TOWER, Paramedic Education for Initial Home Visit/ Tower / Stel RPM

Goals of Initial Paramedic Visit

  • Equipment set-up, plug in HUB, unbox scale and blood pressure cuff

  • Assist patient and family with equipment in the bag

Prior to patient's “complEx patient comprehensive home visit”- in addition ENROLLMENT into Stel RPM program

When the patient is discharged they will receive a phone call from the reading Paramedic to schedule your home visit.

  • It is recommended that this visit occur within 24 hours of your discharge from the hospital (as we know the transition to home can be complex and we want to begin monitoring your vitals signs as quickly as possible)

during patient's “complEx patient comprehensive home visit”

The paramedic will set up the Stel Kit and educate the patient on the usage of the devices.

  • This setup is done by the paramedic at the patient's home, and the patient should already have been added in the dashboard (see TOWER, How to use the Stel dashboard)

  • The paramedic should have a bag for the patient and the backup hubs. These backup devices include some device with a “*” at the end of the HUB ID. This means this hubs work on a separate cellular network.

Technical set up

  1. Seek the best location for safe usage and adherence:

    1. The devices will need to be used in a room with a hard floor (wood, tiles, concrete, avoid soft floors such as carpet as they may affect the weight measurement)

    2. If the patient encounters difficulties with the scale, it is important to consider setting the scale close to a wall or furniture that the patient can use as support. Explain to the patient that they need to take their hands off of this support for a few seconds to take an accurate weight measurement.

    3. The patient should have a spot nearby where they can take their blood pressure, seating.

    4. The hub should be placed as close as possible to the devices, devices have to be in eyesight of the hub, and the distance from a device to the hub should be as small as possible (ideally within 10 feet)

    5. Do not plug the hub behind an electrical appliance or electronic device or metal as they may affect communication.

    6. If possible place the hub facing a window

  2. Plugging the hub: video https://photos.app.goo.gl/zb3LqJQVT2s1ub9z5

    1. NOTE the hub ID

    2. when the hub is plugged it should go through these colors in 1 to 5 mn:

      1. RED

      2. ORANGE

      3. YELLOW

      4. GREEN

    3. If the hub starts blinking GREEN/OFF/GREEN/OFF, this means the hub is updating and will reboot, just wait 5 to 10 min for the whole cycle to complete.

    4. The hub does not stay solid green:

      1. if the hub keeps blinking: try a different hub (with no * after the HUB ID)

      2. if the hub does not turn green, but stays yellow/orange (more than 5mn):

        1. try a different location in the house

        2. IF After your attempts to set the hub in different locations in the home the hub still stays orange/yellow, then Try a hub with a * at the end of the HUB ID

      3. if you still cannot get the hub to turn green with the backup HUB (with * at the end of the HUB ID), then see the patient cannot be set up section below

  3. At this point it is very important that the Nurse has associated the HUB ID to the patient. see TOWER, How to use the Stel dashboard

  4. Testing the scale

    1. first take the scale out of the packaging and place it in a hard surface,

    2. The paramedic should educate the patient about the usage of the scale, see Patient education below

    3. If this fails TODO

5. Testing the BP device

  1. The paramedic should take the BP device out of the packaging and check that the batteries are working

  2. The paramedic can test the BP by

    1. being close to the hub (1 step away)

    2. pinch the pipe of the blood pressure cuff to block the airflow

    3. start a BP measurement by pressing the start button on the cuff

    4. The BP device should try to take a measurement, fail, and display the ERR message

    5. The HUB will blink blue acknowledging the connection is working

  3. If this test failed, The paramedic should try to repair the HUB and the BP device, see repair the hub procedure in TOWER, Troubleshoot Stel

  4. The paramedic should educate the patient to take a BP measurement, see patient education below

  5. The paramedic could check over the phone that the nurse received the data

  6. At this point everything is ready

Patient cannot be set up

It may happen in some rare occasion that the cellular coverage is insufficient to set up the patient. The paramedic should recollect the devices and postpone the set up of this patient until further notice.

In this case:

  1. The nurses should be informed

  2. Stel should be informed

  3. Stel will contact the paramedic to try to directly understand the problem

  4. Stel will ask the location of the patient (over a phone line) to determine if it is possible to solve the coverage issue.

  5. Within a few days what may happen is:

    1. Stel offers an alternative to set up this patient

    2. There is not a solution for this particular issue and this patient may have to be removed from the program.

Patient education

Refer to “Easy to USE picture guide”

How to measure Weight

Video demo: https://photos.app.goo.gl/EFfFvjLb7UdB5oHQ6

during a measurement, the patient needs to stay still long enough on the scale so that the measurement is stable on the scale (the measurement is stable when the weight blinks on the device)

  1. the patient can then step off

  2. The HUB should blink blue

how to measure Blood Pressure

Also see BP Instructions delivered in the bag of the BP cuff. And see video example here https://photos.app.goo.gl/WCYFtL8SqLf7NXyV9

Remove heavy clothing on arm

  1. Sit down with your feet on the floor, and relax

  2. Apply cuff to your arm above the elbow

  3. Rest your arm outstretched on table, relax, refrain from speaking, and breath normally

  4. Press the start button

  5. When measurement appears on the screen you can take off the cuff

  6. HUB light will blink again with BLUE light

 
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day to day usage education

Data will be sent when the measurements are taken and the light Blinks Blue

  • The Care Navigator will call you if you:

    • Miss a scheduled measurement or

    • Have a measurement that is out of bounds

  • The Paramedic can return to your home if you are experiencing difficulties or having trouble with any of the devices such as

    • Potentially needing to change the HUB with another version or other cellular carrier

    • They will alert CN of new HUB 5 digit identification number

These devices are specifically for your use. If a family member tries the device, the measurement will be sent to the care navigator nurse.