Patent Publication Number: US-11653872-B2

Title: Patient support apparatus having vital signs and sepsis display apparatus

Description:
PRIORITY CLAIM 
     This application claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Application No. 62/811,565, filed Feb. 28, 2019, which is expressly incorporated by reference herein. 
    
    
     BACKGROUND 
     The present disclosure is related to patient support apparatuses having alerting capabilities. More specifically, the present disclosure is related to patient support apparatuses that include sensors for monitoring vital signs and structures for alerting caregivers when the vital signs are unacceptable. 
     Patients in healthcare facilities may have a risk of developing sepsis during their stay. Sepsis is a negative condition or response that a person&#39;s body has to an infection. Sepsis results when a person&#39;s immune system stops fighting or has an insufficient response to an infection Sepsis risk assessments of patients oftentimes take place on a sporadic basis with prolonged periods transpiring between the assessments. Furthermore, the results of risk assessments are sometimes only available at a limited number of locations in the healthcare facility such as at an electronic medical records computer or at a computer of a master nurse station. Accordingly, there is a need in the healthcare field to have more timely information regarding the risk assessments of sepsis and there is a need for the risk assessment information to be more readily available to caregivers. 
     SUMMARY 
     The present application discloses one or more of the features recited in the appended claims and/or the following features which, alone or in any combination, may comprise patentable subject matter: 
     In a first aspect of the present disclosure, a patient support apparatus includes a sensor, a controller, and a sepsis-status notification system. The sensor provides signals indicative of vital signs of a patient positioned on the patient support apparatus. The controller is coupled to the sensor and includes a processor and a memory device, the memory device including instructions that, when executed, cause the controller to receive the first and second sensor signals, compare the signals to pre-established acceptable limits, calculate a sepsis risk assessment score based on the signals, and, if the sepsis risk assessment score is at or above a predetermined value, output a command signal. The sepsis-status notification system responds to the command signal from the controller to display a first visual indication that shows that the patient is septic and display second visual indication that shows a status of a sepsis protocol administration. 
     In some embodiments, the vital signs include at least one of temperature, respiratory rate, heart rate, and blood pressure. 
     In some embodiments, the first visual indication includes an alert that shows the patient is septic and second visual indication includes a timer that measures how long the patient has been septic. 
     In some embodiments, the timer is a countdown timer that displays an amount of time remaining in the sepsis protocol administration. 
     In some embodiments, the controller is configured to communicate with an external nurse call station and the visual indications are transmitted for display at a nurse call station. 
     In some embodiments, the second visual indication further includes an iconic representation of the procedures performed on the patient since sepsis was determined to be present. 
     In some embodiments, at least one of the first and the second visual indications includes a projection of a light on a floor around the patient support apparatus. 
     In some embodiments, the at least one of the first and the second visual indications includes an alert message on an interface coupled to the patient support apparatus. 
     In some embodiments, the alert message includes at least one of a textual indication that the patient is septic, an iconic representation that the patient is septic, and a timer. 
     In some embodiments, the controller is configured to communicate with an electronic medical record system to receive information from the electronic medical record system indicative of a medical history of a patient supported on the patient support apparatus. 
     In some embodiments, the controller is configured to compare the signals provided by the sensor to a list of predetermined conditions stored in the electronic medical record system to determine if the patient is septic. 
     In some embodiments, the controller is configured to provide the command signal if at least one of the vital signs deviates from acceptable limits and at least one of the predetermined conditions is present in the patient&#39;s electronic medical record. 
     In some embodiments, the controller is configured to compare the predetermined conditions to pre-established acceptable limits. 
     In some embodiments, the controller is configured to provide the command signal when at least one vital sign deviates from an acceptable limit and at least one predetermined condition deviates from the acceptable limit. 
     In some embodiments, the predetermined condition includes at least one of low blood pressure and a change in mental status. 
     In some embodiments, at least one of the first and the second visual indications includes an indicator panel that has a first color when no command signal is provided and has a second color, different from the first color when the command signal is provided. 
     In some embodiments, the controller is configured to communicate with an external device and display the at least one of the first and the second visual indications that the patient is septic on a screen of the external device. 
     In some embodiments, the sensor simultaneously detects a first vital sign and a second vital sign. 
     In some embodiments, the patient support apparatus includes a plurality of sensors each simultaneously detecting at least one vital sign of the patient. 
     In some embodiments, the plurality of sensors each detects both the first vital sign and the second vital sign. 
     In some embodiments, the controller is configured to receive signals from the plurality of sensors indicative of the position of a patient supported on the patient support apparatus, the controller is configured to utilize the position of the patient to determine whether to disregard the vital sign information from one of the plurality of sensors. 
     In some embodiments, the controller is configured to prompt a user to suspend the operation of the notification system based on the position of the patient. 
     In some embodiments, the notification system is configured to project the first visual indication to a surface spaced apart from the patient support apparatus. 
     In some embodiments, the first visual indication is simultaneously displayed at a surface of the patient support apparatus and projected onto the surface spaced apart from the patient support apparatus. 
     In some embodiments, the first visual indication is projected to the surface spaced apart from the patient support apparatus by a projector located on the patient support apparatus. 
     In some embodiments, displaying the first iconic representation in a first manner comprises displaying the first iconic representation in a first color and displaying the first iconic representation in a second manner comprises displaying the first iconic representation in a second color different than the first color. 
     In some embodiments, providing the visual indication includes simultaneously displaying a first iconic representation of the component on a surface of the patient support apparatus in a first color and projecting the first iconic representation of the component on the surface spaced apart from the patient support apparatus in the first color. 
     In some embodiments, the surface spaced apart from the patient support apparatus is the surface of a floor, the first iconic representation being projected to a position that is not directly below any portion of the patient support apparatus. 
     In a second aspect of the present disclosure, a patient support apparatus includes a first sensor, a second sensor, a controller, and a notification system. The first sensor provides a first signal indicative of a first vital sign of a patient supported on the patient support apparatus and a second sensor provides a second signal indicative of a second vital sign of the patient different than the first vital sign indicated by the first sensor. The controller is coupled to the sensors and includes a processor and a memory device, the memory device including instructions that, when executed, cause the controller to receive the first and second sensor signals, analyze an electronic medical record storing patient information for the patient, compare the signals and the patient information to pre-established acceptable limits, calculate a sepsis risk assessment score based on the signals and the patient information, and, if the sepsis risk assessment score is at or above a predetermined value, output a command signal. The notification system responds to the command signal from the controller to provide at least one visual indication that shows that the patient is septic. 
     Additional features, which alone or in combination with any other feature(s), including those listed above and those listed in the claims, may comprise patentable subject matter and will become apparent to those skilled in the art upon consideration of the following detailed description of illustrative embodiments exemplifying the best mode of carrying out the invention as presently perceived. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The detailed description particularly refers to the accompanying figures in which: 
         FIG.  1    is a perspective view of a patient support apparatus including a sepsis monitoring unit according to the present disclosure; 
         FIG.  2    is a flowchart describing a process of determining the presence of sepsis and providing an indication of the presence of sepsis using a sepsis-status notification system; 
         FIG.  3    is a perspective view of the patient support apparatus of  FIG.  1    including a plurality of devices included in the sepsis-status notification system used to display the indication; 
         FIG.  4 A  is an enlarged view of an indicator panel coupled to the patient support apparatus displaying a visual indication that the patient is septic; 
         FIG.  4 B  is an enlarged view of a mobile device held by a caregiver displaying a visual indication that the patient is septic; 
         FIG.  4 C  is an enlarged view of graphical user interface on a side rail of the patient support apparatus displaying a visual indication that the patient is septic; 
         FIG.  4 D  is an enlarged view of an external monitor displaying a visual indication that the patient is septic; 
         FIG.  5    is another enlarged view of the graphical user interface displaying an action list with statuses for each procedure that should be competed after the patient is diagnosed with sepsis; and 
         FIG.  6    is a diagrammatic view of portion of the patient support apparatus along with a related flowchart. 
     
    
    
     DETAILED DESCRIPTION 
     Referring to  FIG.  1   , a patient support apparatus  10  is illustratively embodied as a hospital bed  10 . The hospital bed  10  includes an integrated sepsis monitoring unit  100  including a sepsis-status notification system  110 . The sepsis monitoring unit  100  is configured to utilize data from a multitude of sources and, when appropriate, instruct the sepsis-status notification system  110  to provide an indication that the patient is at-risk for sepsis or has been diagnosed with sepsis. If the patient is diagnosed with sepsis, the sepsis-status notification system  110  is also configured to monitor a status of a sepsis protocol administration and provide an indication of that status. 
     The sepsis protocol includes a list of actions or procedures that should be administered to the patient within a three hour period and a six hour period beginning at the time the patient is diagnosed with sepsis or otherwise determined to be septic. For example, within the three hour protocols and timeframe, the following actions should be taken: 1) obtain blood cultures, 2) obtain a lactate measurement, 3) administer broad spectrum antibiotics, and 4) administer fluids crystalloid. Within a six hour protocol and timeframe, the following additional actions should be taken: 1) administration of vasopressors for non-responsive resuscitation, 2) maintaining adequate central venous pressure (CVP) and mixed venous oxygen content (CvO2) levels, and 3) obtaining a second lactate measurement if the first lactate measurement was high. Compliance with the sepsis protocols can increase the patient&#39;s chance of survival after being diagnosed with sepsis. The sepsis-status notification system  110  is configured to increase compliance with the protocols by notifying the caregiver and others near the patient if the patient is at-risk or diagnosed with sepsis, an amount of time that has passed, and a status of the actions that need to be completed for compliance with the protocols. 
     Sepsis may be detected using risk assessments that may vary between each healthcare facility. Some non-limiting examples of scores used to determine if a patient is at-risk for sepsis include a quick sequential (sepsis-related) organ failure assessment score (qSOFA) and/or systematic inflammatory response syndrome score (SIRS). Each method includes a set of criteria such as vital signs and/or other conditions that are defined by pre-established acceptable limits and are triggered when the patient deviates from those acceptable limits. Other examples of assessments or tests used to determine if a patient is at risk for sepsis are described in U.S. Provisional Patent Appl. No. 62/655,385, filed Apr. 10, 2018, which is expressly incorporated by reference herein. The sepsis-status notification system  110  may be programmed to operate with any assessment, test, or score criteria relating to sepsis including those that evolve as medical procedures advance. 
     When determining the patient&#39;s qSOFA or SIRS score, a point is assigned for each vital sign and/or other medical condition that deviates from the accepted pre-established limits. When either the qSOFA score or the SIRS score reach a predetermined value, the patient is flagged as being at-risk for sepsis. The qSOFA score is defined within a range of 0-3 points. To determine the qSOFA score, the patient is assigned one point for each deviation from the following accepted pre-established limits: 1) respiratory rate greater than or equal to 22 breaths per minute, 2) systolic blood pressure less than or equal to 100 mm Hg, and 3) a change in mental status (e.g. Glasgow Coma Scale less than 15). If a patient is assigned at least 2 points on the qSOFA score, the patient is at-risk for sepsis. 
     The SIRS score is defined within a range of 0-4. To determine the SIRS score, the patient is assigned one point for each deviation from the following accepted pre-established limits: 1) a body temperature greater than 100.4 degrees Fahrenheit or less than 96.8 degrees Fahrenheit, 2) a heart rate greater than 90 bpm 3) a respiratory rate greater than 20 breaths per minute, and 4) a white blood cell count greater than 12,000 cells/mm 3 , less than 4000 cells/mm 3 , or greater than 10% immature (band) forms. If a patient is assigned at least 2 points on the SIRS score, the patient is at-risk for sepsis. 
     In the illustrative embodiment, the hospital bed  10  further includes at least one sensor  102  mounted to a deck section of the hospital bed  10  and a control system  104  coupled to the sensor  102  as shown in  FIG.  1   . The sensor  102  is configured to provide sensor signals indicative of vital signs of the patient laying on the hospital bed  10 . In one embodiment, the control system  104  is configured to receive the sensor signals and compare the sensor signals to the pre-established acceptable conditions described above to determine if the patient is at-risk or should be diagnosed with sepsis. In another embodiment, the sensor signals and information stored on the patient&#39;s EMR  106  are both compared to pre-established acceptable conditions to determine if the patient is at-risk or should be diagnosed with sepsis. 
     In the illustrative embodiment, the sensor  102  is a non-contact vital signs monitoring sensor available from EarlySense Inc., 135 Beaver Street Suite 307, Waltham, Mass. 02452. It provides a signal indicative of vital signs, such as, for example, a detected heart rate and a signal indicative of a detected respiration rate that is processed by the control system  104 . This sensor  102  is described in greater detail in U.S. Patent Pub. No. 2018/0184984 which is expressly incorporated herein for the purpose of describing a suitable sensor used to detect patient vital signs. The sensor  102  may be mounted in multiple locations on either the fixed seat deck  32  or head deck  28  as suggested in  FIG.  1   . In some embodiments, multiple sensors  102  may be positioned on the fixed seat deck  32  and/or head deck  28  to provide multiple detection points with the signals from each of the multiple sensors  102  being monitored to determine an accurate vital sign signal. The use of redundant signals reduces the risk of signal loss due to movement or improper positioning of the patient on the hospital bed  10 . The sensor  102  has a relatively thin thickness that permits the sensor  102  to be placed under the mattress  54  and does not interfere with the functionality or therapeutic benefit of the mattress  54 . In other embodiments, a different piezoelectric sensor may be utilized in place of the sensor  102 . In another embodiment, the sensor  102  may be positioned inside of the mattress  54 . 
     In other embodiments, additional sensors may be wearable by the patient and communicatively connected to the control system  104  to provide signals indicative of vital signs of the patient. Alternatively, the wearable device or sensor may be specifically designed to detect the presence of sepsis such that the scoring methods described above are omitted and/or used in conjunction with the wearable device. 
     As shown in  FIG.  2   , the sepsis monitoring unit  100  uses the sensor  102  and the control system  104  to monitor the patient&#39;s risk for sepsis at step  116 . At step  118 , the sepsis monitoring unit  100  then determines whether the patient is at-risk for sepsis or should be diagnosed with sepsis based on the vital sign signals provided by the sensor  102  and the information stored on the patient&#39;s EMR  106 . The vital signs and the information on EMR  106  are compared to the pre-established acceptable limits to provide a sepsis assessment score using one of the scoring methods described above or another suitable sepsis assessment method. 
     At step  120 , the control system  104  may determine that additional tests should be performed to determine definitively if the patient is septic and send a command signal to cause the sepsis-status notification system  110  to indicate such information to a caregiver. Alternatively, the control system  104  may send a command signal as soon as the patient is determined to be at-risk for sepsis to cause the sepsis-status notification system  110  to indicate to a caregiver that the patient is septic and start monitoring the protocols. 
     Once the patient is determined to be at-risk or diagnosed with sepsis, the control system  104  sends a command signal to the sepsis-status notification system  110  to cause the sepsis-status notification system  110  to provide the indication to the caregiver at step  122 . The indication notifies the caregiver that the patient is septic and notifies the caregiver of a status of the patient&#39;s protocols. The indication provided by the sepsis-status notification system  110  may include a visual indication or an audible indication. Additionally, the indication may be displayed on or around the hospital bed  10  or transmitted wirelessly to a remote location through the hospital network  108 . At step  124 , the sepsis monitoring unit  100  continues monitoring and updating the indications provided by the sepsis-status notification system  110  in real time until administration of the protocols is completed. 
     The view shown in  FIGS.  1  and  3    is generally taken from a position that is oriented at the left side, foot end of the hospital bed  10 . For purposes of orientation, the discussion of the hospital bed  10  will be based on the orientation of a patient supported on the hospital bed  10  in a supine position. Thus, the foot end  12  of the hospital bed  10  refers to the end nearest the patient&#39;s feet when the patient is supported on the hospital bed  10  in the supine position. The hospital bed  10  has a head end  14  opposite the foot end  12 . A left side  16  refers to the patient&#39;s left when the patient is lying in the hospital bed  10  in a supine position. The right side  18  refers to the patient&#39;s right. When reference is made to the longitudinal length of the hospital bed  10 , it refers a direction that is represented by the lines that generally extend between the head end  14  and foot end  12  of the hospital bed  10 . Similarly, lateral width of the hospital bed  10  refers to a direction that is represented by the lines that generally extend between the left side  16  and right side  18 . 
     The hospital bed  10  includes a base frame  20  which supports a lift system  22 . The lift system  22  engages the base and an upper frame  24  such that the lift system  22  moves the upper frame  24  vertically relative to the base frame  20 . The lift system  22  includes a head end linkage  27  and a foot end linkage  29 . Each of the linkages  27  and  29  are independently is configured and may be operated to cause the hospital bed  10  to move into a tilt position which is when the head end  14  of the upper frame  24  is positioned lower than the foot end  12  of the upper frame  24 . The hospital bed  10  may also be moved to a reverse tilt position with the foot end  12  of the upper frame  24  is positioned lower than the head end  14  of the upper frame  24 . 
     The upper frame  24  supports a load frame  26 . The load frame  26  supports a head deck  28  which is movable relative to the load frame  26 . The load frame  26  also supports an articulated seat deck  30  (seen in  FIG.  3   ), also movable relative to the load frame  26  and a fixed seat deck  32  (also seen in  FIG.  3   ). Also supported from the load frame  26  is a foot deck  34  that is articulated and moveable relative to the load frame  26 . The foot deck  34  in the illustrative embodiment of  FIG.  1    provides for powered pivoting of the foot deck  34  and manual extension and retraction of the foot deck  34  to vary the length of the foot deck  34 . In other embodiments, powered pivoting of the foot deck  34  may be omitted and the related movement may be caused manually, or follow movement of the articulated seat deck  30 . In addition, in some embodiments, extension and retraction of the foot deck  34  may be powered by an actuator. 
     The foot deck  34  includes a first portion  36  and a second portion  38 , which moves relative to the first portion  36  to vary the size of the foot deck  34 . The second portion  38  moves generally longitudinally relative to the first portion  36  to vary the longitudinal length of the foot deck  34  and, thereby, the longitudinal length of the hospital bed  10 . 
     A foot panel  40  is supported from the second portion  38  and extends vertically from an upper surface  42  of the second portion  38  to form a barrier at the foot end  12  of the hospital bed  10 . A head panel  44  is positioned on an upright structure  46  of the base frame  20  and extends vertically to form a barrier at the head end  14  of the hospital bed  10 . A left head siderail  48  is supported from the head deck  28  and is moveable between a raised position shown in  FIG.  1    and a lowered position as is known in the art. A right head siderail  50  is also moveable between the raised position of  FIG.  1    and lowered position. As shown in  FIG.  1   , in the raised position, the siderails  48  and  50  extend above an upper surface  52  of a mattress  54  of the hospital bed  10  when the siderails  48  and  50  are in a raised position. In a lowered position an upper edge  56  of the left head siderail  48  is below the upper surface  52 . 
     The hospital bed  10  also includes a left foot siderail  58  and a right foot siderail  60 , each of which is supported directly from the load frame  26 . Each of the siderails  48 ,  50 ,  58 , and  60  are is configured to be lowered to a position below the upper surface  52 . It should be noted that when the head deck  28  is moved, the head siderails  48  and  50  move with the head deck  28  so that they maintain their relative position to the patient. This is because both of the head siderails  48  and  50  are supported by the head deck  28 . 
     Referring to the left head siderail  48  shown in  FIG.  12   , a user interface  62  includes a hard panel  64  and a graphical user interface  66 . The hard panel  64  provides indications to a user regarding the status of certain functions of the hospital bed  10  as well as providing a standard set of fixed input devices. The graphical user interface  66  includes a touchscreen display that provides information to a user as well as allowing for flexible, menu driven, operation of certain functions of the hospital bed  10 . The graphical user interface  66 , also known as a flip-up display (FUD), is mounted to the siderail  48  with a pivotable connection so that the graphical user interface  66  may be pivoted to allow a user the more easily view and interact with the graphical user interface  66 . In some embodiments, the right head siderail  50  may include a second graphical user interface duplicative of the graphical user interface  66 . 
     As shown in  FIG.  3   , the control system  104  provides all of the functionality necessary to operate the sepsis monitoring unit  100  and includes a system on a module (SOM)  164  and a master controller (MCB)  166 . The sensor  102  communicates through a universal asynchronous receiver/transmitter (UART) connection  162  with the SOM  164 . The SOM  164  is connected to and communicates with the MCB  166  through a UART connection  168 . The SOM  164  is configured to communicate with hospital network  108  through a connection  174  and can connect to external systems, such as nurse call systems or other hospital wide communications systems such as the NaviCare® system from Hill-Rom Company, Inc., Batesville, Ind. using the hospital network  108 . This allows information regarding the vital signs detected, including alarm conditions, to be transferred to other locations in the hospital or other facility in which the hospital bed  10  is located. 
     The sepsis-status notification system  110  displays indications that the patient is septic using a plurality of device as shown in  FIGS.  3 - 5 D . The MCB  166  communicates with each device through a connection  178  or wirelessly using the SOM  164  and the hospital network  108 . The connection  178  may be a simple UART interface, a CAN interface, a discrete wiring connection, or any other suitable connection. Each of the connections  162 ,  168 ,  170 ,  174 ,  178 , and  184  may be a simple UART interface, a CAN interface, a discrete wiring connection, or any other suitable connection as required for the particular application. Relative to the sepsis-status notification system  110 , the MCB  166  includes a processor  165  and a non-transitory memory device  167  that stores instructions. When appropriate, the instructions are executed to operate the sepsis monitoring unit  100  and display the indications. Some of the processing and instructions may be resident on the SOM  164  as it relates to specific tasks to be executed under the direction of the MCB  166 . 
     As shown in  FIG.  3   , the sepsis-status notification system  110  can display the indications using the graphical user interface  66 , a mobile device  68  used by the caregiver, an indicator panel  70  on the hospital bed  10 , and/or one or more monitors  72  located in the room where the hospital bed  10  and the patient are located. The mobile device  68  is illustratively embodied as a tablet, such as an iPad®, that is carried by the caregiver during rounds. The indicator panel  70  is coupled to the foot end  12  of the hospital bed  10 , but may be located on any part of the hospital bed  10  that is easily viewable. The monitor  72  is illustratively embodied as a vitals monitor but may also include a computer monitor or a television screen located in the room. Other devices located in a remote location, such as, for example, a nurse call station, may also be used. 
     In one example, when the SIRS, qSOFA, or other sepsis assessment score is below their predetermined values, the notification system  110  may cause the devices to display a green color to signal to the caregiver that the patient does not have sepsis. Once either of the SIRS, qSOFA, or another sepsis assessment score exceeds their predetermined value, the notification system  110  may cause the devices to display a red color to signal that the patient has been diagnosed with sepsis and action is needed. In some embodiments, the notification system  110  projects an image  83  and the colors on the floor around the hospital bed so that a caregiver may be able to see the data in real time at a distance. In other embodiments, the image  83  and/or the colors may be flashed in the appropriate respective color. 
     As shown in  FIGS.  3  and  4 A , the indicator panel  70  is configured to display several visual indications that indicate that the patient is septic and action is needed. The indicator panel  70  includes a first section  76  with a light that is displayed in a first color prior to the patient being diagnosed with sepsis. Once the patient has been diagnosed with sepsis, the MCB  166  is configured to send a command signal to display the light on the indicator panel  70  in a second color that is different than the first color. The second color notifies the caregiver than the patient is septic and action is needed. The indicator panel  70  further includes a second section  78  that is configured to display a timer  81  indicating an amount of time remaining in the sepsis protocols. The location of the indicator panel  74  makes the statuses of the conditions easily discernable from a distance, such that a caregiver may quickly ascertain the statuses from the hallway or the door of a patient&#39;s room. The indicator panel  70  may further include one or more projectors  80  for projecting the image  83  including a light  85  and a timer  87  on the floor around the hospital bed  10 . The light  85  may have a first color, such as green, to indicate an absence of sepsis and a second color, such as red or amber, to indicate that the patient has been diagnosed with sepsis. An example of a suitable projector is described in U.S. Patent Pub. No. 2018/0184984 which is expressly incorporated by reference herein for the description of a suitable projector that can project images and/or light on a surface. 
     The timer  87  is illustratively embodied as a countdown timer  87  that begins counting at the time the sepsis monitoring unit  100  first determines that the patient is septic. However, in another embodiment, the timer  87  may measure time elapsed after the sepsis monitoring unit  100  first determines that the patient is septic. The timer  87  may count down from three hours indicating that the patient is within the sepsis three hour protocol administration. After completion of the three hour protocol administration the control system  104  may update the timer  87  to track the sepsis six hour protocol administration. The control system  104  may issue additional indications during protocol administration to remind caregivers of actions that need to be completed within each protocol. In some embodiments, the additional indications are provided in response to the timer  87  reaching a predetermined time in the protocol. In other embodiments, the additional indications are provided in response to updates in the patient&#39;s treatment of sepsis, such as, for example, upon completion of one of the actions required during protocol administration. 
     As shown in  FIGS.  3  and  4 B- 4 D , the sepsis-status notification system  110  may also use the other devices  66 ,  68 , and  72  to indicate that the patient is septic and action is needed. The MCB  166  is configured to send a command signal to one or more of the devices  66 ,  68 ,  72  to cause the devices to display an alert message  74  when the patient is diagnosed with sepsis. The MCB  166  may also send a command signal to one or more of the devices  66 ,  68 ,  72  to cause the devices to provide an audible alert to notify the caregiver to check the device or to audibly convey the alert message  74 . The alert message  74  includes information indicating to the caregiver that the patient is septic and information related to the status of the sepsis protocols administration. For example, each time the patient is scanned during rounds or connected to a new device with a monitor, the MCB  166  is configured to send the command signal to the device to cause the alert message  74  to be displayed. Additionally, the alert message  74  may be displayed multiple times during protocol administration to remind caregivers of actions to be taken as described above. 
     As shown in  FIG.  5   , the illustrative alert message  74  displayed on the screen of each device  66 ,  68 ,  72  includes information that helps the caregiver determine what actions are needed for compliance with the sepsis protocols. The alert message  74  includes a timer  82  and an action list  84 . The timer  82  is similar to timer  87  and includes the time when the patient was first diagnosed with sepsis (i.e. time 0) and a countdown timer displaying an amount of time remaining for one or more of the protocols to be completed. The action list  84  includes a list of all of the actions that should be taken in the protocols and the status of each action. The action list  84  displays the status of each of these action in real time. The caregiver may manually update the action list  84  by changing the status in the alert message  74 . Alternatively, the action list  84  may be updated automatically as the control system  104  communicates with the hospital network  108  or another wireless device and the actions are completed. 
     The action list  84  may display the status of each of the actions in several different ways as shown in  FIG.  5   . If an action still needs to be completed, the alert message  74  displays a first representation  90  to indicate to a caregiver that action is still needed. Once the action is completed, the alert message  74  displays a second representation  92  that the action no longer needs to be completed. The first representation  90  may include an icon, color, and/or text that indicate to the caregiver that action is needed. Conversely, the second representation  92  may include a different icon, color, and/or text from the first representation that indicate to the caregiver that no action is needed. Some actions may have a period of time during which their status is pending, such as, for example, when results are pending after a test is completed. In those instances, the alert message  74  displays a third representation  94  with a different icon, color, and/or text from the first and second representations  90 ,  92  indicating that the status is pending. 
     As shown in  FIG.  5   , the device  66  is also configured to display other information in additional to the alert message  74  and/or the action list  84 . The additional information may include the patient&#39;s vitals, other patient information, and/or information related to the hospital bed  10 . The information related to the hospital bed may include a position of the one or more sections of the hospital bed  10  and an indication of features that are included the hospital bed  10 . 
     In operation, the notification system  110  is configurable to allow or prevent the indication capabilities of the devices  66 ,  68 ,  70 ,  72 . A caregiver may choose to disable the devices in the notification system  110  when the caregiver determines that the operation of the devices  66 ,  68 ,  70 ,  72  is unnecessary or would be problematic with a particular patient. In an effort to avoid unnecessary alert conditions, detection and notification system  160  utilizes a process  360  shown in  FIG.  7    to determine whether an alert condition is warranted. The signals from the load cells  330 ,  332 ,  334 , and  336  are provided to the bed controller  166  which makes a determination from the signals, using process  360 . At process step  362 , the controller  166  reads the load cell data. The load cell data is then analyzed at a decision step  364  to determine if a patient is supported on the bed. If the patient is determined not to be in the bed at decision step  364 , then the controller  166  proceeds to step  366 , overrides the heart rate and respiration rate alert conditions, and provides a message on the graphical user interface  66  that the patient is out of the bed  10 . 
     In some cases, the notification system  110  may go into an alert state relative to the patient exiting the bed as disclosed in the PCT application WO2016/196403 which is expressly incorporated by reference for the teaching of a patient exit detection system. However, alerts related to vital signs would be invalid and, in embodiments where the process  360  is applied, will cause the alerts to be ignored. However, if the patient is determined to be in bed at step  364 , the controller  166  proceeds to step  368  and informs the notification system  110  that vital signals are expected from the sensor  102 . The process  360  then proceeds to step  370  and the notification system  110  operates normally. 
     In some embodiments, the controller  166  may determine from the load cells  330 ,  332 ,  334 , and  336  that a patient is in a particular location on the bed  10 . If more than one sensor  102  is present on the bed  10 , then the controller  166  may use the information regarding the patient location to discount one or more of the sensor  102  signals to ensure that the best signal is being considered in the determination of the vital signs. In addition, the controller  166  may consider the angle of the head deck  28  in making the determination as to which of multiple sensors  102  should be used in the analysis. For example, if the head deck  28  is raised to an extreme angle, then a sensor  102  positioned in a back section may be discounted or disregarded. 
     Although certain illustrative embodiments have been described in detail above, variations and modifications exist within the scope and spirit of this disclosure as described and as defined in the following clauses and claims.