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Informational/Educational Report
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Hospital bed safety and entrapment Paula Gruccio, RN, MSN, CWCN, COCN, CCCN, Huntleigh Healthcare Introduction.Bed side rails have been utilized throughout the United States for many years. Intended to reduce falls, recent literature has shown them not to always be effective for this purpose. It is important for healthcare professionals to be aware of entrapment issues associated with the use of hospital bed side rails. The responsibility for specialty bed/therapeutic support surface selection is often that of the wound care professional. This review of the literature/poster aims to increase awareness of this subject The Problem.During the past twenty years, adverse events of entrapments in hospital beds have been reported. Between 1985 and 2004, there have been 575 reports of entrapment. Of those, 358 were of deaths, 111 were of injuries, and 106 were reports of near misses. Working Toward Solutions .In 1995, the FDA issued a safety alert: Entrapment Hazards with Hospital Bed Side Rails. The Hospital Bed Safety Workgroup was formed in 1999 to study this matter. In 2004, they published a draft guidance document entitled: Hospital Bed System Dimensional Guidance to Reduce Entrapment. The draft document details locations on the bed, where entrapments have and could potentially occur, and recommendations to reduce risk. The International Electrotechnical Commission's proposed anthropometrical measurements are also being considered for inclusion. Publication of the final guidance document is expected this year Conclusion.Persons who are most at risk for hospital bed entrapment include those over the age of 65, those with impaired mental status, agitation, muscle control impairment, or a combination of these factors. Assessment and identification of this vulnerable population of persons at risk for entrapment is imperative. Equipment choices for those at risk.must be carefully considered Braun JA, Capezuti E. Bedrail entrapment: Is your facility safe? .Nurs Homes Long Term Care Manage. 2004;53(11):56 Conditions of Participation-Hospital CoPs for PatientsÕ Rights. Questions and Answers. Available at: http://www.cms.hhs.gov/cop/2bl.asp..Draft guidance for industry and FDA staff: Hospital bed system dimensional guidance to reduce entrapment. Available at: http://www.fda.gov/cdrh/ocer/guidance/1537.html FDA safety alert: Entrapment hazards with hospital bed side rails..Available at: http://www.fda.gov/cdrh/bedrails.htm HCFA/CDRA Letter regarding physical restraint definition. Available at: http://www.fda.gov/cdrh/beds/hcfa_hospital_bed_letter.htm . .Hospital beds and the vulnerable patient. The Hospital Bed Safety Work Group. Available at: .http://www.fda.gov/cdrh/beds/..Hospital Bed Safety Workgroup. (2003). Clinical guidance for the assessment and implementation of bed rails in hospitals, long term care facilities, and home care settings. Available at: http://www.fda.gov/cdrh/beds/..International Electrotechnical Commission.Medical electrical equipment, Part 2.38:Particular requirements for safety-Electrically and manually operated medical beds for adult use (IEC 60601Ð2Ð38: 1996, MOD) (Revision of AS/NZS 3200.2.38:1997) .. |
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