This invention relates to cabinets or storage facilities for keeping patient medications and prescription drugs for a given patient. The invention is more specifically directed to a locking cabinet suitable for use in a hospital or health care facility, mounted in or on the wall of a patient room in a hospital or health care facility, to secure pharmaceuticals for a given patient or group of patients, and to facilitate keeping an audit trail of access to the items stored in the cabinet.
In general, pharmaceuticals are delivered to patients when needed, and this typically involves use of a medications cart containing the prescription medications for the patients on a given floor of the hospital or health center. The cart is typically loaded in a pharmacy department and then is brought to the particular hospital floor. The cart is wheeled from room to room to deliver each patient his or her drugs at the time that the nurse or other practitioner is to administer them. The use of a cart has been more convenient and more efficient than obtaining each patient's medications individually. However, the use of a cart to transport medications room to room is inefficient and awkward. The medications cart takes up valuable space in the hallway and corridors. Administering drugs from the cart involves bending and stooping to obtain the drugs from lower drawers. If the nurse needs a particular drug for one of her patients when another nurse has the cart for her medication rounds, then the first nurse has to spend time hunting the cart down and often it is difficult to find the cart. Also, when the pharmacy staff comes to the floor to restock the cart, the cart is often in use and difficult to find, resulting in wasted time for the pharmacy staff. Often, the cart does not fit into the patient's room. In addition, the portable cart requires periodic charging of its batteries, and this task is often overlooked and forgotten until a failure occurs.
It is more convenient and better use of the nurse's time and efforts to keep the pharmaceuticals at the patient locations, i.e., in the patient's room or ward, or in the cluster of rooms where the patient is located. Medications need to be secured at the place of administration, that is, kept locked with a key lock or other mechanism, with access limited only to persons in the nursing staff and pharmacy staff. A record of access to the pharmaceuticals needs to be maintained, but this usually requires making pen-and-ink entries on a paper record, or separately keying in information on separate computer work station.
My earlier U.S. Pat. No. 7,668,620 discloses a wall-mounted pharmacy cabinet situated at the patient location. Medications prescribed for a patient can be loaded into the cabinet by pharmacy staff and stored securely until administered to the patient. The system automatically tracks access to the cabinet. Nurse staff can access the cabinet electronically (e.g., using a passcode, a barcode reader, RFID device, fingerprint scanner or wireless means). The medications cabinet is kept secure, and with its drawers being closed and locked after each use.
It is desired for the pharmacy staff to be able to load these wall-mounted cabinets from the hallway, without having to actually enter the patient room. It is also desirable to protect patient privacy. All the advantages of the wall-mounted pharmaceutical cabinet (U.S. Pat. No. 7,668,620) should also be present in any improved cabinet as well. Where multiple patients occupy a hospital room, each patient should be provided with a respective drawer or bin, with the nurse being able to access these bins individually. At the same time, the pharmacy staff should be able to load all the bins or drawers for a given cabinet at one time.
Accordingly, it is an object of the present invention to provide a secure medications cabinet that avoids the drawbacks of the prior art.
It is another object to provide a medications cabinet and tracks of the identity or persons accessing the cabinet and times of such access, for each drawer or bin of the medications cabinet.
More particularly, it is an object to provide an in-wall pass-through medications cabinet to be accessed by pharmacy staff from the hallway side and accessed by nursing staff from the room side, with a number of individually locking bins or bins within locking compartments.
It is a related object that the drawers or compartments can be individually accessed by the nurse, one at a time, and pharmacy access is available by means of a single access door outside the room.
A further object is that access is possible from only one side at a time, so as to maintain privacy, but that the bins or drawers can be removed and replaced from either side.
According to an aspect of the present invention, a pass-through medications cabinet is built into a hospital wall, i.e, mounted in a wall of a patient room, where the wall separates the patient room from a hallway that passes along a number of hospital rooms. An enclosure frame is mounted into the wall and is disposed at an elevated position above the floor of the patient room, so that there is a room side that may be opened to the patient room and a hallway side that may be opened to the hallway. Within the frame there are a number of horizontal support racks or compartments, with elongated medication bins disposed on respective ones of the racks. The racks or compartments and their associated bins are arranged in a row or in a vertical stack (in a preferred embodiment), one above another and each being oriented laterally in the cabinet frame. That is, the racks and associated bins extend parallel to the wall. In an alternative embodiment, the bins or drawers can be in a horizontal row, at a right angle to the wall. A first, hallway-side door is located on the hallway side of the cabinet and is hinged onto the enclosure frame of the cabinet. This door can be opened in the hallway to provide pharmacy personnel with access all of the racks from the hallway side of the cabinet. From this side that the pharmacy staff can restock the medications cabinet without having to enter the patient room, with each door corresponding to a particular compartment and bin. A number of second, patient-side or room-side doors are located on the room side of the cabinet. Each of these doors is positioned in front of a respective one of the racks. The second doors can each be opened individually to access the patient medication bin in the respective rack. A controllable door lock arrangement is associated with the first, hallway-side door and said second, room-side doors. This permits the first, hallway-side door to be opened only when all of the second, room-side doors are closed, and permits the second doors to be opened only when the first, hallway-side door is closed. In a preferred embodiment, the room-side doors are also interlocked so that they can be opened only one door at a time, i.e., to administer medications to a specific patient in the room. Favorably, this can include a bin sensor in the compartment as an option, so that the bin would need to be reinserted into the compartment and the door closed before the nurse can access another compartment.
The controllable door lock mechanism can take the form of an electronic latch for the first door, and may be actuable by a specific pharmacy staff key device. The second door latch mechanism, which unlocks one or more of the room-side second doors, may be actuable by a second device specific to the nurse staff. This may employ RFID technology or bar code technology, for example, or may require entering an identity and/or code into a computer or touch screen. The pharmacy staff access may also occur by means of a physical key lock.
Favorably, the enclosure frame of the cabinet is substantially flush with the wall surface on the hallway side, so that the cabinet does not project into the hallway.
According to another favorable embodiment, a pass-through medications cabinet, also adapted to be mounted in a wall of a patient room, i.e., built-in, has an enclosure frame mounted in the wall and disposed at an elevated position above a floor of the room and has a room side that may be opened to the patient room and a hallway side that may be opened to the hallway. A medications cabinet box is mounted to one lateral side of the enclosure frame, which leaves an access space within the remaining lateral side of the enclosure frame. The box holds a number of pull-out medication bins or drawers stacked one above the other in the box. These drawers are disposed laterally to pull out into the access space within the enclosure frame. A first, hallway-side door is located on the hallway side of the cabinet and is hinged onto the enclosure frame. This first door can be unlocked and opened so that a pharmacy technician can reach into the access space within the enclosure frame.
One (or more than one) second, room-side door is located on the room side of the cabinet and is positioned in front of the afore-said access space. This door can be opened from within the patient room to access the pull-out medication drawers.
A controllable door lock mechanism is associated with the first door and second door. That door lock mechanism permits the first door to be opened only when the second door is closed and permits the second door to be opened only when the first door is closed. A controlled access mechanism in the medications box permits said medications drawers to be pulled out one at a time only when accessed from said room-side.
Favorably, each of the medication drawers can be pulled out and detached from the medication cabinet box for administering medication to the patient, and can then be re-inserted back into the box and pushed back fully into the box. The drawer or bin can be removed from either the hallway side or the room side.
Preferably, there is a tip-down shelf mounted on the room side or proximal side of the box. This shelf pivots between a raised position, in which the shelf is vertical and substantially flush with a proximal side of the box, and a lowered, horizontal position for supporting the medications drawer when the medications are being administered to the patient. There can be a walled shelf built into the lower portion of the second door and extending transversely across the door. This shelf may be used for storing non-medication materials, e.g., swabs, bandages, alcohol, or similar items.
In favorable embodiments, the medication drawers lie parallel to the wall. Also, in a preferred design, the first or hallway-side door is substantially flush with the surface of the wall on the hallway side. In an alternative embodiment, the drawers or bins may be arranged in a horizontal row, and with all the bins accessible from the hallway side, and each drawer being pulled out one at a time on the room side.
In the medications cabinets of this invention, access to the locked medication storage is available from both inside the room (for the nurse staff) and from the hallway (for the pharmacy staff). This has the great advantage that the pharmacy staff does not enter the patient's room to restock the patient's medications. This makes more efficient use of pharmacy personnel time, and also helps guard the patient's privacy. The compartments or bins are individually locking and accessible by the care-giving staff only for each respective patient. The hallway side door can be constructed to be fire-proof and smoke-proof, so as to meet general hospital building standards.
The pass-through cabinet can be opened only from one side at a time, which maintains privacy in the patient room, as one cannot see into the patient room when the hallway-side door is opened.
The bins or drawers can be removed from either side, although only one bin or drawer may be taken at a time from the room side.
A computer or electronic sensor tracks the opening of the doors or opening of the bin drawers, and helps maintain an audit trail of when each drawer was accessed and by whom. A trusted personnel manual over-ride feature can be included, for access during power outages or other malfunction. Normal locking and access are electronically controlled. A touchscreen panel, membrane switch, or PC control may be used for in-room opening. A touch screen panel, membrane switch, hand-held device, or other electronic key arrangement can be used for pharmacy access via the hall-way side door.
The above and many other objects, features, and advantages of this invention will become apparent from the ensuing description of selected preferred embodiments of this invention, with reference to the accompanying Drawing.
With reference to the Drawing, and initially to
The outside, i.e., hallway side or corridor side of the cabinet 10 is seen in
As shown in
In this embodiment, there is an internal interlock feature whereby only one of the room-side doors 12a, 12b, 12c, and 12d can be opened at any one time, and the nursing staff can access only the one bin 18 for a given patient at a time. The accessed compartment door has to be closed before another compartment door can be opened. In addition, the interlock allows the outer or corridor-side door 14 to be opened only when all of the room-side doors 12a to 12d are shut, and also allows the room-side doors 12a to 12d to be opened only when the corridor-side door 14 is shut. This feature precludes having inside doors and outside door or doors opened at the same time. This feature protects patient privacy, as it makes it impossible to see into the room through the cabinet.
While not shown here, the cabinet 10 may include a tip-down shelf at the room side, of the type described in connection with the next embodiment. The tip-down shelf can serve as a work area for the nursing staff.
The bins 18 can be of the general type discussed in my earlier U.S. Pat. Nos. 7,668,620 and 6,775,591. However, the invention should not be limited to a particular style, size, or shape of bin or drawer.
Another medications cabinet 110 embodying this invention is shown in
At the base of the door 112 there is a shelf 117, here in the form of a transverse box with walls and an open top, in which can be stored general medical supplies, such as bandages, wipes, gloves, disinfectants and the like. The medications box 111 and the swing-out door 112 are mounted in a frame 122 that is built into the wall 24.
The medications box 111 holds the pull out bins 118 (four bins in this embodiment) in a vertical stack, one bin above the other, and these pull out to the left, i.e., into the space 115. The bins 118 can be accessed from the interior of the room only when the door 112 is open, and the medications box is provided with a locking mechanism such that the bins or drawers 118 can be pulled out and removed only one bin at a time. Each bin 118 must be replaced and pushed fully back in before the next bin can be removed. As shown in
As in the first embodiment, there is an interlock so that only the hallway-side door 114 or the room-side door 112 can be opened, and preventing both doors to be opened at the same time. This feature enhances patient safety and ensures patient privacy, as it is not possible to see into the room when either the hallway-side door or the room-side door is opened.
In either of these embodiments, and in many other possible embodiments, the pass-through medications cabinet have the features of access to locked medications storage both from inside the room (for administration to the patient) and from the hallway (for the pharmacy staff), with individual locking drawers or compartments. The hallway side can be constructed to be fireproof and/or smoke-proof, so as to meet relevant building standards. There is access from only one side at a time, which maintains privacy in patient rooms. The bins or drawers can be removed from either the room side or the hallway side. The device can sense door opening and/or bin opening, and maintains an audit trail. One bin only at a time can be accessed in the room. The cabinet has electronic locking and unlocking, but also includes a manual over-ride feature for emergency use e.g. during a power failure. In room access may be by touchscreen panel, membrane switch, PC control or other system that is compatible with the hospital network. The outer or hallway-side access may employ touchscreen panel, membrane switch, RFID, or PC control, and there may be manual locking also on the hallway side, with pharmacy control of the physical key. Other beneficial features of the wall-mounted cabinet of U.S. Pat. No. 7,668,620 can also be incorporated into this pass-through medications cabinet system.
A third possible preferred embodiment is illustrated in
As shown in
As shown also in
In this embodiment, the cabinet distal end projects out into the hallway side of the wall 23, as shown in
While the invention has been described in terms of selected preferred embodiments, it should be understood that the invention is not limited only to those embodiments, but rather the scope of this invention is to be measured by the appended claims.
Number | Name | Date | Kind |
---|---|---|---|
1222964 | Matchette | Apr 1917 | A |
1359742 | Quinn | Nov 1920 | A |
1362798 | Hughes | Dec 1920 | A |
1469359 | Craw | Oct 1923 | A |
1639904 | Smith | Aug 1927 | A |
1738539 | Moss | Dec 1929 | A |
2034916 | Majors | Mar 1936 | A |
2163356 | Solberg | Jun 1939 | A |
2530543 | Schneeman | Nov 1950 | A |
2658667 | Mirkin | Nov 1953 | A |
2781965 | Dembs | Feb 1957 | A |
2853231 | Yorgey et al. | Sep 1958 | A |
3110438 | Leckner | Nov 1963 | A |
3129967 | Shoenfeld | Apr 1964 | A |
3130395 | Simjian | Apr 1964 | A |
4358171 | Christen | Nov 1982 | A |
5385265 | Schlamp | Jan 1995 | A |
5921191 | Gabel | Jul 1999 | A |
6079216 | de Marsillac Plunkett et al. | Jun 2000 | A |
6378769 | Wolgamot | Apr 2002 | B1 |
6415552 | Khosropour | Jul 2002 | B1 |
6484531 | Hambleton et al. | Nov 2002 | B1 |
6598546 | Alexander | Jul 2003 | B2 |
7001001 | Spencer | Feb 2006 | B1 |
7668620 | Shoenfeld | Feb 2010 | B2 |
7734372 | Shoenfeld | Jun 2010 | B2 |
20050049747 | Willoughby et al. | Mar 2005 | A1 |
20060265102 | Bain | Nov 2006 | A1 |
20080189779 | Goza | Aug 2008 | A1 |
20100223857 | Sutton et al. | Sep 2010 | A1 |
20100256800 | Heffron | Oct 2010 | A1 |