Communications: electrical – Condition responsive indicating system – Specific condition
Reexamination Certificate
2002-08-01
2004-08-31
Trieu, Van T. (Department: 2632)
Communications: electrical
Condition responsive indicating system
Specific condition
C340S573100, C340S286070
Reexamination Certificate
active
06784797
ABSTRACT:
BACKGROUND OF THE INVENTION
This invention relates generally to monitoring systems and more particularly concerns devices and systems used to monitor bed patients in hospital or other care giving environments.
It is well documented that the elderly and post-surgical patients are at a heightened risk of falling. There are many reasons for this but, broadly speaking, these individuals are often afflicted by gait and balance disorders, weakness, dizziness, confusion, visual impairment, and postural hypotension (i.e., a sudden drop in blood pressure that causes dizziness and fainting), all of which are recognized as potential contributors to a fall. Additionally, cognitive and functional impairment, and sedating and psychoactive medications are also well recognized risk factors.
A fall places the patient at risk of various injuries including sprains, fractures, and broken bones—injuries which in some cases can be severe enough to eventually lead to a fatality. Of course, those most susceptible to falls are often those in the poorest general health and least likely to recover quickly from their injuries. In addition to the obvious physiological consequences of fall-related injuries, there are also a variety of adverse economic and legal consequences that include the actual cost of treating the victim and, in some cases, caretaker liability issues.
In the past, it has been commonplace to treat patients that are prone to falling by limiting their mobility through the use of restraints, the underlying theory being that if the patient is not free to move about, he or she will not be as likely to fall. However, research has shown that restraint-based patient treatment strategies are often more harmful than beneficial and should generally be avoided—the emphasis today being on the promotion of mobility rather than immobility. Among the more successful mobility-based strategies for fall prevention include interventions to improve patient strength and functional status, reduction of environmental hazards, and staff identification and monitoring of high-risk hospital patients and nursing home residents.
Of course, monitoring high-risk patients, as effective as that care strategy might appear to be in theory, suffers from the obvious practical disadvantage of requiring additional staff if the monitoring is to be in the form of direct observation. Thus, the trend in patient monitoring has been toward the use of electrical devices to signal changes in a patient's circumstance to a caregiver who might be located either nearby or remotely at a central monitoring facility, such as a nurse's station. The obvious advantage of an electronic monitoring arrangement is that it frees the caregiver to pursue other tasks away from the patient. Additionally, when the monitoring is done at a central facility a single nurse can monitor multiple patients which can result in decreased staffing requirements.
Generally speaking, electronic monitors work by first sensing an initial status of a patient, and then generating a signal when that status changes, e.g., he or she has sat up in bed, left the bed, risen from a chair, etc., any of which situations could pose a potential cause for concern in the case of an at-risk patient. Electronic bed and chair monitors typically use a pressure sensitive switch in combination with a separate monitor /microprocessor. In a common arrangement, a patient's weight resting on a pressure sensitive mat (i.e., a “sensing” mat) completes an electrical circuit, thereby signaling the presence of the patient to the microprocessor. When the weight is removed from the pressure sensitive switch, the electrical circuit is interrupted, which fact is sensed by the microprocessor. The software logic that drives the monitor is typically programmed to respond to the now-opened circuit by triggering some sort of alarm—either electronically (e.g., to the nursing station via a conventional nurse call system) or audibly (via a built-in siren). Some examples of devices that operate in this general fashion may be found in U.S. Pat. Nos. 4,484,043, 4,565,910, 5,554,835, and 5,634,760, the disclosures of which are incorporated herein by reference.
That being said, patient monitoring systems that rely on sensor mats to detect the presence of a patient in a bed suffer from a variety of drawbacks. For example, the bed monitoring systems currently available in the marketplace feature externally accessible configuration switches that allow the caregiver to reconfigure the device at will and to adjust parameters such as the duration of the alarm, and the time lapse between the sensing of the “empty bed” condition and the sounding of an alarm. External switching makes tampering with the system extremely easy and makes it more difficult to establish and maintain a hospital-wide policy with respect to monitor settings.
A further problem with conventional bed monitoring systems is that they use oscillating transducers in their alarm audio circuits, resulting in single frequency audio alarms. Since bed monitor alarms are frequently employed in environments in which a multiplicity of other problems might also trigger audio alarms, if the single alarm sound provided by the bed monitor happens to be similar to one or more other alarm sounds heard in response to different monitors, confusion and consequential lengthened response times to patient monitor alarms may result.
Those skilled in the art know that there are many nurse call station configurations and it is to the economic advantage of a manufacturer to be able to accommodate all of them. However, another problem with the present state-of-the-art in bed monitoring systems is that they are typically pre-configured internally at the factory for one particular type of nurse call station. Thus, if the unit is misconfigured when it arrives at an installation, it may be necessary to summon a medical technician to reconfigure it, since internal modifications to the unit are required to adapt it to different call station types. This can result in additional expense and delay in getting the unit correctly configured and into operation. Further, there are many hospitals that use multiple incompatible nurse call system types, each having been separately added as a new building or wing was constructed. The inability to quickly and reliably move electronic monitors between these systems means that the hospital will generally be required to maintain excess inventory of each type of compatible monitor, a result that ultimately adds to the health care costs borne by the consumer/patient.
Still another failure in known bed monitoring systems is that they do not provide a method of accumulating statistical data relating to the operation of the unit including, for example, the response times of the caregiver to alarm conditions. This sort of information could be very helpful to the maintenance and proper operation of the monitor, and for caregiver quality control purposes.
It is, therefore, a primary object of this invention to provide a patient monitor that is microprocessor-based so as to be reconfigurable by the uploading of configuration data to an electronically erasable programmable read only memory accessible by the microprocessor. A further object of this invention is to provide a microprocessor based patient monitor which synthesizes multiple alarm sounds in software for selection by the caregiver. It is also an object of this invention to provide a microprocessor based patient monitor having a nurse call interface allowing interconnection with any nurse call station without modification of the monitor. Yet another object of this invention is to provide a microprocessor based patient monitor having an electrically erasable programmable read only memory accessible by the microprocessor for logging statistical data with respect to the use of the monitor and the response time of the caregiver who is responding to the alarm. Another object of this invention is to provide a microprocessor based bed patient monitor which permits the downloading of the logged
Cooper Craig L.
Holmes Fred H.
Lovely Patrick W.
Smith Toby E.
Bed-Check Corporation
Fellers Snider Blankenship Bailey & Tippens, P.C.
Trieu Van T.
LandOfFree
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