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intelligent beds

Intelligent Beds

Presented by

Alexandra Archer, RN

objectives
Objectives
  • Describe intelligent beds.
  • Explore examples, uses, and producers of intelligent beds.
  • Discuss hardware and software used with the VersaCare TC bed.
  • Describe the information system used, it’s functions, and usability.
  • Review the advantages, disadvantages, and any ethical or legal issues that may arise with use.
  • Discuss the competencies needed and responsibilities of the IN or INS.
how smart is your bed
How smart is your bed?
  • What is an intelligent bed?
    • Medical equipment and technology combined.

People + Process + Technology = Enhanced Outcomes

(Hill-Rom, 2007)

medical equipment and technology combined
Medical Equipment and Technology Combined
  • EU and Phillips “My Heart” Project
  • Hill-Rom’s Versa-Care TC Bed
    • Cerner Medical Records System
my heart bed
“My Heart” Bed
  • Four year project to create bed to monitor heart failure patients.
  • European Union and Phillips
  • Approximately 63,500 new cases of heart failure/year in the UK.
  • Possibilities: scale, blood pressure monitor, heart sensors paired with a patient vest.

(BBC News, 2007)

hill rom
Hill-Rom
  • “A leading worldwide and manufacturer and provider of medical technologies and related services for the healthcare industries (Hillenbrand, 2008)…”
  • Creator of first “intelligent bed”
  • Over 250,000 sold since 1995
  • Located in Batesville, Indiana
  • Founded in 1927

(Hill-Rom, 2009)

cerner corporation
Cerner Corporation
  • “Leading supplier of healthcare information technology that optimize clinical and financial outcomes (Cerner, 2009).”
  • Paperless
  • Located in Kansas City, MO
  • Founded in 1979
  • Partnering with Hill-Rom since 2008 to integrate technologies (Hillenbrand, 2008).
hardware of the versacare tc
Hardware of the VersaCare TC
  • CPU
  • Battery Power
  • Memory
  • Power transport and braking
  • Bed monitor screen
hardware continued
Hardware (continued)
  • Connected to Hospital Network Desktops with
    • CPU and Memory
    • IDE
    • Servers and Master Stations
      • with Drives (CD-Rom, flash, etc.)
      • TDM switches connected to call systems in patient’s rooms
    • Power Supply all specific to each hospital system
tdm switch
TDM Switch
  • Switches
  • Signals
  • Functions for landline and wireless telecommunication services via
    • AM
    • SM
    • CM

TDM SWITCH

SM

CM

CPU (AM)

software of the versacare tc
Software of the VersaCare TC
  • Point-of-Care patient controls
  • SideCom patient communication controls
  • Comlix Nurse Communication Module
  • NaviCare patient safety monitoring system
navicare a clinical information system
NaviCare: A Clinical Information System
  • Connects Hill-Rom’s Smart beds to the hospital network, wireless communication devices, and call systems.
  • Direct line to each room
  • No busy signals
  • Easy to use touch screen displays
  • Icon based LED dome lights
  • Secure remote diagnostic and support capabilities

(Hill-Rom, 2007)

navicare s functions
NaviCare’s Functions
  • Reporting and documentation
  • Benchmarking
  • “Actionable data for closed loop continuous improvement”

Hill-Rom, 2009

configuration
Configuration

Hill-Rom, 2009

navicare s users
NaviCare’s Users
    • Nurses
    • Nurse’s aides
    • Physicians
  • Unit clerks
    • Technicians and transport (orderly)
    • Respiratory, physical, and occupational therapists
specific functions for users
Specific Functions for Users
  • Message alarms to nurse’s station
    • Safe bed position/height/ head of bed alarm (less than 30 degrees)/bed brakes
    • Bed exit alarm
  • Therapy alert and reminders sent to nurse’s station
    • Automated percussion/vibration therapy/rotation therapy
    • Chair therapy/stand assist mode/turn assist mode
specific functions for users1
Specific Functions for Users
  • Track and surveillance patient flow
    • Geographic location and length of time spent in any one area
    • Bed position and head of bed angle
  • Track and surveillance staff
    • Geographic location and length of stay in an area
    • Response time to patient calls
navicare system usability
NaviCare System Usability
  • 300 IT professionals to survey and conduct field studies
  • 30 interfaces to major IT vendors for focus groups and surveys of potential and actual users
  • A database of over 1.3 million patients and 700 facilities (Hill-Rom 2008)

“Easy to use and adopt proven platform, running many of the nation’s leading healthcare institutions for nearly a decade.”

axiom 1
Axiom 1
  • 6 different types of beds/cables and 3-4different call systems prior to 2002.
  • Since then, 1 bed and 1 system.
  • Average falls decreased from 5 falls per thousand patient days to 1.4.

“Interconnectivity is key to ensuring that the beds are connected to the call system so that caregivers receive messages and get to the customer in a timely manner at St. Joseph’s/Candler.”

= minimal effort and maximum efficiency! (Hill-Rom, 2007)

axiom 2
Axiom 2
  • Walking stick figure = patient has left admitting and is on their way to Pre-Op.

“HUP staff particularly like the elegant simplicity and functionality of the OR Module.” (Hill-Rom 2005)

axiom 3
Axiom 3
  • Cap Gemini Ernst and Young Study (United Hospital) found
    • full return on investment
      • in less than 6 months
      • realized benefits valued at $5 million annually

United Hospital is “now better positioned to manage capacity, accommodate growth, provide efficient care, and manage resources.” (Hillenbrand 2005)

axiom 3 continued
Axiom 3 (continued)
  • Twin Cities Metropolitan Area EMSystem Hospital Closure Summary (2003)
    • In one year of installation, “United’s ED achieved the lowest divert rate of any Twin Cities hospital…”

“Of the 40,000 patients who visit the United ED annually, 28 percent are now admitted, up from 24 percent just three years ago.” (Hill-Rom 2004)

advantages
Advantages
  • Easy to use
  • Built in safety and transportation features
  • Tracking/surveillance features
  • Research/data collection capabilities
  • Protection for patients against lack of activity, falls, skin breakdown, bacteria, ventilator associated pneumonia for patients
  • Protection against injuries for both patients and nurses
disadvantages
Disadvantages
  • Possible lack of interaction with patient
  • Possible technological malfunctions
  • Expensive maintenance
  • Possible required upgrades
  • PRICE!
ethical legal issues
Ethical/Legal Issues
  • Misuse of equipment
  • Possible injuries incurred
  • Possible negligence
  • Initial increases to already excessive health care costs
informatics competencies
Informatics Competencies
  • Ability to safely utilize hard and software to functionalize the bed
    • Recognize alarms/set alarms/reminders/alerts
    • Perform care and transport safely
  • Instruct patient of proper use of bed to communicate and meet needs
  • Ability to collect and navigate data sent to call system/ wireless system
  • Ability to functionally use surveillance and tracking modes
functions and responsibilities of the in and ins
Functions and responsibilities of the IN and INS
  • Ability to obtain and maintain the competencies reviewed
  • Maintain standards of practice
  • Maintain HIPAA
  • Adhere to certification requirements and continuing education standards
are intelligent beds smart
Are intelligent beds smart?
  • Yes!
  • Are they smart to use? Maybe!
references
References
  • Acuity Care Technology (2008). NaviCare nurse call delivers enhanced features to hill-romnavicare platform. Retrieved July 15, 2009 from: http://new.reillycomm.com/acuity/makingheadlines.php?id=4314.
  • American Nurses Association (ANA).(2001). Scope and standards of nursing informatics practice. Washington, D.C: American Nurses Publishing.
references continued
References (continued)
  • Barton, A.J. (2005). Cultivating informatics competencies in a community of practice. Nursing Administration Quarterly, 29(4), 323-328.
  • Blumberg, et al. (2006). Back out provision for failed programmable hardware update: Patent No. 7146541. Retrieved June 22, 2009 from: http://www.freepatentsonline.com/7146541.html.
  • British Broadcasting Corporation. (February 23, 2008). Heart-check beds to be developed. BBC News (electronic version). Retrieved June 2, 2009 from:http://news.bbc.co.uk/2/hi/health/7259098.stm
references continued1
References (continued)
  • Cerner (2009). About cerner. Retrieved June 2, 2009 from: http://www.cerner.com/public/Cerner_3.asp?id=129
  • Effken, J. (2009). Improving the human-technology interface. Nursing informatics and the foundation of knowledge (pp.65-73). Boston: Jones and Bartlett.
  • Hillenbrand (2008). Cerner corporation and hill-rom partner to unify hospital care delivery. Retrieved June 2, 2009 from: http://ir.hillenbrand.com/releasedetail.cfm?ReleaseID=295836.
references continued2
References (continued)
  • Hillenbrand (2005).Newest version of hill-rom'snavicare® system helps health care facilities improve patient flow, communication and efficiency. Retrieved June 19, 2009 from: http://ir.hillenbrand.com/releasedetail.cfm?ReleaseID=183478.
  • Hill-Rom (2009). About hill-rom. Retrieved May 31, 2009 from: http://www.hill-rom.com/usa/About_History.htm.
  • Hill-Rom (2005). Hospital of the university of pennsylvania dramatically improves performance with the navicare patient flow system. Retrieved June 22, 2009 from: http://www.hill-rom.com/usa/PDF/CLS131.pdf.
references continued3
References (continued)
  • Hill-Rom (2004). Navicare drives increased admissions and reduced ED diversions at united hospital. Retrieved June 18, 2009 from: http://www.hill-rom.com/canada/PDF/CLS129.pdf
  • Hill-Rom (2009). Navicare patient safety. Retrieved June 15, 2009 from: http://www.hill-rom.com/usa/PDF/153284.pdf.
  • Hill-Rom (2009). NaviCare platform brochure. Retrieved July 13, 2009 from: http://www.escocomm.com/downloadables/hill-rom/NaviCarePlatformBrochure.pdf.
  • Hill-Rom (2007). The hill-rom clear lungs program. Retrieved June 22, 2009 from: http://www.hill-rom.com/usa/PDF/148095.pdf
references continued4
References (continued)
  • Hill-Rom (2007). The hill-rom no falls program. Retrieved June 22, 2009 from: http://www.hill-rom.com/usa/PDF/148096.pdf.
  • Hill-Rom (2008). The hill-rom safe skin program. Retrieved June 22, 2009 from: http://www.hill-rom.com/usa/PDF/153696.pdf
  • Hill-Rom (2009). Versacaretc beds. Retrieved May 31, 2009 from: http://www.hill-rom.com/usa/VersaCareTC.htm.
references continued5
References (continued)
  • Solomont, E. (2007, August 16). Smart beds upgrading hospital stays. The New York Sun. Retrieved June 4, 2009 from: http://www.nysun.com/new-york/smart-beds-upgrading-hospital-stays/60620.
  • Staggers, N. (2003). Human factors: imperative concepts for critical care. AACN Clinical Issues, 14 (3), pp.310-319.