System and method for determining incontinence device replacement interval

A method of providing hygiene services to a patient. The method includes acquiring patient status data of a patient with a sensor. Incontinence event data is acquired with an incontinence detection system. After the occurrence of the incontinence event, a sleep status of the patient is determined based the patient status data. A time period to provide hygiene services to the patient is determined based on the incontinence event data and the sleep status of the patient.

BACKGROUND

The present disclosure relates to incontinence detection systems and particularly, to incontinence detection systems that use a pad beneath a patient lying in a hospital bed or garment secured to the patient. More particularly, the present disclosure relates to a method of providing hygiene services to a patient by determining incontinence device replacement intervals.

Good medical practice dictates that patients who are incontinent should be removed from the wet environment as soon as possible to avoid skin breakdown which can potentially lead to pressure ulcers. Incontinence detection systems alert caregivers to the occurrence of an incontinent event so that hygiene services can be provided as quickly as possible. Hygiene services may include changing patient linens, changing patient garments, and/or moving the patient to a clean hospital bed. However, many patients experience difficulty sleeping in a hospital bed. As a result, it may not be advantageous to provide hygiene services immediately after the occurrence of an incontinent event. Particularly, if a patient experiences an incontinent event while sleeping, the caregiver may not want to wake the patient to provide hygiene services.

SUMMARY

According to a first aspect of the present disclosure, a method of providing hygiene services to a patient is provided. The method includes acquiring patient status data of a patient with a sensor, and acquiring incontinence event data with an incontinence detection system. After the occurrence of the incontinence event, the method includes determining a sleep status of the patient based the patient status data. A time period to provide hygiene services to the patient is determined based on the incontinence event data and the sleep status of the patient.

In one embodiment, the method includes at least one of detecting an incontinence event and measuring a fluid volume of the incontinence event. Incontinence event data may be acquired with an incontinence detection system that includes a sensor pad including a plurality of electrically conductive traces. The presence of at least one of urine or fecal matter may be detected, wherein, after detecting fecal matter, the time period to provide hygiene services is as soon as possible. Alternatively, after detecting urine, the method may include determining whether the patient is asleep or awake, wherein, if the patient is awake, the time period to provide hygiene services is as soon as possible.

In one embodiment, the method includes measuring at least one vital sign of the patient, for example measuring at least one of brain activity of the patient with an electroencephalogram and heart activity of the patient with an electrocardiogram.

In one embodiment, the method includes measuring movement of the patient. Movement of the patient may be measured with at least one pressure sensor. Movement of the patient may be measured with a load cell.

In one embodiment, hygiene services include at least one of changing the patient's linens, changing the patient's garments, and moving the patient to a clean hospital bed.

In one embodiment, the method includes at least one of monitoring the occurrence of at least one of non-rapid eye movement sleep and rapid eye movement sleep, determining a period of time that the patient has slept, and comparing a fluid volume of the incontinence event to the period of time that the patient has slept.

In one embodiment, if the patient is asleep and the fluid volume is within a range of approximately 0 ml to approximately 10 ml, hygiene services are not provided. In one embodiment, if the patient is asleep and the fluid volume is within a range of approximately 10 ml to approximately 20 ml, the time period to provide hygiene services is within a range of approximately 1 hour to approximately 2 hours. In one embodiment, if the patient has been asleep for less than approximately four hours and the fluid volume is within a range of approximately 20 ml to approximately 40 ml, the time period to provide hygiene services is within a range of approximately 1 hour to approximately 2 hours. In one embodiment, if the patient has been asleep for a range of approximately four hours to approximately six hours and the fluid volume is within a range of approximately 20 ml to approximately 40 ml, the time period to provide hygiene services is within a range of approximately 30 minutes to approximately 1 hour. In one embodiment, if the patient has been asleep for over approximately six hours and the fluid volume is within a range of approximately 20 ml to approximately 40 ml, the time period to provide hygiene services is as soon as possible. In one embodiment, if the patient has been asleep for less than approximately four hours and the fluid volume is within a range of approximately 60 ml to approximately 80 ml, the time period to provide hygiene services is approximately 30 minutes to approximately 1 hour. In one embodiment, if the patient has been asleep for over approximately four hours and the fluid volume is within a range of approximately 60 ml to approximately 80 ml, the time period to provide hygiene services is as soon as possible. In one embodiment, if the patient is asleep and the fluid volume is greater than approximately 80 ml, the time period to provide hygiene services is as soon as possible.

According to a second aspect of the present disclosure, a system for providing hygiene services to a patient is provided. The system includes a sensor configured to acquire patient status data of a patient and an incontinence detection system configured to acquire incontinence event data. The system also includes, a processor configured to, after the occurrence of the incontinence event, determine a sleep status of the patient based the patient status data. The processor is further configured to determine a time period to provide hygiene services to the patient based on the incontinence event data and the sleep status of the patient.

DETAILED DESCRIPTION

The present disclosure relates to systems and methods for detecting incontinence or other moisture caused events associated with a person being monitored. Thus, it should be appreciated that the systems described herein are able to detect biofluids such as blood, urine, fecal matter, interstitial fluid, saline, or any other fluid having a large concentration of ions that easily conduct electricity. The term “incontinence” as used herein is intended to cover all of these biofluids. The present disclosure further describes systems and methods for reporting detected incontinence events to hospital caregivers, a nurse call system, or an EMR (electronic medical record) system to allow patients to be quickly removed from the soiled environment. The present disclosure further describes a method of determining a patient hygiene schedule. It should be appreciated that the patient hygiene schedule determines an approximate time to provide hygiene services to the patient based on an approximate amount of incontinence and an approximate amount of time that the patient has been sleeping.

A patient support apparatus10embodied as a hospital bed is shown inFIG. 1. It will be appreciated that, although the present embodiments are described with respect to a hospital bed, the present embodiments may be utilized with any occupant support, for example, a hospital bed, a residential bed, a chair, a wheelchair, a mattress, a stretcher, a patient transport device, or any other type of person support apparatus. The patient support apparatus10has a fixed bed frame20which includes a stationary base frame22with casters24and an upper frame26. The stationary base frame22is further coupled to a weigh frame30(shown inFIG. 3) that is mounted via frame member32aand32b(both shown inFIG. 3) to an adjustably positionable mattress support frame or deck34configured to support a mattress18. The mattress18defines a patient support surface36which includes a head section38, a seat section40, and a foot section42. The patient support apparatus10further includes a headboard12at a head end46of the patient support apparatus10, a footboard16at a foot end48of the patient support apparatus10, and a pair of siderails14coupled to the upper frame26of the patient support apparatus10. The siderail14supports a patient monitoring control panel and/or a mattress position control panel54as shown inFIG. 1. The patient support apparatus10is generally configured to adjustably position the mattress support frame34relative to the base frame22. Although the embodiment shows the control panel54supported on a siderail14, the control panel54may be affixed to any portion of the patient support apparatus10. In one embodiment, the control panel54may be configured as a remote that is either wirelessly coupled to or wired to the patient support apparatus10.

Conventional structures and devices may be provided to adjustably position the mattress support frame34, and such conventional structures and devices may include, for example, linkages, drives, and other movement members and devices coupled between base frame22and the weigh frame30, and/or between weigh frame30and mattress support frame34. The details of the structure of a suitable bed embodiment of a patient support apparatus may be found in application number PCT/US2016/034908 filed May 27, 2016 and titled “PATIENT SUPPORT APPARATUS”, which is incorporated herein in its entirety. Control of the position of the mattress support frame34and mattress18relative to the base frame22or weigh frame30is provided, for example, by a patient control pendant56, a mattress position control panel54, and/or a number of mattress positioning pedals. The mattress support frame34may, for example, be adjustably positioned in a general incline from the head end46to the foot end48or vice versa. Additionally, the mattress support frame34may be adjustably positioned such that the head section38of the patient support surface36is positioned between minimum and maximum incline angles, e.g., 0-65 degrees, relative to horizontal or bed flat, and the mattress support frame34may also be adjustably positioned such that the seat section40of the patient support surface36is positioned between minimum and maximum bend angles, e.g., 0-35 degrees, relative to horizontal or bed flat. Those skilled in the art will recognize that the mattress support frame34or portions thereof may be adjustably positioned in other orientations, and such other orientations are contemplated by this disclosure and disclosed in the aforementioned application number PCT/US2016/034908.

The patient support apparatus10may be in communication with one or more vital signs monitoring systems108. Although only one vital signs monitoring system108is shown inFIG. 1, the patient support apparatus10may include any number of vital signs monitoring systems108. The vital signs monitoring system108, as shown, is in wireless communication with the patient support apparatus10. In other embodiments, the vital signs monitoring system108may be in wired communication with the patient support apparatus10. The vital signs monitoring system108may activate or control electronically-controlled components associated with the patient support apparatus10. As shown, the electronically-controlled components include an electrocardiogram112. In one embodiment, the electronically-controlled components may also include at least one of an electroencephalogram114and/or a ventilator116, among other things. In one embodiment, the electronically-controlled components may not include the electrocardiogram112. It will be appreciated that any electronically-controlled components for monitoring vital signs may be incorporated into the vital signs monitoring system108. In one embodiment, the electronically-controlled components may include any combination of electrocardiogram112, electroencephalogram114and/or a ventilator116, among other things. As discussed in detail below, the vital signs monitoring system108is configured to monitor various signals from the electronically-controlled components to receive and analyze vital sign data (e.g., to determine the brain activity, cardiac, respiratory, and/or snoring state of a patient, among other things).

In one embodiment shown diagrammatically inFIG. 2, the patient support apparatus10includes a weigh scale system60and an alarm system90, as disclosed in the aforementioned application number PCT/US2016/034908. The weight scale system60is configured to determine a plurality set of calibration weights for each of a number of load cells50for use in determining a location and an accurate weight of the patient. To determine a weight of a patient supported on the patient support surface36, the load cells50are positioned between the weigh frame30and the base frame22. Each load cell50is configured to produce a voltage or current signal indicative of a weight supported by that load cell50from the weigh frame30relative to the base frame22. The weigh scale system60includes a processor62that is in communication with each of the respective load cells50. The processor62includes a microprocessor-based controller52having a flash memory unit64and a local random-access memory (RAM) unit66. The local RAM unit66is utilized by the controller52to temporarily store information corresponding to features and functions provided by the patient support apparatus10. A memory80may store predetermined calibration positions70, as described inFIG. 3. Additionally, a timer53may monitor the timing of weight displacement as measured by the weigh scale system60. The alarm system90is configured to trigger an alarm if the movement of the patient exceeds a predetermined threshold. The alarm may be an audible alarm92and/or a visual alarm94. The visual alarm94may be positioned, for example, on the mattress position control panel54and/or the patient control pendant56.

In the embodiment ofFIG. 3, four such load cells50a-50dare positioned between the weigh frame30and the base frame22; one each near a different corner of the patient support apparatus10. All four load cells50a-50dare shown inFIG. 3. Some of the structural components of the patient support apparatus10will be designated hereinafter as “right”, “left”, “head” and “foot” from the reference point of an individual lying on the individual's back on the patient support surface36with the individual's head oriented toward the head end46of the patient support apparatus10and the individual's feet oriented toward the foot end48of the patient support apparatus10. For example, the weigh frame30shown inFIG. 3includes a head end frame member30cmounted at one end to one end of a right side weigh frame member30aand at an opposite end to one end of a left side frame member30b. Opposite ends of the right side weigh frame member30aand the left side weigh frame member30bare mounted to a foot end frame member30d. A middle weigh frame member30eis mounted at opposite ends to the right and left side weigh frame members30aand30brespectively between the head end and foot end frame members30cand30d. The frame member32ais shown mounted between the right side frame member30aand the mattress support frame34, and the frame member32bis shown mounted between the left side frame member30band the mattress support frame34. It will be understood that other structural support is provided between the weigh frame30and the mattress support frame34.

A right head load cell (RHLC)50ais shown as positioned near the right head end of the patient support apparatus10between a base support frame44asecured to the base44near the head end46of the patient support apparatus10and the junction of the head end frame member30cand the right side frame member30a, as shown in the block diagram ofFIG. 3. A left head load cell (LHLC)50bis shown as positioned near the left head end of the patient support apparatus10between the base support frame44aand the junction of the head end frame member30cand the left side frame member30b, as shown in the block diagram ofFIG. 3. A right foot load cell (RFLC)50cis shown as positioned near the right foot end of the patient support apparatus10between a base support frame44bsecured to the base44near the foot end48of the patient support apparatus10and the junction of the foot end frame member30dand the right side frame member30a, as shown in the block diagram ofFIG. 3. A left foot load cell (LFLC)50dis shown as positioned near the left foot end of the patient support apparatus10between the base support frame44band the junction of the foot end frame member30dand the left side frame member30b. In the embodiment shown inFIG. 3, the four corners of the mattress support frame34are shown extending beyond the four corners of the weigh frame30, and hence beyond the positions of the four load cells50a-50d.

A weight distribution of a load among the plurality of load cells50a-50dmay not be the same depending on sensitivities of each of load cells50a-50dand a position of the load on the patient support surface36. Accordingly, a calibration constant for each of the load cells50a-50dis established to adjust for differences in the load cells50a-50din response to the load. Each of the load cells50a-50dproduces a signal indicative of the load supported by that load cell50. The loads detected by each of the respective load cells50a-50dare adjusted using a corresponding calibration constant for the respective load cell50a-50d. The adjusted loads are then combined to establish the actual weight supported on the patient support apparatus10.

To determine a set of calibration constants, a calibration weight is sequentially placed on each of several predetermined calibration positions70on the patient support surface36. For example, when determining a set of initial calibration constants, the calibration positions70a,70b,70c, and70dcorresponding to the location of the load cells50a,50b,50c, and50d, respectively, are used. The calibration weight has an established mass which is used to determine the calibration constants. The respective initial calibration constants are determined by placing the calibration weight on a first calibration position70aand measuring the weight distribution of the predefined calibration weight on each of the respective load cells50a-50d. The respective loads detected by each of the load cells50a-50dthat corresponds to the current distribution of the predefined calibration weight on the first calibration position70ais established and stored in the local RAM unit66. The predefined calibration weight is then moved to the next calibration position70band the measuring and storing steps are repeated until a set of load weights are established for each of the respective calibration positions70a-70d.

The plurality sets of load weights that correspond to the location of each load cell50a-50dare used to generate the calibration equations (1)-(4) set forth below.
CWRH=C1L1+C2L2+C3L3+C4L4(1)
CWLH=C1L1+C2L2+C3L3+C4L4(2)
CWRF=C1L1+C2L2+C3L3+C4L4(3)
CWLF=C1L1+C2L2+C3L3+C4L4(4)
where CWRH, CWRF, CWLF, and CWLH are the predefined calibration weight when the predefined calibration weight is positioned on the calibration positions70a-70dwhich correspond to the RHLC50a, RFLC50b, LFLC50c, and LHLC50d, respectively, C1, C2, C3, and C4 are calibration constants for RHLC50a, RFLC50b, LFLC50c, and LHLC50d, respectively, and L1, L2, L3, and L4 are the load weights on RHLC50a, RFLC50b, LFLC50c, and LHLC50d, respectively. CWRH, CWRF, CWLF, and CWLH are all equal to the predefined calibration weight. Thus, the initial calibration constants C1, C2, C3, and C4 are established using a standard Gauss-Jordan or other appropriate elimination method and equations (1)-(4) are solved to obtain values for initial calibration constants C1, C2, C3, and C4. The initial calibration constants C1, C2, C3, and C4 are applied to the loads detected by the respective load cells50a-50dis used to determine the total weight supported on the load cells50a-50d. It should be appreciated that the calibration constants may be dynamically refined based on the position and/or weight of the load.

In some embodiments, the position of the patient is determined by calculating a locus of a centroid of the patient load. The centroid of the patient load is represented as a point relative to a reference position or a coordinate axis of the patient support apparatus10. The point is a coordinate (X, Y) within a two-dimensional Cartesian coordinate system having two horizontally extending X and Y axes along the patient support surface36. The determination of the centroid of the patient load is described in expired U.S. Pat. No. 5,276,432, which is incorporated by reference herein in its entirety for its disclosure of a patient load location determination approach.

FIG. 4is a diagrammatic representation of a pneumatic portion of an airbox for a mattress system110(shown inFIG. 8) that is positioned within the mattress18. The details of the structure of a suitable pneumatic mattress may be found in application number PCT/US2016/34908 filed May 29, 2016 and having the title “PATIENT SUPPORT APPARATUS”, which is incorporated herein in its entirety. In the embodiment ofFIG. 4, the airbox includes a manifold200in a fluid communication with a blower202, the blower having a positive pressure outlet204and a negative pressure inlet206. In addition, the airbox includes a filter208through which air is drawn to the negative pressure inlet206. The positive pressure outlet204feeds a conduit210. The conduit210feeds a first valve212that controls flow to and from the head zone214of the body support216through the supply tube218. A second valve220controls the flow to and from the seat zone222through the supply tube224. Both of the valves212and220are movable between an opened and a closed position to connect the respective zones214and222to the conduit210as necessary. The conduit210also feeds a tap226that is connected to a conduit228through a check valve230. When the pressure in the conduit210is of sufficient pressure to overcome the check valve230, the check valve230will open and allow flow to the conduit228which feeds two valves232, associated with the left turn zone234, and236, associated with right turn zone238. In addition, conduit210is connected to a valve240which is associated with the microclimate management structure242. In some embodiments, the body support216includes an additional lumbar zone244. The zone244is fed by a tube246from a valve248which is connected to the conduit210. Another conduit250is connected to a second port on each of the turn valves232,236and is connected to the inlet206of the blower202. As will be described in further detail, each of the zones214,222,234,238,244may be exhausted through the valve240, with the turn zones234,238being subjected to a rapid evacuation through the use of the negative pressure inlet206of the blower202to draw air from the zones234,238through the respective valves232,236

The zones214,222may be vented through the valve240and microclimate management structure242if the blower202is idle such that the pressure in the conduit210is lower than the pressure in the zones214and222. Opening of the valve240permits air from the zones214and222to flow through the conduit210through the valve240and inlet tube252to escape through the microclimate management structure242.

Venting of the turn zones234,238utilizes the three-way valve structure of valves232,236to connect the respective feed tubes254or256to the conduit250so that the inlet side of the blower202pulls air through the conduits266,256into the conduit250and, thereby, the inlet206of the blower202. In certain conditions, the valves232or236may be positioned to allow air to be drawn from the respective zone234or238into the inlet206of the blower202and fed to one of the other zones214or222. However, if no flow is needed to either the zones214or222, the flow from the turn zones234or238is simply exhausted through the valve240to the microclimate management structure242. As described in the aforementioned application number PCT/US2016/34908, under certain conditions, the pressure in the turn zones234,238may exceed the pressure in another zone, such as the other turn zone234or238, or the head zone214or seat zone222. This may be a result of the weight of a patient and the leverage provided by Z-plate assemblies to urge their out of the bladder assemblies. To protect against damage to a body support, both the head zone214and seat zone222include a respective check valve positioned on a bottom surface of a lower layer. The check valves open at a relief pressure that is higher than the maximum operating pressure of the body support, but lower than the pressure which components of the body support would fail due to excessive pressure. While the turn zones operate at pressures higher than the typical operating pressures of the body support, the presence of the check valves mitigate the potential for a damaging overpressure condition to occur if the turn zones are vented through the microclimate management system242and the flow is constricted sufficiently to cause an overpressure condition in the body support.

An air control board258includes logic that is operable to take pressure readings from the manifold200or any one of the zones214,222,234,238, or244to determine which of the valves212,220,232,236, or240to open or adjust to achieve the flow necessary to meet the operational requirements of the body support216. As described above, the head zone214is connected to a sense tube260which connects to a pressure sensor262, the pressure sensor262providing a signal to the logic of the air control board258indicative of the pressure in the head zone214. Similarly, the sense line280is connected to a pressure transducer264which provides a signal to the logic indicative of the pressure in the seat zone222. The sense tube266provides a signal to a pressure transducer282indicative of the pressure in the right turn zone238and the sense tube270is connected to a pressure transducer272for determining the pressure in the left turn zone234. The conduit210is coupled to a sense line274that is also connected to a pressure transducer276, the pressure transducer276providing the logic a signal indicative of the pressure in the conduit210. A sense line278connects the zone244to a pressure transducer268on the air can control board258.

FIGS. 5-7schematically show two embodiments of a sensor system300,350that detects a volume of incontinence or other moisture. The details of an incontinence sensor system of a patient support apparatus may be found in PCT/US2016/62167 filed Nov. 16, 2016 and having the title “INCONTINENCE DETECTION SYSTEMS FOR HOSPITAL BEDS,” which is incorporated herein in its entirety. Sensor system300is shown inFIG. 5, which shows a substrate, or incontinence pad306, resting on the mattress18, in an area or zone in which it is desired to conduct surveillance for unwanted moisture or other moisture related abnormalities. In other embodiments, the pad306is integrated into the mattress18. In still other embodiments, the pad306is integrated within an undergarment or other article of clothing or the pad306itself is a diaper or disposable undergarment. In other embodiments, the pad306is integrated into any patient support apparatus.

The system300for detecting a volume of moisture on the mattress18includes a plurality of sensor traces302. The plurality of sensor traces302in the embodiment ofFIG. 5includes sensing traces 0-8. It is contemplated that there are more or fewer sensor traces in other embodiments. The sensor traces are placed at predetermined distances304from one another and portions or segments of the traces lie in parallel. It should be understood, however, that while the segments (e.g., 0, 1, 2, 3, 4, 5, 6, 7 and 8) are shown inFIG. 5as linear segments, any suitable spatial arrangement of the sensing traces302that maintains the desired spacing304between the sensing traces302work sufficiently according to this disclosure.

In one embodiment, sensor traces 0-7 are generally Z-shaped, each with a first end segment coupled to an RFID tag308, a second end segment spaced from the first segment and generally parallel therewith, and a middle segment interconnecting the end segments and oriented in substantially perpendicular relation with the end segments. The first segments of traces 0-7 are of decreasing length from trace 0 (i.e., the longest first segment) to trace 7 (i.e., the shortest first segment). The second segments of traces 0-7 are of increasing length from trace 0 (i.e., the shortest second segment) to trace 7 (i.e., the longest second segment). The middle segments of each trace 0-7 is approximately the same length as each of the other middle segments of each of the other traces 0-7. Trace 8 is generally L-shaped in the embodiment ofFIG. 5, having a first segment coupled to the RFID circuit in substantially parallel relation with the middle segments of traces 0-7 and a second segment that is substantially perpendicular to the first segment of trace 8 and substantially parallel with the first and second end segments of traces 0-7. The length of the first segment of trace 8 is approximately equal to the lengths of the middle segments of traces 0-7.

In some embodiments, the distance304between each of the adjacent traces 0-8 is the same for each segment of each trace 0-8. In other embodiments, the distance304between each of the sensor traces 0-8 is different. It is also contemplated by this disclosure that, in some embodiments, the distance304between middle segments of traces 0-7 and between the middle segment of trace 7 and the first segment of trace 8 is different than the distance304between respective first end segments of traces 0-7, respective second end segments of traces 0-7, and the second segment of trace 8 and the second end segment of trace 7 of other traces. The distance304between each sensor trace is defined by one or more moisture management criteria, for example.

The moisture management criterion includes a moisture-related property of the substrate pad306in some instances. For example, a moisture management criterion may be a moisture-related property of the moisture absorbent material of the incontinence pad (such as, for example, a wicking or absorption property).

In one embodiment, the distance304is in the range of about 4 inches, based on a desired moisture sensitivity in the range of about 50 milliliters (e.g.,304is the distance that 50 ml of liquid travels in the specified type of material forming the substrate306or a layer of an incontinence pad in which the substrate306is integrated). Thus, a notification is issued by a notification device as described elsewhere herein, when the sensor traces 6-7 are exposed to moisture indicating an amount of moisture in the range of about 50 milliliters (i.e., enough moisture to bridge two adjacent traces302). In another embodiment, if moisture is exposed to sensing traces 6, 7, 8, a signal is generated indicating an amount of moisture in the range of 100 milliliters (i.e., enough moisture to bridge three adjacent traces302). Likewise, if sensing traces 5, 6, 7, 8 are exposed to moisture, a signal is generated indicating an amount of moisture in the range of 150 milliliters (i.e., enough moisture to bridge four adjacent traces). Thus, system300is a high resolution incontinence detection system in that it is able to determine how much biofluid is being sensed by traces302. The sensor traces302are connected to a passive RFID tag308in the embodiment ofFIG. 5. RFID tag308is excited by a controller310which transmits an electromagnetic signal and receives the response from the RFID tag308.

Referring now toFIG. 6, system350is incorporated into a wearable substrate such as a diaper or other wearable pad352. In this embodiment, connector traces354A,354B extend from passive RFID tag356and extend longitudinally in substantially parallel relation along the outer edges of a moisture zone358of the diaper or wearable pad352. Shielding material or a shield360coat or otherwise overlie each of the connector traces354A,354B to prevent the connector traces from being exposed to moisture. Alternatively or additionally, connector traces354A,354B lie outside moisture zone358in some embodiments so as to inhibit any chance for exposure to moisture that is present within zone358. In some embodiments therefore, shields360are not needed for covering traces354A,65-4B and are omitted.

First and second sets of sensor traces362,364extend from respective connector traces354A,354B in a direction substantially perpendicular to traces354A,354B. Traces362,364extend across the moisture zone358but terminate prior to reaching the opposite trace354A,354B. Thus, in one embodiment, traces362each extend from trace354B and terminal ends of traces362are spaced from trace354A. Similarly, traces364each extend from trace354A and terminal ends of traces364are spaced from trace354B. A distance366(shown inFIG. 6between the terminal end of one of traces362and trace354A) is provided between each terminal end of traces362,364and the trace354A,354B spaced therefrom.

The first362and second traces364are arranged in an alternating pattern along the length of the diaper352. Thus, trace354and its accompany traces364form a first comb-like pattern and trace362and its accompanying traces362form a second comb-like pattern. The comb-like patterns are arranged to that traces362are interdigitated with traces364. The spacing distance366is smaller than a spacing368between adjacent traces362,364. Because of the shielding360covering traces354A,354B, moisture that would otherwise make an electrical connection between terminal ends of traces362,364and the traces354A,354B spaced therefrom by distance366, is unable to do so. Instead, an electrical connection is made between only when sufficient moisture is present to expose a first and second sensor trace362,364to moisture across distance368. For example, in some embodiments contemplated herein, distance368between first and second sensor traces362,364requires that 150 milliliters (ml) of moisture be present within moisture zone358before an electrical connection is made between adjacent traces362,364. Thus, the distance368is selected in the one embodiment so that a signal from RFID tag356is generated in response to moisture contacting one first sensing trace362and one second sensing trace364which occurs when about 150 milliliters (ml) of moisture is present in the moisture zone358.

By shielding connecting traces354A,354B with moisture resistant layers (not shown) that comprise shields360, oversensitivity may be avoided such that a signal may only be generated when a prescribed fluid volume is present in the moisture zone358. This prevents, for example, incontinence signals being sent by RFID tag356in response to perspiration or other moisture that bridges across any of spaces366. Alternatively, connecting traces354A,354B are positioned outside of moisture zone358as mentioned above to achieve a similar result. The first sensing traces362and second sensing traces364are spaced apart by a predetermined distance368that is based on a desired moisture sensitivity which also takes into account the wicking and absorbency properties of the diaper or other wearable pad352within zone358. According to the present disclosure, shielded connector traces, similar to traces354A,354B, and unshielded sensor traces, similar to traces362,364, also may be used in non-wearable pad embodiments, such each of the other pad embodiments disclosed herein.

FIG. 7discloses another embodiment of an RFID implemented moisture detection sensor system400employing a pair of sensors410,412on a substrate such as a patient support or pad414. The discussion below of sensor410is equally applicable to sensor412. That is sensor410and sensor412are substantially the same although, in one embodiment, sensor412is a mirror image of sensor410. Sensor410includes first and second trace grids416,418that are spaced apart and form a somewhat serpentine pattern on the bed. Trace418is generally U-shaped and trace416is generally M-shaped or W-shaped depending upon the direction at which trace416is viewed. The U-shaped pattern of trace418is interdigitated with the M-shaped pattern of trace416. Thus, traces416,418form a comb-like pattern. Moisture detection takes place at the sensor410by way of a tuning circuit420connected to an RFID tag422. When moisture bridges any of the spaces between trace416and trace418, tuning circuitry420outputs a signal to RFID tag422which, in turn, emits a wireless signal indicating that moisture is present.

FIG. 8is a block diagram of a system500which includes multiple components of the patient support apparatus10that cooperate to determine a hygiene services schedule for a patient supported on the patient support apparatus10. In one embodiment, hygiene services for the patient may include changing the patient's linens, changing the patient's garments, and/or moving the patient to a clean hospital bed, among other things. A method, as shown in the flowchart ofFIG. 9A-9Bis executed by the system500. The vital signs monitoring system108receives and transmits data to a sleep status calculator504. For example, the data may represent brain activity, cardiac, respiratory, and/or snoring state of a patient. This data is transmitted to the sleep status calculator504, where the data is analyzed along with data from the weigh scale system60and the mattress system110. The data from the weigh scale system60and/or the mattress system110may represent movement of the patient, time that the patient is still, and/or bed exit data, among other things. The sleep status calculator504includes a processor506and a memory508to analyze and compare the data from the vital signs monitoring system108, the weigh scale system60, and the mattress system110. The processor506may include a microprocessor-based controller having a flash memory unit and a local random-access memory (RAM) unit. The memory508may store data related to incontinence events, sleep history, and/or sleep patterns. Additionally, these data are compared to data from the sensor system300,350to determine a hygiene services schedule for a patient. This schedule is displayed on a graphical user interface (GUI)510or similar device.

Referring toFIGS. 9A-9B, determining the hygiene services schedule includes the detection and measurement of incontinence of the patient. At step550, the sensor system300,350detects the occurrence of an incontinent event and then, at step552, determines a type of incontinence, i.e. urine or fecal matter. If the type of incontinence contains fecal matter553, at an alert is sent to the GUI510indicating that the patient should receive hygiene services as soon as possible555, regardless of whether the patient is awake or asleep. It should be appreciated, that the terminology as soon as possible, is known to mean either immediately or upon the first available opportunity. If the type of incontinence contains urine557, at step554, a volume of the urine is determined by the sensor system300,350. In one embodiment, the volume of the urine may be categorized into various ranges (i.e. 0 ml-10 ml, 10 ml-20 ml, 20 ml-40 ml, 60 ml-80 ml, or greater than 80 ml). These ranges are referenced as556inFIG. 10, which shows a chart for determining the hygiene services schedule. It should be noted that one of ordinary skill in the art would recognize that any number of ranges representing any volumes of incontinence are contemplated by this disclosure. It should also be recognized that the shown ranges are contemplated to be approximate.

Determining the hygiene services schedule also includes determining a sleep status of the patient. Particularly, data from the vital signs monitoring system108, the weigh scale system60, and the mattress system110may be processed and analyzed by the sleep status calculator504to determine whether a patient is sleeping or awake. The data may also be utilized to determine an amount of time that the patient has been sleeping. For example, vital signs such as brain activity, heart rate, and/or respiratory rate may be indicative of a patient's sleep patterns. This data, in one embodiment, may be processed and analyzed to determine the occurrence of non-rapid eye movement (NREM) or rapid eye movement (REM) sleep. Additionally, patient movement data in the form of weight and/or pressure measurements from the weigh scale system60or mattress system110may provide evidence of sleeping, movement, and/or restlessness. Particularly, movement of the patient results in changes to the weight measured by the weigh scale system60and/or the pressure measured by the mattress system110, thereby indicating patient movement, which may be attributed to restlessness, or lack of patient movement, which may be attributed to patient sleep. Moreover, the weigh scale system60or mattress system110may detect that the patient has left the patient support apparatus10, thereby indicating that the patient is awake. This data may be utilized to determine whether the patient if awake or asleep and, if asleep, how long the patient has been sleeping. The length of time that a patient has been sleeping factors into the hygiene services schedule because it may be undesirable to wake a patient for hygiene services in certain circumstances.

At step558, one or more vital signs are detected by the vital signs monitoring system108. Concurrently, patient movement is detected by the weigh scale system60, at step560. Based on the data from the vital signs monitoring system108and the weigh scale system60, the sleep status calculator504determines, at step562, whether the patient is awake or asleep. If the patient is awake563, hygiene services are scheduled to be provided as soon as possible at the occurrence of any incontinence event, at step564. If the patient is determined to be asleep565, the sleep status calculator504determines a time period that the patient has been asleep, at step566. In one embodiment, the time period that the patient has been asleep may be categorized into various ranges (i.e. less than four hours, greater than four hours, between four hours and six hours, or greater than six hours). These ranges are referenced as568in chart inFIG. 10. It should be noted that one of ordinary skill in the art would recognize that any number of ranges representing any time period are contemplated by this disclosure. It should also be recognized that the shown time periods are contemplated to be approximate.

The sleep status calculator504determines a hygiene services schedule for the patient based on an approximate time that the patient has been sleeping and an approximate volume of biofluid from the incontinence event. The time that the patient has been sleeping may be compared to the approximate volume of the incontinence event to determine the hygiene services schedule. The hygiene services schedule provides an estimated time that within which the hygiene services should be provided. This schedule may be displayed on the GUI510and/or otherwise conveyed to the health care provider.FIG. 10shows a plurality of exemplary hygiene services schedules based on exemplary sleep statuses and incontinence volumes. These schedules are referenced as572inFIG. 10. It should be noted that these schedules are exemplary and that alternatives schedules are contemplated by this disclosure.

In one embodiment, if the patient is asleep and the fluid volume of incontinence is within a range of approximately 0 ml to approximately 10 ml, hygiene services are not provided regardless of how long the patient has been asleep, at600(as shown inFIG. 9A). In another embodiment, if the patient is asleep and the fluid volume of incontinence is within a range of approximately 10 ml to approximately 20 ml, the time period to provide hygiene services is within a range of approximately 1 hour to approximately 2 hours regardless of how long the patient has been asleep, at602(as shown inFIG. 9A). In a further embodiment, if the patient has been asleep for less than approximately four hours and the fluid volume of incontinence is within a range of approximately 20 ml to approximately 40 ml, the time period to provide hygiene services is within a range of approximately 1 hour to approximately 2 hours, at604(as shown inFIG. 9B). In yet another embodiment, if the patient has been asleep for a range of approximately four hours to approximately six hours and the fluid volume of incontinence is within a range of approximately 20 ml to approximately 40 ml, the time period to provide hygiene services is within a range of approximately 30 minutes to approximately 1 hour, at606(as shown inFIG. 9B). In still another embodiment, if the patient has been asleep for over approximately six hours and the fluid volume of incontinence is within a range of approximately 20 ml to approximately 40 ml, the time period to provide hygiene services is as soon as possible, at608(as shown inFIG. 9B). In still yet another embodiment, if the patient has been asleep for less than approximately four hours and the fluid volume of incontinence is within a range of approximately 60 ml to approximately 80 ml, the time period to provide hygiene services is approximately 30 minutes to approximately 1 hour, at606(as shown inFIG. 9B). In a further embodiment, if the patient has been asleep for over approximately four hours and the fluid volume of incontinence is within a range of approximately 60 ml to approximately 80 ml, the time period to provide hygiene services is as soon as possible, at608(as shown inFIG. 9B). In still further another embodiment, if the patient is asleep and the fluid volume of incontinence is greater than approximately 80 ml, the time period to provide hygiene services is as soon as possible, at610(as shown inFIG. 9A).

Embodiments may be implemented with computer-executable instructions. The computer-executable instructions may be organized into one or more computer-executable components or modules. Aspects of the disclosure may be implemented with any number and organization of such components or modules. For example, aspects of the disclosure are not limited to the specific computer-executable instructions or the specific components or modules illustrated in the figures and/or described herein. Other embodiments may include different computer-executable instructions or components having more or less functionality than illustrated and described herein.