Patent Description:
In order to prevent pressure injuries, conventional practices rely on evaluation of the individual by a caregiver based on the Braden scale. Such practices, however, rely on the subjective evaluation by the caregiver of a number of equally weighted risk factors at a single point in time. Although the Braden scale is used for nearly <NUM>% of pressure injury assessments, over <NUM>% of pressure injuries developed by individuals were not predicted by the Braden scale.

<CIT> describes a method comprising receiving an input indicative of at least one factor that contributes to the development of pressure ulcers; determining a risk score as a function of the input; comparing the risk score to a previous risk score; and at least one of activating a therapy configured to reduce the magnitude of the factor and notifying a caregiver if the risk score is greater than the previous risk score.

<CIT> describes apparatus for assessing medical risks of a patient. The apparatus includes an analytics engine and equipment that provides data to the analytics engine. The equipment includes a patient support apparatus such as a patient bed, a nurse call computer, a physiological monitor, a patient lift, a locating computer of a locating system, and an incontinence detection pad. The analytics engine analyzes the data from the equipment to determine a sepsis risk score, a falls risk score, and a pressure injury score. The apparatus further include displays that are communicatively coupled to the analytics engine and that display the sepsis, falls, and pressure injury risk scores. The displays include a status board display located at a master nurse station, an in-room display provided by a room station of a nurse call system, an electronic medical records (EMR) display of an EMR computer, and a mobile device display of a mobile device of a caregiver assigned to the patient.

<CIT> describes a person support apparatus that may support a person in a laying-down or a seated position. One or more sensors, which may be operably coupled to the person support apparatus, monitor changes in the position of a person situated on the person support apparatus. A control system receives output from the sensor or sensors over a period of time, while the person is positioned on the person support apparatus. The control system makes a determination relating to the activity and/or mobility of the person positioned on the person support apparatus. The control system may use the activity and/or mobility determination to control a feature of the person support apparatus, or for other purposes.

Accordingly, a need exists for systems and methods that determine an objective pressure injury score and alter a treatment plan based on the same. The present invention is defined by the appended claims <NUM>-<NUM>.

According to some embodiments of the present disclosure, a system includes a plurality of load sensors coupled to a person support apparatus configured to support a person on a support surface of the person support apparatus, at least one moisture sensor positioned between the person and the support surface configured to sense a moisture level between the person and the support surface, and at least one computing device coupled to the plurality of sensors coupled to the person support apparatus and the at least one moisture sensor. The at least one computing device includes a processor and memory storing computer readable and executable instructions that, when executed by the processor, cause the computing device to: receive data from the plurality of load sensors coupled to the person support apparatus and the at least one moisture sensor, calculate, using a motion assessment module, a mobility score indicative of a mobility of the person based on the data from the plurality of load sensors, the mobility score being a function of changes in magnitude of sensor inputs received by the plurality of load sensors over a time interval defined for mobility monitoring, obtain data from an electronic medical record associated with the person supported by the person support apparatus, calculate a pressure injury score indicative of a likelihood that the person will develop a pressure injury by adjusting the healthcare facility baseline value based on the mobility score, the moisture level sensed by the at least one moisture sensor, and data obtained from the electronic medical record, the healthcare facility baseline value being a general baseline pressure injury value for the facility and indicative of the likelihood that a person being treated at the facility will develop a pressure injury; and alter a treatment plan for the person based on the calculated pressure injury score.

A person support apparatus <NUM> including a frame <NUM> and a person support surface <NUM> is shown in <FIG>. The frame <NUM> includes a base <NUM>, an upper frame assembly <NUM>, and a lift system <NUM> coupling the upper frame assembly <NUM> to the base <NUM>. The lift system <NUM> is operable to raise, lower, and tilt the upper frame assembly <NUM> relative to the base <NUM>. The person support apparatus <NUM> has a head end <NUM> and a foot end <NUM>, and further includes a footboard <NUM> at the foot end <NUM> and a headboard <NUM> at the head end <NUM> of the person support apparatus <NUM>. The headboard <NUM> is coupled to an upstanding portion <NUM> of the base <NUM> at the head end <NUM> of the person support apparatus <NUM>. The footboard <NUM> is coupled to the upper frame assembly <NUM>. The base <NUM> includes wheels or casters <NUM> that roll along a floor (not shown) as the person support apparatus <NUM> is moved from one location to another. A set of foot pedals <NUM> is coupled to the base <NUM> and is used to brake and release the casters <NUM>.

As shown in <FIG>, the person support apparatus <NUM> has four siderail assemblies coupled to the upper frame assembly <NUM>. The four siderail assemblies include a pair of head siderail assemblies <NUM> (sometimes referred to as head rails) and a pair of foot siderail assemblies <NUM> (sometimes referred to as foot rails). Each of the siderail assemblies <NUM>, <NUM> is movable between a raised position, as shown in <FIG>, and a lowered position (not shown). Siderail assemblies <NUM>, <NUM> are sometimes referred to herein as siderails <NUM>, <NUM>. Each siderail <NUM>, <NUM> includes a linkage <NUM> coupled to the upper frame assembly <NUM> and configured to guide the siderails <NUM>, <NUM> between the raised and lowered positions.

The upper frame assembly <NUM> includes a lift frame <NUM>, a weigh frame <NUM> supported with respect to the lift frame <NUM>, and a person support deck <NUM>. The person support deck <NUM> is carried by the weigh frame <NUM> and engages a bottom surface of the person support surface <NUM>. The person support deck <NUM> includes a head section <NUM>, a seat section <NUM>, a thigh section <NUM>, and a foot section <NUM>, as shown in <FIG>. In various embodiments, sections <NUM>, <NUM>, and <NUM> are each movable relative to the weigh frame <NUM>. For example, the head section <NUM> may pivotally raise and lower relative to the seat section <NUM>, the foot section <NUM> may pivotally raise and lower relative to the thigh section <NUM>, and the thigh section <NUM> may articulate relative to the seat section <NUM>. Additionally, in some embodiments, the foot section <NUM> may extend and retract to change the overall length of the foot section <NUM> and, therefore, to change the overall length of the person support deck <NUM>.

In the embodiment depicted in <FIG>, the seat section <NUM> is fixed in position with respect to the weigh frame <NUM> as the person support deck <NUM> moves between its various positions including a horizontal position (shown in <FIG>) and a chair position (not shown). In other embodiments, the seat section <NUM> also moves relative to the weigh frame <NUM>, such as by pivoting and/or translating. In such embodiments, the thigh and foot sections <NUM>, <NUM> may also translate along with the seat section <NUM>. In the chair position, the head section <NUM> extends upwardly from the weigh frame <NUM> and the foot section <NUM> extends downwardly from the thigh section <NUM>.

Additionally, the person support apparatus <NUM> includes four foot pedals 146a, 146b, 146c, 146d coupled to the base <NUM>. In embodiments, the foot pedals may be used to raise and lower portions of the person support apparatus <NUM>. For example, foot pedal 146a may be used to raise the upper frame assembly <NUM> relative to the base <NUM>, the foot pedal 146b may be used to lower the upper frame assembly <NUM> relative to the base <NUM>, the foot pedal 146c may be used to raise the head section <NUM> relative to the weigh frame <NUM>, and the foot pedal 146d may be used to lower the head section <NUM> relative to the weigh frame <NUM>. In other embodiments, one or more of the foot pedals may be omitted, or additional foot pedals may be included.

In embodiments, each siderail <NUM> includes a first user control panel <NUM> coupled to the outward side of the siderail <NUM> and each siderail <NUM> includes a second user control panel <NUM> coupled to the outward side of the siderail <NUM>. The control panels <NUM>, <NUM> include various buttons that may be used by a caregiver to control associated functions of the person support apparatus <NUM>. For example, the first user control panel <NUM> may include buttons that are used to operate a motor to raise and lower the head section <NUM>, buttons that are used to operate a motor to raise and lower the thigh section <NUM>, and buttons that are used to operate motors to raise lower, and tilt the upper frame assembly <NUM> relative to the base <NUM>. The second user control panel <NUM> may include buttons that are used to operate a motor to raise and lower the foot section <NUM> and buttons that are used to operate a motor to extend and retract the foot section <NUM>.

In various embodiments, one or more components of the person support apparatus <NUM> are coupled to a computing device <NUM>, which is configured to sense and/or collect information from the components coupled thereto, process the information, and perform one or more actions based on the information. The computing device <NUM> may additionally provide various resources to the person support apparatus <NUM>. Resources include providing, for example, processing, storage, software, and information from other systems in the facility to the person support apparatus <NUM>. In various embodiments, as will be described in greater detail below, the computing device <NUM> can calculate a pressure injury score based on information sensed or collected from various components of the person support apparatus <NUM>, other sensors coupled to the computing device <NUM>, and the electronic medical record (EMR) for the person. The components may be coupled wirelessly to the computing device <NUM>, such as through a network <NUM>, or the components may be coupled to the computing device <NUM> via wires. Accordingly, in some embodiments, one or more components of the person support apparatus <NUM> may include wireless communication circuitry, or be communicatively coupled to wireless communication circuitry incorporated into the person support apparatus <NUM> (not shown).

The computing device <NUM> may be any device having hardware (e.g., chipsets, processors, memory, etc.) for communicatively coupling with the network <NUM>. Specifically, the computing device may be a mobile device, a desktop computing device, or a computing device incorporated into or attached to the person support apparatus <NUM>, depending on the particular embodiment. For example, the computing device <NUM> may be a smart phone, a tablet device, an e-reader, a laptop computer, a desktop computer, or a computer associated with the person support apparatus <NUM>. In various embodiments, the computing device <NUM> may be a device accessible by one or more caregivers, such as a computing device located at a nurses' station, in a doctor's office, or carried by the caregiver. In various embodiments, the computing device <NUM> can include an analytics engine, such as the analytics engine described in <CIT>, entitled "Patient Risk Assessment Based on data from Multiple Sources in a Healthcare Facility". For example, the analytics engine can perform any or all of the functions attributed herein to the computing device <NUM>, including, without limitation, receiving data from sensors, calculating a pressure injury score, and altering a treatment plan for the person based on the calculated pressure injury score, as described herein.

Moreover, in various embodiments, the computing device <NUM> may be a digital safety net (DSN) platform, as described in greater detail in <CIT>. In such embodiments, the DSN platform may include an analytics engine, a Power over Ethernet (PoE) switch, a router or gateway that receives data from a multitude of sources as described herein and routes risk assessment information to a plurality of output devices such as graphical displays or mobile computing devices assigned to caregivers.

In various embodiments, the computing device <NUM> includes one or more non-transitory memory components, one or more processing devices, a display <NUM>, a speaker, at least one input device, and network interface hardware. The one or more non-transitory memory components store computer readable and executable instructions that, when executed by the processor, cause the computing device <NUM> to perform one or more functions described herein. In particular, the one or more non-transitory memory components may store computer readable and executable instructions that, when executed by the processor, cause the computing device <NUM> to perform the functions of the various modules described hereinbelow, including but not limited to, analyzing data from one or more components of the person support apparatus <NUM>, calculating a pressure injury score, causing a pressure injury score to be logged in an electronic medical record corresponding to the individual and/or altering a treatment plan for the individual. The at least one input device can include, by way of example and not limitation, a microphone, a keyboard, a touch screen, a mouse, or the like. The network interface hardware may depend on the particular embodiment, and may include the hardware to enable the computing device <NUM> to communicate via the network. The display can include any medium capable of transmitting an optical output such as, for example, a cathode ray tube, light emitting diodes, a liquid crystal display, a plasma display, or the like. Moreover, in some embodiments, the display is a touchscreen that, in addition to providing visual information, detects the presence and location of a tactile input upon a surface of or adjacent to the display. The computing device <NUM> may include additional or fewer components, depending on the particular embodiment. For example, in embodiments in which the computing device <NUM> is a smart phone, it may further include cellular network hardware and a microphone and not include a mouse, while in embodiments in which the computing device <NUM> is a desktop computing device, it may include a keyboard and a mouse and not include a touch screen.

In various embodiments, the computing device <NUM> is communicatively coupled to one or more input devices of the person support apparatus <NUM> that collect information indicative of mobility of a person or other factors that may influence the development of a pressure injury. For example, in various embodiments, the person support apparatus <NUM> may include sensors such as load cells 152a-152d, an angle sensor <NUM>, a moisture sensor <NUM>, or the like, that provide data to the computing device <NUM> which calculates a pressure injury score based on the received data. Various input devices and methods for calculating a pressure injury score will now be described.

In various embodiments, the person support apparatus <NUM> includes a number of load cells (collectively, load cells <NUM>) positioned between the weigh frame <NUM> and the base <NUM>. Each load cell is configured to produce a voltage or current signal indicative of a weight impressed on that load cell from the weigh frame <NUM> relative to the base <NUM>. In the embodiment shown in <FIG>, four load cells 152a, 152b, 152c, and 152d are positioned between the weigh frame <NUM> and the base <NUM>; one at or proximate to each corner of the person support apparatus <NUM>, although only two of the load cells 152a and 152c can be seen in <FIG>. However, all four load cells 152a, 152b, 152c, and 152d are shown in <FIG>.

Some of the structural components of the person support apparatus <NUM> will be designated hereinafter as "right," "left," "head," and "foot" from the reference point of an individual lying on the individual's back on the person support surface <NUM> with the individual's head oriented toward the head end <NUM> of the person support apparatus <NUM> and the individual's feet oriented toward the foot end <NUM> of the person support apparatus <NUM>. For example, the weigh frame <NUM> illustrated in <FIG> includes a head end weigh frame member 134c mounted to one end of a right side weigh frame member 134a and at an opposite end to one end of a left side weigh frame member 134b. Opposite ends of the right side weigh frame member 134a and the left side weigh frame member 134b are mounted to a foot end weigh frame member 134d. A middle weigh frame member 134e is mounted at opposite ends to the right and left side weigh frame members 134a and 134b, respectively, between the head end and foot end weigh frame members 134c and 134d.

A right head load cell (RHLC) 152a is illustratively positioned near the right head end of the person support apparatus <NUM> between a base support frame 106a secured to the base <NUM> near the head end <NUM> and the junction of the head end weigh frame member 134c and the right side weigh frame member 134a, as shown in the block diagram of <FIG>. A left head load cell (LHLC) 152b is illustratively positioned near the left head end of the person support apparatus <NUM> between the base support frame 106a and the junction of the head end weigh frame member 134c and the left side weigh frame member 134b. A right foot load cell (RFLC) 152c is illustratively positioned near the right foot end of the person support apparatus <NUM> between a base support frame 106b secured to the base <NUM> near the foot end <NUM> of the person support apparatus <NUM> and the junction of the foot end weigh frame member 134d and the right side weigh frame member 134a. A left foot load cell (LFLC) 152d is illustratively positioned near the left foot end of the person support apparatus <NUM> between the base support frame 106b and the junction of the foot end weigh frame member 134d and the left side weigh frame member 134b. In the embodiment depicted in <FIG>, the four corners of the person support deck <NUM> are shown extending beyond the four corners of the weigh frame <NUM>, and hence beyond the positions of the four load cells 152a-152d.

In the illustrated embodiment, each of the load cells 152a-152d are weight sensors comprising resistive strain gauges coupled to a deflectable block (not shown), and structurally couple the weigh frame <NUM> to the base <NUM>. It will be appreciated, however, that other weight detection devices may be used. Such devices may include, but are not limited to, linear variable displacement transducers (LVDTS) and/or other weight detection devices operable in accordance with known capacitive, inductive, or other physical principles. Moreover, alternative person support apparatuses can be employed, including but not limited to, air mattresses or the like.

In various embodiments, the load cells 152a-152d generate a signal which is transmitted to the computing device <NUM>. In other words, the load cells 152a-152d generate load cell data that is transmitted to the computing device <NUM>. As will be described in greater detail below, the computing device <NUM> receives the load cell data and, using a load pattern analysis module <NUM>, may analyze the load cell data (e.g., waveforms) received from the load cells 152a-152d in order to detect a mobility level for a person supported on the person support apparatus <NUM>. For example, the load pattern analysis module <NUM> may determine that a particular waveform is indicative of a possible patient turn, a person changing positions on the person support apparatus, a general degree of movement within the person support apparatus, or the like.

Returning to <FIG>, in various embodiments, the person support apparatus <NUM> further includes an angle sensor <NUM> coupled to the computing device <NUM>. The angle sensor <NUM> may be, for example, an accelerometer that operates as part of a head of bed angle monitoring system, such as the head of bed angle monitoring system described in <CIT>, and entitled "Head of bed angle mounting, calibration, and monitoring system". The angle sensor <NUM> detects an angle of the head of the bed. In embodiments, the angle sensor <NUM> is positioned on the back side (e.g., a side opposite the person support surface) of the articulating head section <NUM> of the person support deck <NUM> such that the angular position of the angle sensor <NUM> follows the angular position of the head section <NUM> through the full range of articulation. However, it is contemplated that the angle sensor <NUM> may be coupled to another suitable portion of the head section <NUM>, such as, for example, a frame member, a deck panel, a portion of the mattress, or a siderail <NUM> that moves along with the head section <NUM>. The angle sensor <NUM> is oriented such that a measurement axis of the angle sensor <NUM> enables the angle sensor <NUM> to measure dynamic acceleration along the measurement axis over time. In embodiments, the angle sensor <NUM> may further measure static acceleration. The static acceleration measurement represents the orientation of the measurement axis of the angle sensor <NUM> relative to the force of gravity, which is vertical to the true horizon.

As the head section <NUM> is moved from one position to a different position, the measurement axis experiences sufficient changes in gravitational force to resolve the head of bed angle degree changes throughout the range of movement within a specified margin of error. In embodiments, the output generated by the angle sensor <NUM> is transmitted to the computing device <NUM>, which processes the output, including, for example, amplifying the output, and using the output to calculate a pressure injury score.

Still referring to <FIG>, various embodiments further include at least one moisture sensor <NUM> coupled to the computing device <NUM>. The moisture sensor <NUM> may be, for example, a moisture sensor that operates as part of a moisture detection system, such as the moisture detection system described in <CIT>, and entitled "Moisture detection system". In embodiments, the moisture sensor <NUM> detects a moisture level between a person supported on the person support surface <NUM> and the person support surface <NUM>. The moisture sensor <NUM> may be, by way of example and not limitation, a capacitive sensor, a resistive sensor, or a thermally conductive sensor. It should be appreciated that other types of moisture sensors may be employed.

The moisture sensor <NUM> of various embodiments may be external to the person support apparatus <NUM>, such as a sensor disposed on top of the person support surface <NUM>, or it may be integrated into the person support apparatus <NUM>, such as positioned between a core layer and a ticking of the person support surface <NUM>. Moreover, the moisture sensor <NUM> may be positioned at any one or more locations along the length and width of the person support apparatus <NUM>. In various embodiments, the moisture sensor <NUM> is positioned at a seat area of the person support apparatus <NUM> such that the moisture sensor <NUM> can detect, for example, incontinence.

In some embodiments, the moisture sensor <NUM> may be coupled to a moisture detection sheet (not shown). The moisture detection sheet may be made of any suitable material, including organic, inorganic, or synthetic materials or fabrics. In some embodiments, fibers of the moisture detection sheet may serve as moisture sensors <NUM>. In embodiments including a moisture detection sheet, the moisture detection sheet may absorb moisture between the person supported on the person support apparatus <NUM> and the person support surface and/or redistribute and direct the moisture to the moisture sensor <NUM>.

As described above, the moisture sensor <NUM> is coupled to the computing device <NUM> and conveys data to the computing device <NUM> in the form of electrical signals indicative of the moisture level between the person supported on the person support apparatus <NUM> and the person support surface. Communication between the moisture sensor <NUM> and the computing device <NUM> may be wired or wireless. In embodiments, the moisture sensor <NUM> may transmit raw data regarding the moisture level to the computing device <NUM>, while in other embodiments, the moisture sensor <NUM> may include components to enable the moisture sensor <NUM> to determine a moisture level and transmit the moisture level to the computing device <NUM>. The computing device <NUM> of various embodiments may utilize the moisture level to calculate the pressure injury score.

Additional sensors coupled to the computing device <NUM> may further be used to collect data for use in calculating a pressure injury score. For example, a physiological monitor <NUM> (shown in <FIG>) for sensing data regarding a blood pressure, a temperature, or another physiological parameter, including without limitation, a heart rate, a respiration rate, a blood oxygen saturation level, of the person may be coupled to the computing device <NUM>. Such physiological monitors may be standalone monitors, or may be integrated into the person support apparatus <NUM>, as described in <CIT>. As with the other sensors and monitors described herein, the physiological monitor <NUM> are communicatively coupled to the computing device <NUM> via wires or wirelessly, and may transmit data to the computing device <NUM> regarding one or more physiological parameters for the person supported by the person support apparatus <NUM>. In embodiments, raw data may be transmitted to the computing device <NUM> by the physiological monitor <NUM>, or the physiological monitor <NUM> may transmit final calculations regarding the physiological parameter to the computing device <NUM>. In some particular embodiments, the physiological parameter may be saved into the EMR for the person along with a time stamp indicative of the time that the physiological parameter was measured.

<FIG> is a schematic block diagram illustrating components of the computing device <NUM>. In various embodiments, the computing device <NUM> includes a pressure injury score calculation module <NUM> and a motion assessment module <NUM>. It is contemplated that other modules may be included, depending on the particular embodiment.

In various embodiments, the pressure injury score calculation module <NUM> is adapted to calculate a pressure injury score indicative of a likelihood that the person supported on the person support apparatus <NUM> will develop a pressure injury. In particular, the pressure injury score calculation module <NUM> is adapted to analyze the data from the load cells <NUM> (and/or the motion assessment module <NUM>), angle sensor <NUM>, moisture sensor <NUM>, physiological monitor <NUM>, and combinations thereof to objectively determine whether the person is likely to develop a pressure injury. For example, in various embodiments, the pressure injury score calculation module <NUM> may utilize a non-linear regression model which bounds a probability of developing a pressure injury between <NUM> and <NUM> to determine whether the person is likely to develop a pressure injury. In the various embodiments described herein, the computing device <NUM> may provide a notification regarding the pressure injury score to a caregiver via one of the user interfaces described herein, and/or cause a treatment plan for the person to be altered.

The computing device <NUM> may include circuitry (not shown) for processing the raw signal generated by the load cells 152a-152d, the angle sensor <NUM>, the moisture sensor <NUM>, and/or the physiological monitor <NUM>, such as at least one pre-amplifier, at least one filter, and an analog-to-digital (A/D) converter. The filter may be a band-pass or a low-pass filter. The low-passed data may be digitized at an appropriate sampling rate (e.g., <NUM>) and stored in memory. After the A/D converter converts the amplified and filtered signal, it is passed to the motion assessment module <NUM> for assessment of the mobility and/or activity level of the person and/or to the pressure injury score calculation module <NUM> for calculation of the pressure injury score.

The motion assessment module <NUM> may be used to assess a person's activity and/or mobility based on at least information from the load cells <NUM>. As used herein, the term "mobility" refers to a person's ability to offload themselves (e.g., egress), or make relatively minor changes in the position of their body, or an extremity thereof, while they are supported by a person support apparatus, without assistance from another person. Some examples of changes in position that are representative of a person's mobility include rolling from one's side onto the back or front, rolling from the back or front onto one's side, lifting or turning the head, raising or lowering an arm or leg, bending a knee or elbow, and flexing a foot or wrist.

In some embodiments, a person's motion may be considered separately from a person's activity level, as is described in <CIT>.

In various embodiments, the motion assessment module <NUM> receives one or more inputs, such as from the load cells <NUM>. It is contemplated that other inputs may be received by the motion assessment module <NUM> and used to calculate the mobility and/or activity score, such as inputs regarding a pressure of one or more air bladders forming or supporting the person support surface. In various embodiments, the mobility score is a function of the changes in magnitude of sensor inputs received by the load cells <NUM> over a time interval defined for mobility monitoring. In embodiments, the motion assessment module <NUM> can analyze the data, and particularly, the number and frequency of changes in the magnitude of inputs over the defined mobility monitoring time interval, in order to focus on sensor inputs indicative of mobility and/or activity rather than physiological signals and, in some embodiments, activity. Other factors that can affect the motion assessment include person's weight, body type, or other factors. Activity and mobility can also change as a function of time as the factors influencing those scores change.

The mobility or activity scores may be derived, for example, by mapping the results of the analysis to predetermined or threshold values. The predetermined values and corresponding mobility and activity scores may be stored in computer memory, such as in the form of a lookup table. Additional details on analysis of the data and derivation of the mobility score are provided in <CIT>.

In various embodiments, the mobility score is communicated from the motion assessment module <NUM> to the pressure injury score calculation module <NUM> and may be used by the pressure injury score calculation module <NUM> to calculate a pressure injury score. In particular, a higher mobility score (corresponding to a lower mobility) may indicate a higher risk of developing a pressure injury and a lower mobility score may indicate a higher degree of mobility and, thus, a lower risk of developing a pressure injury. For example, a mobility score of "<NUM>" may indicate that a person is completely immobile, i.e., unable to make even slight changes in the position of the body or an extremity without assistance. A mobility score of "<NUM>" may indicate that a person's mobility is very limited, but the person is not completely immobile, and can make occasional slight changes in position of the body or extremity, but is unable to make frequent or significant changes without help. A mobility score of "<NUM>" may indicate that the person's mobility may be only slightly limited and that the person is able to make frequent, though slight, changes in position of the body or extremity without assistance. A mobility score of "<NUM>" may indicate that the person has no limitations relating to mobility, and can make frequent and major changes in position without assistance. Accordingly, an assessment of a person's mobility can include an assessment of a change in position (e.g., whether the person moved from laying down to sitting up, or merely raised their head) and an assessment of the frequency of such changes in position (e.g., how often the person makes even minor changes in position).

In various embodiments, an activity score is communicated from the motion assessment module <NUM> to the pressure injury score calculation module <NUM> and may be used by the pressure injury score calculation module <NUM> to calculate a pressure injury score. In particular, a higher activity score (corresponding to a lower activity) may indicate a higher risk of developing a pressure injury and a lower activity score may indicate a higher degree of activity and, thus, a lower risk of developing a pressure injury. For example, an activity score of "<NUM>" may indicate that a person did not exit the bed at all during a predetermined time period. An activity score of "<NUM>" may indicate that a person's activity is very limited, but the person very occasionally exits and re-enters the bed, such as a couple of times per day. An activity score of "<NUM>" may indicate that the person's activity may be only slightly limited and that the person is able to frequently exit and re-enter the bed without assistance. An activity score of "<NUM>" may indicate that the person has no limitations relating to activity, and can frequently exit and re-enter the bed without assistance. Accordingly, an assessment of a person's activity can include an assessment of a number of times the person exited and re-entered the bed.

<FIG> depicts an example method <NUM> of altering a treatment plan based on a calculated pressure injury score. The method <NUM> may be performed, for example, by the pressure injury score calculation module <NUM> on the computing device <NUM>. As described herein, the method begins by receiving data from various sensors (step <NUM>). The various sensors may include, by way of example and not limitation, the angle sensor <NUM>, the load cells <NUM>, the moisture sensor <NUM>, physiological monitors <NUM>, and the like.

Although in embodiments, the computing device <NUM> is described as receiving or collecting information from the angle sensor <NUM>, the load cells 152a-152d, the moisture sensor <NUM>, and the physiological monitor <NUM>, it is contemplated that any number of separate computing devices may be employed. For example, the angle sensor <NUM> may be communicatively coupled to one computing device while the load cells 152a-152d are communicatively coupled to a second computing device including the motion assessment module <NUM>, with each computing device performing analysis on the data it receives. For example, the computing device communicatively coupled to the load cells 152a-152d, and specifically, the motion assessment module <NUM>, may perform a mobility analysis for the person to determine a motion level based on movement of the person on the person support apparatus <NUM>. Moreover, it should be understood that additional and/or alternative inputs may be employed depending on the particular embodiment. For example, in some embodiments, the person support surface <NUM> may include one or more pressure sensors that can detect movement of a patient based on a redistribution of pressure over the person support surface <NUM>. Such systems may be used for predicting egress of an individual from the person support apparatus <NUM>, and the data may be additionally analyzed by the motion assessment module to determine motion of the person or otherwise calculate the pressure injury score. Additional details on systems for use in predicting egress may be found in <CIT>, entitled "Occupant Egress Prediction Systems, Methods, and Devices.

Next, at step <NUM>, data from person's electronic medical record (EMR) is obtained. For example, the pressure injury score calculation module <NUM> may obtain information regarding previous clinical events stored in the person's EMR, such as may be stored on an EMR server <NUM>. Accordingly, as depicted in <FIG>, the pressure injury score calculation module <NUM> may be communicatively coupled to an EMR server <NUM> storing the EMR for the person. However, it is contemplated that, in some embodiments, the EMR may be stored on the computing device <NUM>. Regardless of where it is stored, the EMR may provide to the computing device <NUM> information such as, by way of example and not limitation, data regarding previous or existing pressure injuries, an age of the person, the sex of the person, medication administered to the person, an amount of time the person was in an operating room, an indication that the person has diabetes, and nutritional information related to the person. Additionally, as described above, one or more physiological parameters for the person may be stored in the EMR and provided to the computing device <NUM>.

Returning to <FIG>, at step <NUM>, the pressure injury score is calculated. In various embodiments, the pressure injury score calculation module <NUM> calculates a pressure injury score by adjusting a baseline pressure injury value upwards or downwards, depending on the data received from the various sensors. The baseline pressure injury value is a facility baseline value that is determined based on the likelihood that a person being treated at a particular facility will develop a pressure injury. For example, the facility baseline value may be a value of from <NUM> to <NUM>, where <NUM> indicates that the facility very rarely has persons develop pressure injuries and <NUM> indicates that the facility very frequently has persons develop pressure injuries. In some particular embodiments, the baseline pressure injury score may be the percentage of individuals that develop a pressure injury in the facility, expressed as a decimal.

In the embodiments described herein, the pressure injury score calculation module <NUM> may modify the baseline pressure injury value by weighting the data received from the various sensors described herein. The weighting may be determined according to an importance to the particular factor in the development of a pressure injury or in the prevention of a pressure injury. As but one example, the mobility score received from the motion assessment module <NUM> may be accorded the greatest weight (e.g., <NUM>-<NUM> times greater than any other factor), while an indication that the person supported by the person support apparatus <NUM> is male may be weighted less heavily. The weighting of the factors may depend on, for example, the amount of data received by the pressure injury score calculation module <NUM> and the particular non-linear regression employed. It is contemplated that any suitable non-linear regression may be employed to calculate the pressure injury score, provided that the model bounds the probability between <NUM> and <NUM>.

The influence of various factors, the sensor(s) from which the data pertaining to each factor is obtained, and example weighting for each factor are provided in Table <NUM>.

The baseline pressure injury value is adjusted up or down based on the weighted factors, and the result, in various embodiments, is the pressure injury score. The pressure injury score may be stored in the person's EMR and updated at particular periods of time, such as every <NUM> hours, every <NUM> hours, every <NUM> hours, every <NUM> hours, every <NUM> hours, or every <NUM> hours, for example. In embodiments, the pressure injury score may be a value between <NUM> and <NUM>, where <NUM> indicates that person is very unlikely to develop a pressure injury and <NUM> indicates that the person is certain to develop pressure injuries.

By way of example, in various embodiments, a baseline pressure injury score is <NUM> for an individual that is within a demographic and possesses the average characteristics for an individual treated at a particular facility (e.g., average age, average weight, and no comorbidities that would increase the risk of a pressure injury). When an individual is admitted, a new pressure injury risk score may be calculated based on their characteristics which may increase that risk. For an individual that has an average age and average weight for that facility, the pressure injury score remains at <NUM>. However, when the individual is a male, the pressure injury score increases by a factor of <NUM>, giving a pressure injury score of <NUM>. An existing pressure injury was recorded in the individual's EMR, increasing the risk by a factor of <NUM>, increasing the score to <NUM>. Accordingly, the individual's pressure injury score at admission was <NUM>.

Consider that, during the time the individual is in the facility, the person support apparatus determines that the individual is only able to make small shifts in his weight (e.g., diminished mobility), increasing his score from <NUM> by a factor of <NUM> to <NUM>. Then, the individual has an incontinence event, which increases the score by a factor of <NUM>, giving a pressure injury score of <NUM>. After a few days in the facility, the individual is admitted to the intensive care unit (ICU) (increasing the pressure injury score by a factor of <NUM>) and administered vasopressors (further increasing the pressure injury score by a factor of <NUM>), and his pressure injury score increases to <NUM>. Based on the progression of the pressure injury score of the individual during his time in the facility, his treatment plan is not adjusted based on the pressure injury score at admission (<NUM>), but the treatment plan is subsequently modified as it is determined that he has limited mobility based on the adjusted score. Specifically, following the individual's admission to the ICU, the treatment plan may be adjusted based on the calculated pressure injury score, as it has increased from medium risk to high risk.

In addition to calculating and causing the pressure injury score to be stored in the person's EMR, in various embodiments, the computing device <NUM> alters a treatment plan for the person based on the calculated pressure injury score (step <NUM>). The treatment plan may be altered, for example, by providing suggested treatment steps to a caregiver via the display <NUM> or via a mobile computing device carried or otherwise accessed by the caregiver. Additionally or alternatively, the treatment plan may be altered by transmitting a reminder, alert, or notification to the caregiver.

In some embodiments, alterations to the treatment plan can include turning the person or increasing the frequency with which the person is turned, recommending that an incontinence pad be positioned or replaced between the person and the support surface, recommending a nutrition consult for the person, replacing or altering a support surface on which the person is disposed, or combinations thereof. In some embodiments, alterations to the treatment plan may include providing reminders regarding the angle of the head of the bed, ordering lateral rotation therapy, adjusting a blower coupled to the person support surface, providing a skin care treatment, or the like. As will be appreciated, the particular alterations to the treatment plan may depend on the specific pressure injury score. For example, if the calculated pressure injury score is between <NUM> and <NUM> (on a scale between <NUM> and <NUM>), the score may be saved into the EMR, but the treatment plan may not be altered to include preventative measures. If the calculated pressure injury score is greater than <NUM> and less than or equal to <NUM>, the treatment plan may be altered by providing a turn reminder if the person is not mobile (based on the motion assessment score) and/or recommending that the incontinence pad be replaced. If the calculated pressure injury score is greater than <NUM> and less than or equal to <NUM>, the treatment plan may be altered by providing a turn reminder if the person is not mobile (based on the motion assessment score), recommending that the incontinence pad be replaced, recommending a nutrition consult for the person, and/or adjusting the firmness/softness of the support surface to reduce or redistribute pressure on one or more areas of the person's body. If the calculated pressure injury score is greater than <NUM> and less than or equal to <NUM>, the treatment plan may be altered by providing a turn reminder if the person is not mobile (based on the motion assessment score), recommending that the incontinence pad be replaced, recommending a nutrition consult for the person, adjusting the firmness/softness of the support surface to reduce or redistribute pressure on one or more areas of the person's body, and/or replacing the person support apparatus with a different person support apparatus, such as a person support apparatus including a therapy surface.

As described above, in various embodiments, altering the treatment plan may include providing a suggestion, alert, or notification to a caregiver, such as through a status board, a graphical room station, or a mobile device assigned to a caregiver. Such devices may be associated with a nurse call system, such as the NAVICARE® Nurse Call system available from Hill-Rom Company, Inc. of Batesville, IN. Additional details of suitable nurse call systems, status boards, graphical room stations, and mobile devices can be found in <CIT>; <CIT>; <CIT>; <CIT>; <CIT>; <CIT>; <CIT>; <CIT>; <CIT>; and <CIT> and in <CIT>; <CIT>; <CIT>; <CIT>; and <CIT>. In some embodiments, altering the treatment plan may further include automatically placing an order for one or more items to be provided to the person. For example, if the calculated pressure injury score is greater than <NUM> and less than or equal to <NUM>, the treatment plan may be altered by the computing device <NUM> ordering an incontinence pad to be delivered to the person's room. Other alterations to the treatment plan are contemplated, based on the particular embodiment and facility.

Although the method is described as being performed by a computing device, it is contemplated that in some embodiments, more than one computing device or server communicatively coupled to the network <NUM> may perform one or more of the steps in the method. Accordingly, it should be understood that various facility information systems (e.g., the NaviCare® system from Hill-Rom, EMR systems, the Smart Connect® system from Hill-Rom, and the SmartSync® system from Hill-Rom) may communicate with one another in the various embodiments described herein to perform the functions described. Additionally, it is contemplated that the computing device <NUM> may receive health-related data from network-enabled products in the room and other facility information systems in addition to the data described hereinabove for use in calculating the pressure injury score.

In some embodiments, feedback regarding whether the person later developed a pressure injury (e.g., such as may be included in the person's EMR) may be received by the pressure injury score calculation module <NUM> and used to improve the calculation method (e.g., non-linear model) over time via machine learning techniques.

Moreover, in some embodiments, the computing device <NUM>, and specifically the pressure injury score calculation module <NUM>, may compare treatment plans for different individuals and identify caregivers or treatment practices that produce a decreased risk of pressure injuries, such as fewer overall pressure injuries or less severe pressure injuries. Identification of treatment practices that result in lower pressure injury scores may be used to alter treatment plans for other individuals, as described above.

Claim 1:
A system comprising:
a plurality of load sensors (152a-152d) coupled to a person support apparatus (<NUM>) configured to support a person on a support surface (<NUM>) of the person support apparatus (<NUM>) and configured to sense a mobility of the person on the person support apparatus (<NUM>);
at least one moisture sensor (<NUM>) positioned between the person and the support surface (<NUM>) configured to sense a moisture level between the person and the support surface (<NUM>); and
at least one computing device (<NUM>) coupled to the plurality of sensors and the at least one moisture sensor (<NUM>), the at least one computing device (<NUM>) comprising a processor and memory storing computer readable and executable instructions that, when executed by the processor, cause the computing device (<NUM>) to:
receive data from the plurality of load sensors (152a-152d) coupled to the person support apparatus (<NUM>) and the at least one moisture sensor (<NUM>);
calculate, using a motion assessment module (<NUM>), a mobility score indicative of a mobility of the person based on the data from the plurality of load sensors (152a-152d), the mobility score being a function of changes in magnitude of sensor inputs received by the plurality of load sensors (152a-152d) over a time interval defined for mobility monitoring;
obtain data from an electronic medical record associated with the person supported by the person support apparatus (<NUM>);
calculate a pressure injury score indicative of a likelihood that the person will develop a pressure injury by adjusting a healthcare facility baseline value based on the mobility score, the moisture level sensed by the at least one moisture sensor (<NUM>), and data obtained from the electronic medical record, the healthcare facility baseline value being a general baseline pressure injury value for the facility and indicative of the likelihood that a person being treated at the facility will develop a pressure injury; and
alter a treatment plan for the person based on the calculated pressure injury score.