Designing touch screen devices includes many variables off how to address design issues in the best possible way. The design includes what type of touch interaction method is to be used, how the interface is to be designed and in which context it will be used. The problematic issue that has to be dealt with is how the designer must put together all these parameters into one final product. This paper presents the case of re-designing a touch screen bedside monitor, a device used in hospitals to observe the vital signs of patients. The design solution presented deals with the issues of how the device was designed to suit the users and environment of a hospital. A contextual inquiry showed the many constraints and standards that had to be met and how they shaped the design solution. Earlier work shows the different methods for touch interaction, interface design and feedback that can be applied for touch screen devices. The resulting design is discussed in relation to the different ways of creating touch screen interfaces, and an example of a work method is presented in the end of the paper on how to design for contextual touch screen devises.