Choosing the right profiling bed after brain injury: sleep safe and well with neuro OT tips!

on Tuesday, 30 March 2021. Posted in Blog

Choosing the right profiling bed after brain injury: sleep safe and well with neuro OT tips!

Neuro occupational therapists (neuro OTs) are skilled in matching solutions to needs – and advising on assistive equipment, such as profiling beds is no exception.

The origins of these beds lie in the 1900s, with the invention of the first mechanised hospital beds boasting features such as hinged heads and adjustable side rails [1]. 

In the 1940s, the first push-button beds began springing up before making way for electric beds and then, in the 1990s, the mechatronics - beds that combine mechanical, electrical and information technology [2].

 

   Smart beds…have a unique opportunity in enabling more efficient efforts for caregivers and more responsive environments for patients.   

 

 

Today’s versions of mechatronic or ‘smart’ profiling beds - so-called due to the ability to personalise programs – offer differing arrays of functional, interactive and aesthetic features [3]. 

But regardless of state-of-the-art ratings, it’s user safety that takes priority when cognitive skills have been impaired, or there are Mental Capacity Act [4] protections in place.

So what does a neuro OT consider when prescribing a profiling bed for a brain injury survivor? What better time than National Bed Month (March) to find out!

 

Tucked up

Getting it wrong when choosing and using profiling beds for vulnerable people can have tragic consequences, as recent cases show:

 

 In Powys, Wales, a care home was fined £25,000 and ordered to pay costs of over £11,000 when a resident had to have a leg amputated after it was repeatedly trapped between her mattress and the bed rail. [5] 

 -  In Hartlepool, Co. Durham, a nursing home provider was fined £24,000 with a further £14,000 after the death of an 83-year-old woman, found trapped between broken bed rails after infrared motion sensors failed [6].

 -  A bed occupant died after touching the bed position control, raising the bed to its maximum height, trying to climb out, and falling [7].

 -  In separate cases involving bed rails, two children died after an insufficient risk assessment of body size and unsuitable combination of bed and rail [7].

 -  A bed occupant sustained a serious head injury after falling over the top of bed rails after a pressure ulcer reduction overlay was added on top of a mattress [7].

 

To help ensure profiling beds chosen by and for brain injury survivors are safe and suitable, neuro OTs follow advice drawn up by the Royal College of Occupational Therapists [8], which includes assessing:

 

  • The bed occupant’s functioning environment.
  • The bed’s impact on family life.
  • The occupant’s ability to safely use the equipment.
  • The occupant’s capacity to understand and follow instructions.
  • The bed’s positioning to facilitate specialist care, transfers and occupations.
  • Accessibility to safety features, such as brakes.
  • Common risk factors, such as falls prevention, bed height, trip hazards.
  • Manual handling concerns [9].

 

Neuro OTs can also facilitate demonstrations of how selected profiling beds work and how they are cleaned and maintained, which can be recorded and shared with all care team members.

 

And so to bed…

How you choose the right profiling bed from the many makes and models on the global market is made easier by:

  • Asking for advice from a neuro OT.
  • Setting your budget.
  • Listing the features you need and/or want.
  • Ensuring room and bed size match. 
  • Checking base/mattress compatibility.
  • Exploring delivery and installation options.

 

An internet search for profiling beds provides a long list of global manufacturers with UK suppliers, but make sure you can try different options via home demonstrations or showroom visits.

 

   The wrong bed can lead to loss of occupant independence, work-related pain for staff and informal carers and increased risk of pressure damage.   

Health and Safety Executive [10]

 

We spoke to one supplier - the winner of the first OT Show Award for Excellence in Caring in 2018 – to see how state-of-the-art bed technology is being used to enhance neurorehabilitation.

Theraposture's Rotoflex rotational beds, reportedly the only ones in the world to include a powered rising heel section, are aimed at achieving independent bed access for users with neurological conditions.

But since its 2018 award for the Rotoflex 235, the company – a partner of charities Parkinson’s the UK and MS Society - has now developed a ‘Mark II’ version in a move to assist users left without carers due to covid lockdown restrictions.

The updated model includes pre-programming, soft start movement and inbuilt software for personalised functionality, such as rotation and incline angles.

And the price is aimed at reducing long-term care costs when compared to standard care.

Theraposture Sales Director Liam Braddell said: “When two carers are potentially replaced by a Rotoflex, the cost of the bed could be repaid within 14 weeks.”

Information about disability grants for profiling beds can be found here: disability grants .org

The Sleep Council organises the UK’s National Bed Month to encourage us all to learn about the importance of good sleep to our health and well-being. More here: sleep council.org

Further reading

Vitamin d deficiency and chronic fatigue

Fatigue and brain injury

Opinions and endorsements published by others on Krysalis Consultancy Ltd blogs or publications do not necessarily reflect the views of Krysallis Consultancy Ltd.

References

[1] Ghersi, I. et al., “From Modern Push-Button Hospital-beds to 20th Century Mechatronic Beds: A Review,” Journal of Physics: Conference Series, 2016.

[2] https://collection.sciencemuseumgroup.org.uk/objects/co409776/kings-fund-hospital-bed-hospital-bed”.

[3] Ghersi, I. et al., “Smart medical beds in patient-care environments of the twenty-first century: a state-of-art survey,” BMC Medical Informatics and Decision Making, 2018.

[4] https://www.krysalisconsultancy.co.uk/resources/item/mental-capacity-everyday-decisions-and-brain-injury”.

[5] https://www.hsmsearch.com/Nursing-home-fined-bedrail-breaches, Health and Safety Matters, January 2021.

[6] https://www.carehomeprofessional.com/nursing-home-provider-fined-24000-following-residents-death/, May 2019.

[7] https://www.gov.uk/guidance/bed-rails-management-and-safe-use#adverse-incidents

[8] https://www.rcot.co.uk/sites/default/files/Prescribing%20beds%20briefing%20%28July%202020%29.pdf

[9] https://www.hse.gov.uk/research/rrpdf/rr764.pdf

[10] https://www.hse.gov.uk/healthservices/epb-health-care.pdf

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