WO2022162349A1

WO2022162349A1 - Medical gown

Info

Publication number: WO2022162349A1
Application number: PCT/GB2022/050188
Authority: WO
Inventors: Millicent STONE; Grace Helen O'GORMAN
Original assignee: iOwna Gowns Limited
Priority date: 2021-01-26
Filing date: 2022-01-25
Publication date: 2022-08-04
Also published as: GB202101019D0; GB2603008A; US20240081444A1; GB2603008B

Abstract

The invention relates to a medical gown for a hospital patient, the medical gown comprising: a top part arranged to cover a patient's torso, the top part comprising sleeves and a front-facing opening with a wrap-around fastening; and a bottom part, separate to the top part and arranged to extend from patient's waste downwards to cover at least a portion of the patient's legs; wherein the top part comprises at least one slit positioned in a back or side portion of the top part and arranged to allow medical examination of the patient's torso through the slit without removal of the top part. The medical gown according to the present invention allows a clinician to perform a full systematic medical examination of a patient, without requiring the patient to remove any part of the gown.

Description

MEDICAL GOWN

Field of invention

The present invention relates to a medical gown for hospital patients, in particular a medical gown that facilitates medical examination.

Background

Hospital gowns are used by patients when visiting hospital to have examinations, operations and are often used as clothing by bedridden patients. They are generally designed so that hospital staff have easy access to the part of the patient’s body that is being treated.

The standard hospital patient gown has a simple design and has changed very little over many years. The design is one size fits all and consists of fabric from the neck down to below the knee, with wide sleeves ending above the elbow. The standard design ties together at the back, sometimes overlapping but other times leaving the patient’s back exposed. Generally, they are made out of fabric that can withstand repeated washing at high temperatures, usually cotton.

Although the standard hospital gown is non-restrictive for doctors performing operations and good for nurses dealing with patients who are in bed the majority of the time, there remain significant issues with balancing the need for access to perform examination whilst maintaining patient comfort and dignity. In particular, the semi open back design can be revealing for patients who are in a hospital environment but need to walk around, while, if tied at the back to preserve patient dignity, it is very hard to gain access for an examination of the patient or conduct of procedures such as inserting cannulas, providing injections or intimate examination of genitals for gynae or urological specialties.

These problems with known hospital gowns are becoming more significant due to a change in approach in patient care and recovery. While previously it was standard practice to recommend that patients prioritise rest in recovering from an operation, increasingly patients are now encouraged to get up and move around at an earlier stage of recovery. This exacerbates the known problem with achieving the balance between ensuring patients can be examined such that their recovery can be assessed, while preserving the patient's comfort and dignity during the hospital stay.

A related problem relates to the increasingly common practice of using multiple gowns to preserve patient modestly whilst performing medical examination. In particular, while a patient is wearing one gown, in a hospital setting a clinician will often use a second gown to cover parts of the patient’s body during examination. In addition to restricting the clinician from performing a full systematic examination, this practice also has a detrimental environmental impact as a large number of used gowns must be replaced or washed for re-use.

There accordingly exists a need for a hospital gown which preserves patient dignity and is comfortable to wear and move around in, while ensuring doctors can effectively perform any required medical examination and the most common medical procedures.

Summary

According to a first aspect of the invention there is provided a medical gown for a hospital patient, the medical gown comprising: a top part arranged to cover a patient's torso, the top part comprising sleeves and a front-facing opening with a wrap-around fastening; and a bottom part, separate to the top part and arranged to extend from patient's waste downwards to cover at least a portion of the patient's legs; wherein the top part comprises at least one slit positioned in a back or side portion of the top part and arranged to allow medical examination of the patient's torso through the slit without removal of the top part.

The medical gown according to the present invention allows a clinician to perform a full systematic medical examination of a patient, without requiring the patient to remove any part of the gown. The gown further provides a greater degree of covering that the standard hospital gown, during normal wear and during performance of a medical examination or procedure, as well as providing improved freedom of movement and comfort to the patient. In particular, the applicant's research has shown that the combination of (1) separate top and bottom parts, (2) a wrap-around front opening, and (3) one or more appropriately positioned examination slits, together allow a clinician to provide each of the most common medical examinations required, enabling improved decision making, diagnostic and test order choices and minimising unnecessary delays in diagnosis, without requiring the patient to remove any part of the gown.

The provision of a wrap-around front opening with a two-part arrangement in particular significantly departs from the standard back opening arrangement which is used almost exclusively in existing hospital gowns.

The two-part arrangement allows for abdominal examination to be performed by lifting up of the top part, which is not possible with the standard one-piece hospital gown without exposing the lower half of the patient. The wrap-around fastening further facilitates the examination since the lower half of the top, below the fastening, is easily lifted and may be cut so as to fit loosely on the patient, without reducing coverage of the upper abdomen or reducing patient comfort. The wraparound fastening further facilitates precordial (chest wall and breast) examination, which can be achieved by (partially) unfastening the wrap-around fastening, and facilitates skin to skin contact after child birth. The back or side positioned slit provides access for back, lung examination and axillary examination.

Together this combination of features therefore provides access to the clinician to perform a thorough examination of a patient's torso, including all of the most common examination processes, without requiring the patient to remove the gown, solving the problems associated with known hospital gowns. The gown also allows for improved ease of movement, while more fully covering the patient's body, facilitating use during extended hospital stays where the patient is encouraged to move around the hospital or attend physiotherapy, particularly after joint e.g. hip or knee replacement. The gown also requires very little additional material over conventional gowns and may be manufactured at relatively low cost. The greater freedom of movement, cover of the body and associated comfort provided by the gown directly result in improved patient outcomes, since patient discomfort with existing gowns has shown to lead to patients electing early discharge.

Preferably the top part comprises a back-examination slit positioned centrally in the back part of the top part. In this way, the clinician can perform back, lung and axillary examination through the back-examination slit, without requiring the patient to remove the gown. In particular the top part may comprise a back panel arranged over the patient’s back when worn and the back-examination slit is positioned centrally in the width and/or vertical direction across the back panel. Preferably the back-examination slit is arranged such that it lies centrally on the patient’s back, preferably between the shoulder blades. A medical gown with one or more of these features allows the clinician to equally access both sides to perform a lung examination.

In certain preferable examples of the invention the back examination slit is positioned to run vertically down the centre of the back and is at least 20cm in length, preferably 25 to 40 cm in length, most preferably 30 to 35cm. Testing has shown that this provides optimum access to the clinician to perform lung examination while ensuring that the slit remains closed and does not expose the patient’s back while wearing the gown. The slit preferably begins at a position of around 10cm below the collar and extends downwards.

The top part preferably further comprises an under arm examination slit positioned on a side of the top part under the sleeve, arranged to allow examination of the patient's under arm and/or breast. In this way the clinician is able to perform axillary and breast examination through the under arm slit. In particular, although the back examination slit provides access for axillary examination, the underarm slit greatly improves the access for the clinician with little or no detrimental effect on the exposure of the patient. The underarm slit in particular allows for a great range of examinations and procedures to be performed and enables more accurate diagnosis. The underarm slit is preferably at least 10cm in length, more preferably 10 - 20cm, most preferably 12 - 16cm. Testing has shown that that a slit in the fabric of this size provides the greatest balance of clinician access while ensuring that the patient is not exposed through excessive opening of the slit.

Preferably the medical gown according to the present invention comprises a full front opening positioned between two opposing portions of closure fabric, the portions of closure fabric arranged to wrap consecutively around the patient to cover the patient's torso, the top portion further comprising a belt fastening for securing the closure fabric in place. By providing a full opening wrap-around fastening in this way, the present invention solves the problems with known gowns that they need to be removed to perform chest and/or back examinations, and allows for chest, precordial, breast and shoulder examination, shoulder injection and insertion of a line, without requiring removal of the gown. The ability to provide routine breast examination without removal of the gown is a particular advantage not found in existing gowns, where patient comfort and dignity is a particularly important factor. Furthermore, since each portion of closure fabric can be opened individually, one side of the body may be exposed for examination selectively, leaving the remainder of the body covered. The wrap-around fastening also preferably leaves a portion of the upper chest exposed so that many of these examinations, particularly chest and precordial can take place without even partially opening the wrap around fastening. The opposing portions of closure fabric preferably have an angled edge so as that they form a V-shaped neck line when closed, thereby facilitating access to the upper chest without removal of the top.

The belt is preferably arranged to be positioned at or above a patient’s waist such that the closure fabric below the belt may be lifted to examine the patient’s lower abdomen.

Preferably the bottom part comprises trousers, thereby providing a greater degree of coverage and greater freedom of movement in comparison to conventional medical gowns. The trousers preferably comprise two hip examination slits, each hip examination slit positioned on an outer side of the trousers and running vertically along the length of the trousers to allow medical examination of the hip. In this way a clinician has access to examine the hip and to administer joint injection of the hip and trochanteric bursa. Preferably the hip examination slits are 10 - 30 cm in length, more preferably 20 - 25 cm in length, which testing has shown to provide optimum clinician access while limiting exposure of the patient. The hip examination slits preferably begin at a position adjacent a waistband of the trousers on the outer side of the leg and run along the leg towards the knee.

The medical gown of the present invention preferably further comprises a groin examination slit running vertically along an inner side of an upper portion of a leg of the trousers and arranged to allow medical examination of the groin. In this way, the clinician may examine the patient using the groin examination slit for analysis of lymph nodes, inguinal examination and testicular examination, without removing of the gown, which is particularly important for examination of sensitive areas when patient modesty must be maintained as far as possible. The groin examination slit preferably extends from a position near the crotch of the trousers along the leg towards the knee. The groin examination slit is preferably 10 - 20 cm in length, more preferably 12 - 16 cm, which provides the optimum degree of clinician access whilst ensuring the slit remains closed and covers the patient during wear of the gown.

The sleeves preferably do not extend beyond the elbow of the patient to allow for elbow examination and also to comply with bare below the elbows policy. This latter ensures that the gown meets hygiene standards and complies with CQC guidance. The sleeves preferably comprise a slit extending from an opening at the end of the sleeve towards the underarm. In this way the opening of the sleeve is wider to allow additional access through the sleeve opening. The sleeve openings the openings may have a circumference of at least 30cm, preferably at least 60cm. The one or more slits provided in the medical gown preferably comprise fastenings arranged to hold the slit closed. In this way, the slits remain closed to cover the patient’s body more completely but may be easily opening by a clinician for examination, without removing any part of the gown. The fastenings preferably comprise snap fastenings or Velcro fastenings. In this way, the fastening can be easily opened and re-fastened to allow access and may also be usable by patients with reduced fine motor skills. In some examples one or more of the slits may be closable with a zip fastening, which facilitates straightforward opening and closure, even for patients with reduced dexterity.

Preferably the top and/or bottom part are made from an antibacterial material. In this way the infection risk is minimised. Preferably the gown is made from Tencel, preferably jersey T encel.

Brief description of the drawings

Figure 1 A schematically illustrates a front view of a medical gown according to the present invention;

Figure 1 B schematically illustrates a back view of a medical gown according to the present invention;

Figure 2 schematically illustrates a medical gown according to the present invention being worn by a patient.

Detailed description

Figure 1 A and 1 B respectively illustrate a front view and a back view of a medical gown 1 for a hospital patient according to the present invention. The medical gown comprises a top part 10 arranged to cover the patient's torso and a separate bottom part 20 arranged to extend from the patient's waist downwards to cover at least part of the patient's legs. The top part 10 of the gown 1 has sleeves 15 and a front-facing opening 11 which is closed at the front of the gown and secured by a wrap-around fastening 12. The top part 10 includes at least one slit 30 positioned on a back or side portion of the top part 10, where the slit 30 is arranged to allow medical examination of the patient's torso. The combination of the wraparound opening at the front, side or back positioned access slit and the two-part arrangement together allow for each of the common torso examinations to be carried out by a clinician, without requiring the patient to remove the gown.

In more detail, the specific exemplary gown 1 illustrated in the figures, comprises a wrap-around or "kimono-style" top 10. In other words, unlike standard hospital gowns which generally open at the back, the top part 10 has a jacket or “kimono” style front opening 11 positioned between two front panels which comprise opposing pieces of closure fabric 12a, 12b which are extend sufficiently to allow them to wrap consecutively around the patient's torso, the second piece 12b wrapping over the first 12a, to cover the majority of the front of the patient's torso.

The top of this example further comprises a fastening 13 usable to secure the portions of closure fabric 12a, 12b in the wrapped and closed arrangement shown in Figure 1A. In this example the fastening comprises a tie fastening, or belt fastening, but in other examples it may equally be replaced with a button, hook and loop or VELCRO (RTM). A tie fastening is particularly preferable as it is more accessible for patients with reduced manual dexterity, such as those with arthritis of the fingers, who cannot manage buttons.

The fastening 13, in this case a tie fastening, is preferably positioned above the hip, for example so as to be aligned with the bottom of the rib cage or higher. Positioning of the fastening higher on the body facilitates lower abdominal examination by lifting the bottom, free portion 14 of the top, without requiring the patient to remove the gown. The bottom portion 14 of the front panels of the top 10 preferably extend below the waist to cover the top of the bottom part 20 of the gown 1 , thereby providing cover of the lower abdomen while not extending so far as to inhibit access for lower abdominal examination. Preferably the top part 10 extends to below the hip but not to the knee so as to facilitate examination. The lower part of the top 10 may preferably also comprise one or more slits 37 which extend upwards form a lower edge of the top part 10, preferably positioned in the back and sides of the gown as shown in Figure 1 B, to further facilitate lifting of individual parts of the lower part 10 of the gown for examination of specific regions of the lower abdomen, while the top 10 is being worn by the patient.

The wrap-around arrangement has been selected by the applicant for the provision of a number of advantages related to clinical patient examination. Whereas standard hospital gowns which generally fasten at the back or are pulled over the head do not allow for chest, abdominal or shoulder examination without the gown being removed, the present invention facilitates the examination of each of these key areas. In particular, by opening one side of the gown, i.e. by opening one of the closure portions 12a, the patient is able to expose only one side of the body for examination, which particularly facilitates breast examination. With a patient wearing a standard open back hospital gown, routine breast examination is not possible without removing the gown, providing significant intrusion and discomfort for the patient.

The wrap-around front fastening therefore facilitates chest, precordial, breast and shoulder examination, shoulder injection and insertion of a line, without requiring removal of the gown. The wrap-around fastening also preferably leaves a portion of the upper chest exposed so that many of these examinations, particularly chest and precordial can take place without even partially opening the wrap around fastening. To facilitate this further, the closure portions 12a, 12b of the top part 10 preferably have angled facing edges 16 defining the opening 11 , thereby providing a V-shaped neckline, illustrated in Figure 2, which can be adjusted in size to allow for examination of the upper chest without removable of the top 10.

As shown in the rear view of the gown in Figure 1 B, the top part 10 includes at least one slit 30 to provide access for clinical examination. The size and position of the one or more slits must be carefully configured such that, together with the front wrap-around fastening, a clinician has appropriate access for each of the most common examinations, whilst maintaining sufficient coverage to ensure patient comfort and dignity. The example of Figure 1 includes a back examination slit 31 positioned centrally in the back panel of the top part 10, which runs vertically down the top part 10, i.e. from a position toward the neck downwards to a position near the waist. The back examination slit 31 thereby provides access for back and lung examination and also axillary examination. The back examination slit preferably extends over a majority of the upper back and is preferably vertically aligned, following the spine. The back examination slit should preferably be at least 20cm and more preferably 30cm to provide adequate access to the clinician to examine the back and lungs. In the present example the slit is 33 cm in length.

However, the medical gown 1 may alternatively or additionally include an under arm slit 32, positioned under each sleeve 15 to provide access to both the back and underarms for axillary examination. Preferably, as shown in the example of the figures, the gown 1 includes both a back examination slit 31 and underarm slits 32 which significantly increases ease of access for both back and lung examination and axillary examination. The underarm slits 32 are preferably at least 10cm in length to provide sufficient access. In the example of Figure 1 they measure 14 cm in length. The underarm slits preferably extend vertically along the side of the top part 10 under the sleeve 15.

The combination of the two-part structure of the gown 1 , the wrap around fastening 12 and the back and under arm slits 31 , 32 therefore allows for a full torso examination of the patient, without requiring them to remove the gown. It also provides greater coverage of the body to ensure patient comfort in the hospital environment and provides greater ease of movement that conventional hospital gowns.

A number of further features are included in the exemplary gown 1 illustrated in the figures to further enhance its function. The sleeves 15 of the gown are preferably loosely cut to allow for the sleeves 15 to be lifted up to facilitate elbow and shoulder examination - and to not obstruct the application of IV line cannula. The sleeves preferably have a circumference around the sleeve opening of at least 30 cm, preferably at least 45 cm. They may also have a slit 33 in the opening of the sleeve to further facilitate elbow and shoulder examination and to allow application of a cannula. The sleeves 15 preferably do not extend beyond the elbow to further facilitate examination and to minimise infection risk.

The bottom part 20 of the gown covers the patient's legs from the waist downwards, extending over a majority of the legs. In the example of Figure 1 the bottom part 20 is in the form of trousers 20, which provide greater comfort and range of movement than traditional gowns. This supports movement during recovery rather than prolonged periods in bed, as is increasingly being encouraged for patients recovering from procedures. The trousers 20 are preferably adjustable at the waistband 21 , for example by means of a drawstring 22 so as to be easily adjustable, even for patients with limited dexterity such as those suffering from arthritis. The trousers extend preferably below the knee and may comprise a slit 36 at the opening to facilitate examination of the legs as shown in Figure 2.

The bottom part 20 of the gown also preferably comprises one or more slits to facilitate medical examination of the lower half of the body. In particular, the bottom part 20 preferably comprises a hip examination slit 34 positioned on each side over the upper part of the leg. The hip examination slit 34 preferably extends vertically down the leg from a position near the waistband 21 downwards long the side of the leg towards the knee. The hip examination slit 34 is preferably over 15 cm, more preferably over 20 cm to provide the required access to a clinician to examine the hip and to administer joint injection of the hip and trochanteric bursa. In this example the hip examination slit is 22 cm in length.

The bottom part 20, i.e. the trousers in the example of the figures, preferably further includes an inner thigh slit 35 providing access to examine the groin, for example for analysis of lymph nodes, inguinal examination and testicular examination. An inner thigh slit 35 may be provided on one or both legs, with each running vertically down the inner side of the leg from the groin, towards the knee. The inner thigh slits are preferably at least 10cm in length and less than 20cm in length, in this case having a length of 14 cm. Genital examination is clearly particularly prone to causing anxiety and discomfort in patients and the provision of the inner thigh slits to facilitate examination without requiring removal of the gown and unnecessary exposure is a particular advantage.

The trousers 20 preferably extend to just below the knee to facilitate examination of the lower limb joints. The opening of each leg is preferably provided with a slit 36 extending up the leg from the leg opening to the knee to provide access to the knee for examination, as shown in Figure 2. The slit preferably extends over a length of greater than 10 cm, preferably 10 - 20 cm, in this case 16.5 cm. As with the sleeves, the leg openings are preferably loosely cut to allow the legs to be lifted up for examination. For example the openings may have a circumference of at least 30cm, preferably at least 60cm.

Each of the slits 30 provided in the gown may be simply be open as, if appropriately sized and positioned as described above, they will not expose the patient's body unless opened. However, in some examples of the invention the slits may comprises closures to ensure they remain closed until access for examination is required. In particular, the slits may be closed by snap fastenings, hook and loop or VELCRO (RTM) fastenings, buttons or tie strings.

The gown is preferably made from an antibacterial material, for example Lyocell fibre, such as TENCEL (RTM) which is cost effective but maintains patient comfort and provides antibacterial properties suitable for use in hospital.

The patient gown 1 according to the present invention therefore provides increased patient comfort by facilitating medical examination without requiring removal of the gown.

Claims

1 . A medical gown for a hospital patient, the medical gown comprising: a top part arranged to cover a patient's torso, the top part comprising sleeves and a front-facing opening with a wrap-around fastening; and a bottom part, separate to the top part and arranged to extend from patient's waist downwards to cover at least a portion of the patient's legs; wherein the top part comprises at least one slit positioned in a back or side portion of the top part and arranged to allow medical examination of the patient's torso through the slit without removal of the top part.

2. The medical gown of claim 1 wherein the top part comprises: a back-examination slit positioned centrally in the back of the top part.

3. The medical gown of claim 2 wherein the back-examination slit is positioned to run vertically down the centre of the back and is at least 20cm in length.

4. The medical gown of any preceding claim wherein the top part comprises: an under arm examination slit positioned on a side of the top part under the sleeve, arranged to allow examination of the patient's under arm.

5. The medical gown of claim 4 wherein the under arm examination slit is at least 10cm in length

6. The medical gown of any preceding claim wherein the top comprises: a full front opening positioned between two opposing portions of closure fabric, the portions of closure fabric arranged to wrap consecutively around the patient to cover the patient's torso, the top portion further comprising a belt fastening for securing the closure fabric in place.

7. The medical gown of claim 6 wherein the belt is arranged above the hip of the patient and the top comprises a lower free portion below the belt, wherein the lower free portion comprises one or more slits extending upwards from a lower edge.

8. The medical gown of any preceding claim wherein the bottom part comprises trousers.

9. The medical gown of claim 8 wherein the trousers comprises two hip examination slits, each hip examination slit positioned on an outer side of the trousers and running vertically along the length of the trousers to allow medical examination of the hip.

10. The medical gown of claim 8 or claim 9 further comprising a groin examination slit running vertically along an inner side of an upper portion of a leg of the trousers and arranged to allow medical examination of the groin.

11. The medical gown of any preceding claim wherein the sleeves have a length such that they do not extend beyond the elbow when worn by a patient.

12. The medical gown of claim 11 wherein the sleeves comprise a slit extending from an opening at the end of the sleeve towards the underarm.

13. The medical gown of any preceding claim wherein one or more slits comprise fastenings arranged to hold the slit closed.

14. The medical gown of claim 13 wherein the fastenings comprise snap fastenings or Velcro fastenings.

15. The medical gown of any preceding claim wherein the top and/or bottom part are made from Lyocell fibre.