Harvest Healthcare

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Harvest Healthcare

Bed Rail Regulations: Your Guide

Did you know that there are side rail regulations put in place by the government and checked by the Care Quality Commission (CQC) in order to prevent entrapment? These rail regulations have to be adhered to by all care providers, which can be difficult, especially in homes with a range of bed and mattress types.
What do the Regulations Say?
Side Rail Regulations 60601/2/52 state that the height of the top edge of the side rail must be more than 220mm above the non- compressed mattress.
This means that when a mattress is placed on the bed platform the top of the mattress must be at least 220mm from the top of the side rails, as illustrated in the image below:

The regulations also state that the gap between side rails must be smaller than 120mm. Shown in the image below:

How is Compliance Tested?
The distance between the top of the mattress and the top of the side rail is measured by care providers – see below our handy tool to help – and the gap between the side rails is tested by manufacturers using a Cone Tool.

The Cone Tool is 120mm in diameter at its widest and 60mm at its smallest. The 60mm end of this tool is placed between the side rails at the weakest point and 250N of force is applied. If the 120mm part of the cone does not pass through the side rails, then they pass the compliance test. The Cone Test is shown below.

How Can Harvest Healthcare Help?

  • All Harvest Healthcare’s standard beds are side rail compliant.
  • All Harvest Healthcare’s mattresses can be placed on any Harvest Healthcare Woburn bed and be compliant.
  • We offer easy to assemble rail sections.
  • Part of our servicing package includes Bed Inspections where side rails are checked for compliance.
  • We offer simple to use bed rail height measurement tools, shown below, so that you can quickly and easily check if you are compliant. If you would like to be sent copies of these testers, please get in touch.

Our aim is to solve your problems to ensure that you can offer excellent care and remain complaint all at a reduced cost.
If you would like more information on how we can help you then please contact us.

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Plus Sized Pressure Care

In the current climate accessible care for all has never been so important.

In one US study the prevalence of obesity increased from 16.9% to 25.8% among newly admitted nursing home residents in just ten years (Cai, Rahman et al. 2013). Sadly, alongside increased body mass comes reduced mobility, increased difficulty for care workers when repositioning and a higher risk of having some secondary health issues, all risk factors for pressure ulcer development.

In the same study residents with moderate or severe obesity had, on average, 15.0% higher odds of having pressure ulcers as compared with non-obese residents in the same facility.

With these statistics in mind it’s easy to see why our plus sized patients need to be afforded the right care using the right equipment, which can come with challenges for care homes or for care in the community equipment providers.

Private homes and non-purpose-built nursing homes can have infrastructure issues that hinder plus sized care. In an acute care environment rooms for plus sized patients are recommended to be 17ft wide and 13.5ft long, not including space for furnishings (Muir 2009), quite a challenge to replicate in longer term care settings.

Secondly, many care providers simply do not keep in stock the equipment needed for those at the more extreme definitions of bariatric, or certainly do not have this equipment in quantity.

Finally, it can be a challenge to source all the required equipment simply and easily – a frustration when a new resident is arriving at a care home with specific needs, or a private home needs to be fitted out to allow a patient to be discharged from hospital.

At Harvest Healthcare we aim to relive the stress of sourcing and fitting plus sized equipment, leaving you to focus on providing the best quality care and support.  Our plus sized brochure contains our full range, making choosing what you need simple and easy, and our knowledgeable customer services and sales teams can talk you through any tricky situations. Our sister company Prism Medical can also support with ceiling track hoists, an excellent way to make use of smaller spaces.

The Harvest range includes beds, mattresses, hoists and bathroom equipment, all designed to make life easier for residents and for their carers and give everyone access to the love and support they deserve.

Contact us for more information on our plus sized range.

 

Cai, S., M. Rahman and O. Intrator (2013). “Obesity and pressure ulcers among nursing home residents.” Medical care 51(6): 478-486.

Muir, M. (2009) “Space Planning for the Bariatric Patient.” Bariatric Times.

 

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Top Tips for a Safe and Effective Engineer Visit

Harvest Healthcare recognises that both essential testing such as LOLERs and equipment repairs must continue in order to protect vulnerable residents.

To make sure that this essential work can continue as safely and seamlessly as possible, please see these top tips for a Harvest Healthcare engineer visit.

Top Tips:

  • If the equipment to be looked at can be moved out of bedrooms/bathrooms/communal spaces please do this in advance of our engineer arriving.
  • Our engineer will wipe down any equipment they touch with disinfection wipes after they are finished. Despite this, we recommend following your own in-house disinfection protocols as a secondary measure.
  • Our engineer will thoroughly wash their hands following strict washing protocols between homes and will always wear gloves during site visits. Please follow social distancing measures as much as possible while our engineers are on site to support these risk reduction measures.
  • If equipment can be serviced/repaired outside the building our engineers are happy to do this. Please place the equipment on a secure, flat, dry surface to maintain engineer safety and decontaminate any equipment before taking it outside.
  • If you have any concerns about the risks posed by a site visit, please contact Harvest Healthcare in advance of your scheduled visit to discuss the safest arrangement to protect staff and residents. We are happy to support the needs of individual homes in order to undertake essential work.

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Warning Signs and Symptoms of Pressure Ulcers

Pressure ulcers often develop slowly but can develop in just a few hours with the right conditions.

Pressure ulcers are likely to develop faster when there is higher pressure on a smaller area, and more slowly when there is lower pressure over a wider area.

What are the Early Signs of Pressure Ulcer Development?

Early signs of pressure ulcer development include:

  • A change in the colour of the skin. People with pale skin are more likely to see red patches on the skin, and people with darker skin area more likely to see purple or blue patches.
  • Reddening of the skin that does NOT turn white when you press it. This is called a ‘non-blanching erythema’.
  • Any unusual changes in skin texture may be related to pressure damage. Common changes include skin feeling spongy or ‘boggy’.
  • A patch of skin that feels cooler or warmer to the touch than others.
  • A sore or itchy patch of skin.

Bedsores fall into one of several stages based on their depth, severity and other characteristics. The degree of skin and tissue damage ranges from red, unbroken skin to a deep injury involving muscle and bone. Skin showing these signs of pressure ulcer development may be referred to as ‘category one’.

See our related article for more information on the staging of pressure ulcers.

What are the Later Signs of Pressure Ulcer Development?

As pressure ulcers worsen, they may break the skin. Signs of worsening pressure ulcers include:

  • An open wound or
  • A deep wound that reaches the deeper layers of the skin.
  • A very deep wound that may reach the muscle and bone.

When should I get help for a Pressure Ulcer?

The NHS website says that if you’re in hospital or a care home, you should tell your healthcare team as soon as possible if you develop symptoms of a pressure ulcer as it will probably continue to get worse if nothing is done about it.

If you’re recovering from illness or surgery at home, or are caring for someone confined to bed or a wheelchair, contact your GP surgery if you think you or the person you’re caring for might have a pressure ulcer.

Get medical advice immediately if there is:

  • Red, swollen skin
  • Pus coming from the pressure ulcer or wound
  • Cold skin and a fast heartbeat
  • Severe or worsening pain
  • A high temperature (fever) of 38C (100.4F) or above

These symptoms could be a sign of a serious infection that needs to be treated as soon as possible.

 

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Staging / Grading of Pressure Ulcers

Pressure ulcers vary in size and severity of the tissue affected, ranging from reddening of the skin to damage to muscle and underlying bone.

How are Pressure Ulcers Staged / Graded / Classified?

According to the international classification system pressure ulcers can be staged as one of six categories.

Superficial

Stage 1: Intact skin with persistent reddening, known as ‘non-blanching erythema’. For more information on non-blanching erythema, click here.

Stage 2: An abrasion or a blister can be seen, without bruising. There is some skin loss or damage affecting the top skin layers.

Superficial ulcers are more difficult to spot than deep ulcers. For information on the warning signs of pressure ulcer development click here.

Deep

Stage 3: Full thickness skin loss which can expose fat in areas where this exists. Damage is limited to the skin and fat layers.

Stage 4: Full thickness skin loss with damage to the underlying structures, such as tendons or bone, which may be exposed.

Other

Deep tissue injury: Tissue injury hidden under intact skin. These appear as deep bruises and can quickly deteriorate into a high-stage pressure ulcer. For more information on why deep tissue injuries occur, click here.

Unstageable Pressure Injury: Pressure ulcer with an undetermined level of tissue injury because the entire base of the wound is covered by slough tissue.

Figure 1 Staging of pressure injury, NPUAP resources

The grading of a pressure ulcer is a critical part of the process of caring for a person with pressure ulcers.

While treatment is tailored to the individual, as may factors can impact the development of a pressure injury, the grade of pressure sore is an important part of creating a treatment/management plan.

For more information on what the risk factors are for developing a pressure injury, click here.

 

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