Direct Thermal Printer Labels in Today’s Health Care Environment
Labeling is necessary in many aspects of the medical and healthcare industries. Healthcare providers are required to have labeling systems in place for patient identification with wristbands, containers of specimens and samples sent for diagnostic lab work, and pharmaceutical directions and dosages for bedside therapies and treatment. In 2001 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) issued patient requirements that included instituting technology to control patient medication administration and identify patients in a manner that reduces medical errors. Bar-coding was determined to be a suitable choice to accommodate these requirements .
Many hospitals in the United States have implemented new bar code systems to address medical errors in response to a 2000 federal report and president’s directive . Thermal printing technologies have been implemented as a way to obtain crisp, clear, and consistent bar codes in a manner that reduces and avoids medical errors upon scanning. One such technology is direct thermal printing, which does not require ink. The image is created by the direct contact of pins in the thermal print head with a heat-sensitive coating on the label material.
A 2005 case study of Beloit Memorial Hospital in Beloit, Wisconsin, found that medication administration errors were reduced 67 percent in the first four months after introducing a bedside bar code system in 2003, which was further reduced by an average of 82 percent upon program expansion. The bar code system also increased nurses’ job satisfaction, improved patient satisfaction, and generated positive public relations without increasing nurse staffing time as the system was expanded to additional clinical units . The bar- coding systems used with medication administration have also improved inventory systems and billing accuracy . Similarly, laboratory samples are often labeled with bar codes at the patient’s bedside or prior to staining to avoid errors in labeling and attribution to the specific patient. Direct thermal labels have cut sample identification errors and increased efficiency at the labs of Massachusetts General Hospital, which handles roughly 400,000 samples a year .
Compared to traditional ink and paper printing, direct thermal printing offers more flexibility at the bedside, more reliable bar codes, and a better financial and time investment for institutions that are investing in bar code labeling systems. However, the heat coating on direct thermal labels can be sensitive to chemicals, such as alcohol. The reaction between alcohol and the paper's thermal coating fades the printed information or darkens the paper, which can interrupt efficient bar code scanning, increasing the time and effort needed to ensure proper labeling and decreasing the accuracy aimed for with the implementation of the printing system.
Hand washing with soap and water still only has an adherence rate of approximately 40 percent in some healthcare settings . Hygiene practices and cleansing the hands with antimicrobial washes and sanitizers have been encouraged as part of an initiative to increase patient safety . Alcohol-based sanitizers are recommended and used in medical settings as a low-cost method of reducing the incidence of infection, and the availability of these waterless cleansers has resulted in boosting general adherence to good hygiene practices . Generally, medical quality sanitizers contain 60 percent to 95 percent ethanol or isopropanol  to be effective.
The Centers for Disease Control and Prevention (CDC) recommends the use of alcohol-based sanitizing gel by health care workers whenever soap and water are not available for washing their hands. A small amount of the product is added to the palm of the hand and then rubbed all over the hand and fingers. Though the guidelines recommend rubbing until the hands are dry  (and it only takes an average of 15 to 30 seconds for the sanitizer to evaporate ), different types of sanitizer and alcohol concentrations dry at different speeds , and some individuals may use more than recommended. The presence of the alcohol on hands immediately before handling bar code labels may not be conducive to obtaining the clear images desired with direct thermal printing, as the material fades or turns black.
Companies like United Ad Label (UAL) are coming up with unique solutions to the problems caused by alcohol-based sanitizer use. UAL has secured a material that protects the bar code against chemical vulnerabilities. Our new direct thermal label has a heat-sensitive coating with reduced susceptibility to alcohol, which will further increase the reliability and efficiency of the thermal printing systems implemented in many health care settings. The introduction of this product for use as labels in healthcare settings would greatly improve upon the advancements already made in the field of bedside bar code technology. This new label will solve the problems created by healthcare workers touching the labels with alcohol on their hands. Labels will no longer be at risk of fading or discoloration when alcohol-based sanitizers are used.
Direct thermal printing is a cost-effective and relatively flexible technology for printing bar- code labels in healthcare settings. Though great strides have been made in introducing bedside bar-code scanning, the prevalence of alcohol-based sanitizers sometimes interferes with their efficient use. The introduction of UAL’s improved label material for use in direct thermal printing would solve the issues of mixing alcohol-based hand sanitizers with direct thermal labels while maintaining advances in the reduction of medical errors and increased patient safety.
- Agency for Healthcare Research and Quality. Patient Safety Practices Rated by Strength of Evidence. Addendum to Summary. July 2001. AHRQ Publication No. 01-E057b. Available at: http://www.ahrq.gov/clinic/ptsafety/addend.htm. Accessed July 22, 2010.
- American Hospital Association, Health Research & Educational Trust, and the Institute for Safe Medication Practices. “Assessing bedside bar-coding readiness.” Pathways for Medication Safety, 2002. Available at: http://www.ismp.org/tools/pathwaysection3.pdf.
- Centers for Disease Control & Prevention. Clean hands save lives!
- Germ-X. Hand Sanitizer. Available at: http://www.germx.com/faq_detail.aspx?id=1. Accessed July 22, 2010.
- Lincoln County, Nevada. Hand Sanitizer Safety. Available at: http://www.lincolncountynv.org/Hand_SanitizerSafety_Squib.pdf. Accessed July 22, 2010.
- Moher, Ralph and Wilson, Kevin. Labeling and tracking preventing errors in the lab. Patient Safety and Quality Healthcare. 2005. Available at: , 2010.
- Quality Interagency Coordination Task Force. Doing what counts for patient safety: Federal actions to reduce medical errors and their impact. February 2000. Available at: http://www.quic.gov/report/toc.htm. Accessed July 22, 2010.
- Reynolds S, Levy F, Walker E. Hand Sanitizer Alert. Emerging Infectious Diseases. 12(3), 2006.
- Schnirring, Lisa. CDC joins WHO push for better hand hygiene in healthcare. Center for Infectious Disease Research & Policy, University of Minnesota. 4 May 2010. Available at: http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/may0410hygiene-br.html. Accessed July 22,2010.
- Work, Mitch. Improving medication safety with a wireless, mobile barcode system in a community hospital. Patient Safety & Quality Healthcare, May/June 2005.
United Ad Label is an RR Donnelley product line providing labels and products to the healthcare industry. You may order via our website www.unitedadlabel.com or toll-free 800-423-4643.