The invention relates to systems which assist in repositioning patients who are situated on beds, gurneys, or other such patient supports. The invention more particularly relates to systems which give a single health care worker the ability to move a patient from a slumped position to a more elevated or upright position in a patient support.
It is often desirable for patients to lie on platforms or patient supports in which the head portion of the platform has been raised or angled upwardly. Often, to obtain the most benefit and comfort from a bed in this raised position, the patient should be disposed such that the patient's abdomen and thorax are in an elevated position. However, elderly, weak, or incapacitated patients tend to slide or slump from this position toward the foot of the bed, thereby losing the healthful benefits of a more upright position. Many are unable to push or pull themselves back to a more comfortable, upright position.
Elderly, weak, or incapacitated persons in hospitals, nursing homes, or other assisted care settings must often be routinely and periodically pulled up from a slumped position when situated in patient supports, such as beds, carts, and gurneys. This pull-up maneuver is typically done manually by two or more attendants, although the number of attendants required to perform a maneuver increases with the weight of the patient. To return the patient to a position more toward the head of the bed, two or more health care workers may either grasp the patient by the upper arms, or grasp the sheet on which the patient is resting, and attempt to lift or drag the patient toward the head of the bed. This manual lifting may cause strain on the workers' upper and lower backs, as well as possible contact bruises on the patient. These lifting events may be necessary for a particular patient several times in a regular shift, requiring that the procedure be repeated.
A typical patient weighs between 45 and 90 kilograms, although many weigh more. These manual lifting activities often create unacceptable risks of injury to healthcare workers, almost without regard to the number of health care workers used in repositioning the patient. The risks are particularly high when a sufficient number of workers are not available to assist in a patient repositioning event. Injuries to workers' backs account for approximately 50% of worker's compensation costs for work place injuries in the health care industry in the United States.
Since a health care worker often has to bend at the waist to accomplish a patient pull-up, the stresses encountered are potentially magnified well beyond what would otherwise be expected for a maximum recommended lift of approximately fifty pounds. Normally this recommended maximum lift is measured with the lift at or near the worker's center of mass. Extremes in a health care worker's height, either taller or shorter than average, or any weakness in either the arms or legs, may further exaggerate these risks. Thus, back injuries to health care workers are a particularly vexing problem.
Given these difficulties, there have been attempts to mechanize the patient pull-up process. Typically, space is limited in hospital and assisted care rooms. Therefore, a device to effect patient pull-ups should preferably occupy a minimum of space or should be incorporated into the design of existing patient supports. Patient pull-ups are typically performed at frequent intervals and it is usually not feasible to transport equipment to and from a room to perform a patient pull-up every few hours, for example.
U.S. Pat. No. 2,827,642, issued to Huff on Mar. 25, 1958, discloses a device for moving a patient on a bed. The device includes a shaft mounted in ball bearing brackets. The brackets are bolted or otherwise secured to the headposts of the bed. Straps for a fabric webbing are secured to the shaft and a fabric supporting section is secured to the straps. A crank handle is removably secured to one end of the shaft. A patient lying on the fabric supporting section is pulled toward the head of the bed by cranking, and thereby winding the straps on, the shaft.
U.S. Pat. No. 5,608,929, issued to Crane on Mar. 11, 1997, discloses a patient-positioning device. The positioning device includes a sheet which is placed under the patient and connected to a rope or braided line. One end of the braided line is anchored to a metal peg on the headboard. The remainder of the braided line is threaded through several pulleys. One of the pulleys is attached to a frame assembly. The patient is pulled up when the head portion of the bed is raised or by an independent motor operating to wind the line.
U.S. Pat. No. 3,597,774, issued to Warren on Aug. 10, 1971, discloses a patient moving device which is attached to hospital beds. The patient moving device includes an adjustable post and clamps for attaching the post to the head of a bed. A winch is mounted on the post. A patient to be pulled up is secured with apron straps and apron tabs are connected to a T-bar. The T-bar is connected to a cable. The winch is operated to wind the cable and pull the patient up. Alternatively, a harness is employed. The harness is arranged under the patient's arm pits and connected to the T-bar before the winch is operated to pull the patient up.
U.S. Pat. No. 4,776,047 issued to DiMatteo on Oct. 11, 1988, discloses a multiple function invalid bed arrangement for transferring a prone patient longitudinally or laterally between beds or surfaces adapted to accept the patient in a prone position. The longitudinal bed transfer is accomplished by equipping the patient's bed with two rollers, one roller at the head and one roller at the foot of the bed. A bed sheet is connected from the head to the foot roller much like a piano roll. The rollers are rotated to transfer the patient to a second bed which is equipped similarly.
U.S. Pat. No. 4,868,938 issued to Knouse on Sep. 16, 1989, discloses a transportable patient mover and moving method. The patient mover moves a patient laterally from a first to a second surface such as from a bed to a gurney. The patient mover includes a bottom stand member and an upstanding support frame carrying an elongated roller. The support frame may be mounted on wheels or casters. One edge of a web-like sheet material is attached to the roller. The other edge of the web material is attached to a clamp. The clamp secures a transfer sheet disposed beneath a patient and the roller winds the web thereon, thereby transferring the sheet and patient thereon.
A need exists for a device which can enable a single attendant to effect patient pull-ups which may either be retrofitted on existing patient supports, or which may be incorporated into the design of future patient supports, such as beds, gurneys, carts, tables, or similar patient supports.
A patient support apparatus having a support frame and a sheet disposed on the support frame, is adapted to support a patient situated on the sheet. A patient pull-up device is operatively coupled to the patient support apparatus, the patient pull-up device comprising a translating device, a frame member operatively coupled to the translating device, and a fastener operatively coupled to the frame member adapted to engage the sheet. The translating device is adapted to move the frame member generally longitudinally with respect to the support frame, thereby moving the patient to a more upright position on the patient support apparatus.
A patient pull-up device according to an embodiment of this invention is adapted to be mounted on or coupled to a patient support, such as a bed, gurney, cart, table, or like patient supports. The patient pull-up device of this invention is contemplated to be used to effect patient pull-ups on patient supports which may be conformable to a generally horizontal position, although patient pull-ups may be effected on patient supports without this capability as well. Embodiments of the invention can be used to effect patient pull-up events on patient supports in which the head portion thereof may be in an elevated position, such as anywhere from about 5 degrees to about 90 degrees from the horizontal.
A patient pull-up device according to an embodiment of the invention comprises a translating device, a frame member operatively coupled to the translating device, and a fastener operatively coupled to the frame member. The patient pull-up device is adapted to be coupled to a patient support apparatus for moving a patient situated on a sheet disposed on the support apparatus. The fastener engages the sheet. The translating device is actuated to move the frame member generally longitudinally to the patient support apparatus, thereby moving the sheet and the patient situated thereon.
A method of moving a person into a more upright position on a support apparatus, according to an embodiment of the invention, includes providing a support apparatus on which a person is situated on a sheet, coupling a pull-up device to the support apparatus, the pull-up device having a fastener, a frame member coupled to the fastener, and a translating device coupled to the frame member, operating the fastener to engage the sheet to the frame member, and operating the translating device to move the frame member longitudinally to the support apparatus, thereby moving the sheet and patient situated thereon into a more upright position.
The following discussion is presented to enable a person skilled in the art to make and use the invention. Various modifications to the illustrated embodiments will be readily apparent to those skilled in the art, and the generic principles herein may be applied to other embodiments and applications without departing from the spirit and scope of the present invention as defined by the appended claims. Thus, the present invention is not intended to be limited to the embodiments shown, but is to be accorded the widest scope consistent with the principles and features disclosed herein. The following detailed description is to be read with reference to the figures, in which like elements in different figures have like reference numerals. The figures, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention. Skilled artisans will recognize the examples provided herein have many useful alternatives which fall within the scope of the invention.
Embodiments of the invention are not limited to patient supports, such as those found in hospitals, for example, and may be adapted for use in other types of supports, such as beds, chairs, and couches. However, for purposes of illustration only, the invention is described below in the context of hospital beds.
Patient 100 may gradually slide down from a comfortable upright/reclined position into an uncomfortable slumped position, due to the force of gravity. A weak or incapacitated patient may be unable to return themselves to a more comfortable upright position after sliding down into a slumped position. Patient 100 may be periodically returned to a more comfortable position using patient pull-up device 110 to move patient 100 nearer the head of the patient support 112 (i.e., nearer headboard 108 in the embodiment shown in
Patient pull-up device 110 comprises several elements which assist in moving sheet 104. As shown in
As illustrated in
Frame member 122 may include a bed rail 103 on either end as shown in
Translating device 130 is operatively coupled to frame member 122. Translating device 130 may house a drive mechanism and motor assembly within translating device 130, and may include a configuration of gears adapted to transfer an appropriate amount of torque and speed from the motor within translating device 130 to move frame member 122 relative to patient support 112. A wide variety of motors and drive mechanisms may be utilized and can be appropriately selected for this purpose by one of ordinary skill in the art. Additionally, the motors and drive mechanisms may be selected from among those disclosed in U.S. Pat. Nos. 6,378,148, 6,496,991, and 6,772,456, each of which is herein incorporated by reference in its entirety. Electric, magnetic, hydraulic, and other forms of motors and drive mechanisms may be suitably adapted for use in translating device 130 to provide the motive force for moving frame member 122 relative to patient support 112.
In one embodiment, for example, a worm gear and electric drive motor may be housed within translating device 130 to provide the motive force to move frame member 122. The drive motor may be configured to cause the worm gear to rotate. The rotating worm gear thereby causes horizontal motion of a threadably coupled member within translating device 130 that is operatively coupled to frame member 122, thereby providing horizontal motion to the frame member 122. The direction of motor rotation may also be reversed, thereby reversing the rotation of worm gear and ultimately, reversing the direction of horizontal motion of the frame member 122. The motor may be designed, for example, to apply a slow, steady and constant force to move patient 100 without jerking. The motor may further provide variable speeds of movement consistent with gradual starts and stops and safe movement of the patient throughout the length of travel. Sheet 104 helps distribute forces over significant areas of the patient's body to minimize any localized pressure or pain to patient 100. When patient 100 has been pulled up to a comfortable position, the motor may be turned off or otherwise disengaged.
Translating device 130 may be operated from a control panel (not shown), as is known in the art. The control panel may be located on any suitable portion of patient pull-up device 110, such as on translating device 130, on a portion of frame member 122 such as a bed rail support portion 105, or on a portion of bed rail 103 such as upper portion 102 or fastener (clamp 106), according to the embodiment of the invention depicted in
Frame member 122 may include a bed rail support portion 105 disposed on either end of beam 120 for operatively coupling each bed rail 103 to the frame member 122 as shown in
A portion of frame member 122 is further illustrated in
As noted previously, bed rail 103 may be adapted to engage sheet 104 to effectuate the patient pull-up event. In
Clamp 106, depicted in
In practice, a healthcare worker may pull a portion of sheet 104 across frictional surfaces 111 exposed between upper portion 102 and clamp 106, as illustrated in
Clamp 106 and upper portion 102 of bed rail 103 may be adapted to mechanically interlock with one another when clamp 106 is placed in the closed or clamped position. The bed rail 103 may, in certain embodiments, include means for releasing the mechanical interlock, such as by a release button, for example. A release button may be located on clamp 106, for example, where indicated by local controls 115 in
There are many possible embodiments of control units for controlling the operation of translating device 130. In one possible embodiment, a remote control unit may be adapted to communicate with translating device 130 by means of electromagnetic radiation, such as by radio frequency, or by other means, and thereby control operation of translating device 130. Other embodiments of control units may communicate with translating device 130 by means of an electrical coupling or other suitable communication means. The cord may mechanically and/or electrically couple the control unit to the translating device 130 and may be disposed on a spool or other retaining means proximate the patient pull-up device 110. In an alternative embodiment, a control unit for the patient pull-up device 110 may be operated via voice actuation as is known in the art. Voice actuation would enable the patient 100 to effect the patient's own pull-up and to halt a transfer in progress if the need to do so arose.
The patient pull-up device 110 may also contain an automatic recording and/or display mechanism for recording each patient pull-up event. Recording may be via a printout on paper, for example to facilitate placement in a patient's chart, or by other means, such as by electronic storage or transfer of information. The stored information may then be transferred to a computer or other device as desired. Information regarding a pull-up event may include the time of day, the patient's number and name, the attendant's name and number, and the time length of the pull-up event. Other items, such as motor performance, speed, acceleration, alignment, or other parameters of the patient 100 or the pull-up device 110 when transferring the patient 100 may also be recorded.
As shown in
Referring again to the embodiment shown in
In an alternate embodiment, the fastener may be a clamp, for example, adapted to pivot transversely rather than longitudinally, such that the clamp opens and closes in a direction that is either toward or away from patient 100. A variety of alternative clamp designs as are known in the art may be employed for use as the fastener (rather than clamp 106 as shown in
Thus, embodiments of a BED RAIL CLAMP PULL-UP are disclosed. One skilled in the art will appreciate that the present invention can be practiced with embodiments other than those disclosed. The disclosed embodiments are presented for purposes of illustration and not limitation, and the present invention is limited only by the claims that follow.
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