Patent Application
20170333279
Sequential compression therapy (SCT) is often used for prevention of deep venous thrombosis (DVT). Traditionally monitoring compliance and the utilization of sequential compression therapy by a patient are accomplished by a caregiver. While various systems have been developed for monitoring sequential compression therapy, there is still room for improvement. Thus, a need persists for further contribution in this area of technology.
The present disclosure includes one or more of the features recited in the appended claims and/or the following features which, alone or in any combination, may comprise patentable subject matter.
One embodiment of the system to track usage of a compression sleeve comprises a compression sleeve, a fluid supply operable to inflate the compression sleeve, a processor configured to control the operation of the fluid supply and a memory device configured to record duration of the inflation of the compression sleeve.
Another embodiment of the system to monitor compliance of a compression sleeve usage comprises a memory device configured to record usage of a compression sleeve, a processor configured to compare the usage with a predetermined threshold.
One embodiment of the method to monitor compliance of a compression sleeve usage comprises determining usage of a compression sleeve, comparing usage of a compression sleeve with a predetermined threshold and determining compliance by comparing usage of a compression sleeve with the predetermined threshold.
Another embodiment of a system to monitor compliance of a compression sleeve usage comprises a compression sleeve and a first processor mounted on the compression sleeve configured to determine duration of inflation of the compression sleeve and communicate with a second processor mounted on a person support apparatus.
According to some embodiments, a system may include a sequential compression device (SCD) that may be used by a patient as part of a sequential compression therapy (SCT) protocol and a computer device that may determine whether the SCD is in use in substantially real time in compliance with the protocol and that may initiate a notification to a caregiver if noncompliance with the SCT protocol is detected.
In some embodiments, the computer device may determine whether an excused non-use condition exists. The excused non-use condition may correspond to a caregiver being present in the room of the patient or may correspond to the patient being off a person support apparatus.
In some embodiments, the computer device may determine that the SCD should be in use currently. The determination that the SCD should be in use may be based on one or more of the following: a locating tag of the SCD being sensed in the patient's room, a locating tag attached to a compression sleeve of the SCD being sensed in the patient's room, a locating tag attached to an SCD pump of the SCD being sensed in the patient's room, and the patient being sensed to be in the patient's room. In this regard, the system may include a locating tag for tracking the location of the patient or a wristband for tracking the location of the patient.
The determination that the SCD should be in use may be based on an electronic order. The electronic order may be entered at the patient's bedside or may be stored in a patient's electronic medical record (EMR), for example. Alternatively or additionally, the determination that the SCD should be in use may be based on at least one risk factor of the patient. The risk factor may include the patient having poor circulation or that the patient is recovering from surgery.
In some embodiments, the SCD being in use may be determined based on detecting one or more of the following: an SCD pump is on, the SCD pump is blowing air, the SCD pump is moving fluid, a motor of the SCD pump is drawing current, a compression sleeve is connected to the SCD pump, the compression sleeve is inflated to a threshold pressure, the SCD pump experiences a threshold back pressure due to pressurization of the compression sleeve, or a threshold amount of force is sensed by a sensor indicative of force between the compression sleeve and the patient.
Additional features, which alone or in combination with any other feature(s), such as those listed above, may comprise patentable subject matter and will become apparent to those skilled in the art upon consideration of the following detailed description of various embodiments exemplifying the best mode of carrying out the embodiments as presently perceived.
The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the claimed subject matter and, together with the description, serve to explain the principles of the claimed subject matter. In the drawings:
The embodiments of the claimed subject matter and the various features and advantageous details thereof are explained more fully with reference to the non-limiting embodiments and examples that are described and/or illustrated in the accompanying drawings and detailed in the following description. It should be noted that the features illustrated in the drawings are not necessarily drawn to scale, and features of one embodiment may be employed with other embodiments as the skilled artisan would recognize, even if not explicitly stated herein. Descriptions of well-known components and processing techniques may be briefly mentioned or omitted so as to not unnecessarily obscure the embodiments of the claimed subject matter described. The examples used herein are intended merely to facilitate an understanding of ways in which the claimed subject matter may be practiced and to further enable those of skill in the art to practice the embodiments of the claimed subject matter described herein. Accordingly, the examples and embodiments herein are merely illustrative and should not be construed as limiting the scope of the claimed subject matter, which is defined solely by the appended claims and applicable law. Moreover, it is noted that like reference numerals represent similar parts throughout the several views of the drawings.
It is understood that the subject matter claimed is not limited to the particular methodology, protocols, devices, apparatus, materials, applications, etc., described herein, as these may vary. It is also to be understood that the terminology used herein is used for the purpose of describing particular embodiments only, and is not intended to limit the scope of the claimed subject matter.
Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art.
A person support apparatus 10 according to one illustrative embodiment of the current disclosure is shown in
FIG.1 illustrates a system to track usage of a compression sleeve comprising a fluid supply 22 mounted on the person support apparatus 10 and fluidly connected to the compression sleeve 20 using any one of a multitude of connection mechanisms, including quick disconnect type connectors. Compression sleeve 20 may be of any form, including but not limited to cuffs, boots and/or a wrap and may be customized to fit any body part. In one embodiment, the fluid supply 22 is removably mounted on the foot board FB, head board HB or the side rails SR. In another embodiment, the fluid supply 22 may be mounted on the compression sleeve 22. The fluid supply 22 may be used for other functions of the person support apparatus 10, including but not limited to inflation and/or deflation of a mattress.
In another embodiment, the system to track usage of a compression sleeve 20 comprises a dedicated fluid supply 22. The fluid supply 22 provides fluid to the compression sleeve 20 during inflation and vents the fluid from the compression sleeve 20 during deflation of the compression sleeve 20 in one embodiment. The fluid supply unit may be pneumatic or hydraulic in nature and may comprise a pump, blower, fan and/ or a compressor. Therefore, the compression sleeve may be inflated with air, water, oil or any other fluid.
A controller 24 comprises a processor 26 in communication with the fluid supply 22 and provides a control signal to the fluid supply 22 to inflate or deflate the compression sleeve 20. The processor 26 also communicates with a pressure sensor 34 mounted on the compression sleeve 20 to allow measurement of the pressure inside the inflated compression sleeve 20 and/or the pressure applied on a patient's extremity to which the compression sleeve 20 is mounted. Alternatively, back pressure and/or electrical characteristics such as current and voltage changes of the prime mover of the fluid supply 22 may be used to determine the pressure in the compression sleeve in another embodiment.
An electrical stimulation device 36 is mounted in the compression sleeve 20 to provide appropriate therapy to the patient in some embodiments. The electrical stimulation device 36 may be of any type, including a Transcutaneous Nerve Stimulation (TENS) type for blocking pain and/or an Electro Muscle Stimulation (EMS) device for stimulating muscles. The electrical stimulation device 36 is in communication with and receives control signals from the processor 26 to initiate or terminate therapy. In one embodiment, the electrical stimulation device 36 receives power from the controller 24 while in another embodiment the electrical stimulation device 36 has a dedicated power source such as a battery pack.
The controller 24 is in communication with a Graphical User Interface (GUI) 48 to display alarms and other messages. The GUI 48 is integral to the person support apparatus 10 in one embodiment and is used to control other functions of the person support apparatus 10. The GUI 48 also allows for user inputs and commands to set thresholds for the amplitude, frequency and/or time duration of SCT and/or electrical stimulation therapy. These thresholds may be in the form of an upper bound (should not exceed), lower bound (should be greater than) and/or a range. The processor 26 uses these thresholds to determine compliance with prescribed therapy.
In one embodiment, the duration of cumulative therapy is tracked by the processor 26, by storing, in a memory device 28, data related to inflation and deflation of the compression sleeve 20 and/or operation of the electrical stimulation device. The memory device 28 may be of any type, including volatile and non-volatile types. If the cumulative duration of therapy does not meet the criteria established earlier, an alarm will be displayed on the GUI 48. Display of other performance characteristics of the therapy on the GUI 48 is well within the scope of this disclosure, including, but not limited to cumulative duration of therapy, duration of therapy of current session, average amplitude of therapy which in one embodiment may be the pressure and/or the electrical stimulation applied and frequency of therapy. The GUI 48 also allows a user to clear previously stored data in the memory device 28 and/or initiate therapy. In another embodiment, the system to track usage of a compression sleeve includes a dedicated GUI 48, which may be in the form of a pendant.
The illustrative embodiment of FIG.2 shows a compression sleeve 20 mounted in a stirrup 30 used in conjunction with an operating table. In the embodiment shown in
The illustrative embodiment as shown in
The GUI 48 is also configured to display data obtained from physiological sensors 32 via processor 26. The illustrative embodiment as shown in
The illustrative embodiment of
In the illustrative embodiment shown in
In the illustrative embodiment shown in
According to this disclosure, a system and method is provided for determining noncompliance with a protocol relating to the use of a sequential compression device (SCD) as part of sequential compression therapy (SCT). The system determines that an SCD should be in use in substantially real time (aka that the device should be in use “at this moment”) and alerts one or more caregivers of the nonuse of the SCD so that the nonuse can be rectified. In order to determine compliance or non-compliance with the SCT protocol, the system first determines whether SCD use is required. This determination is made, in some embodiments, based on the detection of a physical trigger, such as a locating or tracking tag of an SCD being sensed in a particular location, such as a patient's room. In some embodiments, a tag attached to a compression sleeve and a tag attached to an SCD pump both need to be sensed in the same location in order for the system to determine that SCD use is required. Alternatively or additionally, a patient also needs to be sensed in the same location as the sleeve and/or pump. A patient wristband or location tag may be used to sense the location of the patient. Thus, in this latter embodiment, if a patient along with one or both of a compression sleeve and an SCD pump are determined to be in the same location (e.g., patient room), then the system makes the determination that the SCD device should be in use.
In other embodiments, an electronic order, such as one entered at the bedside or stored in a patient's electronic medical record (EMR) is considered by the system in making the determination that an SCD should be in use. In such embodiments, even if an SCD (e.g., pump and/or sleeve) is absent from a patient's location, if there is a physician's order for the patient to be undergoing SCT, then the system makes the determination that an SCD should be in use. Alternatively or additionally, based on other information in a patient's EMR or based on care setting, the system makes the determination that an SCD should be in use. For example, patients with poor circulation or other risk factors may be prescribed SCT after surgery for a certain number of hours in some healthcare facilities. Thus, based on information that a patient with such risk factors has just finished surgery, the system is able to make the determination that an SCD should be in use for that patient.
To summarize, there are a variety of ways contemplated by this disclosure to determine whether an SCD should be in use for a particular patient including the following: a tagged SCD pump has been placed in the patient's room; a tagged compression sleeve has been placed in the patient's room; a patient is designated as an at risk patient in the patient's EMR; the patient is designated as an at risk patient based on information transmitted from the patient's wristband; the patient is designated as an at risk patient based on a standard protocol; there is a physician's order for the patient to receive SCT; and/or the patient is in a particular location (e.g., all patients in post-op should be receiving SCT from an SCD).
In some embodiments, the algorithm of
If at block 54, the patient is not in bed, then algorithm loops back to block 50 without checking the patient's identity. The patient being out of bed is considered to be one of the situations in which non-use of the SCD is excused according to some embodiments. For example, the patient may be going to the bathroom or may be scheduled for therapy or lab work in a different area of the healthcare facility. After the patient's identity is confirmed at block 56 and the patient is in bed as determined at block 54, then the second iteration through block 54 results in the algorithm advancing to block 58 and making a determination that no caregiver is present in the patient's room. If a caregiver is present in the patient's room, then this is also considered an excused non-use of the SCD by the patient, the assumption being that a caregiver may be attending to other medical needs of the patient or may be replacing a soiled compression sleeve or performing some other task. If at block 58 it is determined that caregivers are absent from the patient's room, then the SCD should be in use as indicated at block 60.
After it is determined that the SCD should be in use, the algorithm proceeds to make the determination regarding whether or not the SCD is actually in use currently by the patient as indicated at block 62. This determination is made based on data transmitted by compression sleeve 20 and/or fluid supply 22. For example, data indicating that the pump is active and/or that various zones of sleeve 20 are being pressurized is indicative that the SCD is in use currently. In some embodiments, a detected use involves detecting one or more of the following: the SCD pump is on, the SCD pump is blowing air (or moving other fluid), the motor of the SCD pump is running or drawing current, the compression sleeve is connected to the pump, the compression sleeve is inflated to a threshold pressure, the pump experiences a threshold back pressure due to pressurization of the compression sleeve, and/or a threshold amount of force is sensed by a sensor (e.g., piezoelectric sensor or force sensitive resistor (FSR)) positioned between the sleeve and the patient or otherwise positioned to sense pressure between the sleeve and the patient. On the other hand, if the one or more conditions just described are not detected, then this corresponds to a detected non-use. So, if no pump or sleeve is determined to be located in the room, if the pump is not operating, or if the sleeve is not being pressurized, then the algorithm determines at block 60 that there is a detected non-use condition.
After the use or non-use of the SCD is detected at block 62, the algorithm proceeds to block 64 and determines whether the use or non-use detected at block 62 is in compliance with the protocol for the associated patient. For example, even if the SCD is not in use, it could be that the duration of the SCT has expired or rest periods are permitted within the scope of the protocol. Thus, a detected non-use does not necessarily indicate a violation of the protocol. If at block 64 it is determined that the use or non-use of the SCD is in compliance with the protocol, then algorithm 66 proceeds to block 66 and tracks the use or non-use of the SCD. For example, the starting and ending times of the SCT are tracked in some embodiments. Alternatively or additionally, the frequency and/or pressure set points are tracked. Tracking refers to storing information in a database regarding the use and/or non-use of the SCD.
If at block 64 it is determined that the use or, more likely, the non-use of the SCD is not in compliance with the protocol, the algorithm proceeds to block 68 and notifies a caregiver of the noncompliance. After the notification, the algorithm proceeds to block 66 and data continues to be tracked even in the event of non-compliance. In the event of noncompliance with the SCT protocol, a number of solutions for achieving compliance may be undertaken according to this disclosure. For example, a caregiver is reminded of the protocol, such as via a message to a communication device carried by the caregiver, and guided to implement the SCT. A caregiver is notified that a patient has disabled the SCT and the caregiver can then work with the patient to address the issue and convince the patient of the benefits of compliance with the SCT protocol.
In some embodiments, a nurse manager is notified of the noncompliance and provides further training to an assigned caregiver regarding the value of the SCT and protocol compliance. Optionally, hospital administrators are able to track and reward continually increasing compliance with the SCT protocol. Hospital administrators may also use the gathered information of compliance and noncompliance with the SCT protocol to demonstrate a correlation between protocol compliance and improved patient outcomes. Furthermore, it is contemplated by this disclosure that the data regarding SCT protocol compliance is stored in other healthcare information systems such as the EMR 44.
In connection with the locating and tracking tags mentioned above, it will be appreciated that locating and tracking system are known in the art. See, for example, U.S. Pat. Nos. 8,421,606; 7,907,053; 7,734,476; 7,450,024; 7,248,933; 7,242,306; 6,972,683; and 6,825,763, each of which is hereby expressly incorporated by reference herein.
The use of the terms “a” and “an” and “the” and similar referents in the context of describing the subject matter (particularly in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. Furthermore, the foregoing description is for the purpose of illustration only, and not for the purpose of limitation, as the scope of protection sought is defined by the claims as set forth hereinafter together with any equivalents thereof entitled to. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illustrate the subject matter and does not pose a limitation on the scope of the subject matter unless otherwise claimed. The use of the term “based on” and other like phrases indicating a condition for bringing about a result, both in the claims and in the written description, is not intended to foreclose any other conditions that bring about that result. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention as claimed.
Preferred embodiments are described herein, including the best mode known to the inventor for carrying out the claimed subject matter. Of course, variations of those preferred embodiments will become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventor expects skilled artisans to employ such variations as appropriate, and the inventor intends for the claimed subject matter to be practiced otherwise than as specifically described herein. Accordingly, this claimed subject matter includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed unless otherwise indicated herein or otherwise clearly contradicted by context.
The disclosures of any references and publications cited above are expressly incorporated by reference in their entireties to the same extent as if each were incorporated by reference individually.
This application is a continuation of U.S. application Ser. No. 14/041,128, filed Sep. 30, 2013, which is a continuation-in-part of U.S. application Ser. No. 13/410,502, filed Mar. 2, 2012, each of which is expressly incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| Parent | 14041128 | Sep 2013 | US |
| Child | 15659906 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 13410502 | Mar 2012 | US |
| Child | 14041128 | US |
