AU721263B2 - A hospital bath - Google Patents

Description

WO 99/20166 PCT/AU98/00617 -1- A HOSPITAL BATH Field of the Invention The present invention relates to apparatus for bathing elderly and disabled persons and, in particular, to a hospital bath pivotable between a generally upright "access/egress" position and a generally horizontal bathing position.

Background of the Invention The prior art in relation to such bathing devices can be categorized into two broad groups. One category includes stationary baths with improved access devices such as lifting frames or pivotable doors in a side wall of the bath. The frames are inherently dangerous since the patient is suspended in a sling in mid-air and will be severely hurt if the lifting mechanism slips or gives way. In addition, the patient feels humiliated by being transported as "a sack of potatoes".

The door or like arrangements suffer from high installation costs and the possibility of leaks. There is also the problem that the floor of the bath is slightly elevated above the floor of the room thereby necessitating the patient to step up.

However, the bath is still at a low height so that a nurse or similar assistant is still obliged to bend or stoop during the bathing procedure.

The second category of prior art may be termed "bathing wheel chairs" in that they consist of a wheelable chair in which the patient is transported from their room or ward to a bathing site such as a bathroom. The wheel chair either becomes the bath as disclosed in W096/05762 (PCT/SE95/00949) or inserts the patient into the bath as disclosed in Australian Patent No. 648,153.

The bathing wheel chair of the type of W096/05762 allows for the easy access of patients who would otherwise have difficulty entering and exiting a conventional bath tub. This is achieved by rotating the bathing wheel chair between a generally upright position and a generally horizontal bathing position. In its generally upright position, the foot end of the tub is substantially at floor level. A pair of wheels is arranged substantially halfway between the head end and the foot end of the tub. The WO 99/20166 PCT/AU98/00617 -2patient is seated in an upright position in the bathing wheel chair and can then be transported from their bed to the bath or shower room utilising the pair of wheels. The chair is then manually connected to a height adjustment rail and pivoted about the axis of the wheels to a position where the foot end and the head end are arranged at an equal level above the floor. The patient is then recumbent in the bath, supported by the seat which, at the horizontal bathing position, forms a triangular-shaped knee rest that has its apex at a point level with the back of the patient's knees. The seat supports the patient so as to stop the patient from sliding toward the foot end of the bath which could result in drowning when the bath is full of water.

The above prior art arrangement, therefore has several advantages compared with a conventional bath tub. However, it suffers from several disadvantages and several inherent dangers which will be discussed below.

First, wheeling the bathing wheel chair with the patient already seated in the chair is ergonomically unsound. The bathing wheel chair can topple backwards, during the transport of the patient, thereby possibly injuring the head of the patient (and possibly also the nurse). In this connection, it is generally a requirement for safe wheel chair operation that the wheel chair be unable to be tilted backwardly.

Second, the necessity of aligning the bath with the rear height adjustment rail and then connecting the bath to the rail is quite difficult to achieve. The difficulty of the task is further increased by the weight of the patient who is seated in the bathing wheel chair. This method necessitates the nurse manoeuvring the bath from a side or front standing position and requires both a great deal of physical strength and considerable stretching. Either of these actions is liable to cause injury to the nurse.

Third, the position of the bathing wheel chair is adjusted through vertical displacement of a cylinder assembly. To change the position of the tub from a horizontal bathing position to an upright access/egress position, the cylinder assembly extends and the head end of the tub is raised up the wall while rolling on the base under the tub by means of wheels. In this connection, the centre of gravity of the bathing WO 99/20166 PCT/AU98/00617 -3wheel chair is continually changing meaning that a lot of energy is required to pivot the bathing wheel chair.

Fourth, when the position of the bathing wheel chair is changed from its upright access/egress position to a horizontal bathing position, the foot end of the bathing wheel chair initially moves in a forward direction as it is raised. This creates a pinch point whereby the foot end wheels can run over a nurse or carer's foot or strike them in the leg causing injury.

The fifth disadvantage of the bathing wheel chair arrangement is that the patient would need to be naked (ie. prepared for the bath) whilst being transported from their bed to the bath or shower room. This would generally necessitate the use of a modesty sheet to be draped over the patient and also result in the patient becoming cold during the time of transport.

The other prior art bathing wheel chair, known from Australian Patent No.

648,153, inserts the patient into the bath. This arrangement takes the form of a wheeled bath chair, for supporting the patient, and a separate tiltable tub. The patient is seated in an upright position in the wheeled bath chair which is then advanced towards the lowered, opened head end of the tub and manually interconnected with the tub tilting apparatus. With further advance of the bath chair, the head of the tub is lifted to a fully raised position, and at the same time the chair is tilted, its back being raised relative to its rear wheels. The patient is thus slidingly conveyed into the tub which is then filled with water to the required depth.

Again, this arrangement has several advantages compared with a conventional bath tub. However, it too suffers from several disadvantages and several inherent dangers which are outlined as follows.

First, the engagement of the wheel chair with the tub creates a number of pinch points which could result in an injury to the patient. For instance, the patient could jam their hand or arm between the tub and the wheel chair during the process of being conveyed into the tub. Similarly, the scissors-like tub tilting apparatus could WO 99/20166 PCT/AU98/00617 -4inadvertently catch and pinch fingers. This could result in serious injury to either the patient or the nurse.

Second, the arrangement necessitates the nurse pushing the chair to engage it with the tub and then pushing the chair in a substantially upward motion to convey the patient into the tub. This task requires a great deal of physical strength and, like the 'bathing wheel chair' arrangement, is made more difficult with increasing weight of the patient. A similar problem also occurs when the patient is being removed from the tub.

A third disadvantage in this arrangement, as with the bathing wheel chair arrangement, is that the patient would need to be naked whilst being transported from their bed to the bathroom.

Finally, as with the lifting frame, there is a danger in the tub tilting apparatus giving way and causing injury to the patient if the tub suddenly drops to a lower position.

Object of the Invention It is an object of the present invention to substantially overcome, or ameliorate, one or more of the deficiencies of the above mentioned arrangements by provision of a hospital bath that allows for the easy transfer of patients into and out of the bath, that is easily adjustable and that is considerably safer to use.

Summary of the Invention In accordance with the present invention there is disclosed a hospital bath having a seat means and being mounted at a fixed floor position so as to be pivotable between a generally upright access/egress position and a generally horizontal bathing position, said bath being pivotable about a substantially horizontal axis extending traversely and generally centrally through said bath, and wherein said axis is stationary, and wherein said bath has a pivot means connected between said bath and a fixed support adjacent said axis to permit said bath to be pivoted between said two positions.

Brief Description of the Drawings WO 99/20166 PCT/AU98/00617 Two embodiments of the present invention will now be described with reference to the accompanying drawings in which: Fig. 1 is a longitudinal cross-section of a pivotable bath according to a first embodiment and showing the bath in its access/egress position; Fig. 2 is a a view similar to Fig. 1 but illustrating a seated patient to be bathed; Fig. 3 is a view similar to Fig. 2 but showing the bath tilted into an intermediate position; Fig. 4 is a view similar to Fig. 3 but showing the bath in its horizontal bathing position; Fig. 5 is a perspective view of a the bath of Fig. 1 in its horizontal bathing position; Fig. 6 is a transverse cross-sectional rear view of the bath of Fig. 1 in its horizontal bathing position; Fig. 7 is a longitudinal cross-section of a pivotable bath according to a second embodiment and showing the bath in its access/egress position; Fig. 8 is a view similar to Fig. 7 but illustrating a seated patient to be bathed; Fig. 9 is a view similar to Fig. 8 but showing the bath tilted into an intermediate position; Fig. 10 is a view similar to Fig. 9 but showing the bath in its horizontal bathing position; Fig. 11 is a perspective view of the bath of Fig. 7 in its horizontal bathing position; and Fig. 12 is a transverse cross-sectional rear view of the bath of Fig. 7 in its horizontal bathing position.

Detailed Description of the Preferred Embodiments As illustrated in Figs 1 to 6, the bath of the first embodiment includes a tub 1, a fixed support 2 and a cylinder assembly 3. The tub 1 incorporates an integrally WO 99/20166 PCT/AU98/00617 -6formed bench 17 positioned centrally within the tub, the seat portion 4 of which in the access/egress position illustrated in Fig. 1 is substantially horizontal. The end wall functions as a back rest and is substantially vertical in Figs. 1 and 2.

The tub 1 is shaped approximately like a right angled isosceles triangle with the apex cut off to produce a flat base 11. The tub 1 opens upwardly at 10. A rim 12 of small dimension runs around the perimeter of the opening Seen from above (Fig. the tub 1 is of a generally rectangular configuration.

The fixed support 2 forms a yoke having a rectangular base 13 with two vertical journals 14 mounted on either side of the base 13. The base 13 is firmly secured to the floor 15. Furthermore, the vertical journals 14 are interconnected by means of a horizontal axle 18 which passes through the base 11.

The cylinder assembly 3 takes the form of an extendable piston 16 which is pivotally attached at its ends to the floor 15 and base 11 respectively. Furthermore, the cylinder assembly 3 includes an actuator section 21 which is remotely operable to extend and contract the assembly 3 in conventional fashion.

The tub 1 and the fixed support 2 are interconnected via the axle 18. The axle 18 is substantially co-incident with the centre of gravity of the tub 1. As seen in Fig.

6, the tub 1 of the first embodiment is positioned centrally between the vertical journals 14. This arrangement, therefore, protects both the nurse and the patient in that there is no danger of the bath canting and causing injury.

The bath is pivotable, about the horizontal axle pin 18, by vertical displacement of the piston 16 of the cylinder assembly 3. The range of movement of the bath is between a generally upright access/egress position and a generally horizontal bathing position. In the upright standing position, the tub 1 has a very shallow front sill 6 leading to a planar end wall 7 for the purpose of facilitating access and egress to the tub. This arrangement also minimises the risk of slipping. At its horizontal bathing position, the tub 1 supports the patient in a convenient position and at a convenient height conducive with the bathing of the person by a nurse or carer. Therefore, this WO 99/20166 PCT/AU98/00617 -7arrangement only requires rotational movement to pivot the bath and the centre of gravity remains the same.

The bath is physically located adjacent to substantially conventional plumbing fixtures 22. The plumbing fixtures are preferably thermostatically controlled for the supply of warm water (illustrated in Fig. Further, the spout 26 of the plumbing fixtures 22 is preferably rotatable and extendable such that it can be retracted and rotated to a position against the wall after the tub is filled with water. This arrangement therefore has the advantage in that both sides of the tub 1 can be accessed when bathing an incapacitated patient.

The inside of the tub 1 includes a releasably closeable spout 7 shaped in order to be operatively associated with a substantially conventional floor waste 8. The spout 7 is sealed using a substantially conventional automatic pop-up plug 9. Furthermore, the bench 17, which is preferably integrally formed with the tub 1 is situated centrally within the tub, positioned in order to allow water to drain around the periphery of the bench 17 (illustrated in Fig. This arrangement, therefore, only necessitates the use of one outlet spout 7 to drain the bath.

A second embodiment is illustrated in Figs 7 to 12 in which equivalent items have been assigned a designation number which is increased by 100. The fixed support 102 includes two rectangular base sections 113, one on either side of the fixed support 102. The base sections 113 are secured to the floor 115. Each base section 113 has a vertical journal 114 mounted on it. The fixed Support 102 also includes two supporting members 130 mounted on each base section 113 and connected to a respective vertical journal 114. The base sections 113 are interconnected by means of two cross members 132.

The tub 101 and the fixed support 102 are interconnected by an axle 118. As seen in Fig. 12, the tub 101 of the second embodiment is positioned such that the vertical journals 114 and axle 118 are positioned within the floor area occupied by the periphery of the tub 101 when it is in either position. This arrangement, therefore, WO 99/20166 PCT/AU98/00617 -8decreases the area required to install the bath and allows for easy access around the periphery of the bath.

The inside of the tub 101 of the second embodiment includes two waste outlets 134 which are connected via a rigid conduit T-piece 136 or similar piping. The conduit T-piece 136 is connected to a length of flexible conduit 138 which is connectable to a substantially conventional floor waste.

The above described embodiments have a number of advantages which are outlined below: First, due to the configuration of the tub 1 and the method with which the patient is easily transferred to and from the tub 1, there is no chance of the patient being injured by a pinch point. The patient can walk or be transported (eg by conventional wheel chair) to the bath/shower room, easily undressed and then easily conveyed to or from the tub 1.

Second, there is no need for the nurse to manually manoeuvre the tub 1. After the patient has been seated in the tub 1, the tub 1 is automatically pivoted to the horizontal bathing position by the nurse easily operating a switch 24. The switch 24 can be conveniently located adjacent to the tub 1. In the horizontal bathing position, the patient is supported in a safe position and at a convenient height for bathing.

Third, since the axis of rotation of the tub 1 is stationary, only rotational movement is required to pivot the bath and the centre of gravity remains substantially fixed. Therefore, less effort is required to pivot the tub compared to, say, the prior art bathing wheel chair arrangement.

Fourth, there is no danger of the tilting mechanism suddenly collapsing and thereby causing injury to the patient or nurse. If pressure is lost in the cylinder actuator 21, due to an inadvertent leak in the actuator 21, the tub 1 will slowly return to the horizontal bathing position. In order to overcome any possible problem with loss of pressure, the actuator 21 can be replaced with an electric motor which powers a WO 99/20166 PCT/AU98/00617 -9conventional worm gear and threaded rod. With this arrangement in the event of loss of power the threaded rod maintains its degree of extension or retraction.

Finally, there is no danger of the bath canting and causing injury to the patient or nurse. The tub 1 is securely interconnected to the fixed support 2 which in turn is securely fixed to the floor The foregoing describes only two embodiments of the present invention, and modifications, obvious to those skilled in the art, can be made thereto without departing from the scope of the present invention. For example, a small motor driven pinion and a curved rack arrangement connected to the underside of the bath can be used to pivot the bath about the axle. Alternatively, the axle 18 can be driven either directly, or via a gear train, to rotate the bath.

Claims (13)

1. A hospital bath having a seat means and being mounted at a fixed floor position so as to be pivotable between a generally upright access/egress position and a generally horizontal bathing position, said bath being pivotable about a substantially horizontal axis extending traversely and generally centrally through said bath, wherein said axis is stationary, wherein said bath has a pivot means connected between said bath and a fixed support adjacent said axis to permit said bath to be pivoted between said two positions, said fixed support being substantially contained within the floor area occupied by the 10 periphery of said bath when said bath is in said bathing position, wherein said seat means comprises a centrally located bench member which in said bathing position forms an inverted substantially V-shaped knee rest and which in said access/egress position forms a seat.

2. The bath according to claim 1, wherein said bath is substantially symmetrical about said axis.

3. The bath according to any of claims 1 or 2, wherein said pivot means is connected to said bath adjacent said bench member.

4. The bath according to any one of claims 1 to 3, wherein said bath is pivotable about said substantially horizontal axis by extension and retraction of a link member connected to said pivot means.

5. The bath according to claim 3, wherein said link member is a pneumatic or hydraulic cylinder assembly. 28/04 '00 FRI 14:34 [TX/RX NO 8530] FRPR 28 '00 01:35PM SPRUSON FERGUSON [n:libo1012525oF

6. The bath according to claim 3, wherein said link member is a worm gear driven threaded rod.

7. The bath according to any one of claims 1 to 6, wherein said bath is locatable adjacent substantially conventional plumbing fixtures to permit said bath to be illed in said bathing position,

8. The bath according to claim 7, wherein said plumbing fixtures are p. thermostatically controlled.

9. The bath according to claim 7 or 8, wherein said plumbing fixture includes a :spout which is both retractable and pivotable. The bath according to any one of claims 1 to 9, wherein said fixed support is secured to the floor. i. The bath according to any one of claims 1 to 1.0, wherein said fixed support includes a base with two vertical journals each mounted on a corresponding side of said fixed support.

12. The bath according to claim 11, wherein said vertical journals arc interconnected by means of a horizontal axle.

13. The bath according to claim 12, wherein said bath and said fixed support axe interconnected via said horizontal axle.

14. The bath according to any one of claims 11 to 13, wherein said bath is positioned between said vertical j ournals. 28/04 '00 FRI 14:34 [TX/RX NO 8530] AlPR 28 '00 01:35PM SPRUSON FERGUSON P.4 Cn:~Jboo]1252;SatF -1 The bath according to claim any one of claims 11 to 13, wherein said vertical journals are located within the floor area occupied by the periphery of said bath when said bath is in said bathing position.

16. The bath according to any one of claims 1 to 15, wherein said bath includes at least one releasably closeable spout operatively associated with a floor waste. be17. The bath according to claim 16, wherein said bench member is situated be. 10 substantially centrally within said bath and includes side channels, positioned in order to allow water to drain around the periphery of said bench member. is. The bath according any one of claims 1 to 15, wherein said bath includes two outlets each joined to a flexible conduit which is connectable to a drain. 28/04 '00 FRI 14:34 [TX/RX NO 8530]