DESIGN DEVELOPMENT AND IMPLEMENTATION OF
WIRED NURSE CALLING SYSTEM
Chaman Sharma
Research Scholar, INDIA
chaman.218@gmail.com
Abstract— In recent decade, hospitals turns into smart
hospitals by the advent of recently developed technologies around
the world. The growth in technologies like networking and other
provides a brighter future and open scenario to interconnect
different equipment in the hospitals, which gives us a new field of
research which is called nurse calling system. Also due to growth
in the fields of communication which aids such facilities with the
used to technology. And which indeed make feasible such type of
systems in today’s world. In a generalized methodology for
implementing Nurse calling system make use of a trigger button
facility attached to the patient’s bed. When pressed by the
patient, it alerts the center nurse station by giving out an audible
tone or light flashes and requesting patient is severed accordingly
by a nurse or other health care staff member. But in recent
scenario nurse calling systems are improved and user friendly so
they are in demand now. The proposed system is one step toward
the remedy of such condition. Which enables the implementation
of nurse calling system with more ease by the application of wired
technology like RS-485, Modbus protocol, along with wireless
technology of RF/ZigBee modules. This proposed nurse calling
system is capable of operating large numbers of beds by means of
RS-485 Protocols. So automatically controlling devices in a
hospital is being feasible by such systems. This system is another
step in technology by the technology for ease of a human being.
Keywords—Nurse calling system (NCS), embedded system,
protocols, RS-485, STM32, ARM Cortex M3, bed unit, nurse panel.
I. INTRODUCTION
Remote control or local control is always useful for those
human being who are physically challenged in the world. Such
a system always aids them for spending life more easily then
without such systems [2].the key of nurse calling system is to
make calls from patients to remotely situated nurse control
room [3]. There are so many methods have been proposed for
such condition but ease of operation, cost, stability etc. are
came as obstacles to such systems development. Highly
complicated implementation is used for the nurse calling
system which uses Java based system. It needs high
performance PC which added to cost. In such systems web
server type remote controlling is done which are connected to
physical board through embedded devices. Although such
system are complexes but they offers a good solution for nurse
calling system [4].
On the other hand system based on Bluetooth it operated
as there is a one coordinator which is connected to different
routers type systems for functioning. There is a connection
held from local Bluetooth with the sub-controller section [1] in
the system. The command is given to the sub-coordinator from
978-1-4673-7910-6/15/$31.00 2015
c IEEE 1258
Deepak Kumar Gautam
Member, IEEE, INDIA
deepakkrgautam@ieee.org
coordinator generally. The time requires for such system for
communicating is very high which cases delay in overall
system [5]. Lack of flexibility and stability is phone based
system is always there in this method along with the
knowledge of all access codes. In a phone operated controller
for hospital and building automation, the system have problem
of suffers from the problem of flexibility. Because users must
have to memories the code of operation.
Hand gesture type system is used for the control
applications in controlled networks. The security is main
drawback of such system. In the recent years the applications
of remote controller increased with enormous rate. All devices
in every field from house to office and even in work location
is make use of remote for operation. There is large amount of
devices have been made which works on remote in house and
industries The proposed system is one step toward the remedy
of such condition. Which enables the implementation of nurse
calling system with more ease by the application of RS-485
protocol over a range of 1200 meters. In order to implement
this system in a room in hospital is taken into consideration
with different beds.
While proposing the new approach for nurse calling
system following objectives have been taken in account as
follows:
1) Make system scalable for ‘N’ beds and ‘N’ wards.
2) Stable operation of overall system over long range
without interruption.
3) Make sure which device user wants to operate on
will responses in no time stably
4) Full protection in case of any short circuit at any end
of system.
5) Keep an eye on the energy saving by mean of
monitoring the presence of call made in room for
certain period of time? If not so then turn ON the
indicator section immediately.
There is always possibility of chances of replicate activity
mainly caused by less interoperability. There is always
possibility of different networks due to co-channel networks
and two successive inputs from co-existing networks caused
undesired operation.
Power saving at hospital along with less human
intervention is a main goal of this system. It focuses on the
development of an embedded system for nurse calling system
that use STM32 ARM CortexM3 microcontroller, bed unit as
user input device. Difficulty faced in operating nurse calling
system is removed in this system. Which are present in many
other systems proposed for the applications of NCS.
II. FORMER WORK
Remote control or local control is always useful for those
human being who are physically challenged [11] in the world.
Such a system always aids them for spending life more easily
then without such systems [2].the key of nurse calling system
is to make calls made by patients remotely situated from nurse
control room [3].
A. Research on coordination and mobility in health care
Mobility causes huge and immense motivation for the
sensitive applications in the field of health care and solutions.
You cannot connect to a phone over wired media in all places,
the idea has been given by Brown and Randell [9]. There is
always chance of overhead conditions in phone and a mobile
worker, as described e.g. in Belotti and Bly [6] and Bardram
and Bossen [7]. Mobile users can be facilitates with Fixed
devices, may also give facility for mobile users. In [5] this a
big display on wall mounted facility is used for study, study
also includes mounted small displays at the dimension of light
switches.
These are many interpretive divisions. In a generalized all
resultants denied interrupts and reducing the affects generated
due to interrupts might find its applicability together [12]. In
Scholl et al. [16] it has been mentioned that some doctors used
to forwarded their calls on their pagers. The documents states
that doctors perceive the pager less cumbersome [10] and
interruptive when compared to the calls received (due to its
small size, the manner it give indications for incoming
messages). Their research gives the evident proof for reducing
the interruptions harms perceived by them. The resultant
analysis in Bardram and Hansen [8] and Scholl et al. [16] both
make use of calls (and text messaging or /and paging)
originated by workers who works in health care. This solution
doesn’t includes calls made by external resources other than
health care persons.
B. Research on nurse calling system
There so many methods have been proposed for such
condition but ease of operation , cost, stability etc. are came as
obstacles to such systems. Highly complicated implementation
is used for the nurse calling system which uses Java based
system. It needs high performance PC which added to cost. In
such systems web server type remote controlling is done
which are connected to physical board through embedded
devices. Although such system are complexes but they offers a
god solution for nurse calling system [4].
On the other hand system based on Bluetooth it operated
as there is a one co-ordinator which is connected to different
routers type systems for functioning. There is a connection
held of local Bluetooth with the sub controller section in the
system. The command is given to the sub co-ordinator from
co-ordinator generally. The time requires for such system for
2015 International Conference on Green Computing and Internet of Things (ICGCIoT)
communicating is very high which cases delay in overall
system [5].
Lack of flexibility and stability is phone based system is
always there in this method along with the knowledge of all
access codes. In a phone based remote controller for hospital
and office automation, the system suffers from the problem of
flexibility. Because users have to remember an access code.
Hand gesture type system is used for the control applications
in controlled networks. The security is main drawback of such
system. In the recent years the applications of remote
controller increased with enormous rate.
All devices in every field from house to office and even
in work location is make use of remote for operation. There is
large amount of devices have been made which works on
remote in house and industries The proposed system is one
step toward the remedy of such condition. Which enables the
implementation of nurse calling system with more ease by the
application of MAX RS-485 line drive modules. In order to
implement this system in a normal room is taken in
consideration with different beds.
Power saving at hospital along with less human
intervention is a main goal of this system. It focuses on the
development of an embedded system for nurse calling system
that use STM32 ARM CortexM3 microcontroller, bed unit as
user input device. Difficulty faced in operating nurse calling
system is removed in this system. Which are present in many
other systems proposed for the applications of NCS.
C. Analysis of existing nurse calling system
Although the field of research for nurse calling system is
wide spread but adaptation of these systems are very limited
in present time. This criteria of slow adaptation of any
automation system can be characterized into following
groups:
• Complexity architecture: in all present nurse calling
system the architectures involves the use of PC over
network connection in order provides the remote
controlling operation of household devices. It aids to
the complexity in overall system when it comes to
implementation.
• Intrusive installation: such system needs different
wiring levels in the hospitals in order to provide the
stable architectures for operation. This, in some
cases, mainly due to the cost involves in the form of
wireless technologies. Therefore these systems
required high cost of implementation.
• Lack of network interoperability: there are different
types of hospital networks and the nurse calling
systems. Which lead them to interoperability when
comes to implementation. This leads to complexes
networks with less interoperability as main potential
problem.
• Interface inflexibility: in existing system there is only
one controlling method involves. And those systems
which provides more than one controlling
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 mechanism always lead to confuse the user when it
comes to the operation of the system.
• Security and safety: the security and safety is also a
main consideration when implementing such system
in home environment. All system must have these
features more or less. Due to presences of such
systems the risk of damage protection in operating
such systems in reduced and all system can works
stably without effecting other system in home.
that this room made needed attention. Along with this STM32
ARM CortexM3 send data frame MAX RS-485 line driver
which send this data to receiver section i.e. nurse panel over
range of 1200 meters. Therefore, nurse panel at receiver side
also get the information which room and which bed has made
call. Here, STM32 ARM CortexM3 is configured as slave and
nurse panel is configured as master in network of nurse calling
system.

III. METHODOLOGY
In prosed NCS, we used STM32F1xx ARM Cortex M3
Microcontroller for processing, MAX 485 line drive modules,
which enables the long distance (up to 1200 meters)
communication link establishment between BED unit and
Nurse Panel. Fig. 1 shows the generalized layout of proposed
NCS (Nurse calling system).

Fig. 2. Block diagram of Patient control unit

B. Nurse Display Panel

Second section i.e. receiver section of this system is
comprised as nurse panel. Generalized block diagram of the
receiver section is illustrated below in Fig. 3. STM32 ARM
CortexM3 receiver section is used to indicate the room and
which bed made call by an indication of led on panel. Here,
multi-color led is used which indicates patient asked for
• Emergency,
Fig. 1. Generalized Layout of proposed nurse calling system
• Medicine,
This system consists of two sections; • Water or other thing.
1. Patient control unit Receiver section also having MAX RS-485 line driver to
2. Nurse display panel decode the transmitted data frames from the different rooms
A. Patient control unit over RS-485 line. Also, a switch is given for each bed call so
when nurse goes for attending called bed it indicates that some
First section of system Patient control unit i.e. one gone for that patient.
transmission sections is consist of a remote device which is
interfaced with STM32 ARM CortexM3 microcontroller by
Opto-Isolator , which is used to interface bed unit to STM32
ARM CortexM3 used as input to system. Here, Opto-Isolator
is used to extend the range of the bed units from STM32 ARM
CortexM3. Because the microcontroller operates on +3.3V so
when comes to implements the system the bed unit is far from
the STM32 ARM CortexM3 transmitter section so it is aided
by Opto-Isolator which not only extend the range but also
isolates bed units from STM32 ARM CortexM3 in terms of
safety and stability.
Generalized block diagram of the transmitter section is
illustrated below in Fig. 2. Different bed units are used in
interfaced with STM32 ARM CortexM3. Each STM32 ARM Fig. 3. Block diagram of Nurse Display panel
CortexM3 is capable of controlling maximum 7 bed. After that
the receiving the user input from the bed unit is fed to STM32 Also each bed having one bed reset button, when nurse
ARM CortexM3. attended the called patient it reset its bed call.
Then STM32 ARM CortexM3 send signal to bed unit Correspondingly the signal raised for call in nurse panel is
which made a call along with room indication outside of room turned OFF.

1260 2015 International Conference on Green Computing and Internet of Things (ICGCIoT)
 VI. RESULT AND DISCUSSION
In STM32 ARM cortex M3 microcontroller, port A is
programmed for the interfacing of bed module to system ,
Port C made display module functional along with port B act
as serial communication Transceiver, which for interfacing
with RS-485 USART. ST-link is used for programming ARM
STM32F1xx. Keil µ Vision Integrated Development
Environment (IDE) is used for debugging.
Once the system is installed and enabled for functionality,
whenever the patient (say patient bed no.1) pressed the
pushbutton, the corresponding signal for that bed (line 1)
enabled for that Bed indication as well as for that room from
which call is originated. Proposed designed and developed
layout of Nurse calling system is shown in Fig. 4.
Hence the data packet containing information
corresponding for the calling patient is transmitted over the
serial port of STM32 over RS-485 line for nurse display panel.
The STM32 at receiver side is controlling nurse display panel,
is also programmed in such a way that whenever it receives
the data packet it decodes it and extract the information
regarding calling bed. After decoding the data packet over RS-
485 it raised the alarm and turned on the corresponding led for
room and bed. So this way nurse will get information about
requesting patient location.
Fig. 4. Designed and developed transmitter and receiver circuits
Therefore, whenever a call is made by pressing a switch,
the call generation for that bed (having unique ID number) is
initialized. This is an adequate and strengthened out method
by providing information to nurse center where care is needed.
S fi d t ti t il t h i
2015 International Conference on Green Computing and Internet of Things (ICGCIoT)
required. It also make sufficient reduction in nurse-to-bed
ratio in a hospital. Further, high baud rate i.e. 19200 make this
system functional over 1 kilometer range.
Thus, with ability to transmit over long range make this
system more efficient and reliable to cover the larger area of
entire critical care section in the hospital environment and
thereby it save cost incurred in the implementation and
utilization of hundreds of meters of conductor cables that is
used in traditional systems. Where this system only uses 3
lines of communications (i.e. Receiver, Transmitter and
Ground lines) to build the whole network of communication
in proposed nurse calling system. It makes it feasible and
function in the scenario of complex hospital environment.
V. CONCLUSION
Although there are many systems are present in the
market but the desired output in real time is still not
satisfactory from many of them when used in problem
imposed in commercial applications. Thus the proposed
methodology for implementing nurse call system can
intelligently alerts nurse control room upon raised help request
initialization from patient who looks for care. It makes
appropriate steps in improvement of time management of
nurse servicing in Critical care patient’s section. This aids to
valuable way of managing human resource in hospitals. It also
makes influential steps in reducing the nurse-to-bed ratio and
also has effective credentials for functional and low cost
involved in managing hospital resources.
Since whole system communicating using RS-485, the
final product comes out to be compact in terms of designing
and implementation. Proposed system requires much lesser
space for installation in complex hospital environment without
conflicting with the existing hospital layout and structure.
High cost of conventional switch has been reduced by
replacing them with the proposed calling panels. The desired
output is still no satisfactory from them when used in problem
imposed in commercial applications. This application design
can be further improved by using wireless technique of
communication.
VI. FUTURE ENHANCEMENTS
When seeing the past history of the nurse calling system
and its state -of -the- art has been computed with emphasizing
on the practical benchmark. Like some other engineering
problems related to the nurse calling system requirements tries
to contribute to the real time controlling of the different
environments in coming future. Also some of these conditions
are contributing to this field. Among these technologies to
take the edge of disasters, in order to increase the way of life
of human happiness as ease and comfortable living.
Use of wireless methods like RF, ZigBee etc. is step
closer to advanced wireless system. Also embedding this
system with physiological and medical parameters enables
automated mode of nurse calling system in near future. The
calling request will be send when the medical parameters of
patient reaches abnormal value For this purpose ECG signal
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can be used for automating the system. It can send data over is
multichannel transmitter and receiver. The received signal
then can be applied to Pan- Tompkins algorithm [13] for
computing heart rate of patient. The computed value of heart
rate can be used as the key parameter which will automates the
NCS.
Therefore whenever the values of heart rate falls in
abnormal range, call is automatically initiated for specific
patient. In this mode there is no need of patient involvement
all the time, especially in case of emergency (when patient in
unconscious state) to trigger the call. Electrooculography
(EOG) signal can also be acquired from the equipment and can
be conveyed to system, hence to nurse control room for
detection of consciousness state of patients those who are
bedridden [14]. EOG is a type of signal which originated due
the eyeball movement of a human being (patient) and this
yields the functionality of monitoring for consciousness of
patients in hospitals [15].

REFERENCES
[1] N. Sriskanthan, F. Tan and A. Karande, "Bluetooth based home
automation system", Microprocessors and Microsystems, Vol. 26, no. 6,
pp. 281-289, 2002.
[2] L. McGillis Hall, C. Pedersen, and L. Fairley, “Losing the moment:
Understanding interruptions to nurse’s work”, JONA, 40(4), pp. 169-176,
2010
[3] Tika Miller, “Nurse Call Systems: Impact on Nursing Performance,” Journal
of Nursing Care Quality, Vol.11, Issue 3, Feb. 1997, pp. 36-43.
[4] R. Al-Ali and M. Al-Rousan, "Java-based home automation system",
IEEE Transactions on Consumer Electronics, vol. 50, no. 2, pp. 498-
504, 2004.
[5] S.Aswin, N. Gopalakrishnan, Member, IEEE, S.Jeyender, R.Gnana
Prasanna and S. Pravin Kumar , “Design development and
implementation of Wireless nurse call station”, India Conference
(INDICON), 2011 Annual IEEE, Dec. 2011, pp 1-6.
[6] M.S. Ackerman, “The Intellectual Challenge of CSCW: The Gap
Between Social Requirements and Technical Feasibility”, Human-
Computer Interaction, 15(2-3), pp. 179-203, 2000.
[7] J.E. Bardram, and C. Bossen, “Mobility Work: The Spatial Dimension
of Collaboration at a Hospital”, CSCW, Vol. 14, 2, pp. 131-160, 2005.
[8] J. Bardram, J. and T.R. Hansen, “The AWARE architecture: supporting
context-mediated social awareness in mobile cooperation”. In CSCW
Conf., 2004, pp. 192-201.
[9] B. Brown and R. Randell, “Building a Context Sensitive Telephone: Some
Hopes and Pitfalls (…)”, CSCW, Vol. 13, 3-4, pp. 329-345, 2004
[10] F. Cabitza, et al., “When once is not enough: the role of redundancy
(…)”, In GROUP’05, 2005, pp. 158-167.
[11] P. Dourish and V. Bellotti, “Awareness and coordination in shared
workspaces”. In CSCW Conf., 1992, pp. 107-114.
[12] R. Harr, and V. Kaptelinin,”Unpacking the Social Dimension of
External Interruptions”, In GROUP’07, 2007, pp. 399-408.
[13] C.B. Jensen,”The Wireless Nursing Call System: Politics of Discourse,
Technology and Dependability (…)”, CSCW, 15 (5-6), pp 419-441,
2006.
[14] L. McGillis Hall, C. Pedersen, and L. Fairley, “Losing the moment:
Understanding interruptions to nurse’s work”, JONA, 40(4), pp. 169-
176, 2010
[15] A. Minnick, K. Pischke-Winn and M.B. Sterk, “Introducing a two-way
wireless communication system”, Nursing Management, Vol. 25, 7, pp.
42-47, 1994.
[16] J. Scholl et al.”Managing communication availability and
interruptions: a study of mobile communic. (..) ”, In Pervasive, 2007, pp.
234-250.

1262 2015 International Conference on Green Computing and Internet of Things (ICGCIoT)