BED ENVIRONMENT SAFETY Beyond 2010 Transformation Imperative

1. BED ENVIRONMENT SAFETYBeyond 2010 Transformation Imperative

2. PRESENTER Kylie Burke Regional Physiotherapy Consultant UnitingCare Ageing - Western Region

3. TRANSFORMATION IMPERATIVE Call to arms for the Aged Care Industry to: Combine forces Work with manufacturers Design products for aged care Assessed against safety standards Address client needs Appeals to clients Consider budget BED & ASSOCIATED EQUIPMENT

4. PROJECT AIM Assess and control risks to staff and residents in the bed environment Consideration to costs and aesthetics

5. ROLE Coordination of: Allied Health service delivery Manual handling program Falls prevention program Review Restraint use Clinical equipment purchases

6. PURCHASING History of purchasing of beds and accessories Different brands Price based Limited risk assessment Did not consider the integration of accessories

7. REPLACEMENTS NEEDED

8. OVERVIEW OF UNITINGCARE AGEING

9. OUR STAFF

10. RESIDENTIAL SERVICES

13. Residential Services UnitingCare Ageing Residential Services = 5354 places Western Region = 1004 places

14. PROJECT AIM Assess and control risks to staff and residents in the bed environment Consideration to costs and aesthetics

15. PROJECT TEAM Director of Residential Care Care staff Hotel Services OHS Manager & Representatives Education & Training Physiotherapy Support Worker Physiotherapists

16. PURCHASING Factors to influence purchase choice Cost Maintenance Cleaning Appearance OHS for staff Resident safety (Falls / Restraint / Pressure / Dementia) Resident comfort

17. NOT IN UNITINGCARE AGEING

18. WORK STATION - CARE STAFF

19. INJURY PREVENTION

20. OUR CLIENTS FIRST

21. INSPIRED CARE STRATEGIC CHALLENGE Our Clients First Align our model of care to our mission and respond to changing patterns of care and customer preference.

22. INSPIRED CARE

23. PERSON CENTERED CARE

24. INDUSTRY PROGRESS

25. INDUSTRY PROGRESS

26. PROCESS Review of hazards and incidents Review of literature, policies and guidelines Audit of current beds and accessories Review of purchase options Develop recommendations

27. HAZARDS and INCIDENTS Skin tears due to rails Minor entrapment in rails – limbs only Climbing over rails Bed rails failing Dynamic mattress pumps – electrical Slide from dynamic mattress Inappropriate beds Mechanical failure of beds

28. ELECTRICAL HAZARDS

29. ELECTRICAL HAZARDS

30. ELECTRICAL HAZARD

31. INDUSTRY INCIDENTS In USA from 1985 – 2008 bed rail entrapment resulted in: 460 deaths 136 non fatal injuries 176 near misses without injury A Guide to Bed Safety (2008) – US Dept of Health Services - Food and Drug Administration

32. INDUSTRY INCIDENTS In USA from 1994 – 2000 entrapment between air mattresses and bed rails resulted in 35 deaths A Guide to Bed Safety (2008) – US Dept of Health Services - Food and Drug Administration

33. LITERATURE Bed rails Bed selection for health industry Restraint minimisation Falls prevention Manual handling Pressure care Bed safety standards / guides

34. POLICIES UnitingCare Ageing Restraint Minimisation – Care Services Policy 0009 Bed Rail Safe Operating Procedure

35. Workcover NSW Pre-purchase Checklist for Hospital Beds Advised conformance to Australian Safety Standards where available

36. AUSTRALIAN STANDARDS AS/NZS 3200.2.38:2007 Medical electrical equipment - Particular requirements for safety - Electrically and manually operated medical beds for adult use (IEC 60601-2-38, Ed.1.0(1996) MOD)

37. Australian Standards Incorporates international standards Stringent criteria on bed rail specifications to minimise risk of entrapment Risk assessment on bed and accessories Not legislated Minimal standard for the net benefit of the community

38. ENTRAPMENT ZONES

39. BED AUDIT Electric = 774 Manual = 149 Fixed = 80 Rails likely to be unsafe Rails may not match bed Limited king single / floor line beds Mattresses not conforming to bed Electrical hazards with dynamic mattresses

40. CURRENT STOCK

41. RECOMMENDATIONS Beds - Option of rails, knee break and hand set lock out - High / low - Low / low - Floor line - King single

42. RECOMMENDATIONS Mattress surfaces - Low - medium pressure care - High pressure care static - High pressure care concave - Alternating pressure mattress

43. RECOMMENDATIONS Accessories - Self help pole - Custom head and foot board - Movement alarms

44. RECOMMENDATIONS Preferably from one distributor Package to be certified to conform to Australian Standards Person centred (not institutional) Lead management for AP mattress Prompt delivery and maintenance

45. RECOMMENDATIONS Develop procedures for assessment and allocation of bed and accessories in RACF Develop assessments and procedures for bed rail minimisation Determine budget requirements

46. OUTCOMES - Beds High / low bed with rails – conforms to the mechanical clauses of AS/NZS 3200.2.38:2007 Bed manufacturer and distributor modifying product and preparing for assessment against Australian Standard Prompt service and 24 emergency cover

47. OUTCOME – Mattress Surfaces Trialed mattress surfaces (comfort, high relief static and alternating pressure replacement) and accepted Manufacturer and distributor have installed lead management system on alternating pressure mattress cover

48. OUTCOME - Regional Regional Physio assists with bed and accessory prescription Bed Rail Minimisation Projects Budgets for upgrade / replacements in 2010 – 2012 financial years

49. TRANSFORMATION IMPERATIVE Regional approach Purchasing Implementation of best practice /policies Allocation of equipment Manufacturers Adherence to safety standards Consideration to aged care industry

50. TRANSFORMATION IMPERATIVE AGED CARE INDUSTRY NEEDS TO UNITE TO TRANSFORM OUR BED ENVIRONMENT (AND OTHER CARE EQUIPMENT) BEYOND 2010

51. ONE SIZE FITS ALL