1. beds & accessories - home page - cornwall council · 2014-12-15 · 1. beds &...

1. Beds & Accessories

Equipment in this section:

1.1 Bed cradle

1.2 Cantilever table

1.3 Rope Ladder

1.4 Bed lever

1.5 Cot sides/ bed rails

1.6 Bed/ chair raisers

1.7 Foam wedges

1.8 Back Rest for Bed

1.9 Pillow elevator

1.10 Mattress variator

1.11 Bed electric & hydraulic

1.12 Profiling beds

1.13 Raiser Recliner chair

General considerations:

Weight limits of equipment

Height of bed in relation to service user

Positioning within the room- safety and dignity

Maintenance- prescribers/delivers of equipment need to reinforce with users/carers the need for equipment to be regularly checked-

particularly aids that may need adjusting or tightening. If user is unable to take on this responsibility an alternative arrangement needs to be

identified.

Provision of an alternative bed should be a last resort. People generally prefer to keep their own bed.

Double beds would only be prescribed in truly exceptional circumstances and if to be used by a couple then they may be asked to make a

financial contribution.

It is essential to refer to the Tissue Viability Pathway when prescribing equipment that can increase a person’s skin vulnerability.

The HSE and MHRA websites have a large selection of guidance documents regarding the safe provision of beds and bed accessories.

Additional beds such as chair beds and standing beds would be available in exceptional circumstances.

Delivery requirements – e.g. access & risks

1.1 Equipment: Bed Cradle

Description: C shaped metal frame which sits under mattress creating raised resting surface for bedding

Dimensions:

Related policies/Guidance:

Example Brand Names: Days Health care

Indicators:

The person is at risk of peripheral vascular disease.

The person is unable to tolerate the weight of bedding &/or the weight of bedding restricts movement within the bed.

Ladder Approach Contraindications Safety & function Prescriber/assessor Actions

All other alternatives have been explored

Functional change/improvement

Risk assessment Carer assessment Increased care package

Trauma injury Progression of condition

Impact upon temperature control

Need to lag frame to reduce risk of injury by knocking against it

Pressure care

Risk assess

Product familiarisation completed

Risk assessment

Prescription goals identified.

Prescription form completed

Demo/delivery planned

Review date

Safety Checking of Community Loan Equipment

DESCRIPTION

STANDARD EQUIPMENT ITEMS

FI Bar Coded

Manufacturer’s Instructions Supplied to User/Carer

Single use Items

Legislation Comments/ technical

instruction N R LOLER PUWER

Bed cradle

M C

Y Y

Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store

1.2 Equipment: Cantilever table NB never stand on the cross bar of the table – it is not safe to do so.

Description: A height adjustable table top supported on one side only so that the table can be positioned close to, or over a bed/chair. Some have the option of a tilting top for supporting a book, newspaper, or writing paper at an angle. Fitted with 4 castors

Dimensions: Table top size: 18" x 24" (450mm x 600mm) Height adjustable range: 23"-35" (580 - 890mm)


Example Brand Names: Welland Medical

Indicators:

The person needs a secure surface to ensure safety whilst eating/drinking from whilst confined to a bed or chair and normal furniture is not suitable.

The person needs a secure surface to rest essential equipment or medication on whilst they are confined to bed/chair and normal furniture is not suitable.


Risk assessment Carer assessment Increased care package All other alternatives have been explored

Lap trays (self purchase)


Service user confused

Poor balance & mobility

Restraint

Progression of condition

Without castors can be used with chairs/beds that have limited clearance

Table fitted with casters can be an advantage or disadvantage for clients

Consider risks when used with height adjustable beds When misused can discourage mobility & independence

Risk assess


Risk assessment




Review date


DESCRIPTION


FI Bar Coded


Single use Items



Cantilever table

M C

Y Y


1.3 Equipment: Rope Ladder

Description: A rope Ladder with plastic rungs that is attached to the foot of the bed - either the foot board, the bed frame or the two end feet. The user pulls up on the rungs to get into a sitting position. Some wooden rung versions still in circulation.


Example Brand names: Homecraft

Indicators

The user needs assistance to sit up in bed and the user would otherwise be dependent upon a carer or their safety compromised.


All other alternatives have been explored:

Alternative techniques

Rehabilitation Increased care costs. Risk assessment Carers assessment

Uneven upper limb strength

Upper limb joint instability

Poor trunk control and balance

Postural needs

Reduced cognitive ability will increase confusion & risk

Poor grip strengthen

Risk of entanglement

User environment


Weight limits

Risk of Ladder falling off bed in the night

Risk assess


HSE/MHRA recommendations

Risk assessment



Review date

Advise user of need to regular check Ladder is securely attached.


DESCRIPTION


FI Bar Coded


Single use Items



rope ladder

M N//A

N Y Y


1.4 Equipment: Bed Lever nb need to order straps separately on MICES

Description: available in wooden or metal materials. Base fits under mattress to provide grab rail.

There are specific designs for single, double, & slatted beds. Heavy duty version also available.

Dimensions: standard maximum user weight- 17 stone (108kg)

Related policies/Guidance: HSE & MHRA ref guidance on fitting of straps

Example Brand Names: Liftwell

Indicators:

The person needs assistance to get from lying to sitting in bed.

The person needs assistance getting from sitting to standing out of bed.

The person has difficulties turning/rolling in bed. and

The person would otherwise be dependent upon assistance from a carer or their safety compromised. The carer is at risk due to demands of existing technique.

Ladder Approach Contraindications Safety & function Prescriber/ assessor

Actions


Adapted technique

Rehabilitation




Poor balance & trunk control

Compatibility with other equipment

Poor grip

Weakened or damaged upper limbs

User environment


Hand dominance

Risk of entrapment

Proximity to other furniture & risk of misuse e.g. near bed by commode & it’s used as grab rail.

Use with profiling beds

Risk assess



Risk assessment

Assess for provision of optional straps


Review date

Specify bed type



DESCRIPTION


FI Bar Coded


Single use Items



Bed lever

M

C

Y Y


1.5 Equipment: Cot sides/bed rails includes sides rails, bed guards, safety rails

Description: adjustable length side rails which may be fitted to either side of a bed. Safety lock into the raised position, released

via a spring plunger. Slides lower to mattress height. Cot sides are also available for profiling beds – electric, hydraulic- beds.

Prescribers must refer to manufactures guidance before requesting these.

Dimensions: various

Related policies/Guidance: CIOSPCT Policy for safe Use of Bedrails. MHRA doc Safe Use of Bedrails. HSE Bed Rail Risk

Management - LAC No 79/8.

Example Brand Names: Roma medical, Days Medical, Invacare

Indicators;

The person is at risk of failing out of bed.

Ladder Approach

Contraindications Safety & function Prescriber/assessor Actions

All other alternatives have been explored.

Tucking in bedding

Lowering bed

Wander alarms

Fixed rail


Referral to other agencies Increased care package Risk assessment

Service user confused/restless/ at risk of climbing over rails

cot sides must never be used as a form of restraint

Orthopaedic mattress/Air mattress may need extra high cot sides.

Person has condition that would prevent them from escaping if they became entrapped e.g. they can

User environment


Carers ability to operate

Impact upon other equipment

Assess for extra high cot sides when using in


Risk assess

HSE/MHRA recommendations referred to

Risk assessment

Assess need for bumpers



Specify bed type

Refer to MHRA, HSE guidance & local bedrails policy


Review date

Carer assessment

only move in 1 direction, epilepsy, choreic movements.

Service user assessed as requiring an overlay mattress of any type in situ, will increase height of person, will need higher height cot sides or an alternative mattress replacement system

Mental capacity

conjunction with overlay type air mattress


DESCRIPTION


FI Bar Coded


Single use Items



Cot sides/ bedrails

M C

Y Y

Y


1.6 Equipment: Bed/chair raisers

Description: a variety of models exist including: 4 moulded blocks linked together by wooden slats. 2 wing nuts allow for

adjustment to enable fitting to different sizes of bed & chair, then tighten when in position. Individual blocks can be fitted to most

chair types- both with & without legs

Dimensions- refer to individual manufacturer

Related policies/Guidance: Choosing Seating DLF. Chailey Levels of Ability TV pathway

Example Brand Names: Woodbuilder, Grip on. Leg Ex. Linked. Multipurpose. Triangles. Ladywells

Indicators:

The person needs additional assistance to rise from a low chair or bed and their safety is being compromised.

To raise a bed/chair to facilitate hoist transfers.

To alter angle of chair & promote pressure relief/ postural drainage



Rehabilitation

Alternative seating already within the patient’s home.

Foam wedge. Risk assessment Carer assessment Increased care package

Poor condition of person’s chair

Poor balance

Chair is difficult to move

Chair will need regular moving

Access for mobile hoist may be affected by some styles of raiser

Shift pressures

Increase pressures

Not to be used with stander/recliner type chairs

User environment

Weight limits

Balance


Impact on care package

Aim to raise bed/chair to same height as distance between person’s heel & back of knee.

Tripping hazard caused by block style raisers

Users/ carer ability to maintain


TV course

Risk assess

Risk assessment

Prescriber goals identified


Advise user to check & maintain

Review date

Multipurpose packs: I pk for chair 2 pks for bed/sofa Plus spreader bars & height adjustors.


DESCRIPTION


FI Bar Coded


Single use Items



Bed /chair raisers

M C

N Y


1.7 Equipment: Foam wedge

Description: wedge of medium density foam that sits on top of a mattress or on an armchair

Dimensions: 2” or 4”


Example Brand Names: Tremorvah

Indicators:

The person needs support to sit up in bed to meet their care, posture and/or pressure needs.

The person has a medical need which can not otherwise be meet e.g. postural drainage, respiratory failure.

The person needs to alter the angle of their seating to promote transfers and their safety is being compromised.

The person needs to raise their legs/ankles/feet for an identified medical reason.






Impact upon exiting/future equipment

Pressure risks e.g. shearing

Person gets confused

Social & emotional impact if provision separates person form partner

User environment


Weight limits

Single use- cross contamination

Risk assess

TV training



Risk assessment



Review date


DESCRIPTION


FI Bar Coded


Single use Items



Foam Wedge

M N/A

N N/A N


1.8 Equipment: Back rest for bed

Description: light coated white framework covered with easy clean fabric with padded head cushion. Can be set at 5 different angles up to 85 degrees

Dimensions: Width: 490 mm, Depth: 500 mm, Overall Width: 640 mm, Overall Depth: 560 mm, Width of Base: 490 mm, Depth Of Base: 500 mm, Canvas Width: 560 mm, Canvas Depth: 460 mm. Weight 108kg (17 stone) limit


Example Brand Names: Aidapt

Indicators;

The person needs support to sit up in bed to meet their care, posture and/or pressure needs and their safety is being compromised. The person has a medical need which can not otherwise be meet e.g. postural drainage, respiratory failure




Foam wedges




Pressure risks



Increased risk of shear

User can only sit up with a knee break

Do not use on top of static air mattresses or dynamic mattresses

User environment


Weight limits

Risk assess



Risk assessment

Assess need for cot sides




Review date


DESCRIPTION


FI Bar Coded


Single use Items



Back rest for bed

M C

Y Y


1.9 Equipment: Pillow lift/elevator

Description: Electrically operated air inflated pillow lift that sits on top of a mattress or a metal framed inflating riser unit

Dimensions: Inflated width 61cm. Deflated width 71cm. Deflated length 80cm. Max angle of backrest 55degrees.

Maximum user weight- Mangar= 22st/139kg. Centromed 18st/ 114kg plus heavy duty version available 25stone/158kg.


Example Brand Names: Mangar International Centromed

Indicators:

The person needs assistance to get from lying to sitting in bed and their safety is being compromised.

The person would otherwise be dependent upon assistance from a carer. The carer is at risk due to demands of existing technique.



Foam wedge

Back rest

Rehabilitation

Functional change /improvement




Compatibility with other equipment e.g. risk of entrapment if used with cot sides

Refer to manufactures guidance when person is using a dynamic mattress

Cannot be used on top of dynamic mattresses

Person assessed as requiring a dynamic mattress

User environment


Hand dominance

Not for use as a back rest

Metal framed style can encroach beyond mid line when used in double bed

Trailing leads

Maybe more appropriate then mattress elevator when there is a couple sharing the bed.

Cannot be used with dynamic mattress

Risk assess


Risk assessment

Prescription goals Identified


Specify bed type


Review date

Add to maintenance/servicing contract

Add to PAT list


DESCRIPTION


FI Bar Coded


Single use Items



Pillow lifer/elevator

M C

C C

Y


1.10 Equipment: Mattress variator

Description: electrically operated lifting device which is fitted under the mattress. Raises the mattress to lift the person from lying

to sitting or reverse. Adjustable to fit single or double beds.

Dimensions: maximum user weight 21stone/133kg. Heavy duty version available up to 40stone/254kg


Example Brand Names: RMA

Indicators:

The person needs assistance to get from lying to sitting in bed and their safety is being compromised.

The person would otherwise be dependent upon assistance from a carer.

The carer is at risk due to demands of existing technique.



Bed lever

Back rest

Pillow lifter

Rehabilitation




Orthopaedic mattress


Compatibility with other equipment

Shearing pressure risk

Obstructed by headboard

Compatibility with existing equipment

Refer to manufactures guidance when person is using a dynamic mattress

User environment


Hand dominance

Sliding down bed & positioning issues

Not for use as a back rest

Impact upon partner

Stability of mattress & need for foot board


Risk assess

HSE/MHRA recommendation referred to

Risk assessment

Prescription goals identified


Specify bed type


Review date

Add to maintenance/servicing contract

Add to PAT list

Cannot be used on top of dynamic mattresses

Person assessed as requiring a dynamic mattress

Trailing lead

Cannot be used with dynamic mattress

User may slide down bed

Consider height of person & shortening of bed effect


DESCRIPTION


FI Bar Coded


Single use Items



mattress variator

M C

Y Y

Y


1.11 Equipment: Bed – electric or hydraulic

Description: An electrically operated height adjustable bed

Dimensions

Related policies/Guidance: MHRA & HSE guidance

Example Brand Names: Invacare Etude, Minute 2

Indicators:

The person requires a height adjustable bed to meet their care and /transfer needs and their safety is being compromised .

Height adjustable bed is required to support carers (informal and/or formal)

Palliative care- and other solutions not applicable due to time. Short term solution to enable hospital discharge e.g. spinal surgery




Rope Ladder

Bed lever

Back rest

Foam wedges

Bed raisers

Pillow lifter

Mattress elevator Functional

change/improvement



Pressure risks



Weight limit of person and care if care tasks involve kneeling on bed

Hoist clearance

User environment


Operator controls

Weight limits

Ability/need to access both sides of bed

Access to site for safe delivery

Battery back up

Trailing leads

Heights required for transfers & care tasks

Risk assess



Risk assessment






Review date

Add to maintenance/service contract

Add to PAT list


DESCRIPTION


FI Bar Coded


Single use Items



Bed- electric/ hydraulic

M C

Y Y

Y


1.12 Equipment: Profiling beds

Description: An electrically operated height and /or positional adjustable bed base. Available in two sections- head riser or four

sections head rest and leg adjustment.

Dimensions:

Related policies/Guidance: HSE & MHRA guidance

Example Brand Names: Huntleigh Medical, Invacare Etude, Minute 2

Indicators:

The person requires a positioning bed to meet their care, posture and/or pressure needs and prevention of shear forces.

The person has a medical need which can not otherwise be meet e.g. postural drainage, respiratory failure

Height adjustable bed is required to support carers (informal and/or formal)

Palliative care- and other solutions not applicable due to time.

Short term solution to enable hospital discharge e.g. spinal surgery




Mattress elevator

Rope Ladder

Pillow lifter

Bed lever

Back rest

Foam wedges

Bed raiser

Height adjustable bed


Pressure risks



Weight limit of person and care if care tasks

User environment


Operator controls

Weight limits

Ability/need to access both sides of bed

Access to site for safe delivery

Battery back up

Trailing leads

Heights required for

Risk assess



Risk assessment






Review date



involve kneeling on bed

Hoist clearance

transfers & care tasks Add to maintenance/service contract

Add to PAT list


DESCRIPTION


FI Bar Coded


Single use Items



Profiling beds

M C

Y Y

Y


1.13 Equipment: Raise & Recline Chair

Description: Chairs which can provide specialised seating and/or motorised sit to stand facility and have been specifically designed

for use as a bed. Note this is not the same as general raise and recline chair that would be provided as seating These items are

ordered as ‘special items of equipment’ in exceptional circumstances. Option of removable cushions should always be considered,

so that pressure cushions can be inserted at later date if required by this user or for future re-cycling.

Dimensions: refer to individual manufactures guidance

Related policies/Guidance: Choosing Seating DLF.

Chailey levels of ability

TV pathway

MHRA & HSE guidance

Example Brand Names: A variety of models may be available from CELS as previously ordered special stock eg Pride and

Theraposture. Please note these models are often not suitable for those with postural support or pressure relief needs. Clinicians

should carry out a risk assessment in these cases and document the outcome.

Indicators:

The person needs to sleep in a semi upright position due to a medical condition and is unable to access a bed.

The person’s safety is being compromised by not providing the chair.

Stated medical need e.g. oedema in addition to transfer difficulties and no other solution is available. NB. The person should always have been advised to take bed rest and /or use of a foot stool in the first instance.

The person needs to sleep downstairs & there isn’t space for a bed.

Prevent hospital admission

Temporary solution during DFG

The person needs additional pressure relief and this is only way to address this.

NB when obtaining 2 quotes, please ensure the cost of delivery is included in each quote Assessment must include therapist (OT or physio) and nurse (Community or DN, or TV nurse)



Referral to other service e.g. Rehab OT/FALLS

Back Rest for Bed

Foam wedges

Mattress elevator

Pillow lifter



Pressure relief needs i.e. if the person has a special cushion this will alter the seat height.

Consider the safety of pets or small children if in the household, regarding this equipment e.g. entrapment.

Weight limit of product.

Additional pressure risks

Postural needs

Impact upon existing/future equipment

Design of chair appropriate for use as bed e.g. mechanism failure to due person turning over during the night

Dignity & privacy of user & household members

height of leg elevation, (?effective height for dependent oedema)

environmental space , is there adequate space for person to utilise recline/elevation facility

User environment

Weight limits

Balance

Operator controls


Impact on care package

Space to operate chair

Trailing leads

Operators ability to use controls

Can an integral pressure relieving cushion be incorporated, changed at a later date


TV course

Risk assess

HSE/MHRA recommendation referred to

Risk assessment

Prescriber goals identified

Completed prescription form


Review date

Refer to MHRA/HSE guidance

Maintenance & service contract

Add to PAT list


DESCRIPTION


FI Bar Coded


Single use Items



Raise and recline chairs

M C

Y Y

Y


1. beds & accessories - home page - cornwall council · 2014-12-15 · 1. beds &...

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