System and method for dynamically adjusting patient therapy

Abstract

A system and method of managing therapy provided to patients in an institution. The system monitors all aspects of the medication delivery to a patient, as well as other information related to the patient, such as values of vital signs, laboratory results and patient factors such as history, diagnosis, allergies and the like. The system includes one or more databases of information, including institutionally developed rules, guidelines and protocol representing the best medical practices of the institution. The system provides alerts and/or recommendations based on the application of the rules to the information being monitored, and alerts care givers accordingly, providing for dynamic adjustment of the patient's therapy. The system also monitors the status of the alerts, and if no action is taken in a selected period of time, may escalate the priority of the alert and/or halt the delivery of medication to the patient until the alert is resolved.

1 - 29 . (canceled) 
     
     
         30 . A patient safety system comprising:
 at least one physiological monitor configured to monitor at least one physiological parameter of a patient and provide a patient signal representative of the monitored parameter;   a database comprising at least one institutionally determined rule; and   a first processor coupled to the database and the physiological monitor, the first processor configured to:
 receive the patient signal from the physiological monitor; 
 retrieve the institutionally determined rule from the database; 
 compare the received patient signal to the retrieved rule; and 
 provide an alert signal if the received patient signal violates the retrieved rule. 
   
     
     
         31 . The patient safety system of  claim 30 , further comprising a second processor coupled between the at least one physiological monitor and the first processor, wherein the second processor is configured to:
 receive the patient signal from the at least one physiological monitor; and   provide a data signal to the first processor, wherein the data signal comprises the patient signal from the at least one physiological monitor;   wherein the first processor is configured to receive the data signal from the second processor.   
     
     
         32 . The patient safety system of  claim 31 , further comprising a bedside device that comprises the second processor. 
     
     
         33 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises a blood oxygenation monitor. 
     
     
         34 . The patient safety system of  claim 33 , wherein the at least one physiological monitor comprises a pulse oximeter. 
     
     
         35 . The patient safety system of  claim 33 , wherein the at least one institutionally determined rule comprises a minimum blood oxygen level. 
     
     
         36 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises a heart rate monitor. 
     
     
         37 . The patient safety system of  claim 36 , wherein the at least one institutionally determined rule comprises a minimum heart rate. 
     
     
         38 . The patient safety system of  claim 36 , wherein the at least one institutionally determined rule comprises a maximum heart rate. 
     
     
         39 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises a breathing rate monitor. 
     
     
         40 . The patient safety system of  claim 39 , wherein the at least one institutionally determined rule comprises a minimum breathing rate. 
     
     
         41 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises a carbon dioxide monitor. 
     
     
         42 . The patient safety system of  claim 41 , wherein the at least one physiological monitor comprises an end-tidal carbon dioxide (etCO 2 ) monitor. 
     
     
         43 . The patient safety system of  claim 41 , wherein the at least one physiological monitor comprises a partial-pressure carbon dioxide (pCO 2 ) monitor. 
     
     
         44 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises a temperature monitor. 
     
     
         45 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises an electrocardiogram (EKG) monitor. 
     
     
         46 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises an electroencephalogram (EEG) monitor. 
     
     
         47 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises an intracranial pressure (ICP) monitor. 
     
     
         48 . The patient safety system of  claim 30 , wherein the at least one physiological monitor comprises a glucose monitor. 
     
     
         49 . The patient safety system of  claim 30 , further comprising a server that comprises the first processor. 
     
     
         50 . The patient safety system of  claim 30 , wherein the first processor provides the alert signal to a notification device. 
     
     
         51 . The patient safety system of  claim 50 , wherein the notification device comprises a pager. 
     
     
         52 . A patient safety system comprising:
 a bedside monitor configured to monitor at least one physiological parameter of a patient and provide a signal comprising the at least one monitored parameter;   at least one pager configured to be carried by a caregiver and to receive alert signals;   a server coupled to the bedside monitor and the at least one pager, the server comprising an acceptable range for the at least one monitored parameter, the server being configured to:
 receive the signal from the bedside monitor; 
 compare the received at least one monitored parameter to the respective acceptable range; and 
 provide an alert signal to the pager if the received at least one monitored parameter is outside of the acceptable range. 
   
     
     
         53 . The patient safety system of  claim 52 , wherein the at least one physiological parameter comprises a blood oxygenation. 
     
     
         54 . The patient safety system of  claim 53 , wherein the bedside monitor comprises a pulse oximeter. 
     
     
         55 . The patient safety system of  claim 52 , wherein the at least one physiological parameter comprises a rate of respiration. 
     
     
         56 . The patient safety system of  claim 55 , wherein the bedside monitor comprises comprises a respiration monitor. 
     
     
         57 . A method of monitoring a patient, the method comprising the steps of:
 monitoring with a clinical device at least one physiological parameter of the patient;   comparing automatically the monitored parameter to an acceptable range; and   providing automatically an alert to an electronic messaging system if the monitored parameter is outside the acceptable range.   
     
     
         58 . The method of  claim 57 , wherein the electronic messaging system is a pager configured to provide an alert to a care giver. 
     
     
         59 . The method of  claim 57 , wherein the acceptable range is retrieved from a database. 
     
     
         60 . The method of  claim 57 , further comprising the step of:
 displaying on a monitoring station at a nurses' station the at least one physiological parameter of the patient.   
     
     
         61 . The method of  claim 57 , further comprising the step of:
 providing automatically a signal representative of the monitored parameter.   
     
     
         62 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring a blood oxygenation of the patient. 
     
     
         63 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring a respiration rate of the patient. 
     
     
         64 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring a heart rate of the patient. 
     
     
         65 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring a carbon dioxide level in the patient. 
     
     
         66 . The method of  claim 65 , wherein the step of monitoring at least one physiological parameter comprises monitoring an end-tidal carbon dioxide (etCO 2 ) level in the exhaled breath of a patient. 
     
     
         67 . The method of  claim 65 , wherein the step of monitoring at least one physiological parameter comprises monitoring a partial-pressure carbon dioxide (pCO 2 ) level in the blood of a patient. 
     
     
         68 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring a temperature of a patient. 
     
     
         69 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring an electrocardiogram (EKG) measurement of a patient. 
     
     
         70 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring an electroencephalogram (EEG) measurement of a patient. 
     
     
         71 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring an intracranial pressure (ICP) measurement of a patient. 
     
     
         72 . The method of  claim 57 , wherein the step of monitoring at least one physiological parameter comprises monitoring a glucose level of a patient. 
     
     
         73 . A non-transitory computer-readable medium having computer-executable instructions stored thereon for execution by a processor to perform a method of monitoring a patient, the method comprising the steps of:
 monitoring with a clinical device at least one physiological parameter of the patient;   comparing automatically the monitored parameter to an acceptable range; and   providing automatically an alert to an electronic messaging system if the monitored parameter is outside the acceptable range.   
     
     
         74 . The medium of  claim 73 , wherein the electronic messaging system is a pager configured to provide an alert to a care giver. 
     
     
         75 . The medium of  claim 73 , wherein the acceptable range is retrieved from a database. 
     
     
         76 . The medium of  claim 73 , wherein the method further comprises the step of:
 displaying on a monitoring station at a nurses' station the at least one physiological parameter of the patient.   
     
     
         77 . The medium of  claim 73 , wherein the method further comprises the step of:
 providing automatically a signal representative of the monitored parameter.   
     
     
         78 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring a blood oxygenation of the patient. 
     
     
         79 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring a respiration rate of the patient. 
     
     
         80 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring a heart rate of the patient. 
     
     
         81 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring a carbon dioxide level in the patient. 
     
     
         82 . The medium of  claim 81 , wherein the step of monitoring at least one physiological parameter comprises monitoring an end-tidal carbon dioxide (etCO 2 ) level in the exhaled breath of a patient. 
     
     
         83 . The medium of  claim 81 , wherein the step of monitoring at least one physiological parameter comprises monitoring a partial-pressure carbon dioxide (pCO 2 ) level in the blood of a patient. 
     
     
         84 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring a temperature of a patient. 
     
     
         85 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring an electrocardiogram (EKG) measurement of a patient. 
     
     
         86 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring an electroencephalogram (EEG) measurement of a patient. 
     
     
         87 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring an intracranial pressure (ICP) measurement of a patient. 
     
     
         88 . The medium of  claim 73 , wherein the step of monitoring at least one physiological parameter comprises monitoring a glucose level of a patient.