Determine whether a wired or wireless temperature monitoring system best suits the needs of your hospital. Facilities with a robust WiFi network will benefit the most from wireless temperature monitoring, while hospitals without a highly coordinated IT infrastructure may be wise to consider a wired system. Also, be sure to consider the size of your hospital and health system when evaluating which type of automated technology would best suit your needs. Smaller facilities may be best served with a wired system, while WiFi, battery-driven technology might be ideal for a very large health system with hundreds of refrigerators, to avoid having to install hundreds of new data jacks. In addition, when considering a wireless system, be sure to inquire if each device requires its own IP address; if this is the case, confirm that your WiFi system is sophisticated enough to process the required volume before committing to wireless technology.

Furthermore, some types of medical-grade refrigerators—for instance, those designed with steel doors—may interfere with receiving WiFi signals. Verify with the vendor that the system under consideration is compatible with your hospital’s existing technology before making a purchase.

Choose a device that is appropriately sensitive to temperature changes. Select a system with adjustable alarm-triggering capacity. The system should be configurable to ensure the alarm signals only when the refrigerator’s temperature truly goes out of range, not every time the door is opened causing a slight temperature fluctuation. The device must be appropriately programmable to suit the needs of the hospital. If you do decide to adopt a system that uses preselected settings, evaluate the defaults carefully before purchase to find the best fit for your facility.

Some systems alarm immediately when the temperature goes out of range, while others can be programmed to send an alarm only after the temperature has been out of range for a specified time period. Choosing a system that triggers an alarm only when the temperature has been out of range for a sustained time is preferable to prevent alert fatigue. This capability is also important if the system will be employed in off-site clinics or other remote areas, especially on nights and weekends when staff may be unable to address the alarm immediately. 

An ideal system will enable documentation of the actions taken in response to an alarm. Being able to document how temperature alerts are addressed is required in TJC’s medication management standard MM.03.01.01, element of performance (EP) 2, and surveyors will undoubtedly inquire about this during an audit. The ability to require a documented response to an out-of-range warning is one of the benefits of these systems over traditional paper temperature recording. The system should be able to prompt for and record actions taken as a result of every alarm, and this information should be stored electronically to ensure ease of reporting. For example, if a refrigerator goes out of range for a significant time period, and as a result medications are quarantined, the refrigerator temperature is adjusted, and the medications are subsequently put back in the refrigerator after the temperature comes back into range, these actions and any accompanying information must be recorded. This is especially true if affected medications were administered to patients following an out-of-range reading. 

Electronic recording is preferable to a manual process, but in the absence of this capability, utilizing a manual log detailing alarms and actions taken is sufficient, provided the logs are organized and complete. However, electronic record keeping is clearly more efficient and more accurate than any manual process. 

Consider purchasing a system with smart capabilities. Different systems provide alerts in various formats: email, pager, automated phone call, text message, or notification generated and printed on paper. Although multiple methods are available, the ability to customize the alerting process to your institution’s specific needs will ensure a smooth workflow. Beyond that requirement, some systems provide enhanced notification technology. For example, a system may first alert via pager, and then if the alert is not addressed within a certain amount of time, the system will prompt an email as well or send a pager alert to a different user. This level of sophistication safeguards a prompt temperature alert response.

Jeff Little, PharmD, MPH, BCPS, is currently the assistant director of pharmacy at Children’s Mercy Hospitals and Clinics in Kansas City, Missouri. He received his doctor of pharmacy from the University of Kansas and his masters of public health from the University of Pittsburgh.