The present disclosure is related to patient support apparatuses that monitor patient conditions. More specifically, the present disclosure is related to a patient support apparatus that includes a control system that monitors movement of a patient supported on the patient support apparatus and displays information related to the movement on a user interface.
The mobility of a person supported on a patient support apparatus is of interest to caregivers in assessing the risk of the patient developing skin injuries, such as pressure sores, for example. Generally, mobility is scored subjectively by caregivers. Many factors introduce error into the mobility scoring process.
The present disclosure includes one or more of the features recited in the appended claims and/or the following features which, alone or in any combination, may comprise patentable subject matter.
According to a first aspect of the disclosed embodiments, a patient support apparatus may include a frame and a patient support surface positioned on the frame. A plurality of force sensors may be coupled to at least one of the frame and the patient support surface. Each of the plurality of force sensors may be configured to detect a force applied to the respective force sensor. A controller may be in communication with each of the plurality of force sensors. The controller may include a processor and a memory device. The memory device may include instructions that, when executed by the processor, process data signals from the plurality of force sensors to determine a mobility score of a patient supported on the patient support surface. Determining the mobility score may include determining a change of distance of in a center of gravity of the patient. The change of distance of in the center of gravity may be multiplied by a patient weight to compute an instantaneous work. The instantaneous work may be summed over a time period to compute a power. The power may be utilized as an input to a statistical model to generate the mobility score.
In some embodiments of the first aspect, the mobility score may be output to a user. The mobility score may be output to a display of a user interface. The data signals from the plurality of force sensors may be processed in real-time.
Optionally, in the first aspect, the memory device may include instructions that, when executed by the processor, cause the mobility score to be stored over time. The memory device may include instructions that, when executed by the processor, create a data array of the mobility score stored over time. The memory device may include instructions that, when executed by the processor, cause at least a portion of the data array to be displayed as a graph. The memory device may include instructions that, when executed by the processor, display the graph on a display of a user interface.
It may be desired, in the first aspect, that the mobility score may include a plurality of mobility indices. Each of the mobility indices may be modified by at least one predetermined factor. The at least one predetermined factor may include at least one of a patient factor, a bed factor, and a statistical scaling factor.
It may be contemplated, in the first aspect, that the mobility score over time may include a number of data points. Each of the data points may be selectable on the user interface to display additional information related to the respective data point. The additional information may include a summary of data accumulated to a point in time corresponding with the data point. The additional information may be displayed on a display of a user interface. The additional information may include a graphical indication of a time at which the patient moved relative to the patient support surface.
According to a second aspect of the disclosed embodiments, a patient support apparatus may include a frame. A patient support surface may be positioned on the frame and may include a plurality of bladders organized into a plurality of zones. Each of a plurality of pressure sensors may be operable to measure a pressure in a respective zone. A plurality of load cells may be coupled to the frame. A controller may be in communication with each of the plurality of pressure sensors to receive data signals indicative of a pressure applied to each of the plurality of pressure sensors. The controller may also be in communication with the load cells to receive data signals indicative of a force applied to each of the plurality of load cells. The controller may include a processor and a memory device. The memory device may include instructions that, when executed by the processor, process the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells to determine if the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells are related to a patient on the patient support surface or a load independent of the patient.
In some embodiments of the second aspect, the memory device may include instructions that, when executed by the processor, output an indication of a cause of the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells. The indication may be an indication that the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells are related to the patient. The indication may be an indication that the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells are related to a load independent of the patient.
Optionally, in the second aspect, the controller may receive the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells simultaneously. The controller may be in communication with a user interface and operable to cause the user interface to display at least one of the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells. The memory device may include instructions that, when executed by the processor, cause the data signals from the plurality of pressure sensors and the data signals from the plurality of load cells to be displayed as a graph.
According to a third aspect of the disclosed embodiments, a patient support apparatus may include a frame. A weigh frame may be coupled to the frame and may include a pair of long edges and a pair of short edges extending between the long edges. A plurality of load cells may be positioned on the weigh frame. Each of the plurality of load cells may be configured to detect a force applied to a respective load cell. A controller may be in communication with the plurality of load cells and configured to receive data signals indicative of the force applied to each respective load cell. The controller may include a processor and a memory device. The memory device may include instructions that, when executed by the processor, process the data signals from each of the plurality of load cells to detect patient movement by comparing data signals from the load cells positioned on the long edges of the weigh frame and the load cells positioned on the short edges.
In some embodiments of the third aspect, the detected patient movement may include lateral patient movement. The detected patient movement may include detecting that the patient is supine or turned. The detected patient movement may include detecting whether a caregiver offloaded a section of the patient support apparatus before a patient turn occurred.
Optionally, in the third aspect, the controller may output an indication of the detected patient movement to a user. The controller may be in communication with the user interface and operable to cause the user interface to display the data signals from each of the plurality of load cells. The memory device may include instructions that, when executed by the processor, cause the data signals from each of the plurality of load cells to be displayed as a graph.
According to a fourth aspect of the disclosed embodiments, a patient support apparatus may include a frame. A patient supporting surface may positioned on the frame and may include a plurality of bladders organized into a plurality of zones. Each of a plurality of pressure sensors may measure a pressure in a respective zone. A weigh frame may be coupled to the frame and may include a plurality of load cells. A controller may be in communication with each of the plurality of pressure sensors to receive data signals indicative of a pressure in each of the plurality of zones. The controller may also be in communication with the plurality of load cells to receive data signals indicative of a force on each load cell. The controller may include a processor and a memory device. The memory device may include instructions that, when executed by the processor detect movement signals from at least one of the data signals indicative of a pressure in each of the plurality of zones and the data signals indicative of a force on each load cell. The movement signals may be processed using a Fourier transform to determine peaks in the movement signals that correlate to an onset of a disease.
In some embodiments, of the fourth aspect, the disease may be Parkinson's disease. The peaks in the movement signals may be in a range of 3 Hz to 6 Hz. The disease may be an epileptic seizure.
Optionally, in the fourth aspect, the controller may be in communication with a user interface and operable to cause the user interface to display data related to the peaks. The memory device may include instructions that, when executed by the processor, cause the peaks detected by the system to be displayed as a graph.
The detailed description particularly refers to the accompanying figures in which:
While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that there is no intent to limit the concepts of the present disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.
A patient support apparatus 10, illustratively embodied as a hospital bed 10, includes a frame 20 that supports a mattress 22 as shown in
As will be described in further detail below, the present disclosure is directed to the application of sensors (discussed in detail below) of hospital bed 10, or other patient support apparatuses, to detect certain conditions and physiological characteristics of a patient supported on the frame 20 and/or mattress 22. Because a patient spends a majority of their time, when they are in a care facility such as a hospital, for example, in a patient support apparatus such as hospital bed 10, the use of existing sensors on the hospital bed 10 to detect certain characteristics of the patient provides efficiencies. For example, because the sensors are already present in the patient support apparatus 10 and the detection of the sensors occurs without directly engaging the patient, there is no additional cost for separate sensor systems and the patient is less likely to be concerned with or attempt to manipulate the sensors and their output. This ongoing ability to use signal from a set of load cells 272, 274, 276, 278 (see
Referring again to
The upper frame assembly 30 includes an intermediate frame 34, a weigh frame 36 supported with respect to intermediate frame 34, and a patient support deck 38. The patient support deck 38 is carried by the weigh frame 36 and engages the surface 22. As will be discussed in further detail below, the load cells 272, 274, 276, 278 are supported on the intermediate frame and support the weigh frame 36 so that loads are transferred through the load cells 272, 274, 276, 278. The patient support deck 38 includes a head section 40, a seat section 42, a thigh section 43 and a foot section 44. The sections 40, 43, 44 are each movable relative to the weigh frame 36. For example, the head section 40 pivotably raises and lowers relative to seat section 42 whereas the foot section 44 pivotably raises and lowers relative to thigh section 43. Additionally, the thigh section 43 articulates relative to the seat section 42. Also, in some embodiments, the foot section 44 is extendable and retractable to change the overall length of the foot section 44 and therefore, to change the overall length of the deck 38.
Referring to
In the illustrative embodiment, the bed 10 includes a pneumatic system 72 (See
The pneumatic system 72 includes a source of pressurized air 212, illustratively embodied as a compressor and a manifold 214 that directs air to and from each of the zones 202, 204, 206, 208, and 210. Other sources of pressurized air may be used in other embodiments, such as, for example, a blower, a pump, centralized hospital compressed air, or any other source of pressurized air suitable for inflating the bladders of mattress of a hospital bed. In addition, the pneumatic system 72 includes pressure sensors 222, 224, 226, 228, and 230 that are each in fluid communication with a respective zone 202, 204, 206, 208, and 210 so that the air in the respective zone engages the respective sensor 222, 224, 226, 228, and 230 and operable to measure a pressure in the respective zone. In the illustrative embodiment, the pressure sensors 222, 224, 226, 228, and 230 include a piezoelectric element that provides signals responses to the pressure applied to the piezoelectric element as is known in the art. Referring to
The processor 172 may be embodied as any type of processor capable of performing the functions described herein. The processor 172 may be embodied as a single or multi-core processor(s), digital signal processor, microcontroller, or other processor or processing/controlling circuit. The memory 174 may be embodied as any type of volatile or non-volatile memory or data storage capable of performing the functions described herein. In operation, the memory 174 may store various data and software used during operation of the bed 10 such as operating systems, applications, programs, libraries, and drivers. The memory 174 is communicatively coupled to the processor 172 via an I/O subsystem which may be embodied as circuitry and/or components to facilitate input/output operations with the processor 172, the memory 174, and other components of the bed 10. For example, the I/O subsystem may be embodied as, or otherwise include, memory controller hubs, input/output control hubs, integrated sensor hubs, firmware devices, communication links (i.e., point-to-point links, bus links, wires, cables, light guides, printed circuit board traces, etc.) and/or other components and subsystems to facilitate the input/output operations. In some embodiments, the I/O subsystem may form a portion of a system-on-a-chip (SoC) and be incorporated, along with the processor 172, the memory 174, and other components of the bed 10, on a single integrated circuit chip.
A user input block represents the various user inputs such as buttons of control panels 66, 67 shown in
The control circuitry 98 receives user input commands from the graphical display screen 142 when the display screen 142 is activated. The user input commands control various functions of the bed 10 such as controlling the pneumatic system 72 and therefore, the surface functions of the surface 22. In some embodiments, the input commands entered on user interface of the display screen 142 also control the functions of one or more of the actuators 70, 90, 92, 94, 96 but this need not be the case. In some embodiments, input commands entered on the user interface of the display screen 142 also control functions of the weigh scale system 270, which is discussed in more detail below.
Illustrative bed 10 has four siderail assemblies 48, 49, 50, 51 coupled to the upper frame assembly 30. The four siderail assemblies 48, 49, 50, 51 include a pair of head siderail assemblies 48, 49 (sometimes referred to as head rails) and a pair of foot siderail assemblies 50, 51 (sometimes referred to as foot rails). Each of the siderail assemblies 48, 49, 50, 51 is movable between a raised position, as shown in
Each siderail 49 includes a first user control panel 66 coupled to the outward side of the associated barrier panel 54 and each siderail 51 includes a second user control panel 67 coupled to the outward side of the associated barrier panel 54. The controls panels 66, 67 include various buttons that are used by a caregiver (not shown) to control associated functions of the bed 10. For example, the control panel 66 includes buttons that are used to raise and lower the head section 40, buttons that are used to raise and lower the thigh section 43, and buttons that are used to raise, lower, and tilt the upper frame assembly 30 relative to the base 28. In the illustrative embodiment, the control panel 67 includes buttons that are used to raise and lower foot section 44 and buttons that are used to extend and retract a foot extension 47 relative to main portion 45 (both shown in
According to one aspect, an approach for determining a value representative of a patient's mobility is disclosed in
At process step 602, the signals from each load cell 272, 274, 276, 278 is monitored and the process advances. At process step 604, the control circuitry 98 processes the signals from the load cells 272, 274, 276, 278 and stores the values of the signals in memory 174. The loads detected by each of the respective load cells 272, 274, 276, 278 is adjusted using a corresponding calibration constant for the respective load cell 272, 274, 276, 278 as discussed above. The adjusted loads are then combined to establish the actual weight supported on the patient support apparatus 10. At decision step 606, the actual weight is compared to initial weights stored in the memory 174 to determine if a patient is present. If there is no patient present, monitoring of the load cells 272, 274, 276, and 278 is resumed at process step 602 and this loop is repeated until a patient is detected. If a patient is determined to be present, a biological threshold rate change of that patient is calculated at process step 608. Determination of a biological threshold rate is discussed in as described in U.S. Pat. No. 10,054,479 which is incorporated herein in its entirety and relied upon for the determination of a biological threshold and determination of non-patient loads. At process step 610, the sum of the measurements from the load cells 272, 274, 276, 278 are compared to the biological threshold rate determined at process step 608. If the total weight change is greater than the biological threshold rate, it is determined that data signals being captured are not all a result of changes in weight of the current patient assigned to the patient support apparatus, and the change is due to a different person exerting force on the patient support apparatus or some other extraneous factor not related to patient mobility. This is communicated to the graphical display screen 142 via control circuitry 98 at process step 612, and the monitoring of the load cells at process step 602 is resumed.
If the rate of weight change sensed by the load cells 272, 274, 276, 278 is less than the biological threshold as determined at process step 610, it is determined that patient is moving, and this is communicated to a graphical display screen 142 via control circuitry 98 at process step 614. Furthermore, if the patient is moving as determined in step 614, step 616 is executed. At process step 616, the instantaneous work is calculated as described below.
To determine the instantaneous work, first, the change of position of the center of gravity ΔCGXY of the patient is calculated using Equation 1 below. This analysis is completed within a two-dimensional Cartesian coordinate system having two horizontally extending X and Y axes along the patient support deck 38 as indicated in
ΔCGXY=√{square root over ((ΔXCG)2+(ΔYCG)2)} (1)
where:
ΔXCG=Xt−Xt-1 (2)
ΔYCG=Yt−Yt-1 (3)
Then, this change is multiplied by the patient's weight (pw) to determine instantaneous work (WInt) in units of force times length.
W
In(t)=(pw)×ΔCGXY (4)
In one embodiment, the instantaneous location of the center of gravity is calculated using readings from the load cells 272, 274, 276, 278 at a given time where the reading of a given load cell is designated as Ri. The location of the center of gravity is determined using the resolved position of the center of gravity CGxy by determining the constituent positions XCG and YCG according to equations 5 and 6 below.
X
CG=[Σi=03(Ri×Xi)]/pw (5)
Y
CG=[Σi=03(Ri×Yi)]/pw (6)
where:
pw=Σ
i=0
3
R
i (7)
Power (P) over a time period (n) is calculated by summing the instantaneous work of Equation 4 over time according to Equation 8 below.
P=Σ
i=0
n
W
in(t)
×t
i (8)
So, for each time period (n) a value of P can be determined to provide a measure of the exertion of a patient over that time. This calculation of the power exerted by a patient is used as an analogue for the mobility of the patient.
At process step 620, the computed power is used as the input to a statistical model to determine a mobility score. At process step 622, the mobility score of the patient is updated in memory 174 and may be communicated to the graphical display screen 142 via the control circuitry 98. A mobility score, such as the mobility score calculated using the approach described above, is used for various clinical analyses and as a predictor of the risk of injury to a patient.
Referring now to
A control bar 306 allows a user to activate an alarm silence icon 322 to silence alarms that may be active. In addition, a screen lock icon 324, when activated, allows a user to lock the display screen 142 so that no inputs will be processed without authorization. For example, a user may be prompted for a password, or the screen may remain locked until the system detects the presence of an authorization token, such as a radio frequency identification transmitter or a similar authorization device. In addition, an icon 326 may be activated by a user to call up a screen displaying maintenance function. An icon 328 may be activated to call up a screen displaying help functionality. In the illustrative embodiment, the control bar 306 is always available to a user regardless of the data or information displayed elsewhere on the graphical display screen 142.
Referring now to the navigation bar 300, a home screen icon 308 allows a user to immediately activate and jump to a home screen (not shown) from any screen display. Similarly, an alarm screen icon 310 will jump to an alarm screen (not shown) from any active screen. The illustrative embodiment of
Referring now to
At process step 702, the signals from each load cell 272, 274, 276, 278 is monitored. At process step 704, the processor module 172 processes the signals from the load cells 272, 274, 276, 278 and stores the signals in memory 174. The loads detected by each of the respective load cells is adjusted using a corresponding calibration constant for the respective load cell as described above. The adjusted loads are then combined to establish the actual weight supported on the patient support apparatus 10 as described with regard to Equation 7 above. At decision step 706, the actual weight is compared to an initial weight stored in the memory 174 to determine if a patient is present. If there is no patient present, step 702 is repeated. If a patient is present, the sum of forces captured by the pairs of load cells 272, 276 or 274, 278 grouped on a long edge of the weigh frame 36, and the sum of forces captured by the load cells 272, 276 or 274, 278 grouped on the other long edge are calculated at process step 708. The sum of forces captured by the load cells on either long edge of the weigh frame 36 is compared to the sum of forces captured by the load cells on the other long edge at decision step 710. If the sum of forces captured by the two load cells grouped on one long edge of the weigh frame 36 shows an increase in value, and the sum of forces captured by the load cells on the other long edge shows a decrease in value, it indicates that the center of gravity of the patient has moved in the two-dimensional Cartesian coordinate system having two horizontally extending X and Y axes along the patient support deck 38.
At decision step 712, it is determined if this lateral change is more than the threshold amount for the patient as calculated at process step 700. If the lateral change is more that the threshold amount, the biological threshold of the patient is calculated at process step 714 as described above with regard to process steps 608 and 610. At decision step 716, the sum of the measurements by all the load cells are compared to the biological threshold determined at process step 714. If the algorithm determines that the weight change is excessive, then the data is ignored for the mobility analysis as being not patient related. This may be communicated to the graphical display screen 144 via control circuitry 98 at process step 718 and the monitoring of the load cells at process step 602 is resumed. If the sum of the load cell measurements is less than the biological threshold as determined at process step 714, it is determined that patient has turned and this may be communicated to a graphical display screen 144 via control circuitry 98 at process step 720. At any given time, the caregiver can invoke the comparison of the values being measured by the force sensors at that time to the baseline values recorded previously, and determines the patient's position.
When tracking the baseline values of all load cells 272, 276 or 274, 278 and, these values may be invoked manually by using a snapshot button 335 by the caregiver on the display 302 as described below. Some other indicators that a patient is supine can be used, such as knowledge that a turn assist has been evoked, then the patient has returned to normal and the patient has been resettled. After the baseline has been captured, the system can keep track if there has been a lateral movement by tracking if the weight measured by load cells on one long edge of the bed has gone up, while the others have gone down. This indicates that the center of gravity has moved by a few inches laterally (in keeping with the anthropocentric data for that patient weight), without directly monitoring the movement of the center of gravity. Additional information, such as momentary dips of the sum of forces on the weigh frame 36, which indicate that a caregiver has offloaded part of the bed before the turn occurred, is also used to determine a turn.
As shown in
The basis for this determination can be illustrated with regard to the differences between the case shown in
Referring to
In some embodiments, the control circuitry 98 of the bed 10 communicates with a remote computer device 176 shown in
The bed 10 has a communication interface or port 180 which provides bidirectional communication via link 179 with the infrastructure 178 which, in turn, communicates bidirectionally with the computer 176 via the link 177. The link 179 is a wired communication link in some embodiments and is a wireless communications link in other embodiments. Using these communication systems, data and analysis performed by the control circuitry 98 may be communicated to external systems.
Any theory, mechanism of operation, proof, or finding stated herein is meant to further enhance understanding of principles of the present disclosure and is not intended to make the present disclosure in any way dependent upon such theory, mechanism of operation, illustrative embodiment, proof, or finding. It should be understood that while the use of the word preferable, preferably or preferred in the description above indicates that the feature so described can be more desirable, it nonetheless cannot be necessary and embodiments lacking the same can be contemplated as within the scope of the disclosure, that scope being defined by the claims that follow.
In reading the claims it is intended that when words such as “a,” “an,” “at least one,” “at least a portion” are used there is no intention to limit the claim to only one item unless specifically stated to the contrary in the claim. When the language “at least a portion” and/or “a portion” is used the item can include a portion and/or the entire item unless specifically stated to the contrary.
It should be understood that only selected embodiments have been shown and described and that all possible alternatives, modifications, aspects, combinations, principles, variations, and equivalents that come within the spirit of the disclosure as defined herein or by any of the following claims are desired to be protected. While embodiments of the disclosure have been illustrated and described in detail in the drawings and foregoing description, the same are to be considered as illustrative and not intended to be exhaustive or to limit the disclosure to the precise forms disclosed. Additional alternatives, modifications and variations can be apparent to those skilled in the art. Also, while multiple inventive aspects and principles can have been presented, they need not be utilized in combination, and many combinations of aspects and principles are possible in light of the various embodiments provided above.
This application claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application Ser. No. 63/017,790, filed Apr. 30, 2020, and titled “MOBILITY SENSING USING LOAD CELLS,” which is herein incorporated by reference in its entirety.
Number | Date | Country | |
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63017790 | Apr 2020 | US |