a biological hazard, but can affect patient care.

Unsecured bottles or vials are easily broken and their contents leaked. A leak occurring during carrier transmission impacts every inch of the tube network traveled. After the magnitude of the spill has been determined a technician must send a special cleanout carrier from station to station until all affected segments of the system have been cleaned. It is a multi step process that requires time, patience and skill to complete.

During the clean-out process, the pneumatic tube system is rendered inactive until it has been restored to meet best practices standards. This can take hours or days, depending on the availability of someone trained to clean the tubes.

This doesn’t mean the need for hospital material transport stops. Until the hospital’s tube system is approved for transport, materials will need to be walked through the hospital complex by employees who must also complete their original tasks. The time spent can quickly add up to hundreds of hours and thousands of dollars wasted on non-patient facing activities.

Pneumatic tube policy, training, accountability, and safety measures

There are a few things management can do to help ensure that their pneumatic tube systems are not shut down due to ill informed actions or employees that aren’t familiar with the physics behind tube system transport.

• Have a pneumatic tube system policy. To avoid improper materials and sloppy packaging of items, hospitals should have a clear policy, complete with best practices for handling and transport of materials through the pneumatic tube system.
• Provide training. Onboarding must include training on best practices for handling materials and working with the pneumatic tube system.
• Ensure accountability. This can be achieved through new technologies, such as Translogic’s WhoTube®, which creates a “signature” of who has signed out and signed in a carrier, by reading a code on the employee’s badge. When an employee knows that they are identified with every item sent, it creates a high level of accountability.
• Equip doors with safety features. Station access doors should be locked to all but authorized personnel.
  
  

Hospital tube systems play a critical role in the efficient transfer of medications and specimens throughout the hospital. When used properly they save time and money, enabling a higher level of patient care. Adopting a strategic approach, supported by regular training and accountability measures, will help ensure that the tube system continues to work safely and effectively for your hospital.