Abstract:
A method for governing care of a person includes determining the importance of a candidate activity ( 84 ) relative to the importance of patient sleep continuity ( 104 ) and, if the candidate activity is more important than sleep continuity, carrying out the activity or indicating the acceptability of carrying out the activity ( 106 ) and, if the candidate activity is not more important than sleep continuity, refraining from carrying out the activity or indicating the unacceptability of carrying out the activity ( 108 ). A system for patient care governance comprises a decision engine ( 80 ) for determining the importance of the candidate activity relative to the importance of sleep continuity, and a controller ( 92 ) responsive to the decision engine for issuing a command to carry out the activity or indicate the acceptability of carrying out the activity ( 106 ), refrain from carrying out the activity or indicate the unacceptability of carrying out the activity ( 108 ).

Description:
TECHNICAL FIELD 
       [0001]    The subject matter described herein relates to beds of the type used in hospitals, other health care facilities and home health care settings, in particular a bed having at least one powered width expansion wing. 
       BACKGROUND 
       [0002]    Beds used in hospitals, other health care facilities and home health care settings include a deck and a mattress supported by the deck. Some beds have a fixed width deck. Other beds include a fixed width center deck section, a left width adjustment wing and a right width adjustment wing. The wings can be stored under the fixed width center section, in which case the deck width equals the width of the fixed width section. The wings can also be stored partially under the fixed width center section so that they each project laterally beyond the lateral edges of the center section by a distance D1, in which case the deck width equals the width of the fixed width section plus two times the distance D1. The wings can also be deployed so that they each project laterally beyond the lateral edges of the fixed width section by a distance D2, which is greater than D1, in which case the deck width equals the width of the fixed width section plus two times the distance D2. With the wings deployed, the bed may be outfitted with a bariatric mattress, which is wider than a nonbariatric mattress, to accommodate a bariatric occupant. A typical bariatric mattress has a center section, a left width augmentation section and a right width augmentation section. Examples of augmentation sections include air filled bladders and foam inserts. The width adjustment wings are useful because with the wings deployed in order to accommodate a bariatric occupant the bed is too wide to fit through a typical doorway. When it becomes necessary to transport the occupant to a different location without removing him or her from the bed, the wings can be temporarily moved to their stored position and the mattress can be temporarily reduced in width, for example by deflating the augmentation bladders or laterally compressing the augmentation foam, so that the bed is able to fit through the doorways. Upon reaching the intended destination the bed can then be restored to its bariatric configuration, i.e. with the wings deployed and the mattress re-expanded to its bariatric width. 
         [0003]    In a typical width adjustable bed the stored position of the wings is underneath the fixed width deck section. A caregiver deploys the wings by manually pulling them laterally away from the longitudinal centerline of the bed, and stores them by manually pushing them laterally toward the centerline. U.S. Pat. No. 7,730,562 describes a bed having powered width expansion wings. The only specific means disclosed for powering the wings are a hydraulic cylinder or a linear actuator. Such actuation devices can suffer from disadvantages such as bulk, weight and cost. Accordingly, it is desirable to devise more compact, lightweight, low cost systems for powering the expansion wings without sacrificing simplicity and reliability. It is also desirable if such systems can be retrofit onto existing beds having manually operated wings. It is also desirable if such systems or their components can be economically and easily repaired or replaced when necessary. 
       SUMMARY 
       [0004]    A bed disclosed herein comprises a fixed width section having a width and an outboard edge, a wing movably coupled to the fixed width section, a motor assembly mechanically grounded to one of the fixed width section and the wing, and a lead screw coupled to the motor assembly and to a lead screw receiver nonmovably associated with the other of the fixed width section and the wing. In practice, operation of the motor is capable of moving the wing between a deployed position in which a lateral extremity thereof is outboard of the outboard edge and a stored position in which the lateral extremity is inboard of its deployed position. 
         [0005]    A retrofit kit as disclosed herein for upgrading a host bed having manually operable width extension wings comprises a motor assembly, a bracket for mounting the motor assembly to a bed frame, a lead screw set comprising oppositely handed lead screws each attachable to the motor assembly, and a lead screw support bracket set. Each member of the support bracket set is securable to a width extension wing of the host bed. The members of the support bracket set have oppositely handed lead screw receivers. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0006]    The foregoing and other features of the various embodiments of the width adjustable bed and retrofit kit described herein will become more apparent from the following detailed description and the accompanying drawings in which: 
           [0007]      FIG. 1  is a simplified schematic right side elevation view of a hospital bed. 
           [0008]      FIG. 2  is a perspective view of a hospital bed deck having a fixed width center deck section, a left width adjustment wing and a right width adjustment wing as seen by an observer looking from beneath the deck. 
           [0009]      FIG. 3  is a view of a typical deck segment, specifically a thigh deck segment, as seen by an observer looking from beneath the segment. 
           [0010]      FIG. 4  is a perspective view showing the right outboard portion of a typical deck segment, specifically an upper body deck segment, as seen by an observer looking from beneath the segment. 
           [0011]      FIGS. 5A and 5B  are perspective views showing the right outboard portion of a typical deck segment, specifically a torso deck segment, with a width adjustment wing in its deployed state ( FIG. 5A ) and its stored state ( FIG. 5B ) as seen by an observer looking from above the segment. A deck plate which rests atop the deck framework is absent from the illustration in order to expose to view components that would otherwise be obscured. 
           [0012]      FIG. 6  is a view of a portion of a deck segment as seen by an observer looking from beneath the segment showing part of a width expansion wing in relation to a crossbar of a bed frame. 
           [0013]      FIG. 7  is a partially exploded perspective view of a motor assembly, a motor mounting bracket, a coupling shaft, a pair of a lead screws, and a coupling collar shown in the context of a bed frame crossbar and an inboard connector component of a typical width expansion wing. 
           [0014]      FIGS. 8-9  are schematic plan views comparing kinematic inversions of beds with width expansion wings. 
           [0015]      FIG. 10  is a perspective view of a portion of a seat deck segment as seen from beneath the segment showing an alternative mounting bracket for the motor assembly and also showing the width expansion wings in their stored positions. 
           [0016]      FIG. 11  is a schematic plan view of a bed with width expansion wings coupled to each of four deck segments and with a dedicated motor associated with each segment. 
           [0017]      FIG. 12  is a view similar to that of  FIG. 11  showing an architecture in which a common motor services the width expansion wings of more than one deck segment. 
           [0018]      FIG. 13  is a side view showing a link connecting the width expansion wings of neighboring deck segments. 
           [0019]      FIG. 14  is a perspective view of components of a retrofit kit for upgrading a bed having manually operated width expansion wings, the kit including a motor assembly mounting bracket for attaching a motor assembly to a suitably located bed frame component. 
           [0020]      FIG. 15  is a perspective view of components of an alternative retrofit kit for upgrading a bed having manually operated width expansion wings, the kit including an alternative motor assembly mounting bracket for attaching a motor assembly to a bed frame that does not already include a frame component suitable for mounting the motor assembly. 
           [0021]      FIGS. 16-18  are perspective views of a portion of a deck segment, as seen from beneath the segment, showing the alternative bracket of  FIG. 15  used to mount a motor assembly. 
       
    
    
     DETAILED DESCRIPTION 
       [0022]    Referring to  FIGS. 1 and 2  a hospital bed  20  includes a base frame  22  and an elevatable frame  24 . A lift system represented by links  26  renders the elevatable frame vertically moveable relative to the base frame. The bed extends longitudinally from a head end H to a foot end F and laterally from a right side R (seen in the plane of the illustration) to a left side L. Casters  28  extend from the base frame to floor  40 . The elevatable frame  24  includes a deck  30  comprising longitudinally distributed deck segments. The deck segments include an upper body or torso deck segment  32  corresponding approximately to an occupant&#39;s torso, a seat deck segment  34  corresponding approximately to an occupant&#39;s buttocks, a thigh deck segment  36  corresponding approximately to an occupant&#39;s thighs, and a calf deck segment  38  corresponding approximately to an occupant&#39;s calves. The upper body, calf, and thigh deck segments are orientation adjustable through angles α, β and θ. The bed also includes a controller  42  for controlling various functions of the bed and a user interface  44  in communication with the controller. 
         [0023]    Deck segments  32 ,  34 ,  36 ,  38  are width adjustable segments that include wings  50  movably coupled to a fixed width center section  52 . The fixed width center section has a width WF measured between left and right outboard edges  54 ,  56 . In the illustration all four segments are width adjustable segments with both left and right wings. Alternatively, one or more wings could be coupled to only one side (left or right) of the bed. The illustrated bed has ten wings, two of which (one left and one right) are coupled to each of the seat, thigh and calf segments and four of which (two left and two right) are coupled to the upper body segment. A mattress  60  rests on the deck. 
         [0024]    As seen in  FIG. 3 , a typical deck segment includes a pair of longitudinally spaced apart crossbars  64 , connected together by longitudinally extending rails  68 . The illustrated crossbars are in the form of C-channels having open sides  66  (seen best in  FIG. 4 ) that face toward each other. 
         [0025]    The bed also includes left and right head end siderails  70 , and left and right foot end siderails  72 . As seen most clearly in  FIG. 4 , each siderail is connected to a wing  50  by a center link  74  and a longitudinally split link  76  such that the siderail  70  or  72 , wing  50  and links  74 ,  76  comprise a four bar linkage which enables a user to vertically raise and lower the siderail. 
         [0026]    Each wing comprises a pair of longitudinally spaced apart spars  80 , an inboard connector  82  (also referred to as a lead screw support bracket) spanning longitudinally between the spars at their inboard ends, an outboard beam  84  spanning longitudinally between the spars at their outboard ends, and a panel  88  extending between the spars and overlying the outboard beam. As seen best in  FIG. 4 , outboard edge  90  of panel  88  and outboard face  92  of beam  84  lie in approximately a common vertical plane  94  and therefore define the outboard lateral extremity of the wing. Connector  82  includes a lead screw receiver  96  comprising a threaded bore  98  (seen best in  FIGS. 14-15 ) that penetrates through the connector. The receivers on the left and right wings are oppositely handed and each receiver is nonmovable relative to its respective wing. Each wing spar  80  nests in one of the deck segment C-channels  64  so that the spars, and therefore the wing, are laterally translatable relative to fixed width section  52 . As seen best in  FIG. 6 , the illustrated embodiment includes bearings  102  rotatably attached to the spars to reduce resistance when the wings translate relative to the fixed section. Other types of interfaces between the spars and the C-channels, such as rollers, could also be used. 
         [0027]    Referring additionally to  FIG. 7 , the bed also includes a motor assembly  110  comprising an electric motor  112  and a gear train  114 , such as a worm and pinion, housed in a housing  116 . The motor assembly is mechanically grounded to fixed width section  52 . Specifically the motor assembly is bolted to a motor mounting bracket  120  which itself is bolted to rail  68 . A coupling shaft  124 , which is rotatably driven by the gear train, projects out of the left and right sides of housing  116 . One end of a lead screw  126 L having a rotational axis  128 L is coupled to one end of shaft  124 , and therefore to motor assembly  110 , by a coupling collar  130  and a pair of R-pins  134 . The other end of lead screw  126 L is received in receiver  96  of left wing  50 L. Another lead screw  126 R is coupled to the other end of shaft  124 , and therefore to motor assembly  110 , by another coupling collar  130  and an additional pair of R-pins  134 . The other end of lead screw  126 R is received in receiver  96  of right wing  50 R so that its rotational axis  128 R is colinear with axis  128 L. The colinear axes  128 L,  128 R define a common rotational axis for the lead screws. Lead screws  128 L,  128 R are oppositely handed as are the lead screw receivers in the left and right wings. Each lead screw and its receiver are same-handed. 
         [0028]      FIG. 8  schematically show the above described kinematic arrangement in which the motor assembly  110  is mechanically grounded to fixed width section  52  and the lead screw receivers are nonmovably associated with each wing.  FIG. 9  shows a kinematic inversion in which a motor assembly  110  is mechanically grounded to each wing  50  and the lead screw receivers are nonmovably associated with fixed width sections  52 . In the architecture of  FIG. 9  coordination of the direction of movement of the width expansion wings can be accomplished with oppositely handed lead screws or with opposite motor rotational directions. 
         [0029]    In practice, operation of the motor in a first rotational direction moves the left and right wings in unison in a laterally outboard direction. Operation of the motor in a second rotational direction, opposite that of the first rotational direction, moves the wings in unison in a laterally inboard direction. In particular the motor can move the wings between a deployed position in which the lateral extremity  92  of the wing is outboard of the outboard edge  56  or  58  of the fixed width section  52  (e.g.  FIGS. 2-5A ) and a stored position in which the lateral extremity  92  is inboard of its deployed position ( FIGS. 5B ,  10 ). When the wing is stored its outboard extremity  94  may be outboard of, inboard of, or substantially laterally aligned with outboard edge  56  or  58  of fixed width section  52 . 
         [0030]      FIG. 11  is a schematic representation of the above described architecture having four deck segments, all four of which are width adjustable. The motor (or a set of motors in the variant in which the motors are mechanically grounded to the wings) is associated with and dedicated to one and only one of the four segments  32 ,  34 ,  36 ,  38 . In other words each width adjustable segment has a dedicated motor assembly associated with it for moving the wings coupled to that same segment. In general, in a bed having at least two deck segments, and in which at least two of those segments are width adjustable segments, each segment is serviced by its own dedicated motor assembly or assemblies. 
         [0031]      FIGS. 12-13  show an alternative in which the wings of at least two of the width adjustable segments are movable by a common motor assembly. Specifically, a motor assembly  110  is mechanically grounded to center section  52  of thigh deck segment  36 . Wings  50  of segment  36  are master wings driven directly by the common motor assembly. Wings  50 , of the seat and calf segments  36 ,  38  are slave wings connected to the master wing by a link  138  which conveys the lateral motion of the master wings to the slave wings. The slave wings are considered to be indirectly driven because the master wings intervene between the motor assembly and the slave wings. The wings of the upper body section of  FIG. 9  are serviced by a motor dedicated to the upper body section. 
         [0032]    The foregoing explanation and accompanying illustrations are directed to beds manufactured with the powered width adjustment feature. However a retrofit kit may be provided for upgrading beds having manually operable width expansion wings. As seen in  FIGS. 14-15  a retrofit kit includes at least a motor assembly  110 , a motor mount bracket  120  ( FIG. 14 ) or  140  ( FIG. 15 ) for mounting the motor assembly to a bed frame, a lead screw set comprising oppositely handed lead screws  126 L,  126 R each of which is attachable to the motor assembly, and a lead screw support bracket set comprising a pair of lead screw support brackets  82 . The members of the lead screw support bracket set have oppositely handed lead screw receivers  96  and are securable to a width extension wing e.g. by welds or bolts. Other hardware such as a coupler shaft  124 , coupling collars  130 , R-clips  134  and other fasteners may also be part of the kit. Although  FIGS. 14-15  show several kit components as individual parts, certain kit components, such as the motor assembly and motor mount bracket, can be preassembled to each other rather than provided as individual components. 
         [0033]      FIGS. 14 and 15  show two different styles of motor mount brackets. Motor mount bracket  120  of  FIG. 14  is configured to attach the motor assembly to a preexisting, longitudinally extending rail  68  of the bed frame, for example rail  68  of  FIG. 3 . Motor mount bracket  140  of  FIG. 15  is configured to span longitudinally between crossbars  64  of the bed frame. The ends of brackets  140  are secured to the crossbars by bolts (not shown). Bracket  140  is useful if the deck segment or segments of interest do not have a suitable, preexisting rail  68  to which the bracket can be attached.  FIGS. 16-18  are views of bracket  140  shown in the context of a bed frame but with the mounting bolts not illustrated. 
         [0034]    Although this disclosure refers to specific embodiments, it will be understood by those skilled in the art that various changes in form and detail may be made without departing from the subject matter set forth in the accompanying claims.