Hospital bed

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A modern hospital bed at public hospital at Hong Kong Hospital bed at Pok Oi Hospital.jpg
A modern hospital bed at public hospital at Hong Kong
Hospital beds per 1000 people 2013. Hospital-beds-per-1000-people.png
Hospital beds per 1000 people 2013.

A hospital bed or hospital cot is a bed specially designed for hospitalized patients or others in need of some form of health care. These beds have special features both for the comfort and well-being of the patient and for the convenience of health care workers. Common features include adjustable height for the entire bed, the head, and the feet, adjustable side rails, and electronic buttons to operate both the bed and other nearby electronic devices.

Contents

Hospital beds and other similar types of beds such as nursing care beds are used not only in hospitals, but in other health care facilities and settings, such as nursing homes, assisted living facilities, outpatient clinics, and in home health care.

While the term "hospital bed" can refer to the actual bed, the term "bed" is also used to describe the amount of space in a health care facility, as the capacity for the number of patients at the facility is measured in available "beds."

There are various pros and cons for the different types of hospital beds, depending on the functions and features available, among other factors. [2]

History

Beds with adjustable side rails first appeared in Britain some time between 1815 and 1825. [3]

In 1874 the mattress company Andrew Wuest and Son, Cincinnati, Ohio, registered a patent for a type of mattress frame with a hinged head that could be elevated, a predecessor of the modern day hospital bed. [4]

The modern 3-segment adjustable hospital bed was invented by Willis Dew Gatch, chair of the Department of Surgery at the Indiana University School of Medicine, in the early 20th century. This type of bed is sometimes referred to as the Gatch Bed. [3]

The modern push-button hospital bed was invented in 1945, and it originally included a built-in toilet in hopes of eliminating the bedpan. [5]

Modern features

Hospital beds at the Hospital Regional de Apatzingan in Apatzingan, Michoacan, Mexico. Inauguracion del Hospital Regional de Apatzingan. (20503993770).jpg
Hospital beds at the Hospital Regional de Apatzingán in Apatzingán, Michoacán, Mexico.

Alternating pressure mattress

Alternating pressure mattresses use computer-controlled pumps to inflate and deflate automatically in order to lower the risk of bed sores. [6]

Bed exit alarm

Many modern hospital beds are able to feature a bed exit alarm whereby a pressure pad on or in the mattress arms an audible alert when a weight such as a patient is placed on it, and activating the full alarm once this weight is removed. This is helpful to hospital staff or caregivers monitoring any number of patients from a distance (such as a nurse's station) as the alarm will trigger in the event of a patient (especially the elderly or memory impaired) falling out of the bed or wandering off unsupervised. This alarm can be emitted solely from the bed itself or connected to the nurse call bell/light or hospital phone/paging system. [7] Also some beds can feature a multi-zone bed exit alarm which can alert the staff when the patient start moving in the bed and before the actual exit which is necessary for some cases.

CPR function

In the event of the bed occupant suddenly requiring cardiopulmonary resuscitation, some hospital beds offer a CPR function in the form of a button or lever which when activated flattens the bed platform and put it in lowest height and deflates and flattens the bed's air mattress (if installed) creating a flat hard surface necessary for CPR administration. [8]

Elevation

Beds can be raised and lowered at the head, feet, and their entire height. While on older beds this is done with cranks usually found at the foot of the bed, on modern beds this feature is electronic.

Today, while a fully electric bed has many features that are electronic, a semi-electric bed has two motors, one to raise the head, and the other to raise the foot. [9]

Raising the head (known as a Fowler's position) can provide some benefits to the patient, the staff, or both. The Fowler's position is used for sitting the patient upright for feeding or certain other activities, or in some patients, can ease breathing, or may be beneficial to the patient for other reasons. [9]

Raising the feet can help ease movement of the patient toward the headboard and may also be necessary for certain conditions.

Raising and lowering the height of the bed can help bring the bed to a comfortable level for the patient to get in and out of bed, or for caregivers to work with the patient.

There are 5 function beds which comes with many functions such as head elevation, foot elevation, Trendelenburg, reverse Trendelenburg positions with height adjustment options. [10] These type of beds are typically used in ICUs and for patients who are high dependent.

Side rails

Beds have side rails that can be raised or lowered. These rails, which serve as protection for the patient and sometimes can make the patient feel more secure, can also include the buttons used for their operation by staff and patients to move the bed, call the nurse, or even control the television. [11]

There are many types of side rails to serve different purposes. While some are simply to prevent patient falls, others have equipment that can aid the patient themself without physically confining the patient to bed.

Side rails, if not built properly, can be of risk for patient entrapment. In the United States, more than 300 deaths were reported as a result of this between 1985 and 2004. [12] As a result, the Food and Drug Administration has set guidelines regarding the safety of side rails. [13]

In some cases, use of the rails may require a physician's order (depending on local laws and the policies of the facility where they are used) as rails may be considered a form of medical restraint.

Specialist beds

Many specialist hospital beds are also produced to effectively treat different injuries. These include standing beds, turning beds and legacy beds. These are usually used to treat back and spinal injuries as well as severe trauma.

Tilting

Some advanced beds are equipped with columns which help tilt the bed to 15-30 degrees on each side. Such tilting can help prevent pressure ulcers for the patient, and help caregivers to do their daily tasks with less of a risk of back injuries. [14]

Wheels

Wheels enable easy movement of the bed, either within parts of the facility in which they are located, or within the room. Sometimes movement of the bed a few inches to a few feet may be necessary in patient care.

Wheels are lockable. For safety, wheels can be locked when transferring the patient in or out of the bed. [15]

Disadvantages

Cost

A hospital bed can cost over US$1000.00; on average with different costs associated with completely manual functions, 2-motor functions and fully electric 3-motor functions (whole bed going up and down). Other costs are associated with bariatric heavy duty models that also offer extra width. [16]

Effect on health of patients

Hospital beds can make a patient's spine more rounded because a patient who sits up a lot, such as when watching television, tends to slip down. [17] Some of the category a bed manufacturers are providing their beds with a built-in function which acts as an anti-slip. LINET is providing Ergoframe while others have different names. [18]

Safety

During the 1980s, patient safety had been a concern with hospital beds.

In 1982, a 3-year-old Milwaukee girl hospitalized for pneumonia was killed when crushed by a mechanical hospital bed. [19]

In 1983, an 11-year-old Illinois boy was strangled to death by a hospital bed. [20]

See also

Related Research Articles

<span class="mw-page-title-main">Do not resuscitate</span> Legal order saying not to perform CPR if heart stops

A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on country, indicating that a person should not receive cardiopulmonary resuscitation (CPR) if that person's heart stops beating. Sometimes these decisions and the relevant documents also encompass decisions around other critical or life-prolonging medical interventions. The legal status and processes surrounding DNR orders vary from country to country. Most commonly, the order is placed by a physician based on a combination of medical judgement and patient involvement.

<span class="mw-page-title-main">Nursing home</span> Type of residential care

A nursing home is a facility for the residential care of older people, senior citizens, or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF) or long-term care facilities. Often, these terms have slightly different meanings to indicate whether the institutions are public or private, and whether they provide mostly assisted living, or nursing care and emergency medical care. Nursing homes are used by people who do not need to be in a hospital, but cannot be cared for at home. The nursing home facility nurses have the responsibilities of caring for the patients' medical needs and also the responsibility of being in charge of other employees, depending on their ranks. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.

<span class="mw-page-title-main">Air mattress</span> Type of mattress

An air mattress is an inflatable mattress or sleeping pad.

<span class="mw-page-title-main">Bed</span> Piece of furniture used as a place to sleep or relax

A bed is an item of furniture that is used as a place to sleep, rest, and relax.

Computerized physician order entry (CPOE), sometimes referred to as computerized provider order entry or computerized provider order management (CPOM), is a process of electronic entry of medical practitioner instructions for the treatment of patients under his or her care.

Medical restraints are physical restraints used during certain medical procedures to restrain patients with (supposedly) the minimum of discomfort and pain and to prevent them from injuring themselves or others.

Residential care refers to long-term care given to adults or children who stay in a residential setting rather than in their own home or family home.

Home health is a nursing specialty in which nurses provide multidimensional home care to patients of all ages. Home health care is a cost efficient way to deliver quality care in the convenience of the client's home. Home health nurses create care plans to achieve goals based on the client's diagnosis. These plans can include preventive, therapeutic, and rehabilitative actions. Home health nurses also supervise certified nursing assistants. The professional nursing organization for home health nurses is the Home Healthcare Nurses Association (HHNA). Home health care is intended for clients that are well enough to be discharged home, but still require skilled nursing personnel to assess, initiate and oversee nursing interventions.

<span class="mw-page-title-main">Caregiver</span> Person helping another with activities of daily living

A caregiver, carer or support worker is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commonly assist with impairments related to old age, disability, a disease, or a mental disorder.

<span class="mw-page-title-main">University of Virginia Health System</span> Hospital in Virginia, United States

As populations age, caring for people with dementia has become more common. Elderly caregiving may consist of formal care and informal care. Formal care involves the services of community and medical partners, while informal care involves the support of family, friends, and local communities. In most mild-to-medium cases of dementia, the caregiver is a spouse or an adult child. Over the period of time, more professional care in the form of nursing and other supportive care may be required medically, whether at home or in a long-term care facility. There are evidences to show that case management can improve care for individuals with dementia and the experience of their caregivers. Furthermore, case management may reduce overall cost and institutional care in the medium term. Millions of people living in the United States take care of a friend or family member with Alzheimer’s disease or a related dementia.

An adjustable bed is a bed which has a multi-hinged lying surface which can be profiled to a number of different positions. Common adjustments include inclining the upper body and raising the lower body independently of each other. Other common features include height adjustment and tilting the bed to raise the upper body or the lower body into the Trendelenburg or reverse Trendelenburg positions.

Wandering occurs when a person with dementia roams around and becomes lost or confused about their location. It is a common behavior that can cause great risk for the person, and is often the major priority for caregivers. It is estimated to be the most common form of disruption from people with dementia within institutions. Although it occurs in several types of dementia, wandering is especially common in people with Alzheimer's disease (AD). People with dementia often wander because they are stressed, looking for someone or something, attending to basic needs, engaging in past routines, or with visual-spatial problems. Other times, they may wander without aim at all.

<span class="mw-page-title-main">Hospice care in the United States</span>

In the United States, hospice care is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice as a place to treat the incurably ill has been evolving since the 11th century. Hospice care was introduced to the United States in the 1970s in response to the work of Cicely Saunders in the United Kingdom. This part of health care has expanded as people face a variety of issues with terminal illness. In the United States, it is distinguished by extensive use of volunteers and a greater emphasis on the patient's psychological needs in coming to terms with dying.

An informal or primary caregiver is an individual in a cancer patient's life that provides unpaid assistance and cancer-related care. Due to the typically late onset of cancer, caregivers are often the spouses and/or children of patients, but may also be parents, other family members, or close friends. Informal caregivers are a major form of support for the cancer patient because they provide most care outside of the hospital environment. This support includes:

<span class="mw-page-title-main">Nurse call button</span> Button that allows patients in health care settings to alert a nurse

A nurse call button is a button or cord found in hospitals and nursing homes, at places where patients are at their most vulnerable, such as beside their bed and in the bathroom. It allows patients in health care settings to alert a nurse or other health care staff member remotely of their need for help. When the button is pressed, a signal alerts staff at the nurse's station, and usually, a nurse or nurse assistant responds to such a call. Some systems also allow the patient to speak directly to the staffer; others simply beep or buzz at the station, requiring a staffer to actually visit the patient's room to determine the patient's needs.

Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anaesthesiologists, nurse anaesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in the operating theatre.

Unlicensed assistive personnel (UAP) are paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living (ADLs). UAPs also provide bedside care—including basic nursing procedures—all under the supervision of a registered nurse, licensed practical nurse or other health care professional. UAPs must demonstrate their ability and competence before gaining any expanded responsibilities in a clinical setting. While providing this care, UAPs offer compassion and patience and are part of the patient's healthcare support system. Communication between UAPs and registered nurses (RNs) is key as they are working together in their patients' best interests. The scope of care UAPs are responsible for is delegated by RNs or other clinical licensed professionals.

Alarm fatigue or alert fatigue describes how busy workers become desensitized to safety alerts, and as a result ignore or fail to respond appropriately to such warnings. Alarm fatigue occurs in many fields, including construction and mining, healthcare, and the nuclear power field. Like crying wolf, such false alarms rob the critical alarms of the importance they deserve. Alarm management and policy are critical to prevent alarm fatigue.

A nursing care bed is a bed that has been adapted to the particular needs of people who are ill or disabled. Nursing care beds are used in private home care as well as in inpatient care.

References

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  19. Los Angeles Times, Jan 15, 1982 Girl, 3, Killed by Mechanical Hospital Bed, Her Family Says
  20. The Sun Baltimore, Md. Apr 19, 1983 Illinois boy, 11, strangled in hospital-bed accident