U.S. patent number 3,627,122 [Application Number 05/041,811] was granted by the patent office on 1971-12-14 for system and apparatus for the administration of drugs.
Invention is credited to Robert Richard Garbe, Jr..
United States Patent |
3,627,122 |
Garbe, Jr. |
December 14, 1971 |
SYSTEM AND APPARATUS FOR THE ADMINISTRATION OF DRUGS
Abstract
Special drug-carrying trays and associated equipment for
pharmacists and nurses for the administration of drugs to a
plurality of patients, such as in hospitals or nursing homes,
comprising the separate packaging, sealing, and labeling of each
drug dose for each patient and arranging these individually
packaged drugs in compartments in such trays. These compartments
correspond to each room or bed and are labeled to correspond to
each patient and each dose to be administered with separate trays
being used for different dose times. These trays have specifically
designed compartments for retaining the labels and drugs during
transport, and for nesting and locking stacks of them together for
transport between the pharmacy and the nursing facility. Thus the
pharmacist prepares the trays and delivers one or more stacks of
them to one or more nursing facilities all ready for the nurses to
check and administer directly to their patients. This system also
includes a form, slip, or card for checking the drugs, which form
may be adapted for direct computerized billing.
Inventors: |
Garbe, Jr.; Robert Richard
(Columbus, OH) |
Family
ID: |
21918445 |
Appl.
No.: |
05/041,811 |
Filed: |
June 1, 1970 |
Current U.S.
Class: |
206/571; 206/1.5;
206/232; 206/459.5; 206/511; 206/560; 206/561; 220/507; 312/209;
116/308; 206/223; 206/366; 206/499; 206/558; 206/580; 312/111 |
Current CPC
Class: |
A61J
7/0069 (20130101); A47B 87/02 (20130101) |
Current International
Class: |
A47B
87/00 (20060101); A47B 87/02 (20060101); A61J
7/00 (20060101); B65d 071/00 (); B65d 001/34 () |
Field of
Search: |
;116/121
;206/1.5,17.5,63.2R,65R,65K,72 ;220/21,97R ;312/111 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Leclair; Joseph R.
Assistant Examiner: Lipman; Steven E.
Claims
I claim:
1. Apparatus for the preparation and administration of a plurality
of individual doses of drugs to a plurality of patients,
comprising:
A. a plurality of identical trays for different times during a
predetermined period, each tray having a plurality of compartments
with at least one compartment for each patient for his dose at a
given time, each compartment comprising:
1. four sidewalls at right angles to each other and a bottom,
2. a longitudinal pocket in one wall for a signal identification
card, said pocket having a bottom spaced from and overhanging the
bottom of said compartment, and
3. a patient and dose identification card covering said bottom and
having a folded portion extending under said bottom of said pocket
for holding said card in place,
B. means for nesting said trays when stacked one on top of the
other,
C. means for covering the top tray of said stack, and
D. means for fastening said trays and covering means together.
2. An apparatus according to claim 1 wherein said trays are
rectangular and said compartments in said trays are all
substantially of the same size.
3. An apparatus according to claim 1 wherein the opposite sidewalls
of each compartment are provided with notches for receiving
syringes.
4. An apparatus according to claim 1 wherein said nesting means
comprises feet on the bottom corners of each of said trays and of
said covering means.
5. An apparatus according to claim 1 wherein said means for
fastening said trays together comprises a rod means extending
through all of said trays.
6. An apparatus according to claim 5 wherein each tray has a
noncircularly shaped aperture in the bottom of a center compartment
and a correspondingly shaped means on one end of said rod means to
prevent its rotation, and a wingnut means for screwing onto the
other end of said rod means.
7. An apparatus according to claim 1 including handle means for
said stack attached to said fastening means.
8. An apparatus according to claim 7 including means for said
covering means for engaging said handle means for locking said
covering means and trays together.
9. An apparatus according to claim 8 wherein said locking means
comprises a latching key mechanism mounted on said covering means
adjacent said handle means.
10. A tray for use in the administration of drugs comprising:
A. a rectangular bottom,
B. four sides of equal height around the edges of said bottom,
C. a plurality of partitions between opposite pairs of sides of
equal height to said sides and each other to form a plurality of
rectangular compartments of substantially the same size, with the
partitions between one pair of sides being notched in their upper
edges between adjacent compartments, and
D. a pocket in each compartment on the partitions between the other
pairs of sides, said pockets being spaced from said bottom to form
an overhanging portion.
11. A tray according to claim 10 including feet at each corner of
the bottom of said tray, which feet fit into the upper corners of
the corner compartments of another tray below it.
12. A stack of trays for use in the administration of drugs wherein
each tray comprises:
A. a rectangular bottom having a noncircular-shaped hole near its
center,
B. four sides of equal height around the edges of said bottom,
C. a plurality of partitions between opposite pairs of sides of
equal height to said sides and each other to form a plurality of
rectangular compartments of substantially the same size, the
partitions between one pair of sides having notches in their upper
edges aligned between adjacent compartments,
D. a pocket in each compartment on the partitions between the other
pair of edges and spaced from said bottom to form an overhanging
portion,
E. feet at each corner of the bottom which fit into the corners of
the corner compartments of another tray below it, and wherein said
stack comprises:
1. a transparent rectangular cover for the top tray with a hole
near its center, comprising
a. feet on each corner which fit into the corners of the corner
compartments of said top tray,
b. a raised portion in its center with a hole therein aligned with
said hole in said cover, and
c. a latch and lock mechanism attached to said cover adjacent said
raised portion,
2. a pedestal and rod having a noncircular portion adjacent said
pedestal for fitting into and extending through all said
noncircular shaped holes in the bottom of said trays in said stack,
and said rod having a threaded upper end which extends through said
hole in said cover and slightly above said raised portion of said
cover, and
3. a handle means having a threaded socket therein for receiving
said threaded upper portion of said rod, which handle means clamps
said cover and stack of trays together.
13. A stack of trays according to claim 12 wherein said handle
means has a keeper portion, and said cover has a locking mechanism
mounted thereon for engagement with said keeper portion.
14. A stack of trays according to claim 13 wherein said locking
mechanism includes means for locking said locking mechanism into
engagement with said keeper portion.
Description
BACKGROUND OF THE INVENTION
Previously drugs for a plurality of patients such as in a hospital
or nursing home usually have been prepared from bulk containers at
the nursing facility, placed in individual open paper cups resting
on identifying cards on a flat tray. Previous improvements in this
system include the use of open trays with pluralities of cavities
with means for inserting labels at each cavity, and to individually
package at least some of the drugs.
All of these prior systems have disadvantages of being quite time
consuming and involving a high possibility of error (sometimes as
high as 20 percent). These errors occur due to human errors, poor
checking procedures, possibility of doses and/or labels moving from
one compartment of the tray to another during transport of the
tray, etc.
SUMMARY OF THE INVENTION
The system of the present invention comprises means or facilities
at a pharmacy for separately packaging and labeling and/or storing
pluralities of different doses of the same and different drugs, in
the forms of tablets, capsules, liquids, injectables,
suppositories, ophthalmics, powders, etc. into individually sealed
containers, such as plastic heat or zip-lip sealable envelopes or
bags, ampuls bottles, syringes, and the like. The individual
packages for the drugs are usually transparent so as to give an
additional appearance check of the kind of drug that is being
administered, such as its color code, shape, consistency, and the
like. Since the same drug is often administered at several
different hours and for several days in the same amounts to the
same patient, a plurality of packages of each of these drugs are
prepared and stored in properly labeled drawers or containers at
the pharmacy. Of course many of the drugs may be purchased already
individually prepackaged and labeled with the dosage therein, but
if not, machines may be used by the pharmacist in making up these
individual packages and properly labeling each with the name of the
drug and the dosage in the package.
Since this system is adapted primarily for the administration of a
plurality of different drugs to a plurality of patients at one or
more remote locations, such as in a number of beds in one or more
sections or wards in a hospital or a nursing home, the pharmacist
receives the orders for each of these patients and makes out a
patient profile record sheet, card, or form for each drug for each
patient. These records include all the identifying information for
the patient and drug including its cost, and separate copies of
this record may be used by the pharmacist, by the nursing facility,
and/or by a computer for billing purposes. Since patients in a
nursing home or hospital pay their bills in several different ways,
in that some may be on Medicare, some on Welfare, some covered by
insurance, and some pay directly, each payment method usually
requires a different method of billing. The drug profile record,
however, is adapted for use with all billing systems and may be
used for direct billing or in conjunction with computerized
billing.
Other apparatus employed in this system than the drugs, their
packages, and their information records or forms, includes a
plurality of trays which may be nested together, each of which
trays has compartments with full equal height walls, and means for
stacking the trays together. A lid for the top tray includes means
for clamping all of the trays together once they are stacked, and
for locking them together so that the drugs placed in any of the
compartments cannot easily be changed nor moved from one
compartment to another in the transport of the stack from the
pharmacy to the nursing facility. Thus only the pharmacist and the
nursing facility have means such as keys for unlocking the stacks.
Each compartment in these trays is provided with aligned notches in
its opposite sidewalls for receiving individual syringes, and with
pockets for labels for flagging special treatment instructions, or
to hold medication cards used by nurses to check the drug or drugs
placed in the compartment by the pharmacist. Such a medication card
can be the nurses up-to-date reference of medication changes. These
pockets also are designed to have means for snapping in the labels
identifying each patient and his drugs, so these latter labels
cannot be easily removed. Separate trays are prepared and labeled
for each different time during the day when drugs are to be
administered to all of patients such as eight o'clock in the
morning, noon, four o'clock in the afternoon, and eight o'clock in
the evening, together with possibly another tray for other hours
for special circumstances. Each compartment in the tray corresponds
to a bed, room, or patient in the hospital or home, or ward or wing
thereof, and different stacks are provided for the different
sections or wards as required.
From the drug prescriptions which may be telephoned to the
pharmacist, the patient profile record sheets and labels are made
out with this information. The pharmacist then places in the
corresponding compartments in the trays, the proper labels and
drugs. Different colored labels may be used for different hours of
administration, and compartments which do not correspond to
patients in certain beds or rooms may have blank labels placed
therein as a further check that no patient was forgotten. After the
trays are labeled and filled for a given period, such as a day,
they are stacked, locked and delivered to the nursing facility,
where they are unlocked and may be checked by a nurse both before
and at the side of the patient when being administered, since these
trays are carried directly by the nurses on their rounds to the
patients. When the trays are empty they are restacked and returned
to the pharmacist when the next trays are delivered for the
following period or day. In the event a change in dosage or
cancellation of a dosage is required, all that has to be done is to
telephone the pharmacist, and the proper record or form card will
be made out by the pharmacist and the label in the compartment in
the tray for that patient will be so marked.
Thus the systems and apparatus of this invention is adapted for use
of all dosage forms and is accurate, flexible, economic, time and
space saving, and easy to set up, operate, check, recheck, change,
administer, and bill.
BRIEF DESCRIPTION OF THE VIEWS: =PP The above-mentioned and other
features, objects, and advantages, and the manner of attaining them
are described more specifically below by reference to an embodiment
of this invention shown in the accompanying drawings, wherein:
FIG. 1 discloses a perspective view of a stack of trays according
to this invention, with its transparent cover and locking handle
therefor spaced above the top of the stack;
FIG. 2 is an enlarged plan view of one of the trays from the stack
in FIG. 1, showing the different doses and labels located in its
different compartments;
FIG. 3 is a perspective view showing the central compartment of the
tray shown in FIGS. 1 or 2, through which the clamping rod for
holding the trays together projects, and showing the use of the
notches in the opposite sidewalls for holding a syringe and/or a
pencil;
FIG. 4 is a vertical section taken along line 4--4 of FIG. 2
through one of the corner compartments of a tray, showing a signal
label or nurses medication card A in the pocket at its rear edge,
and how the identification label B is snapped in and held under the
overhanging bottom of the pocket;
FIG. 5 is a perspective underside view of one of the corners of the
tray in FIGS. 1, 2 or 4, showing a foot for the nesting of the
trays one upon another;
FIG. 6 is a perspective view of one of the identification labels B
which is snapped into the bottom of each compartment;
FIG. 7 is a perspective view of a signal label or nurses medication
card or tag which is placed in the pocket at the back of each
compartment shown in FIGS. 1, 2 or 4;
FIG. 8 is a perspective view of the post or pedestal upon which a
stack of trays are placed for enabling them to be clamped and
locked together;
FIG. 9 is an enlarged longitudinal sectional view of the central
portion of the cover or lid for the stack of trays shown in FIG. 1,
showing the handle latch mechanism for clamping, carrying and
locking a stack of trays together; and
FIG. 10 is a view of one sheet of one embodiment of a multisheet
order form which may be filled out by the pharmacist for each drug
for each patient in carrying out a computerized billing system
according to this invention.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENT:
Before describing the steps of the system of this invention the
details of the apparatus involved in this system will first be
described, one of the most important pieces of which is the stack
of nestable trays and the means for locking them together as
disclosed in perspective in FIG. 1.
I The Trays
Referring specifically to these trays shown in FIGS. 1 through 5,
each tray 20 comprises a rectangular full bottom 22, frontside and
backside 24 and 25, and right and left ends or sides 26 and 27, all
of which sides 24 through 27 are at right angles to the rectangular
edges of the bottom 22, of the same height, and preferably formed
integral therewith, such as of a white easily cleanable
lightweight, plastic. Between the frontside and backside 24 and 25
are a plurality of parallel integral partitions 30 parallel to the
sides 24 and 25 and equally spaced from each other and said sides,
and perpendicular thereto and parallel to the end sides 26 and 27
are another plurality of equally spaced partitions 32. All of these
partitions are of the same height as the sides 24 through 27. Thus
a tray is formed which, when covered by another tray or a cover
plate 70, substantially completely closes each of the compartments
40 therein formed by these partitions 30, 32 and sides 24, 25, 26,
27.
In each of the partitions 32 there is provided, preferably adjacent
the front wall of each compartment 40, a notch 42 which is
preferably adjacent the front wall 24 and the back of each of the
partitions 30, which notches 42 are aligned on opposite sides of
each compartment so as to provide means for holding a pencil P or a
syringe S as shown in FIGS. 2 and 3. This syringe S contains a
flag-shaped label L fastened thereon by the pharmacist which
prevents the syringe S from sliding longitudinally or axially too
far through its holding notches 42 and out of the compartment in
which it is placed, in that the edges of the label L will abut
against the side partitions 32.
Also each compartment 40 is provided with a back card pocket 44
attached to its back wall (see specifically FIGS. 1, 2 and 4). This
pocket 44 has a front wall 48 parallel to its backwall formed by
the partition 30 or sidewall 25. The bottom 46 of this pocket 44
(see FIG. 4) is spaced above the top of the bottom 22 of the tray.
This pocket 44 may be used for a special signal or nurse medication
check label, tag, or card A as shown in FIGS. 2, 4, and 7 which may
be of an attractive color, such as red, to signal the nurse
administering the drugs to that patient to check the drugs and/or
only to administer the drugs under certain conditions, such as
after checking the blood pressure or temperature of the patient.
These tags or cards A may be bent over as shown in dotted lines A'
in FIGS. 2 and 4 when the trays 20 are stacked. The inner top edge
of the pocket 44 is slightly below the top edge of its adjacent
tray partition 30 so that the label A may be bent over into its
position A' without obstructing this stacking.
Referring specifically to FIGS. 4 and 6, the label B which is
snapped into each compartment, has a double bend portion b which
snaps under the space below the bottom 46 of the pocket 44, so this
label B cannot easily be shaken out or removed from its
compartment. This label contains on its vertical upright portion b'
the name of the patient, his bed or room number, and the time the
drugs are to be administered. The bottom or base portion b"of this
label B shown in FIG. 6 is printed with the name of each drug and
its amount or dose that is to be administered to that patient at
that time. Thus each of the compartments 40 are semipermanently
labeled for each patient with his drugs and the time it is to be
given, so it may be rechecked by the nurse at the time each drug is
administered. Also these labels B for all the drugs delivered at
one particular time may have a corresponding color, which is
different from the color of the labels B for drugs to be
administered at other times.
II The Stacking Means
At the outside bottom corner of each tray 20 there may be provided
a foot 50 (see FIGS. 4 and 5) which fits into the outer upper
corners of the compartments 40 of the tray below it, to permit even
and interlocked stacking of the trays 20 as shown in FIG. 1. These
feet have outward rectangular angles inset the thickness of the
sides 24, 26 and 25, 27 so as to fit closely into the upper outer
corners of the corner compartments 40 and accurately align the
trays 20 in the stack.
In the bottom 22 of each of the trays 20 adjacent the center of the
center partition wall 30, there is a noncircular or square hole 23
(see FIGS. 2 and 3), through which the rod 60 (see FIGS. 1 and 8)
can project. This rod 60 is attached or welded to a baseplate or
pedestal 62 via a noncircular or square portion 64 which fits into
the square hole 23 of the bottom tray 20 of the stack. The length
of the rod 60 may vary depending upon the number of trays to be
stacked, which number is usually between four and ten trays. The
upper end 66 of the rod 60 is threaded and projects slightly above
the top edge of the top tray as shown in FIG. 9, so as to project
through and above the cover 70 into the wingnut-acting locking
handle 80.
The cover or lid 70 for the top tray of the stack may be of a
translucent or transparent plastic material, and is provided with
feet 72 (see FIG. 1) at its corners, corresponding to the feet 50
at the bottom corners of the trays 20, for nesting the cover 70 in
place. At the center of this cover 70 there is provided a raised
portion 74 (see FIGS. 1 and 9) on which the locking handle 80 seats
and which prevents scratching of the cover 70 when the handle 80 is
rotated to screw it on to the top end of the rod 60.
Referring more specifically to FIGS. 1 and 9, the handle 80 acts
also as a wingnut for the top end 66 of the rod 60 for clamping the
stack of trays 20 and their cover 70 together. Thus the handle 80
has an aperture 82 in its center, which may be threaded or may
contain an embedded nut 84. This nut 84 may be inserted and held
between two pieces 85 and 86 of the base portion of the handle 80,
which pieces may be of plastic and are held or clamped together by
screws 88 which screw into the ends of the bail portion 81 of the
handle 80. These screws 88 may be countersunk into apertures 87 in
the lower piece 86, which lower piece 86 also may be provided at
each of its ends with notches 89 for the latch 92 of the locking
device 90.
This locking device 90 is attached to the cover 70 adjacent one end
of the handle 80 by means of screws 91. Thus after the handle 80
has been rotated to snug the cover 70 onto the top tray and has one
of its ends aligned with the latch 92, the latch 92 may be manually
slid by knob 94 into its dotted line locking position shown in FIG.
9. The locking device 90 may have a key lock 96 to lock the latch
in its handle locking position, to which lock access may be had
only by the pharmacist and a registered nurse at the nursing
facility. Thus once the handle 80 is latched and locked, the stack
of trays 20 cannot be separated, since neither the handle 80 nor
the rod 60 through its base 62 can be turned, because its square
portion 64 is locked into the square hole 23 of the bottom tray
20.
III The System
According to the system of this invention, the prescriptions are
first received by the pharmacist, which may be by telephone or slip
from the doctor in charge of the patient, and from this
prescription a patient profile record sheet is made out, which
sheet is the pharmacist's master record of the patient's
medications.
If a computerized billing system is used, one of the forms 100
shown in FIG. 10 may be made out for each drug for each patient.
This form 100 preferably is a multicopy form and may be of a size
and shape for computerization, such as for direct billing. On this
form 100 are provided spaces for the patient's name, room or bed
number, his account number, the name of the nursing facility, the
name and address of the pharmacy and its registration number,
directions indicating the starting or cancelling of this drug
order, the date, the administering times and spaces for the
initials of the checking pharmacist, the prescription number, the
name of the drug and its dose, and a billing code number for the
drug. This code number may be made up by the pharmacist of several
digits, the first two of which may indicate the number of days for
which the drug is to be administered, the second the number of
times per day, the fourth and fifth the price per dose in cents,
and the last two of which may be reference numbers to prevent
duplications in case another drug may have the same price and
administering times to prevent the computing machine from rejecting
this number as a duplicate. The separate copies of this form 100
are for the pharmacist's file, the nursing facility, and for
computer billing. The copy for the nursing facility may be sent
with the stack of trays to the nursing facility under the cover 70
when that drug is initiated or stopped for check purposes to the
nursing facility.
The pharmacist after making out the patient profile record sheets,
and/or the forms 100, then has to obtain or prepare the drugs in
separate or unit dose packages and make out the labels B, and also
the labels A, if required. Pluralities of these separate drug
packages for all of the patients serviced are arranged in boxes or
containers in alphabetical order so that adequate supply thereof
will be had for at least the number of times that each drug is to
be administered to all of the patients who are to take it. Each
separate package is labeled with the name of the drug and its dose
or amount so that no error will occur therein.
Next the pharmacist lays out the trays 20 for the next period's or
day's administerings, one tray for each different administering
hour for all the patients in one section or nursing facility, and
labels the outside of each tray 20 with this information such as
with replaceable adhesive labels as shown in FIG. 1. Then each tray
20 is filled as shown in FIG. 2, by placing first therein all of
the labels or slips B, shown in FIG. 6 in the bottoms of each
compartment 40, which labels B correspond to each particular bed or
room in that section or facility, and if a patient is in that
location, putting a properly filled out and colored label B
therein. Then these labels B are checked by the pharmacist and/or
may be initialed as checked on the spaces provided on the form 100
mentioned above.
Next the compartments are filled with the drugs according to what
is on these labels B therein, such as with separate packages of
tablets T, capsules C, bottles of liquids BL, injectables I, and
even extra paper cups c for the patient to use if he wishes not to
touch the drug or to take more than one dose of a tablet or pill at
one time. The filled trays 20 are then stacked together on the rod
60, clamped and locked together by the handle 80 and locking device
90, and sent to the nursing facility and the former period's or
day's stack of empty trays are collected for refilling.
For each new drug or change in a drug, a new form 100 may be made
out and a copy thereof sent with the stack as shown in FIG. 1 on
the top tray 20. Thus the transparent cover 70 enables these order
changes to be easily seen and checked at the nursing facility.
Since the nursing facility has copies of all the forms 100, it can
recheck and immediately correct any errors before any drugs are
taken to the patients. In fact there are several ways to operate
this system, depending upon the extent the pharmacy or nursing home
wishes to utilize or not utilize special forms, computers, existing
record systems, individual preferences, state laws, etc. Thus
application of the system of this invention is each facility
requires consideration of all of these variables.
While there is described above the principles of this invention in
connection with specific apparatus and a system for using this
apparatus, it is to be clearly understood that this description is
made only by way of example and not as a limitation to the scope of
this invention.
* * * * *