Healthcare organizations on the lookout for new patient beds can rest easy. That’s because the latest models to hit the market provide substantially more than just a run-of-the-mill resting spot for patients.

In response to aging caregiver populations, imminent pressure from aging baby boomers and facilities’ ongoing push to maximize capital equipment investments, manufacturers are designing state-of-the-art beds that move far beyond their traditional call of duty.

STERIS TranSTAT

"Hospitals are looking for beds that can serve as an asset in improving patient care and increasing efficiencies," said Derick Elliott, director of marketing for beds and surfaces, Stryker Medical, Portage, MI. "A bed is not just another piece of equipment."

Indeed. Today’s models are significantly more advanced than their predecessors, offering enhanced mobility, safety, comfort and reliability, while at the same time, having the capability to collect pertinent bed- and patient-centric data, and above all, improve patient outcomes. More specifically, feature-rich models can even help facilities meet patient safety requirements, such as risk reduction of healthcare-associated infections and patient harm from falls, and the prevention of healthcare-associated pressure ulcers – three goals outlined in the Joint Commission’s 2007 National Patient Safety Goals.

And in terms of cost, hospitals won’t have to take this information lying down: even the most advanced beds are surprisingly cost-effective and provide a rather rapid return on investment, sources told Healthcare Purchasing News. In the report, U.S. Specialty Bed and Surface Market for Wound Management, market research firm Frost & Sullivan noted that the demand for highly functional, less expensive products is creating a cost-driven market that has compelled manufacturers to lower prices.

Therapeutic systems

More than ever, specialty beds are earning their title. Although what makes a bed purchase-worthy is undoubtedly subjective – and dependent upon facilities’ unique needs and goals – healthcare organizations are responding favorably to manufacturers’ next-generation models.

Beds that incorporate therapy capabilities to aid acute pulmonary patients are just one example. Stryker Medical, Hill-Rom and Kinetic Concepts Inc. all have bed products with built-in therapy features. Hill-Rom’s new TotalCare SpO2RT system features Therapy-On-Demand Modules that offer continuous lateral rotation therapy and percussion and vibration therapies to assist in the treatment and prevention of pulmonary complications related to mobility. Also included is a 30-degree head of bed alarm that alerts caregivers when the head of the bed falls below a 30-degree angle, thus reducing the risk of ventilator-associated pneumonia or the aspiration of gastric contents.

"This is a product for high-acuity areas and is our gold-standard product for the ICU," said Mitch Tidman, director of corporate communications and brand, Hill-Rom Corp., Batesville, IN. "The programmable therapy module increases efficiency because it allows caregivers to focus their attention on other tasks."

San Antonio-based KCI’s RotoProne Therapy System delivers prone therapy and kinetic therapy in a single, automated system. It has been shown to improve oxygenation in patients, reduce Sequential Organ Failure Assessment score and simplify caregiving for severely injured multiple trauma patients.

 "The system gets patients from supine to prone position and can even rotate a patient while they are lying facedown," said Paula Otto, product manager of KCI’s critical care therapies. "Not only does this helps drain pulmonary secretions, it also helps prevent skin breakdown." KCI also offers a lower cost therapy bed designed for less acute patients. The newly released TriaDyne Proventa delivers kinetic therapy but without automatic proning.

 
Stryker’s XPRT sleep surface with touch screen

New to Stryker’s lineup is the XPRT Advanced Pulmonary Therapy support surface that combines rotation, percussion/vibration, low air-loss and pressure relief for advanced pulmonary therapy and ulcer prevention. XPRT has also been shown to deliver superior return on investment by helping to reduce rental expenses.

After purchasing the XPRT therapeutic pulmonary support surfaces, Kaleida Health System, Western New York’s largest healthcare provider, was able to cut its annual specialty bed rental costs (totaling nearly $1 million) by $800,000. The organization primarily rented specialty bed products to address respiratory, pulmonary and bariatric needs. The over-three-quarter savings means Kaleida will pay for the entire purchase in just 3.4 years and will continue to receive a 29 percent return on investment; the organization is on target to save $4 million in specialty bed rental dollars over the next five years.

Positioning pay-off

Ergonomic benefits also come into play with the latest bed systems. Because they do the positioning, they prevent caregivers from lifting and maneuvering patients themselves.

"This helps facilities with no- or minimal-lift policies and is obviously beneficial from a risk management perspective," Otto explained, noting that roughly 40 percent of workplace injuries result in an average ten days of missed work. And with the surge in the number of overweight and obese patients being cared for today, systems that can reduce the need for lifting by caregivers are becoming increasingly popular, she said.

Hill-Rom’s TotalCare SpO2RT system features a Turn Assist feature that facilitates easier patient handling with fewer staff, and its FullChair Patient Positioning Mechanism allows caregivers to easily and frequently position immobile patients with physician and nursing "up-in-chair" orders earlier at the touch of a button. Other caregiver- and patient-friendly positioning features include the Shearless Pivot Patient Positioning, which reduces the need for patient positioning "up-in-bed" and the FullChair Egress Positioning Mechanism, which helps patients safely exit the bed for ambulation. Based on the patient’s condition, the patient has the option of side or foot end of bed egress.

Stryker designs its products to help patients and caregivers by incorporating an intermediate siderail that correctly positions the patient for ingress and provides an integrated lift-assist for egress. Retractable frames ensure that the patient stays in place when the head of the bed is lifted, which helps prevent pressure ulcers associated with shear and helps eliminate the risk of caregiver back injuries that could result from boosting patients up in bed. Stryker’s new GoBed II med/surg bed is available with the company’s patented Chaperone bed exit system and Zone Control technology. According to Elliott, the GoBed II combines safety and simplicity along with ease of mobility, while its low bed height of 14.5 inches further aids safe entry and exiting. The Chaperone bed exit system plays an integral role in fall prevention as well – so much so that Styker offers a performance-based guarantee pledging a fall reduction of at least 30 percent within the first year of use.

Hill-Rom CareAssist ES bed

Hill-Rom’s higher-end med/surg VersaCare platform offers a couple different surfaces for wound care and prevention, and its low height serves as a fall prevention perk. The CareAssist ES bed, the newest in Hill-Rom’s med/surg line, eases patient positioning with its One-Button Dining Chair feature and the Shearless Pivot Mechanism reduces shearing by keeping the patient in place.

"We realized that there are customers who want to buy high performance with all the bells and whistles and those who want a good, robust product that is less expensive," Tidman explained. "The CareAssist is robust, yet price-sensitive. Getting a cost-effective bed that is high quality and feature-rich is a reality for customers today."

Low-height, pressure relieving bed frames and surfaces top Huntleigh Healthcare Inc.’s list of engineering priorities. This year, the company released two new bed products: the Enterprise 9000 electric profiling hospital bed and the Auto Logic system. The Enterprise 9000 model aids fall prevention with its exceptionally low 12-inch height and intregrated patient egress bed exit alarm, and its patented Bio-Contour 3-dimensional profiling system, which combines bed section movements with a curved mattress platform, assists with pressure management by reducing shear and friction.

"Because we are a wound care company, we firmly believe the bed frame should be truly clinically effective and more then just a piece of furniture," explained Peter Lambord, head of Huntleigh’s bed division. "The Enterprise 9000 was designed to profile around the patient mimicking the way a person stretches." He added the "pit stop maintenance" was another design priority. The Enterprise 9000 is fitted with fully removable deck sheets for full engineering access. Maintenance can be performed onsite by one person– with each part requiring only a few minutes to service.

Huntleigh Healthcare’s Auto Logic system provides an automatic, self-setting mattress replacement and cushion combination with battery back-up for active transport. The self-set technology of the Auto Logic system automatically controls mattress pressure to aid pressure area management. In both alternating or Constant Low Pressure modes, an advanced
microprocessor system regularly assesses the body mass distribution of patients and readjusts cell air pressures
to suit the patient’s unique
requirements.

Huntleigh Enterprise 9000

Huntleigh Healthcare’s Auto Logic system

"The Auto Logic system is unique in its ability to provide 24-hour continuous care," said,Chip Vagnoni, product manager for Pressure Area Care, Huntleigh Healthcare. "It’s the only system with an optional battery for active transport and it also features a seat cushion that runs off of the same pump. It allows the patient to receive the therapy while in the bed or while seated in a chair."

Fulfilling the needs of bariatric patients has also moved front and center on vendors’ list of priorities. And while larger, sturdier frames are certainly a must for bariatric bed designs, that’s just the tip of the iceberg. The engineering process for Stretchair Patient Transfer Systems Inc., Largo, FL, involves working with obese models to ensure that their product needs and concerns are adequately addressed.

"It isn’t about just making the product wider and stronger," said Stretchair president Mike Doust. "In working with obese men and women, we gain a real understanding of how weight distribution and size can impact risks associated with the product, such as pinch points." Doust explained that while higher weight capacities are undoubtedly important – Stretchair’s Crosstown 1200 Motorized model has a 1,200-pound capacity – comfort, safety and dignity must also be factored into the design.

Stretchair Patient Transfer Systems

Because Stretchair products allow for infinite positioning, they can convert from a stretcher to an upright or reclining chair position. And because Stretchair’s models now offer the TemperMed pressure management surface, the units can be better utilized as a temporary bed.

"In our research we’ve discovered that approximately 90 percent of individuals who are obese sleep in a reclining chair at home because of airway management issues," said Donna Horn, vice president of sales and marketing for Stretchair.

Positioning versatility also means less lifting and transferring, which again results in less risk for caregivers and patients, and assists in the transition of getting obese patients upright and mobile. "The single greatest fear of obese patients is the fear of falling during [transport]," Doust noted, adding that when a facility can keep a patient comfortable and supported with one product longer, dignity is also positively impacted.

Hill-Rom’s new Excel Care ES bariatric bed — positioned to replace the manufacturer’s Magnum II bed system — features an adjustable frame and mattress with side air bolsters that deflate at a touch of a button, making it easier to move the bed through doorways and allowing caregivers to get closer to the patient. The Excel Care ES also has an adjustable length to prevent patients from sliding down in bed, reducing the need to reposition themselves, and a seat-deflate mechanism helps patients get in and out of bed more easily.

Customers also have access to more motorized bed systems that eliminate the need for heavy, awkward pushing down hallways and corridors. Other features, such as fifth wheels located on the center, underside of the bed, aid with maneuverability.

Smart designs

Thoughtful engineering has resulted in more streamlined features that maximize the bed’s effectiveness without taking up additional space. Siderail communication capabilities can integrate nurse call and television and lighting controls, while software-driven touch screen displays make it possible to check bed status (i.e., if bed rails are up or down, which mode is in operation, the degree of incline, etc.), perform self-diagnostics, and even track patient-centric data, including therapy history and patient weight.

Easy to use integrated scales go beyond the basics by coupling accuracy and weight trending capabilities with new-and-improved positioning requirements. Styker beds, for example, can weigh patients in any position. "Caregivers don’t even have to position the patient’s hips," said Elliott, adding that without the need for positioning, patients can be more comfortable, while caregivers benefit from improved efficiencies and less lifting.

To further streamline patient care delivery today’s beds also offer integrated bottle, pump and IV pole holders to keep critical items handy and in easy reach of the caregiver, while at the same time, safely contained.

Innovating design has also led to the development of an add-on transport system that eliminates the need to disconnect leads on critically ill patients. STERIS’ new TransSTAT Device Transport System, designed to work with leading bed manufacturers’ systems, benefits the patient and caregiver by speeding the preparation process and preventing potentially dangerous errors that can occur while reconnecting leads.

Because leads do not need to be disconnected with the TranSTAT system, "nurses can prepare the patient to move in seconds, which allows staff to spend more time attending to other caregiver activities," said Rosemary Niewolak, product manager, STERIS Corp., Mentor, OH.

Also, because the patient, bed and TranSTAT system move as one unit, there is no stress to the patient or risk of equipment falling on them during transport. Another benefit, according to Niewolak, is that the system permits equipment to be situated and locked away from the head of the bed, allowing staff to have constant access to the patient’s head and a continuous view of critical equipment monitors.

"This allows the transport nurse to react more quickly to a patient crisis, which can make a difference in outcomes for a critically ill patient," she continued.

Like the leading bed manufacturers, STERIS was committed to creating a solution with streamlined dimensions to simplify navigation, even in tight spaces such as elevators. Another bonus is that the TranSTAT system uses no independent moving wheels, allowing staff to focus on the patient and only worry about steering one moving object – the bed.

Stryker Secure II with Chaperone bed exit system

Look for beds to become even smarter and more streamlined in the near future. Bed designs will continue to be modified to meet evolving patient and caregiver demands, and touch screen interfaces will become even more intuitive and integrated. While some smart solutions, such as real-time bed and patient tracking, are not yet available, vendors are already planning for the near future by incorporating features that will allow for easy upgrades. Stryker, for example, launched its iBed option earlier this year, making the company’s bed systems "communication-ready."

"Customers want a flexible system that can meet their changing needs," said Elliott. "Having the capability to take advantage of new technology is a great way to maximize your investment while providing state-of-the-art care." HPN

Are your legacy beds safe? Because hospital beds are, by nature, rugged and built to last, many healthcare organizations keep them in rotation for decades. While that bodes well from a financial perspective, some legacy beds may prove dangerous for frail, elderly or confused patients. That’s especially the case since facilities may have replaced mattresses, bed surfaces and bed rails with models that weren’t a suitable fit for the bed frame. Between January 1, 1985 and January 1, 2006, the U.S. Food & Drug Administration received 691 incidents of patients caught, trapped, entangled or strangled in hospital beds. The reports included 413 deaths, 120 nonfatal injuries and 158 cases where staff needed to intervene to prevent injuries. "While these numbers appear small, we believe they are signals about significant adverse events," noted Larry Kessler, Sc.D., director, Office of Science and Engineering Laboratories, FDA’s Center for Devices and Radiological Health, in a prepared statement. He pointed out that because adverse events often go unreported the numbers may be higher. In March, in response to the reported events that continue to be reported to the FDA, the agency issued a Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment (www.fda.gov/cdrh/beds). The guidance identifies special issues associated with bed systems and provides design recommendations for manufacturers of new hospital beds and suggestions for healthcare organizations on ways to assess existing beds. Beyond that, the guidance characterizes the body parts at risk for entrapment, identifies the locations of hospital bed openings that are potential entrapment areas, recommends dimensional criteria for new hospital bed systems, provides information about reporting entrapment adverse events, and includes a description of recommended test methods for assessing gaps in hospital bed systems. "This guidance will assist individuals, families and healthcare facilities in making better informed decisions to ensure a safe sleeping environment for people who need these beds," added Kessler. While not all patients are at risk for entrapment and not all hospital beds pose an entrapment risk, he stressed that the new guidance will help ensure that new hospital beds are designed to reduce the potential for entrapment and that the risks that may exist with current beds are identified. "The dimensional assessment described in this guidance may be used as part of a manufacturer or facility’s comprehensive bed safety program." Healthcare facilities developing such bed safety programs should consider following the FDA guidance and consulting with the hospital bed manufacturer and their facilities’ risk managers. For further assistance, the Hospital Bed Safety Workgroup – under the FDA’s leadership and in partnership with hospital bed manufacturers, national healthcare organizations, patient advocacy groups, and the Department of Veterans Affairs — has developed a Bed Safety Entrapment Kit containing information and tools that can be used to assess the risk of entrapment in hospital beds. To order the kit or learn more about it, contact National Safety Technologies at (800) 678-7072 or log onto the NST website at www.nst-usa.com.