Hospital beds are designed and constructed to provide safety, comfort, and mobility for a broad range of patients with varying conditions and treatment plans. While the adaptability and versatility of hospital beds and related safety devices allow caregivers to meet the diverse needs of their patients; care must be taken to ensure necessary user training, inspection protocols, and routine maintenance and safety checks are followed.
Falls are the most common type of incident associated with hospital beds, however pressure injuries and entrapments are also notable safety concerns. In this article, Christian Mongrain, Doctor of Physical Therapy and Durable Medical Equipment Expert, provides an overview of hospital bed injuries and proper safety.
Hospital beds are the most common type of durable medical equipment. Despite their name, hospital beds are also used beyond the acute hospital; namely in rehabilitation facilities, nursing homes, and private residences. Given their prolific use, injuries involving hospital beds are not uncommon. These injuries can occur while a patient is positioned in a stationary bed, being transported in a bed, or being transferred into or out of a bed. In this article, the term &#;patient&#; refers to a person receiving care at a health care facility or at a residence, such as a private home or nursing home.
The FDA and the HBSW (Hospital Bed Safety Workshop) have released several informative documents providing guidance for hospital bed safety and strategies for mitigating risks. The Department of Health in several states has chosen to incorporate these documents into their protocol for health care providers.
Hospital bed anatomy & safety features
Bed frame features such as height and position adjustments, casters, and adjustable bed rails distinguish hospital beds from standard beds. Modern hospital beds incorporate a range of safety features that are designed to protect against fall and pressure injuries, assist with patient positioning and mobility, and alert caregivers of a potential mishap. The benefits of these safety features can only be realized through proper training of caregivers and reinforcement of safety protocols.
Patient height, weight, ability to move, diagnosis, and comorbidities must be considered when choosing a hospital bed. After identifying a bed that meets the anthropometric and capacity needs of the patient, providers utilize risk assessment tools (such as the Morse Fall Scale and Braden Risk Assessment Tool) to determine if a patient requires a specialized bed with safety features to assist in preventing falls and/or pressure injuries.
Adjustable settings
Adjustable height settings are a fundamental safety feature of hospital beds. Raising the bed height can reduce the need for patient assistance when standing from a sitting position. Adjusting the bed height can enable a patient to improve balance while seated at the edge of the bed, and lowering the bed height to its lowest height position can reduce the severity of injury in the event of a fall.
Hospital bed frames are usually repositionable in segments. The head of the bed can often be raised independent of the segment of the bed supporting the lower extremities. An additional function enables the knee portion of the bed to be elevated, thereby preventing a patient from sliding into a slouched posture when the head of the bed is elevated. Proper positioning affects the quality of a patient&#;s respirations and is essential for patients suffering from pulmonary compromise due to disease, illness, or injury. Caution, however, must be used when using the adjustable settings on a hospital bed when seating a patient on the edge of the bed as it can create an uneven surface affecting seated balance.
Hospital bed mattress options
Hospital beds commonly have a standard mattress consisting of foam and springs, encased in a protective impermeable cover. To accommodate specific patient needs, several alternative surface options are available. The most common alternative mattress is known as an &#;air mattress.&#; Air mattresses are one intervention commonly assigned to patients having wounds or at risk for pressure injury. Air mattresses are usually powered by external blowers which enable the air pressure within the mattress to be increased or decreased, thereby adjusting the firmness of the mattress. When adjusted appropriately, air mattresses allow a patient to partially &#;sink&#; into the mattress accomplishing distribution of pressure over a greater surface area of a patient&#;s body. When adjusted too firm or too soft, however, the intended benefits of an air mattress can be negated and lead to new or progression of existing pressure injuries.
While air mattresses can offer the patient improved skin protection, they can be more difficult for patient transfer due to surface instability and lower surface friction. Air mattress characteristics and features vary by manufacturer, and should be considered when selecting this intervention to address patient risks.
Settings such as bed height, mattress positioning, and firmness are utilized to maximize comfort and safety for the individual patient&#;s needs. Some specialty mattresses include options for rotation, oscillation, and percussion to assist with managing respiratory secretions. Alternative bed surfaces can optimize skin protection; however they do require appropriate operator settings and do not replace regular repositioning which would relieve pressure on vulnerable areas.
Hospital bed rails & safety devices
Rails on hospital beds are adjustable and are often used to assist in turning and repositioning patients, providing a secure hold grasp for patients, and reducing the risk of fall injuries. However, rails are also associated with strangulation and entrapment injuries, pressure injuries, and more serious fall incidents if a patient climbs/rolls over the barrier or if the rails are not appropriately positioned. Bed rails are not intended as attachment points for restraints. Assessment by the patient&#;s health care team is necessary to determine if and how rails should be utilized to keep the patient safe.
Additional safety devices used in conjunction with hospital beds include floor safety mats, alarms, bolsters, and lighting. Floor mats can be used to attenuate impact in the event of a fall and various alarms can be used to notify health care providers if a patient has left the bed or changed positions. Bolsters or wedges are used for positioning to reduce pressure injuries, and can also provide safety against falls. Specialized lighting can be used to reduce patient confusion associated with waking in a dark unlit room. The patient&#;s care team is responsible for determining the necessary and appropriate hospital bed safety devices that meet the individualized needs of the patient.
Maintenance and inspections
Hospital beds are considered Durable Medical Equipment (DME) and require routine inspection and maintenance. Federal or State laws and regulations (including Life Safety Code requirements adopted as part of Federal regulations) may either require that equipment maintenance (including maintenance, inspection and testing) be performed in accordance with the manufacturer&#;s recommendations, or establish other maintenance requirements. Bed manufacturers and the Department of Health and Human Services direct owners to have hospital beds inspected by a qualified professional, such as a clinical or biomedical technician or engineer.
Common areas for inspection and maintenance include:
All hospital bed incidents must be reported to the bed manufacturer and/or the FDA. The FDA tracks Durable Medical Equipment incidents, issues consumer alerts, and determines if further action is needed (up to and including issuing a recall) based upon the frequency and severity of unintended events.
Incidents involving hospital beds often occur due to provider error or mechanical failure. An investigation of the hospital bed, care records, and witness reports can help determine the cause of the incident. The health care experts at Robson Forensic can analyze the causation behind hospital bed mishaps and the address the relevant standards of care.
For more information, submit an inquiry or contact the author of this article.
Whereas a normal bed is permanently flat, a hospital bed allows the patient or their caregiver to adjust the head and foot sections independently to come to a semi-seated position or raise the legs or knees. This is an important feature for patients who will be spending a significant amount of time in bed.
Foot section. Being able to raise the lower body is a great advantage for patients with a foot or knee injury or a condition that causes swelling in the feet because it encourages blood flow back to the heart.
Head section. The ability to raise the head and back to a semi-sitting position is helpful when the patient wants to watch TV or spend time with visitors. The upper panel can then be lowered again, allowing the patient to sleep comfortably.
Hospital beds, or adjustable medical beds, are made with heavy use in mind. For that reason, the typical hospital bed mattress is made from therapeutic foam that's both comfortable and strong and is covered in a thick, easy-clean vinyl outer layer.
To cushion the patient&#;s pressure points and prevent or treat bed sores, gel, foam, water, and reactive-air overlays are often used on top of the mattress. The head and foot sections of the home hospital bed can also be adjusted to change the patient's position, maximize comfort, and encourage circulation.
Because hospital beds can be raised and lowered vertically, they make it much easier for patients to transfer to a power wheelchair or mobility aid for walking compared to regular beds. This function also makes it easier to transfer the patient from one surface to another using a sit-to-stand lift or a regular patient lift.
Patients with good upper body strength can use the overhead trapeze bar that comes with many hospital beds to help them change positions and go from sitting to standing. For the caregiver, the adjustable height that is a feature of many hospital beds can help to prevent back injuries associated with bending over for long periods of time.
While two people can sleep in a regular bed, hospital beds are made to be used by one patient at a time. In a hospital setting, this is ideal because it gives nurses full access to each patient. However, in a home setting, couples may want to sleep together.
If the patient will only need the hospital bed temporarily while recovering from an illness or surgery, sleeping alone may not be a huge issue and could be the best way to keep the patient safe. For long-term use, consider two hospital beds pushed together (remember to lock the wheels) or an adjustable split-king medical bed.
Because of their utilitarian design, hospital beds typically come in a much smaller range of designs compared to ordinary beds&#;particularly as far as the headboard, footboard, and bed railing are concerned. If you're renting a hospital bed, you will have an even more limited choice of designs from which to choose. Learn the 7 most important factors when renting a hospital bed.
The good news is that&#;as hospital beds become more popular for home use&#;models are now available that look more like traditional beds and can be made to fit your existing decor. If you are looking to buy a hospital bed for long-term use, ask about the options available.
You will get efficient and thoughtful service from KAIRUIJIEDE.
Hospital beds tend to be heavier than regular beds because of the strong frame, electric circuitry, hinges, rails, and head and footboards. Bariatric beds, in particular, weigh a lot more than regular beds thanks to their sturdy construction and extra-large bariatric mattresses. To make them easier to move, hospital beds usually come with wheels or can be broken apart, so you should never have to lift the entire bed.
If you or a loved one requires a hospital bed, consider putting the bed on the ground floor of the home in a room that's easy for the patient and others to access. When renting or purchasing the bed, it's also well worth having it delivered. Don't risk injuring yourself.
Semi-electric hospital beds and full-electric beds&#;such as the ones rented and sold at our Denver, Colorado showroom&#;need to be plugged into a power outlet to power the motor that adjusts the bed. The original manual hospital beds didn't require powering because they were adjusted via a hand crank.
While a manual bed might be too cumbersome for a caregiver who is physically weak, semi-electric beds offer a good compromise&#;the convenience of an electric bed with or without a hand crank to change the vertical height.
When you weigh all factors, hospital beds offer more advantages than disadvantages for a patient who needs additional comfort, safety, and assistance. The few disadvantages that can come with hospital beds (such as separate sleeping, aesthetics, weight, and a power source) are easy to work around and shouldn't be a problem for most.
If you need more help deciding which mobility aids would be most appropriate for yourself or a loved one, consult with your doctor, physical therapist, and an experienced medical supply professional. The right equipment for the right person can have a significant impact on their quality of life.
There are 3 main types of medical beds: manual, semi-electric, and fully electric. There are also options that are more specialized, such as bariatric beds.
Manual beds use hand cranks to raise and lower the head and the foot sections for therapeutic benefits, comfort, and activities such as eating or tv watching and to adjust the height of the bed. These beds are the most economical options and are a good choice for people that do not require frequent repositioning. Hand cranks are typically found at the foot of the bed and require a person that is physically capable to operate.
Semi-electric beds have an electric motor to raise and lower the head and foot portions of the bed. Patients and caregivers adjust the positioning by pressing buttons using a hand pendant. The height of the bed is adjusted manually with a hand crank. Semi-electric beds are ideal for people that do not require the height of the bed to be adjusted often but will benefit from touch of a button positioning. Many semi-electric beds feature battery backup lowering for the head and foot sections in case of an emergency.
Full-electric beds have an electric motor that can raise the head and foot sections of the bed as well as the entire height and positioning of the bed. They are controlled by the patient or caregiver using a hand pendant and do not require the use of a hand crank (unless there is a power outage, but many beds now have a backup battery that would power the bed in emergency situations). Full electric beds often have positions available such as Trendelenburg, reverse Trendelenburg and cardiac chair positions. Full electric beds make it easier for patients to get in and out of bed (lower positions are preferable). They also make it easier for the caregiver to raise the bed to a comfortable height to tend to the patient (higher positions are preferable), or to change linens.
Bariatric beds have a higher weight capacity and often come in wider dimensions. They are typically available for users up to around 600 lb. An example of a bariatric medical bed is the Span Advantage ReadyWide, which expands up to 42&#; and has a 650 lb capacity. Bariatric users may want to consider a ceiling lift to facilitate safe transfers.
Hospital beds are designed and constructed to provide safety, comfort, and mobility for a broad range of patients with varying conditions and treatment plans. While the adaptability and versatility of hospital beds and related safety devices allow caregivers to meet the diverse needs of their patients; care must be taken to ensure necessary user training, inspection protocols, and routine maintenance and safety checks are followed.
Falls are the most common type of incident associated with hospital beds, however pressure injuries and entrapments are also notable safety concerns. In this article, Christian Mongrain, Doctor of Physical Therapy and Durable Medical Equipment Expert, provides an overview of hospital bed injuries and proper safety.
Hospital beds are the most common type of durable medical equipment. Despite their name, hospital beds are also used beyond the acute hospital; namely in rehabilitation facilities, nursing homes, and private residences. Given their prolific use, injuries involving hospital beds are not uncommon. These injuries can occur while a patient is positioned in a stationary bed, being transported in a bed, or being transferred into or out of a bed. In this article, the term &#;patient&#; refers to a person receiving care at a health care facility or at a residence, such as a private home or nursing home.
The FDA and the HBSW (Hospital Bed Safety Workshop) have released several informative documents providing guidance for hospital bed safety and strategies for mitigating risks. The Department of Health in several states has chosen to incorporate these documents into their protocol for health care providers.
Hospital bed anatomy & safety features
Bed frame features such as height and position adjustments, casters, and adjustable bed rails distinguish hospital beds from standard beds. Modern hospital beds incorporate a range of safety features that are designed to protect against fall and pressure injuries, assist with patient positioning and mobility, and alert caregivers of a potential mishap. The benefits of these safety features can only be realized through proper training of caregivers and reinforcement of safety protocols.
Patient height, weight, ability to move, diagnosis, and comorbidities must be considered when choosing a hospital bed. After identifying a bed that meets the anthropometric and capacity needs of the patient, providers utilize risk assessment tools (such as the Morse Fall Scale and Braden Risk Assessment Tool) to determine if a patient requires a specialized bed with safety features to assist in preventing falls and/or pressure injuries.
Adjustable settings
Adjustable height settings are a fundamental safety feature of hospital beds. Raising the bed height can reduce the need for patient assistance when standing from a sitting position. Adjusting the bed height can enable a patient to improve balance while seated at the edge of the bed, and lowering the bed height to its lowest height position can reduce the severity of injury in the event of a fall.
Hospital bed frames are usually repositionable in segments. The head of the bed can often be raised independent of the segment of the bed supporting the lower extremities. An additional function enables the knee portion of the bed to be elevated, thereby preventing a patient from sliding into a slouched posture when the head of the bed is elevated. Proper positioning affects the quality of a patient&#;s respirations and is essential for patients suffering from pulmonary compromise due to disease, illness, or injury. Caution, however, must be used when using the adjustable settings on a hospital bed when seating a patient on the edge of the bed as it can create an uneven surface affecting seated balance.
Hospital bed mattress options
Hospital beds commonly have a standard mattress consisting of foam and springs, encased in a protective impermeable cover. To accommodate specific patient needs, several alternative surface options are available. The most common alternative mattress is known as an &#;air mattress.&#; Air mattresses are one intervention commonly assigned to patients having wounds or at risk for pressure injury. Air mattresses are usually powered by external blowers which enable the air pressure within the mattress to be increased or decreased, thereby adjusting the firmness of the mattress. When adjusted appropriately, air mattresses allow a patient to partially &#;sink&#; into the mattress accomplishing distribution of pressure over a greater surface area of a patient&#;s body. When adjusted too firm or too soft, however, the intended benefits of an air mattress can be negated and lead to new or progression of existing pressure injuries.
While air mattresses can offer the patient improved skin protection, they can be more difficult for patient transfer due to surface instability and lower surface friction. Air mattress characteristics and features vary by manufacturer, and should be considered when selecting this intervention to address patient risks.
Settings such as bed height, mattress positioning, and firmness are utilized to maximize comfort and safety for the individual patient&#;s needs. Some specialty mattresses include options for rotation, oscillation, and percussion to assist with managing respiratory secretions. Alternative bed surfaces can optimize skin protection; however they do require appropriate operator settings and do not replace regular repositioning which would relieve pressure on vulnerable areas.
Hospital bed rails & safety devices
Rails on hospital beds are adjustable and are often used to assist in turning and repositioning patients, providing a secure hold grasp for patients, and reducing the risk of fall injuries. However, rails are also associated with strangulation and entrapment injuries, pressure injuries, and more serious fall incidents if a patient climbs/rolls over the barrier or if the rails are not appropriately positioned. Bed rails are not intended as attachment points for restraints. Assessment by the patient&#;s health care team is necessary to determine if and how rails should be utilized to keep the patient safe.
Additional safety devices used in conjunction with hospital beds include floor safety mats, alarms, bolsters, and lighting. Floor mats can be used to attenuate impact in the event of a fall and various alarms can be used to notify health care providers if a patient has left the bed or changed positions. Bolsters or wedges are used for positioning to reduce pressure injuries, and can also provide safety against falls. Specialized lighting can be used to reduce patient confusion associated with waking in a dark unlit room. The patient&#;s care team is responsible for determining the necessary and appropriate hospital bed safety devices that meet the individualized needs of the patient.
Maintenance and inspections
Hospital beds are considered Durable Medical Equipment (DME) and require routine inspection and maintenance. Federal or State laws and regulations (including Life Safety Code requirements adopted as part of Federal regulations) may either require that equipment maintenance (including maintenance, inspection and testing) be performed in accordance with the manufacturer&#;s recommendations, or establish other maintenance requirements. Bed manufacturers and the Department of Health and Human Services direct owners to have hospital beds inspected by a qualified professional, such as a clinical or biomedical technician or engineer.
Common areas for inspection and maintenance include:
All hospital bed incidents must be reported to the bed manufacturer and/or the FDA. The FDA tracks Durable Medical Equipment incidents, issues consumer alerts, and determines if further action is needed (up to and including issuing a recall) based upon the frequency and severity of unintended events.
Incidents involving hospital beds often occur due to provider error or mechanical failure. An investigation of the hospital bed, care records, and witness reports can help determine the cause of the incident. The health care experts at Robson Forensic can analyze the causation behind hospital bed mishaps and the address the relevant standards of care.
For more information, submit an inquiry or contact the author of this article.
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