OA19647A - Self-contained treatment unit for haemodialysis treatments. - Google Patents

Abstract

The invention concerns a center (10) for treating, by hemodialysis, a plurality of patients, with a solution prepared with at least one solution of hemodialysis concentrates, said center (10) 5 comprising a treatment room for patients received in a reception area (13) and then taken over by a medical division (15) before the start of a treatment programme in a treatment room. The treatment unit (10) further comprises: - a dedicated room (32) where the stocks of concentrates are housed; - a dedicated room (33) for storing pharmaceutical products that are likely to be used by a patient 10 before. during or after treatment; - a dedicated room (34) for managing and, in case of a failure of a network, for producing electrical energy; - a dedicated room (35) for storing chemical products, in particular for the cleaning and disinfecting of the facilities and equipment; 15 - a dedicated room (36) for processing and/or inerting and/or eliminating waste resulting from the treatment: and - a dedicated room (37) for storing technical components for maintaining the equipment.

Description

SELF-CONTAINED TREATMENT UNIT FOR HEMODIALYSIS

TREATMENTS

Technical scope

Tins invention relates to a treatment center for treating by hemodialysis, simultaneously or successively, a plurality of patients, said center comprising at least one care unit equipped with a dtalysis generator, said dialysis generator being amanged to préparé a treatment solution adapted to each of said patients of said plurality of patients, said treatment soluhon being prepared by dilution with hemodialysis water of at least one eoncentrate made of sohd water-soluble compounds, said solid compounds comprising at least sodium chlonde (NaCI), potassium chloride (KCl), calcium chloride (CaCl₂), and magnésium chloride (MgCl₂).

Prior art

The hemodialysis patient treatment centers are often integrated in a hospital or elimc in the forni of a department assigned to this treatment. It appears that these departments are structured differently according to the hospitals and that the admmistrative organization and the medical follow-up of the patients must be designed on a case-by-case basis. Moreover, dependmg on the concemed medical centers, the available space is variable, so that the ancillary services such as the storage of the basic products, the treatment ofthe water mtended for preparing the hemodialysis solutions from concentrâtes, the treatment and disposai ofthe Waste, are scattered because of their diversification, which makes both treatment follow-up and patient safety complicated.

Now, the treatment of patients by hemodialysis is a long-term répétitive process a, a dtalysis panent is usually treated at least twice a week and the interventions take place for months or even years, often life long, almost the same way. This implies that every treatment requîtes substantif the same operations, the stmte préparations, the same control before, during and after the treatment, so that a streamlining ofthe processes and a stan ardization ofthe eqmpment show to be helpful both to simplify the operations to better control and monitor them, to better ensure patient safety and to better constate and/or complété the medical tecord of each ofthe patients so as to hâve at any time an updated record of every patient.

In large medical centers, many affections are treated and the ancillary services must be widely diversified to meet the demand of the varions departments corresponding to the varions assignments. In smaller departments, which can sometimes be located far from a 5 large center, one recognizes the interest to hâve on site the whole of the infrastructures required to ensure the treatments. This is in particular the case for the hemodialysis treatments, which are camed out in large centers supplied by central concentrâtes production units, unlike small centers where, for profitability and efficiency reasons, a local concentrâtes production is recommended or even imposed.

This invention allows reaching these goals by realizing a care center for hemodialysis patient treatment which is a model perfectly adapted to this treatment, which can be reproduced at any location while keeping flexibility in ternis of the size of the patients treatment area itself, according to the géographie location of the installation site, of the 15 demographics and of the locally available means.

The care center according to the invention ideally belongs to a group of substantially identical care centers, which are installed on a territory located more or less around a production unit of concentrâtes for hemodialysis patient treatment. This concept allows 20 simplifying and rationalizing significantly the supply of the treatment centers, makes the treatment less expensive and less risky, while ensuring a regular supply on demand of the care units and a distribution that allows reducing the risks linked with the transport. It also allows bringing the care centers doser to the patients insofar as they do not need preexisting hospital or clinic facilities. Their autonomy allows locating them outside or inside 25 pre-existing buildings, but which hâve no spécifie medical status.

Nevertheless, in the case of smaller units, or if they are very far away from the concentrâtes production center, an integrated service can be arranged in the care center to produce the required concentrâtes on site.

Description of the invention

This is why this invention offers to realize a treatment center able to provide a solution to ail of the problems mentioned above.

This goal is achieved by the treatment center according to the invention as defined in the preamble and characterized in that said treatment center is built in a hosting structure grouping a plurality of elementary modules built substantially the same way, juxtaposed and arranged intemally, individually or in a combination, to form at least one care room for a hemodialysis treatment of said plurality of patients, and dedicated rooms arranged respectively to ensure the réception of the patients, the administrative follow-up of the patients, the medical follow-up of the patients, the storage of the concentrâtes, the préparation and control of the fluids used in said care room and/or the reprocessing and/or disposai of the residual waste and effluents generated by the treatment of the patients.

According to a preferred embodiment, the care unit includes a care room for hemodialysis treatment that is mounted in at least one elementary module and contains at least one seat or bed for treating a patient, associated with a set of technical treatment components including a hemodialysis generator, a device for the connection to an electrical power supply network, a device for the connection to a data processing network, a device for the connection to a hemodialysis water supply, a device for the connection to a hemodialysis concentrâtes supply and a waste collection device.

Said hemodialysis generator is preferably arranged to produce a solution adapted to a spécifie patient by taking a predetermined quantity of at least one hemodialysis concentrate and a predetermined volume of hemodialysis water, and mix these components in order to préparé and inject said solution adapted to said spécifie patient throughout the treatment.

In a particularly advantageous way, said care room for a hemodialysis treatment includes two places and contains two treatment seats or beds arranged facing each other for the simultaneous treatment of two patients, each of said seats or beds being associated to a set of technical treatment components.

In order to ensure both the transport and mounting of the care unit, each elementary module can comprise a rigid frame on which closing and/or separating walls are mounted, in which said rigid frame comprises, in its upper section, an empty space to contain technical components.

Said empty space contains preferably at least one purified air supply duct and at least one ambient air exhaust duct, as well as a circulation circuit for heated or refrigerated liquid to ensure air conditioning inside of said treatment room.

According to a preferred embodiment, ’ said care room is arranged substantially in the center of said hosting structure, which comprises on the one hand a first set of elementary modules making up first dedicated rooms, assembled to be arranged as a patient réception room, an administrative formalities room, a medical care room, and a second set of elementary modules making up second dedicated rooms, assembled to be arranged as a concentrate solutions storage room, a water treatment room, a pharmaceutical products storage room, an electrical energy management room and a waste processing/disposal room.

Said care room for a hemodialysis treatment comprises at least one elementary module 20 assigned to the treatment of patients with particular contaminations, which require medical précautions to protect the other patients and/or the caregivers, said elementary module having a secured access.

Said rigid frame on which closing and/or separating walls are mounted is a métal frame 25 and said closing and/or separating walls are made out of thermally insulated composite material panels covered with impervious fînishing materials.

The rigid frames of the juxtaposed elementary modules are preferably assembled in such a way that each dedicated room has a surface adapted to its fimction and the 30 closing/separating walls are mounted on said rigid frames in order to geometrically delimit said surface adapted to the function assigned to said room.

Each of the elementary modules comprises a double ceiling that defines said free space on top of the care rooms and of the dedicated rooms, said free space being used for channel s and/or technical ducts.

Said technical room advantageously comprises at least means for receiving and storing raw materials, a removal unit, weighing means, a préparation unit for the patient's treatment solutions, a filtration unit and a unit for filling the containers intended for concentrâtes storage.

Brief description of the drawings

The présent invention and its advantages will be better revealed in the following description of an embodiment given âs a non limiting example, in reference to the drawings in appendix, in which:

figure 1 is a schematic general view representing an embodiment of a 15 hemodialysis care unit according to the invention, figures 2 A and 2B represent partial cross-sectional views of an elementary module illustrating the design of the rigid frame and of the walls making up the external walls of this module, figure 3 is a perspective view of a preferred embodiment of a basic care room for 20 a care unit according to the invention, and figure 4 is an operating diagram of a hemodialysis care unit combined with a dedicated treatment products production service.

Best way of realizing the invention

Referring to figures 1 to 3, in particular to 1, center 10 for hemodialysis patients treatment 25 describes below is built in a housing structure 11 that groups a plurality of elementary modules 12 built substantially the same way. Elementary modules 12 are represented more in detail in figures 2A and 2B. They are juxtaposed in their width or in their length and they can be arranged inside, individually or in combination, to form on the one hand one or several care rooms for a hemodialysis treatment of patients, and, on the other hand, 30 dedicated rooms arranged respectively to ensure the réception of the patients, the administrative follow-up of the patients, the medical follow-up of the patients, the storage of the raw materials, the individual préparation of the treatment solutions adapted to the patients, the préparation and control of the fluids used in said care room and/or the reprocessing and/or disposai of the residual waste and effluents generated in particular by said treatment of the patients.

Care room 20 is advantageously made of individual or double cells, which are arranged in one or several elementary modules 12. These elementary modules 12 can be adapted to the needs according to the location of the treatment centers, to the geography of the installation sites and/or to the data relating to the local population and conditions.

Figure 1 represents a hemodialysis patients treatment center 10 comprising a building with a substantially rectangular shape, called housing structure 11, and which is preferably mounted on a Hat plate that serves as a support for a plurality of elementary modules 12. Elementary modules 12 are advantageously boxes or containers (see figures 2A and 2B) or the like, with a parallelepipedic shape, whose dimensions are adapted to allow a simple transport and a cost-effective layout, while still remaining efficient, and to allow the installation in an individual or grouped form of ail the required equipment. This equipment is on the one hand intended and designed to make up at least one care room 20 intended for treating the patients or at least one dedicated room 30 intended for grouping the components suitable for one or several ancillary functions indispensable before, during of after the treatment of the patients.

Treatment unit 10 as a whole is arranged around a central section made of care room 20 formed by one or several basic care cells 21. A basic care cell 21 is illustrated and will be described in detail referring to figure 3. In the represented example, care room 20 comprises at least one subdivision 40 assigned to patients requiring spécifie précautions, in particular patients contaminated by dangerous viruses, which are at risk of propagating and contaminating the caregivers and/or other patients.

The access to the care room is reserved for the patients who hâve previously been received in a réception zone 13 by a réception staff. The réception zone is organized to take in charge the administrative management of the patients, that is to say the registration, the appointments and to direct them to a waiting room 14. The patients are then taken over by a medical division 15 that is arranged to make the required medical analyses and ensure the medical follow-up, to make sure that ail possibly required preparatory medical steps are carried out before the beginning of a treatment sequence in the care room.

Various zones for the caregivers, such as for example a change room and a préparation room 16, a canteen or company restaurant 17 and ancillary rooms 18 to allow the patients to change and put on the patient coats or the like, a sanitary facilities room 19 and an indispensable rest room 40, where the patients stay for a given period after their treatrnent, are also installed close to réception zone 13, before care room 12.

The patients are treated in one of basic care cells 21 or in one of spécial subdivisions 40 of care room 20 according to the decisions made by the medical division. The préparation of the treatment solutions, the fluids and température control, the electrical energy supply, the supply and treatment of the dialysis water, the management of the fluids and pharmaceutical products stocks are organized in another section of center 10, preferably in dedicated rooms 30, which are installed in elementary modules 12, coupled and combined with each other, installed in rooms specifically dedicated to the various functions defined above. The coupling and the combination of elementary modules 12 occur by putting in place separating walls that allow separating the necessary spaces so they can fulfill their functions. The whole of said dedicated rooms that could also be qualified as service rooms is advantageously arranged on the other side of care room 20 with respect to the réception service and the medical patients préparation service.

Among the rooms grouped under the general naine of dedicated rooms 30, one can mention:

- a room 31a comprising water treatment means;

- a room 31b for storing treated water to ensure sufficient autonomy of care unit 10;

- a room 32 that groups the concentrate stocks intended to be diluted by hemodialysis generators, and used as the base for ail hemodialysis treatments;

- a room 33 for storing pharmaceutical products that are likely to be used by a patient before, during or after a treatment;

- a room 34 for the management and, in case of a failure of an electrical power supply network, for the production of electrical energy;

- a room 35 for storing Chemicals, in particular for the cleamng and disinfection of the installations and equipments;

- a room 36 for treating and/or inerting and/or eliminating the waste produced by the treatment; and

- a room for storing technical parts to ensure equipment maintenance.

An electrical energy production unit could be mounted for safety purposes in an additional dedicated room 30, which would hâve the particularity of being located outside. The same applies to a purified air production unit, a heat exchange device for generating, according to the needs, heated fluids or refrigerated fluids, in particular for heating and/or air conditioning. This equipment could, according to the case, be mounted in additional elementary modules separated from housing structure 11 of treatment center 10.

Figures 2A and 2B represent an elementary module 12 in a longitudinal cross-sectional perspective view for figure 2A and open at one end for 2B. An elementary module 12 is substantially designed as a container 60 with a parallelepipedic shape comprising a rigid frame 61, made for example with métal beams 62 manufactured in the form of profiles oui of galvanized Steel or the like, on which is mounted on the one hand a bottom 63 in the form of a wooden floor or a plate out of vibrated concrète or the like 64a associated with a rodent protection Steel sheet 64b located towards the outside, carried by strengtheners in the form of métal beams 65 and, on the other hand, a ceiling 66, preferably made of a fiat galvanized Steel sheet 67. Then, according to the needs of unit 10, an elementary module can be used independently or in combination with other identical elementary modules and closing walls 68 or separating walls, which can be put in place according to the needs imposed by the planned layout. The roof of elementary module 12 is covered with a galvanized Steel sheet 69, which is curved to ensure the runoff of rainwater and arranged to leave a space 70 with respect to galvanized Steel sheet 67 of ceiling 66. This space 70 is filled with an insulating material, for example glass wool of a thickness of the order of 200 mm, or any other suitable insulating material.

It must be noted that elementary module 12 is equipped with a false ceiling 71 in the form of a parallel panel that defines, with the galvanized Steel sheet 67 of ceiling 66, a technical plénum 71a that can be used for various equipments such as the forced air circulation network, the electrical wiring circuits, the air conditioning, etc. The side walls are advantageously made of multilayer panels 72 with a weatherproof protective extemal layer 73, one or several intermediate layers out of insulating materials such as for example polyuréthane foam and an internai coating approved for clean rooms. In a general way, ail internai coatings, and more specifically ail internai coatings 74 that correspond to the care room or to sensitive rooms are made out of materials approved for the coating of clean rooms.

Figure 3 illustrâtes an embodiment of a care room 20 made of at least one basic care cell 21 arranged in an elementary module 12. This is in fact a double care room, i. e. arranged to receive and treat simultaneously two patients. To this purpose, it comprises two treatment seats 80, which could be beds or armchairs, arranged at the two longitudinal ends of module 12, facing each other. They can be separated by a removable curtain or by a screen (not represented) in order to respect the privacy of each of the patients. A hemodialysis generator 81 is associated to each of said seats 80. A technical fluid distribution through 82 and a cable trough 83 are mounted behind each seat, to allow supplying the energy, the communication data and the liquids used during the treatment, on the one hand to the dialysis generator and on the other hand to ail appliances required during this treatment. Trough 82 advantageously contains on the one hand a conditioned air blowing circuit 84a and a retum circuit for this conditioned air 84b. Trough 82 moreover contains a hemodialysis water supply 83a, a dialysis concentrâtes supply 83b, a hemodialysis liquid outlet pipe 83c for its discharge. Wiring trough 83 contains electrical supply cables for dialysis generator 81 and for the electrical equipment of seat 80. Communication cables to connect seat 80 and hemodialysis generator to a computerized data management center are also housed in said wiring trough 83. The hemodialysis generator is designed to be supplied with hemodialysis water at supply port 82a, with concentrate at supply port 82b or by means 5 or 10 liter canisters, so that the concentrate can for example be different from that of the network, to be adapted to the patient. Trough 82 moreover has the possibility to communicate by means of suitable ducts (not represented) with an air blowing duct 84 and a retum grille 86 arranged in the false ceiling. To this purpose, trough contains an air supply duct 84a and a retum duct 84b for air régénération. Refrigerated or heated water circuits 85 are arranged in the false ceiling, to allow cooling or heating the air according to the needs and evacuating it through conditioned air outlet grilles 88 arranged in the false ceiling

Furthermore, one will note that false ceiling 71 allows creating said empty space 70 that contains an air supply duct S4a and a retum duct 84b in care room 20. A refrigerated or heated water circulation circuit 85 allows cooling or heating the ambient atmosphère in care room 20. A conditioned air outlet grille 87 is arranged in the closing plate of false ceiling 71. A lighting 86 is arranged in the closing plate of false ceiling 71.

Figure 4 illustrâtes an évolution of the concept for an adaptation to smaller or remote hemodialysis patients treatment units, which include both the structures allowing the préparation of the treatment products and the structures adapted for the treatment and follow-up of the patients. To this purpose, the schematically illustrated device 200 is made of two units 210 and 250, which are respectively assigned to products préparation and to patients care. Products préparation unit 210 comprises means 211 for receiving and storing the raw materials, a removal unit 212, a weighing 213, a préparation equipment 214, a filtration unit 215 and a filling unit 216 for the containers intended for concentrâtes storage. The concentrâtes can be stored in canisters with for example a capacity of 5 and 10 liters, or in 800 or 1000 liter tanks.

Together with these services, storing means 217 may be provided for the conditioning items in view of their reutilization after use. An analysis laboratory 218 complétés this equipment to ensure the quality of the prepared substances. A purified water préparation unit 219 is integrated in unit 210. Air treatment means 220 can also be provided. They can be assigned as well to products préparation unit 210 as to care unit 250.

Care unit 250 mainly comprises a dialysis generator 251 that is directly coupled to a care room 252, which is for example a common room equipped with screens or internai room dividers. Care room 252 is provided with individual treatment armchairs separated by curtains or screens. Some individual beds may be provided for spécial or severe cases. A réception structure 253 is located at the entrance of care room 252 to receive the patients

H and direct them in the center. A consultation room 254 for doctors is attached to réception 253. A changing room 255 for the patients is attached to réception 253. Technical rooms for effluents neutralization 256 and waste incinération 257 are located at the exit of care room 252. Dialysis generator 251 is directly connected to dialysis concentrâtes storage means 217 and to purified water préparation unit 219 in order to adapt the treatment products according to the patients, taking the results of the analyses into considération.

The invention is not restricted to the examples of embodiment described and can présent different aspects according to certain foreseeable évolutions or according to spécifie needs. The dimensions of the care room, its layout, in particular the arrangement of the treatment armehairs or the arrangement of the dedicated rooms assigned to the varions ancillary services may be modified according to the local needs or availabilities. However, the scope of these modifications is restricted to transformations which are obvions to a person skilled in the art.

In particular technical trough 82 can be made either in partial sections having the dimension of each module or hâve the dimension of several modules with pluggable connections between modules, to receive the varions wired electrical circuits for the highvoltage and low-voltage currents, the fluids networks and the ducts for the conditioned aeraulic circuits.

Claims (13)

1. Claims

   1. Autonomous treatment unit (10, 200) for treating by hemodialysis at least one patient, said unit (10, 200) comprising at least one care unit equipped with a dialysis generator, said dialysis generator being arranged to préparé a treatment solution adapted to said at least one patient, said treatment solution being prepared by dilution with hemodialysis water of at least one concentrate made of solid water-soluble compounds, said solid compounds comprising at least sodium chloride (NaCl), potassium chloride (KC1), calcium chloride (CaCl₂), and magnésium chloride (MgCl₂), characterized in that said treatment unit (10, 200) is built.in a hosting structure grouping a plurality of elementary modules built substantially the same way, juxtaposed and arranged intemally, individually or in a combination, to form a first service room (210) assigned to the care for a hemodialysis treatment of said at least one patient, dedicated rooms arranged respectively to ensure the réception of the patients, the administrative follow-up of the patients, the medical follow-up of the patients, and a second technical room (250) for the préparation and storage of the concentrâtes, the préparation and control of the fluids used in said care room and/or the reprocessing and/or disposai of the residual waste and effluents generated by the treatment of the patients.
2. 2. Autonomous treatment unit (10) according to claim 1, characterized in that said at least one care room for hemodialysis treatment is mounted in at least one elementary module and contains at least one seat or bed for treating a patient, associated with a set of technical treatment components, said technical components including a hemodialysis generator arranged to préparé a treatment solution by diluting said at least one concentrate to adapt it to said patient to be treated, a device for the connection to an electrical power supply network, a device for the connection to a data processing network, a device for the connection to a hemodialysis water supply, a device for the connection to a hemodialysis concentrate supply and a waste collection device.
3. 3. Autonomous treatment unit (10) according to claim 2, characterized in that said hemodialysis generator is arranged to produce a solution adapted to a spécifie patient by taking a predetermined quantity of hemodialysis concentrâtes and a predetermined volume of hemodialysis water, and mix these components in order to préparé and inject said solution adapted to said spécifie patient throughout the treatment.
4. 4. Autonomous treatment unit (10) according to claim 2, characterized in that said care room for a hemodialysis treatment includes two places and contains two treatment seats or beds for the simultaneous treatment of two patients, each of said seats or beds being associated to a set of technical treatment components.
5. 5. Autonomous treatment unit (10) according to claim 2, characterized in that each elementary module can comprise a rigid frame on which closing and/or separating walls are mounted, in which said rigid frame comprises, in its upper section, an empty space to contain technical components.
6. 6. Autonomous treatment unit (10) according to claim 5, characterized in that said empty space contains at least one purified air supply duct and at least one ambient air exhaust duct, as well as a circulation circuit for heated or refrigerated liquid to ensure air conditioning inside of said treatment room.
7. 7. Autonomous treatment unit (10) according to claim 1, characterized in that said care room is arranged substantially in the center of said hosting structure, which comprises on the one hand a first set of elementary modules making up first dedicated rooms, assembled to be arranged as a patient réception room, an administrative formalities room, a medical care room, and a second set of elementary modules making up second dedicated rooms, assembled to be arranged as a concentrate solutions storage room, a water treatment room, a pharmaceutical products storage room, an electrical energy management room and a waste processing/disposal room.
8. 8. Autonomous treatment unit (10) according to claim 1, characterized in that said care room for a hemodialysis treatment comprises at least one elementary module assigned to the treatment of patients with particular contaminations, which require medical précautions to protcct the other patients and/or the caregivers, said elementary module having a secured access.
9. 9. Autonomous treatment unit (10) according to claim 1, characterized in that said rigid frame on which closing and/or separating walls are mounted is a métal frame and in that said closing and/or separating walls are made out of thermally insulated composite material panels covered with impervious finishing materials.
10. 10. Autonomous treatment unit (10) according to claim 1, characterized in that the rigid frames of the juxtaposed elementary modules are assembled in such a way that each dedicated room has a surface adapted to its function and the closing and/or separating walls are mounted on said rigid frames in order to geometrically delimit said surface adapted to the function assigned to said room.
11. 11. Autonomous treatment unit (10) according to daims 1 and 5, characterized in that each of the elementary modules comprises a double ceiling that defines said free space on top of the care rooms and of the dedicated rooms, said free space being used for channels and/or technical ducts.
12. 12. Autonomous treatment unit (200) according to claim 1, characterized in that said technical room (210) comprises means (211) for receiving and storing raw materials, a removal unit (212), weighing means (213), a préparation unit for the patients treatment solutions (214), a filtration unit (215) and a unit (216) for filling the containers intended for concentrâtes storage.
13. 13. Autonomous treatment unit (200) according to claim 1, characterized in that said technical room (210) is integrated in treatment room (250).