Patent Publication Number: US-2021169719-A1

Title: Patient turning apparatus and method

Description:
The present invention relates to patient turning apparatus and method. 
     Individuals who are unable to move autonomously and thus restricted to a particular position, such as a recumbent position when lying on a bed, are prone to developing pressure sores. To minimise the development of these sores, it is necessary to reposition the individual upon the bed at regular intervals. However, this is often difficult for a single carer and often requires several carers to suitably reposition the individual. Moreover, given that those individuals who are susceptible to developing pressure sores require repositioning at regular intervals, typically every 2 hours, then it is evident that this is a time intensive process. 
     GB2449318 discloses an automatic patient turning apparatus having a support platform comprising support sections, which can pivot about a central longitudinal region of the platform to turn a patient lying thereon onto their left or right side. The disclosed apparatus comprises two support sections disposed at each side of the central region which are uncoupled, so that the sections can pivot independently of each other. The uncoupled nature of the two sections at each side of the central region enables the platform to pivot as the configuration of the underlying bed changes. However, the skilled reader will recognise that the positioning of the separation between sections must match the location of the hinge coupling between sections of the underlying bed frame to enable the pivotal movement of the platform. In this respect, a two section support platform is required for a bed frame having two sections which are hingedly coupled. Similarly, a three-section support platform would be required for a bed frame having three sections. It is evident therefore that the apparatus is restricted to the particular bed frame. Moreover, it is desirable for sections of a bed frame to move through auto-regression, whereby the location of the hinge coupling between sections of the bed frame move along the bed to follow the natural movement of a patients legs and waist flexion, for example. 
     We have now devised an improved patient turning apparatus and method. 
     In accordance with a first aspect of the present invention there is provided a patient turning apparatus comprising a reconfigurable support platform comprising a plurality of laterally extending support slats configured for pivotal movement about a longitudinally extending central region of the platform, at least one support slat being configured to follow a pivotal movement of a longitudinally adjacent support slat about the central region, through at least a portion of a pivotal range of movement of the longitudinally adjacent support slat, the apparatus further comprising means operable to control pivotal movement of at least one support slat of the platform about the central region. 
     In an embodiment, each support slat is configured to follow a pivotal movement of a longitudinally adjacent support slat about the central portion, through at least a portion of a pivotal range of movement of the longitudinally adjacent support slat. The support slats are interconnected to permit the support slats to pivot in response to a pivoting of a longitudinally adjacent support slat beyond a threshold pivotal range. 
     In an embodiment, the support slats extend in a substantially parallel configuration when configured in an un-pivoted configuration, and are longitudinally separated along the platform. 
     In an embodiment, the plurality of laterally extending support slats comprise a first plurality of laterally extending support slats which extend to a first side of the central region and a second plurality of laterally extending support slats which extend to a second side of the central region. The first and second plurality of support slats extend in substantially the same plane when configured in an un-pivoted configuration. The first and second plurality of support slats extend at a right and left side of the central region of the platform. 
     In an embodiment, the support platform further comprises a support sheet, which may be formed of a plastics or fabric material, for example. The support sheet comprises a plurality of laterally extending pockets formed therein for separately receiving a support slat. The pockets extend from a longitudinally extending central portion of the support sheet and comprise a respective opening formed proximate a lateral edge of the support sheet. In an embodiment, the support sheet comprises a first plurality of laterally extending pockets which extend to a first side of the central portion of the support sheet and a second plurality of laterally extending pockets which extend to a second side of the central portion of support sheet. The openings may be closable via a respective flap, which may be releasably secured to the sheet via fastening means, such as a hook-and-loop (Velcro®) fastening arrangement. Alternatively, the openings may be closed via a weld for example, once the supports slats have been inserted within the respective pockets. 
     In an embodiment, the apparatus further comprises a reconfigurable base which is disposed in use at an underside of the platform. The base is reconfigurable at least along a longitudinal direction thereof, and is arranged to conform to a support surface of a bed frame and is reconfigurable to conform with a reconfiguration of the bed support surface. 
     In an embodiment, the base comprises a plurality of laterally extending base slats which extend across a width of the base, to either side of a central region of the base. The base comprises a base sheet which may be similarly formed of a plastics or fabric material. The base sheet comprises a plurality of laterally extending pockets formed therein for separately receiving a base slat. The pockets extend along a width of the base sheet, to either side of a central portion of the base sheet, and comprise an opening formed at one end thereof, through which a slat can be inserted into the pocket. The openings may be closable via a respective flap, which may be releasably secured to the base sheet via fastening means, such as a hook-and-loop (Velcro®) fastening arrangement. Alternatively, the openings may be closed via a weld for example, once the base slats have been inserted within the respective pockets. 
     The base slats provide a lateral rigidity to the base, however the longitudinal spacing of the base slats within the flexible base sheet permits the base to reconfigure along a longitudinal direction and thus conform with undulations and/or profiling of the underlying bed frame. The spacing further enables auto-regression of the underlying bed frame to take place. 
     In an embodiment, the central portion of the support sheet and a central region of the base are coupled together via rivets which extend through the support sheet and the base sheet, and at least one of the slats which extend across the width of the base sheet. 
     In an alternative embodiment, the plurality of base slats may be configured for pivotal movement about a longitudinally extending central region of the base. In this respect, the plurality of base slats may comprise a first plurality of laterally extending base slats which extend to a first side of the central region and a second plurality of laterally extending base slats which extend to a second side of the central region. In this embodiment, the base comprises a base sheet, which may similarly be formed of a plastics or fabric material having a plurality of laterally extending pockets formed therein for separately receiving a base slat. The pockets extend from a longitudinally extending central portion of the base sheet and comprise a respective opening formed proximate a lateral edge of the base sheet. The openings may be closable via a respective flap, which may be releasably secured to the base sheet via fastening means, such as a hook-and-loop (Velcro®) fastening arrangement. Alternatively, the openings may be closed via a weld for example, once the base slats have been inserted within the respective pockets. In this embodiment, the base sheet comprises a first plurality of laterally extending pockets which extend to a first side of the central portion of the base sheet and a second plurality of laterally extending pockets which extend to a second side of the central portion of base sheet. 
     In an embodiment, the central portion of the support sheet and the central portion of the base sheet are coupled together via rivets or a weld or other fastening means. 
     In an embodiment, the means operable to control pivotal movement of at least one support slat of the platform is disposed, in use, at an underside of the platform. The means operable to control pivotal movement of at least one support slat of the platform may comprise an inflatable bladder, and in an embodiment is disposed between the platform and the base to permit the support slats to pivot with respect to the base. 
     In an embodiment, the inflatable bladder extends longitudinally of the apparatus and comprises a plurality of bladder portions fluidly coupled via a conduit. 
     In an embodiment, the apparatus further comprises a pump which is fluidly coupled to the inflatable bladder via a duct, such as a hose. The apparatus further comprises a control unit for controlling operation of the pump to control a selected inflation and deflation of the inflatable bladder. The control unit further comprises a timer or clock for inflating and deflating the inflatable bladder at pre-selected times. 
     In an embodiment, the means operable to control pivotal movement of at least one support slat of the platform comprises a first inflatable bladder and a second inflatable bladder, respectively disposed in use at an underside of the first and second plurality of support slats. The control unit and pump are arranged to selectively inflate and deflate the first and second inflatable bladder. 
     In an embodiment, the support slats, base slats, support sheet and base sheet are enclosed within a removable cover, which can be sealed to minimise any ingress of dirt or infectious material onto the support and base sheet. 
     In an alternative embodiment, the support platform comprises a plurality of interconnected support elements, each element being detachably coupled at a proximal end thereof, to a longitudinally extending central region of a reconfigurable base, disposed in use at an underside of the platform. 
     The support elements may be orientated to extend laterally across the support platform, and comprise a first plurality of support elements which extend to a first side of a longitudinally extending central portion of the platform and a second plurality of support elements which extend to a second side of the central portion of the platform. 
     In an embodiment, the pockets extend from a central portion of the platform, to either side of the central portion and comprise an opening formed at a distal end thereof, through which a support slat can be inserted into the pocket. 
     The supports elements may comprise a substantially triangular shape, whereby sides of each element converge from the distal end to the proximal end thereof. In this respect, it is envisaged that the support slats which are configured to be inserted within the pocket comprise a similar shape to accommodate the contour of the pocket. 
     In an embodiment, the means operable to control pivotal movement of at least one support slat of the platform comprises an inflatable bladder, which may comprise at least two inflatable chambers. 
     In an embodiment, each support element comprises a respective inflatable bladder for effecting a pivotal movement of the respective support slat. 
     In an embodiment, the reconfigurable base comprises a base sheet. The base sheet comprises a plurality of laterally extending pockets formed therein for separately receiving a base slat. The pockets extend from a longitudinally extending central region of the base sheet and comprise a respective opening formed proximate a lateral edge of the base sheet. 
     In an embodiment, the base sheet comprises a first plurality of laterally extending pockets which extend to a first side of the central region of the base sheet and a second plurality of laterally extending pockets which extend to a second side of the central region of base sheet. 
     In an embodiment, the support elements are interconnected to permit the support slats to pivot in response to a pivoting of a longitudinally adjacent support slat beyond a threshold pivotal range. 
     In an embodiment, the inflatable chambers associated with each support element are fluidly coupled to each other via a conduit. 
     In an embodiment, the apparatus further comprises a control unit and a pump, the control unit being arranged to control operation of the pump to control a selected inflation and deflation of the inflatable bladder. The apparatus may further comprise a timer or clock for selected timing of the inflation and deflation of the inflatable chamber. 
     According to a second aspect of the invention there is provided a patient turning apparatus comprising a patient turning apparatus comprising: a reconfigurable support platform comprising: a first plurality of laterally extending support slats which extend to a first side of a central region of the platform and a second plurality of laterally extending support slats which extend to a second side of the central region of the platform, both the first plurality and second plurality of laterally extending support slats configured for pivotal movement about the longitudinally extending central region of the platform; at least one support slat being configured to follow a pivotal movement of a longitudinally adjacent support slat about the central region, through at least a portion of a pivotal range of movement of the longitudinally adjacent support slat; a pivot controlling means operable to control pivotal movement of at least one support slat of the platform about the central region; and a reconfigurable base detachably coupled to and disposed in use at an underside of the reconfigurable support platform. 
     According to a third aspect of the invention there is provide a method for turning a patient using a patient turning apparatus according to any previous claim, the method comprising the steps: pivoting a first plurality of laterally extending support slats through a first pivotal range; subsequently pivoting a second plurality of laterally extending support slats through a second pivotal range, the second pivotal range being less than that of the first pivotal range; and subsequently pivoting the first plurality of laterally extending support slats beyond the first pivotal range, while the second plurality of support slats remain pivoted through the second pivotal range. 
     Whilst the invention has been described above, it extends to any inventive combination of features set out above or in the following description. Although illustrative embodiments of the invention are described in detail herein with reference to the accompanying drawings, it is to be understood that the invention is not limited to these precise embodiments. 
     Furthermore, it is contemplated that a particular feature described either individually or as part of an embodiment can be combined with other individually described features, or parts of other embodiments, even if the other features and embodiments make no mention of the particular feature. Thus, the invention extends to such specific combinations not already described. 
    
    
     
       The invention may be performed in various ways, and, by way of example only, embodiments thereof will now be described, reference being made to the accompanying drawings in which: 
         FIG. 1  is a perspective view of a patient turning apparatus according to a first embodiment of the present invention, disposed upon a bed frame configured in a flattened configuration; 
         FIG. 2  is a perspective view of the patient turning apparatus illustrated in  FIG. 1 , disposed upon a bed frame configured in a profiled configuration; 
         FIG. 3  is a perspective view of the patient turning apparatus illustrated in  FIG. 1 , disposed upon a bed frame configured in a profiled configuration, with the first plurality of support slats pivoted about the central portion; 
         FIG. 4  is a perspective view of the patient turning apparatus illustrated in  FIG. 1  disposed upon a bed frame configured in a profiled configuration, with the second plurality of support slats pivoted about the central portion; 
         FIGS. 5 and 6  are perspective views of patient turning apparatus according to a second embodiment of the present invention, disposed upon a bed frame configured in a flattened configuration, with the reconfigurable support platform being detached ( FIG. 5 ) and coupled ( FIG. 6 ) to the reconfigurable base, respectively; 
         FIGS. 7 and 8  are end views of the patient turning apparatus illustrated in  FIGS. 5 and 6 , disposed upon a bed frame configured in a flattened configuration, with the first plurality of support slats pivoted about the central portion through a first pivotal range ( FIG. 7 ), and beyond the first pivotal range ( FIG. 8 ), respectively; 
         FIG. 9  is a perspective view of the patient turning apparatus illustrated in  FIG. 5  disposed upon a bed frame configured in a flattened configuration, with the second plurality of support slats pivoted about the central portion; 
         FIG. 10  is a perspective view of the patient turning apparatus illustrated in  FIG. 5 , disposed upon a bed frame configured in a profiled configuration, with the second plurality of support slats pivoted about the central portion; and, 
         FIG. 11  is an isometric view of the patient turning apparatus illustrated in  FIG. 5 , arranged in multiple configurations.  FIG. 11 a    illustrates the apparatus in a stowed (rolled) configuration;  FIG. 11 b    illustrates the apparatus in an unstowed configuration with the cover removed;  FIG. 11 c    illustrates the apparatus with the second plurality of support elements pivoted; and  FIG. 11 d    illustrates the apparatus in an unstowed configuration, with the second plurality of support elements removed, and the first plurality of support elements pivoted; and, 
         FIG. 12  is a flow chart outlining the steps associated with a method of turning a patient according to an embodiment of the present invention. 
     
    
    
     Referring to  FIGS. 1 and 2  of the drawings, there is illustrated a patient turning apparatus  100  according to an embodiment of the present invention, disposed upon a bed frame  200  arranged in a flattened configuration or profile. The bed frame  200  comprises a support frame  210  upon which the apparatus  100  is disposed and in the illustrated embodiment, the support frame  210  comprises four frame sections  211 - 214  which are hingedly coupled along a lateral direction and which are arranged to provide support to different regions of a patient (not shown), such as the patient&#39;s upper body, waist region and lower body. The frame sections  211 - 214  are arranged to pivot with respect to each other about the respective coupling (not shown) to reconfigure a longitudinal profile of the support frame  210 . The frame sections  211 - 214  are moved relative to each other about the respective hinge couplings (not shown) using a driving mechanism (not shown) which may be controlled via a controller  220 . The driving mechanism may be hydraulic, pneumatic or electric mechanism for example, and is arranged to suitably configure the support frame  210  to a preferred profile, such as that illustrated in  FIG. 2  of the drawings, to suit the patient. 
     The apparatus  100  comprises a reconfigurable support platform  110  which in use is arranged uppermost on the support frame  210  of the bed frame  200 , and arranged to extend adjacent a mattress (not shown), for example. The support platform  110  comprises a flexible support sheet  120  which may be formed of a plastics material, such as polyurethane, or a fabric material, such as Nylon®, for example. The support sheet  120  comprises a plurality of elongate pockets  121 ,  122  formed therein which are orientated to extend laterally across the sheet, in a substantially parallel configuration. The pockets  121 ,  122  are configured to a first plurality of pockets  121  which extend to a first side of a central longitudinal portion  123  of the sheet  120  and a second plurality of pockets  122  which extend to a second side of the central longitudinal portion  123 . 
     The pockets  121 ,  122  comprise an opening  121   a ,  122   a  disposed at a distal end thereof, which respectively comprise a first and second lateral edge of the sheet  120  and are closed at a proximal end thereof, which is disposed adjacent the central longitudinal portion  123  of the support sheet  120 . The opening may be closable via a respective flap (not shown) which is secured at an underside of the support sheet, and arranged to pivot around the distal end of the pocket to an upperside of the support sheet to close the opening  121   a ,  122   a . The flap may be detachably coupled to the sheet via fastening means (not shown), such as a hook-and-loop type fastening arrangement (not shown). Alternatively, the openings may be closed via a weld for example, once the slats have been inserted within the respective pockets. The pockets  121 ,  122  are arranged to separately receive a support slat  130  having a substantially planar, elongate shape. The support slats  130  are formed of a rigid, plastics material, such as high density polyethylene, and are arranged to provide a structural frame to the support sheet  120 . The support slats  130  are longitudinally separated along the platform  110 ; however, owing to the slats  130  being disposed within the pockets  121 ,  122  and the interconnection between pockets  121 ,  122  by the support sheet  120 , it is evident that any pivotal movement of one slat  130  will cause longitudinally adjacent slats  130  in adjacent pockets to follow the pivotal movement. For example, as one slat  130  is pivoted upwardly about the central portion  123 , the portion  124  of the sheet  120  disposed between the pocket holding the one slat and adjacent pockets will cause the slats in the adjacent pockets to also pivot. 
     The apparatus  100  further comprise a base  140  which in use is arranged lowermost on the support frame  210  of the bed frame  200  and arranged to extend adjacent the support frame  210 . The base  140  similarly comprises a flexible base sheet  150 , which may be formed of a plastics material, such as polyurethane, or a fabric material, such as Nylon®, for example. The base sheet  150  comprises a plurality of elongate pockets  151  formed therein which are orientated to extend laterally across the sheet, in a substantially parallel configuration. The pockets  151  are separately arranged to receive a base slat  152  having a substantially planar, elongate shape. The base slats  152  are similarly formed of a rigid, plastics material, such as high density polyethylene, and are arranged to provide a structural frame to the base sheet  150 . 
     In an embodiment, the pockets  151  extend across the full width of the base sheet  150 , either side of a central region  141  of the base  140 . The pockets  151  comprise a respective opening  153  disposed along a longitudinal edge of the base sheet  150  for receiving a respective slat  152 , which similarly extends across the full width of the base sheet  150 , either side of the central region  141 . The openings  153  maybe closable by a respective flap (not shown), similar to the flaps (not shown) associated with the support sheet  120 , or closed via a weld once the slats have been inserted within the respective pocket. The rigid nature of the base slats  152  provides a lateral stiffness and lateral rigidity to the base  140  which resists any flexing of the base  140  along the width thereof. However, the disposition of the base slats  152  within the separated pockets  151  of the flexible base sheet  150  permits the base  140  to reconfigure along the length thereof to accommodate any variation or profile of the underlying support frame  210 . 
     In an alternative embodiment which is not illustrated, the pockets  151  of the base  140  are configured to a first plurality of pockets  151  which extend to a first side of a central longitudinal portion (not shown) of the base sheet  150  and a second plurality of pockets  151  which extend to a second side of the central longitudinal portion. The pockets  151  comprise an opening disposed at a distal end thereof, which respectively comprise a first and second longitudinal edge of the base sheet  150  and are closed at a proximal end thereof, which is disposed adjacent the central longitudinal portion of the base sheet  150 . In this respect, the first plurality of pockets  151  are arranged to receive a first plurality of base slats  152  and the second plurality of pockets are arranged to receive a second plurality of base slats  152 . The first and second plurality of base slats  152  are separately configured to provide a lateral rigidity to the base  140  at the first and second side of the central region  141  of the base  140 , while enabling the base  140  to articulate about the central region  141  to match any lateral undulation of the support frame  210 . It is envisaged that this separation of the base slats  152  into a first and second group will provide for an additional flexibility to the apparatus  100  to accommodate a further variety of bed support frames. 
     In either embodiment of the base  140 , the longitudinal separation of the base slats  152  enables the base  140  to conform to a longitudinally undulating bed support frame  210  and moreover, adopt the profile of the bed support frame  210 . In this respect, it is evident that the base  140  can follow the profile or contour of a multi-section bed frame and is not restricted for use with a three or four section profiling bed frame  200 , for example. 
     The apparatus  100  further comprises means  160  operable to control pivotal movement of at least one support slat  130  of the platform about the central portion. In the embodiment illustrated in  FIGS. 3 and 4  of the drawings, the means  160  comprises a first inflatable bladder  161  and a second inflatable bladder (only one of which is illustrated in the drawings) which is disposed at the underside of the support platform  110 , between the support platform  110  and the base  140 . In particular, the first bladder  161  is arranged to extend longitudinally of the apparatus  100 , between the first plurality of support slats  130  and of the underlying base slats  152 . Similarly, the second bladder is arranged to extend longitudinally of the apparatus  100 , between the second plurality of support slats  130  and the underlying base slats  152 . 
     The first inflatable bladder  161  and second inflatable bladder (not shown) may separately comprise a plurality of chambers  161   a - c  fluidly coupled via a respective conduit  162 . The embodiment illustrated in  FIG. 4  of the drawings comprises only three sub-chambers  161   a - c , however it is to be appreciate that fewer or more sub-chambers may be used. The chambers  161   a - c  and conduit  162  may comprise a single integral bladder  161  with the conduits  162  comprising narrowed or neck regions of the respective bladder  161 . Alternatively, the conduits  162  may comprise separate pipe or hose connections (not shown) which fluidly couple the chambers  161   a - c  in a series configuration. The conduits  162  are arranged at separated regions along the length of the respective bladder  161  and arranged to correspond with the principal hinged couplings (not shown) of the support frame  210  of the bed frame  200 . The conduits  162  are arranged to minimise any kinking or collapsing of the first bladder  161  and second bladders (not shown) as the bladders conforms to the underlying surface of the profiled support frame  210 , which may otherwise fluidly isolate portions of one or both of the bladders  161 , thereby preventing inflation and/or deflation of the bladder(s)  161 . 
     The first bladder  161  and second bladder (not shown) are inflatable via a pump (not shown) which is fluidly coupled to each chamber via a hose  163 , and controlled via a controller  170 . The controller  170  comprises a clock or timer (not shown) which enables an operator (not shown) to select a timing sequence for inflating and deflating the first bladder  161  and second bladder (not shown). For example, the controller  170  may include a control panel  171  having a user interface comprising a plurality of buttons  172  for selecting a 1 hour, 2 hour, 4 hour cycle etc., for inflating and deflating the first bladder  161  and second bladder (not shown). The control panel  171  may alternatively or additionally comprise input means (not shown) for selecting specific times for inflating and deflating the first bladder  161  and second bladder (not shown). 
     The central region  111  of the support platform  110  comprises a width such that a patient lying on the central region  111  extends over at least some of the support slats  130  disposed along the first and second side (namely right and left side) of the platform  110 . In this respect, as the first/second bladder inflates for example, the first/second plurality of support slats  130  pivot about the central region  111  to turn a patient on their left/right side, respectively. In order to minimise any lateral movement of the support slats  130  relative to the central portion  123  of the support sheet  120  (which would typically be formed of a fabric material) as the support slats pivot relative to the base slats  152 , the central longitudinal portion  123  may separately comprise a plurality of support members (not shown) disposed therealong, which extend across the width of the central portion  123 . The support members comprise a similar cross-sectional shape and size to the adjacent slats and provide lateral support to the central portion  123  to minimise any buckling of the central portion  123 . The support members may be arranged in separate pockets (not shown) disposed along the central portion  123 , and the discrete arrangement of support members further enable the central portion  123  and thus the apparatus  100 , to conform to longitudinal variations in the underlying bed support frame  210 . 
     In use, the support platform  110  and base  130 , together with the first  161  and second bladder may enclosed within a cover (not shown) which can be sealed to prevent any ingress of dirt or infectious material onto the platform  110 , base  130  and bladders  161 . The cover (not shown) can be releasably sealed via a closure (not shown) and thus removed from the support platform  110 , base  130  and bladders  161  for cleaning. The support platform  110 , base  130  and bladders  161 , enclosed within a cover (not shown) may be initially arranged in a rolled, storage configuration and deployed by unrolling the arrangement upon the bed support frame  210  such that the central region of the platform  111  extends along a central longitudinal region of the bed support frame  210 , with the support  130  and base slats  152  extending across the frame  210 . Upon referring to  FIGS. 3 and 4  of the drawings, it is evident that alternate pockets  121 ,  122 ,  151  of the support sheet  120  and base sheet  150  have been left unoccupied with a slat  130 ,  152 . This provides for a more flexible support platform  110  and base  130  which can conform more closely with the particular profiling of the bed support frame  210 . It is to be appreciated however, that all of the pockets  121 ,  122 ,  151  could instead be occupied or a selected few pockets  121 ,  122 ,  151  left unoccupied to suit the particular bed support frame  210 . 
     With the platform  110 , base  130  and first and second bladders  161  deployed upon the frame  210  (and a mattress (not shown) disposed upon the support platform  110 ), an operator (not shown) subsequently fluidly couples the first and second bladder  161  to the pump (not shown) and controller  170 , via a respective hose  163 . The operator then selects the desired sequence for inflating and deflating the first and second bladder (only the first bladder  161  is illustrated) for turning the patient. For example, the operator may select a 1 hour cycle via the control panel  171  on the controller  170 . This cycle may initially cause the first bladder  161  to inflate; as the first bladder inflates, it presses against the base  130  which cannot move due to the bed support frame  210  and the inherent lateral rigidity of the base slats  152 , thereby causing the first plurality of support slats  130  to pivot about the central region  111  of the support platform  110  to lift the right side of the mattress (not shown) and thus turn the patient (not shown) onto their left side (as illustrated in  FIG. 3  of the drawings). The first bladder  161  may remain in this inflated state for 1 hour to maintain the patient in this position. After 1 hour, the controller  170  may act to deflate the first bladder  161  which causes the first plurality of slats  130  to pivot downwardly toward the base  140  and thus lower the right side of the mattress (not shown) so that the patient (not shown) becomes lowered onto their back. The controller  170  may subsequently cause the second bladder (not shown) to inflate to cause the second plurality of support slats  130  to pivot about the central region  111 , thereby causing the left side of the mattress to lift and thus turn the patient onto their left side (as illustrated in  FIG. 4  of the drawings). Similarly, the second bladder (not shown) may remain in this position for 1 hour prior to deflating and thus lowering the patient onto their back. The first and second bladder may then remain in a deflated state for a period of 1 hour, before the sequence recommences. 
     The first bladder  161  and second bladder (not shown) act upon the base  130  to cause the first and second plurality of support slats  130  to pivot about the central region  111 . The base  130  provides a suitable surface upon which the bladders can act to lift the support slats  130  while also protecting the bladders  130  from any sharp edges or broken sections of the bed support frame  210  which may otherwise act to puncture the bladders  161 . 
     The flexible nature of the support sheet  120  and base sheet  150  enable the support platform  110  and base  140  to conform to the desired bed profile, while the slats  130   152  provide a structural frame to the support sheet  120  and base sheet  150  to enable the turning of a patient with the bed configured in a profiled configuration, such as that illustrated in  FIGS. 3 and 4 . 
     In an alternative embodiment which is not illustrated, it is envisaged that longitudinally adjacent support slats  130  and separately, longitudinally adjacent base slats  152 , may be directly coupled via one or more flexible straps (not shown), for example. This may obviate the requirement for a support sheet  120  and base sheet  150 . 
     In yet a further embodiment which is also not illustrated, it is envisaged that the sub-chambers  161   a - c  of the first bladder  161  and second bladder (not shown) may fluidly isolated from each other. It is envisaged that each sub-chamber may comprise a dedicated fluid feed or duct from the pump (not shown), so that each sub-chamber of the first/second bladder, can be inflated and deflated separately to other sub-chambers of the first/second bladder, to provide turning of selected regions of the patient. 
     Referring to  FIGS. 5-11  of the drawings, there is illustrated a patient turning apparatus  300  according to a second embodiment of the present invention. Referring to  FIGS. 5 and 6  of the drawings, the patient turning apparatus  300  is illustrated as being disposed upon a bed frame  200  arranged in a flattened configuration or profile. The bed frame  200  comprises a support frame  210  upon which the apparatus  300  is disposed and in the illustrated embodiment, the support frame  210  comprises four frame sections  211 - 214  (see  FIG. 10 ) which are hingedly coupled along a lateral direction and which are arranged to provide support to different regions of a patient (not shown), such as the patient&#39;s upper body, waist region and lower body. 
     The apparatus  300  comprises a reconfigurable support platform  310  and a reconfigurable support base  340 , which in use is arranged upon the support frame  210  of the bed frame  200 , and arranged to extend adjacent a mattress (not shown), for example. The support platform  310  comprises a plurality of interconnected support elements  320  which may be formed of a plastics material, such as polyurethane, or a fabric material, such as Nylon®, for example. The support elements  320  separately comprise a an elongate pocket  321  and are orientated to extend laterally across the platform  310 , in a substantially parallel configuration. 
     The support elements  320  are configured to a first plurality of elements  320   a  which extend to a first side of a central longitudinal portion  323  of the platform  310  and a second plurality of elements  320   b  which extend to a second side of the central longitudinal portion  323 . 
     The pockets  321  comprise an opening  321   a  disposed at a distal end thereof, and the distal end of the pockets associated with the first and second support elements  320   a ,  320   b , respectively define a first and second lateral edge of the platform  310 . The pockets  321  are closed at a proximal end thereof, which is disposed adjacent the central longitudinal portion  323  of the support platform  310 . The opening may be closable via a respective flap (not shown) which is secured at an underside of the respective support element  320 , and arranged to pivot around the distal end of the pocket to an upperside of the support element  320  to close the opening. The flap may be detachably coupled to the element via fastening means (not shown), such as a hook-and-loop type fastening arrangement (not shown). Alternatively, the openings may be closed via a weld for example, once the slats have been inserted within the respective pockets  321 . The pockets  321  are arranged to separately receive a support slat  330  having a substantially planar, elongate shape which tapers towards the central longitudinal portion  323 . The support slats  330  are formed of a rigid, plastics material, such as high density polyethylene, and are arranged to provide a structural frame to the support platform  310 . The support slats  330  are longitudinally separated along the platform  310 ; however, owing to the slats  330  being disposed within the pockets and an interconnection portion  324 , such as a web portion, between longitudinally adjacent elements  320 , it is evident that any pivotal movement of one slat  330  will cause longitudinally adjacent slats  330  in adjacent pockets  321  to follow the pivotal movement. 
     The support apparatus  300  of the second embodiment, further comprises fastening members  390   a ,  390   b  which are used to attach the support elements  320  and thereby the pockets  321  to the base  340 . The fastening means may comprise a detachably coupleable arrangement such as hook and loop fastening arrangement, pop studs, button or any other reasonable releasable attachment mechanism. As shown, the fastening members are disposed at the proximal end of the elements  320  for coupling with fastening members disposed along a central region of the base  340 , thereby forming a point of rotation for the pivoting of the support elements  320 . 
     The apparatus of the second embodiment further comprises means  360  for controlling pivotal movement of the support elements  320 . Referring to  FIGS. 7 and 8  of the drawings, there is illustrated a close up view of a pivot controlling means  360  operable to control the pivotal movement of at least one support slat  330  of the platform  310  about the central portion  323 . The pivot controlling means  360  comprises an inflatable bladder  361  comprising a first inflatable chamber  361   a  and a second inflatable chamber  361   b  disposed one above the other. The bladder  361  is disposed at the underside of the support platform  310 , between the support platform  310  and the base  340 . Each support element  320  comprises a respective inflatable bladder  361  and the bladders  361  are inflated and deflated using a pump  370   a  which is controlled via a control unit  370   b . The pump  370   a  is fluidly coupled to the bladders  361  via a conduit or fluid path, and the bladder  361  associated with each support element  320  may be separately addressable, to permit a selective inflation and deflation thereof. 
     Each inflatable bladder  361  comprises at least two inflatable chambers  361   a ,  361   b . This allows greater control over the inflation and in particular, the pivotal range through which the support elements  320  can be pivoted. The inflatable chambers  361   a ,  361   b  of each element  320  may be fluidly coupled or fluidly isolated from each other. In situations where the chambers are fluidly coupled, then the fluid connection between the chambers may be provided by a valve (not shown) which is arranged to open and thus admit fluid into a second chamber  361   b , only once a pre-determined pressure has been applied to the first chamber  361   a , for example. Alternatively, the chambers  361   a ,  361   b  of the bladder  361  of each element  320  may be inflated and deflated via a respective fluid conduit  375 . 
     Referring to  FIGS. 9 and 10  of the drawings, there is illustrated a patient turning apparatus  300  according to the second embodiment, disposed upon a bed frame  200  configured in a flattened configuration and profiled configuration respectively, with the first plurality of support elements  320   a  pivoted about the central portion  323 . 
     The apparatus  300 , namely the support platform  310  and base  340 , may be enclosed within a removable cover  380  ( FIG. 11 ). The cover  380  is arranged to minimise the ingress of any dirt or infectious material. Referring to  FIG. 11  of the drawings, there are shown different configurations of the patient turning apparatus  300  according to the second embodiment. The reconfigurable nature of the platform  310  and base  340  permits the apparatus to be configured in a rolled configuration for storage, as illustrated in  FIG. 11 a   . This stowed configuration reduces the space occupied by the apparatus so that it can be easily stored when not required and/or transported. 
     During use, when the apparatus is required for use, the apparatus is first reconfigured from the stowed configuration by unrolling the apparatus (as shown in  FIG. 11 b    with the cover  380  removed) upon a support frame of a bed frame and a mattress or equivalent is then placed upon the apparatus. When it is necessary to turn a patient (not shown) lying upon the apparatus  300 , the user initiates a turning sequence via the control unit  370   b . However, it is to be appreciated that this turning sequence may be initiated automatically at pre-set times for example. 
     Referring to  FIG. 12 , there is illustrated a method  400  of turning a patient upon a bed, according to an embodiment of the present invention. During a turning sequence, the control unit instructs the pump  370   a  to commence an inflation of the bladders  361 , and principally the first chamber  361   a  of the bladders  361 , associated with the first plurality of support elements  320   a , to cause the first plurality of support elements  320   a  to pivot through a first pivot range at step  401  (as illustrated in  FIG. 7 ), and thus partially turn the patient to one side. 
     The control unit  370   b  subsequently instructs the pump  370   a  to commence an inflation of the bladders  361 , and principally the first chamber  361   a  of the bladders  361 , associated with the second plurality of support elements  320   b , to cause the second plurality of support elements  320   b  to pivot through a second pivot range at step  402 , which is less than the first pivot range. This pivoting of the second plurality of support elements  320   b  is to support the patient to prevent the patient from completely rolling over during the turning process. 
     The control unit  370   b  subsequently instructs the pump  370   a  to further inflate the bladder  361  of the first plurality of support elements  320   a  and principally the second chamber  361   b  of the bladders  361  associated with the first plurality of support elements  320   a , to cause the first plurality of support elements  320   a  to pivot beyond the first pivot range at step  403  (as illustrated in  FIGS. 8, 11   c  and  11   d  (cover  380  removed) for example) to turn the patient. 
     Once the patient has turned onto their side, the control unit  370   b  instructs the pump  370   a  to deflate the bladders  361  associated with the second plurality of support elements  320   b , and then subsequently instructs the pump  370   a  to deflate the bladders  361  associated with the first plurality of support elements  320   a , so that the support platform  310  becomes deflated and thus flattened upon the underlying support frame  210  of the bed. 
     The method has the advantages that gentle tilting of a patient can occur and reduce the risk of flipping or tipping the patient out of a bed when repositioning them. The two steps of increase the tilt on one side is interspersed with the increase, to a lesser amount, the tilt applied on the other side; this forms a cradle or barrier to halt a patient&#39;s motion from the tilt on the one side. Furthermore, subsets of the first and/or second plurality of support elements  320   a ,  320   b  may be controlled separately to other elements  320 . This allows for a tilt to be applied to different positions of the patient, and the degree of tilt or turning can be varied for example, by progressively increasing a tilt at a lower portion of the patients body at a rate greater than an upper portion of a patients body—this is less likely to disturb a sleeping patient and reduce patient momentum associated with the turning process. The timing and duration associated with the inflation (and deflation) of the bladders  361  of the support elements  320 , can also be varied using the control unit  370   b , to minimize discomfort to the patient. For example, and owing to a weight differential associated with different parts of a patients body, different support elements  320   a ,  320   b  may be pivoted at different rates to ensure that the patient is turned in a controlled manner. 
     It will be appreciated that the invention as described above provides benefits for the healthcare of patients.