Ensuring a Sound, Safe Sleep
With more than 33 percent of Americans suffering from obesity (Centers for Disease Control and Prevention) the bariatric patient base continues to grow. This puts HME providers on the forefront of ensuring bariatric patient safety, and this often starts with the bed, where many bariatric patients spend a majority of their time.
An important first step is to make sure caregivers and family members understand that standard non-bariatric beds can be dangerous, as they are typically not built to sustain excessive weight and, over time, frames can crack and bedsprings can protrude through the mattress.
In addition, a proper bariatric bed is also safer for the home’s other occupants. For example, having the bed adjusted to the correct height or using patient transfer tools (such as a transfer board or a mounted support pole) may prevent caregivers from hurting themselves when helping a patient in and out of bed. Remember, the more mobility-dependent the patient is, the greater the risk for injury for the patient and for those providing the care.
Three of the biggest challenges to safety, says Elaine Latham, a DME provider and equipment specialist for Transfer Master and other American bariatric bed manufacturers, are the height of the bed, how wide it is and how the deck is made. According to Latham, many beds used in homes are spring decks, some are semi-electric and many do not havethe ability to raise the legs, which is critical.
Because there are so many different beds and only limited space available in showrooms, having patients physically lie on many different brands before purchasing can be a problem. To get a good fit, another key to safety, Latham suggests that caregivers or family members help get an accurate measurement.
Patients have to be measured for their girth, she says. That measurement, along with enough room for patients to be able to move and turn either on their own or with a caregiver’s assistance, will help estimate the proper bed width. For the height of the bed, determine patient movement, such as whether he or she will be transferred from a wheelchair. Consider rail guards if there is any suspicion that the patient could fall out of bed or try to remove him or herself without proper help.
“Most dealers lean toward one brand and not too many of them step out of the box to even look for other brands,” says Latham. So to find the safest bed for a patient, sometimes you have to look around. If Latham needs to find an extra low bed, or a high weight capacity, she will use a bed that has all the positions of a hospital bed or one she knows is certified to handle the weight.
Providers should also see if the bed meets the Occupational Safety and Health Administration and the FDA requirements by testing to the UL 60601-1 and IEC 60601-2-38 standards for hospital beds. These beds must be tested to ensure that they measure up to key safety requirements. The UL60601-1 and IEC 60601-2-38 calls for testing of weight capacity with a safety margin, environmental hazard safety standards and fire hazard safety. Beds undergo extensive testing to avoid bed failure, entrapment issues, lawsuits, and to ensure the overall safety of both the patient and caregiver. Beds used in hospitals, nursing homes, or other facilities should have a certification safety mark from a National Research Testing Laboratory, which indicates they meet the standards.
Providers should first inspect the home for safety and practicality purposes to help the patient choose the right bed. Although every home setup can be different, before finding a safe location within the home for the bariatric bed, there are some things to consider.
“When bariatric patients are living in a home, things seem to revolve around them,” says Latham. “Homes are not usually equipped for these patients. There will be a lot of changes and the first floor is the best location. Many times patients can be set up in the family room or the living room if their bedroom is on the second floor. The first floor is best as the patient can be part of the family activities. There may not be a bathroom close by and a commode may be necessary. Because so many patients are now being cared for in a home environment, the most import issue is the bed and mattress. The proper bed will give the patient more independence and a better quality of life and the caregiver will also be happy as this will ‘save their backs.’”
Latham also says that to make sure the patient remains comfortable and safe, she asks family members and caregivers to look six months to a year into the future. The more time a patient spends in bed, the more a bed should have all the options of a true hospital bed. These features include the hi-lo, head, and foot adjustments; the Trendelenburg, reverse Trendelenburg and a cardio chair position; and a seated position for meals. Half rails are an option, too, as are head and footboards. Beds should always have the option of using a patient lift if ever needed in the future.
Points to take away:
- More that 33 percent of Americans suffer from obesity (Centers for Disease Control and Prevention).
- Providers should first inspect the home for safety and practicality purposes.
- Make sure the living space can accommodate a bariatric bed and there is sufficient room to transport the bed to its final destination.
- The first floor is usually the best location for a bed, as the patient can be better observed and be part of the family activities.
- The more time a patient spends in bed, the more a bed should have all the options of a true hospital bed.
- Visit our compendium of bariatric articles/products on HME-business.com
- Visit the Centers for Disease Control and prevention website about obesity at www.cdc.gov/obesity/index.html
This article originally appeared in the June 2012 issue of HME Business.