Detection and classification methodology for movements in the bed that supports continuous pressure injury risk assessment and repositioning compliance.

Pressure injuries are costly to the healthcare system and mostly preventable, yet incidence rates remain high. Recommendations for improved care and prevention of pressure injuries from the Joint Commission revolve around continuous monitoring of prevention protocols and prompts for the care team. The E-scale is a bed weight monitoring system with load cells placed under the legs of a bed. This study investigated the feasibility of the E-scale system for detecting and classifying movements in bed which are relevant for pressure injury risk assessment using a threshold-based detection algorithm and a K-nearest neighbor classification approach. The E-scale was able to detect and classify four types of movements (rolls, turns in place, extremity movements and assisted turns) with >94% accuracy. This analysis showed that the E-scale could be used to monitor movements in bed, which could be used to prompt the care team when interventions are needed and support research investigating the effectiveness of care plans.

[1]  Ann N. Tescher,et al.  All At-Risk Patients Are Not Created Equal: Analysis of Braden Pressure Ulcer Risk Scores to Identify Specific Risks , 2012, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[2]  Tom Defloor,et al.  Adherence to pressure ulcer prevention guidelines in home care: a survey of current practice. , 2008, Journal of clinical nursing.

[3]  D. Berlowitz,et al.  Longitudinal Pressure Ulcer Rates After Adoption of Culture Change in Veterans Health Administration Nursing Homes , 2016, Journal of the American Geriatrics Society.

[4]  Nancy Bergstrom,et al.  The National Pressure Ulcer Long‐Term Care Study: Pressure Ulcer Development in Long‐Term Care Residents , 2004, Journal of the American Geriatrics Society.

[5]  Geoff Fernie,et al.  Toward mitigating pressure injuries: Detecting patient orientation from vertical bed reaction forces , 2020, Journal of rehabilitation and assistive technologies engineering.

[6]  J. Rubin,et al.  Pressure Ulcer Monitoring Platform-A Prospective, Human Subject Clinical Study to Validate Patient Repositioning Monitoring Device to Prevent Pressure Ulcers. , 2020, Advances in wound care.

[7]  Dan Ding,et al.  Design and focus group evaluation of a bed-integrated weight measurement system for wheelchair users , 2016, Assistive technology : the official journal of RESNA.

[8]  Jian Liu,et al.  Motion Scale: A Body Motion Monitoring System Using Bed-Mounted Wireless Load Cells , 2016, 2016 IEEE First International Conference on Connected Health: Applications, Systems and Engineering Technologies (CHASE).

[9]  Henry T. Stelfox,et al.  Efficacy of a pressure-sensing mattress cover system for reducing interface pressure: study protocol for a randomized controlled trial , 2015, Trials.

[10]  N. Bergstrom,et al.  The Braden Scale for Predicting Pressure Sore Risk , 1987, Nursing research.

[11]  M. Curry,et al.  Hospital‐Acquired Pressure Ulcers: Results from the National Medicare Patient Safety Monitoring System Study , 2012, Journal of the American Geriatrics Society.

[12]  Isabelle Guyon,et al.  An Introduction to Variable and Feature Selection , 2003, J. Mach. Learn. Res..

[13]  D. Nadzam,et al.  Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs. , 2011, Joint Commission journal on quality and patient safety.

[14]  S. Bergquist,et al.  Subscales, Subscores, or Summative Score: Evaluating the Contribution of Braden Scale Items for Predicting Pressure Ulcer Risk in Older Adults Receiving Home Health Care , 2001, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[15]  D. Berlowitz,et al.  Adherence to Pressure Ulcer Prevention Guidelines: Implications for Nursing Home Quality , 2003, Journal of the American Geriatrics Society.

[16]  A.M. Adami,et al.  Detection and Classification of Movements in Bed using Load Cells , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[17]  V. Vapnik Estimation of Dependences Based on Empirical Data , 2006 .

[18]  J. Kottner,et al.  Relation between pressure, friction and pressure ulcer categories: a secondary data analysis of hospital patients using CHAID methods. , 2011, International journal of nursing studies.

[19]  Z. Moore,et al.  A review of PU prevalence and incidence across Scandinavia, Iceland and Ireland (Part I). , 2013, Journal of wound care.

[20]  David Pickham,et al.  Pressure Injury Prevention Practices in the Intensive Care Unit: Real-world Data Captured by a Wearable Patient Sensor. , 2018, Wounds : a compendium of clinical research and practice.

[21]  E. Zimlichman,et al.  Using Continuous Motion Monitoring Technology to Determine Patient’s Risk for Development of Pressure Ulcers , 2011, Journal of patient safety.

[22]  N. Altman An Introduction to Kernel and Nearest-Neighbor Nonparametric Regression , 1992 .

[23]  C. Álvarez-Nieto,et al.  Risk assessment scales for pressure ulcer prevention: a systematic review. , 2006, Journal of advanced nursing.