CHHS17/252

Canberra Hospital and Health ServicesOperational Procedure Use and Provision of Bed Sticks/PolesContents

Contents....................................................................................................................................1

Purpose.....................................................................................................................................2

Alerts.........................................................................................................................................2

Scope........................................................................................................................................ 2

Section 1 – Recommendation, use or provision of single bed sticks/poles...............................2

Section 2 – Risk assessment......................................................................................................3

Section 3 – Environmental Considerations...............................................................................4

Section 4 – Training and Education...........................................................................................4

Section 5 – Correct Positioning of Bed Stick/Pole.....................................................................5

Related Policies, Procedures, Guidelines and Legislation.........................................................6

References................................................................................................................................ 6

Search Terms............................................................................................................................ 6

Attachments..............................................................................................................................7

Attachment 1 - Appropriate Bed Sticks and Poles.................................................................8

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CHHS17/252

Purpose

To ensure the safe and appropriate recommendation, use and provision of bed sticks/poles within ACT Health Directorate facilities and to community based patients.

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Scope

Alerts

Double bed sticks/poles (K-Care bed pole model: KA524) are not to be recommended, used or provided for any patient.

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Scope

All staff involved in the use or provision of bed sticks/poles, including: Allied Health Professionals such as occupational therapists, physiotherapists and allied

health assistant staff Nursing staff Equipment Loan Services and/or maintenance staff

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Section 1 – Recommendation, use or provision of single bed sticks/poles

Bed sticks/poles are not designed to prevent falls from a bed and should not be used, recommended or provided for this purpose. In line with the Occupational Therapy Australia Position Statement on the Provision of Bed Sticks and Poles (2015), single bed stick/poles and clamp on bed sticks can be recommended, used or provided in limited circumstances where a comprehensive risk assessment has been completed.

Double bed stick/poles (K-Care bed pole model: KA524) are not to be recommended, used or provided to any patient under any circumstances due to unacceptable risks associated with them. Please refer to attachments for information on some of the types of bed stick/poles available.

There are circumstances where single under mattress bed sticks and poles should NOT ever be recommended, used or provided, as listed below. In situations where the bed is adjustable manually or electrically; ONLY rails and aids

specifically designed by the manufacturer of the bed can be used including clamp on bed sticks;

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Bed sticks/poles are NOT designed to prevent falls from a bed and should not be used, recommended or provided for this purpose.

The recommendation, use or provision of under mattress or clamp on single bed sticks/poles including models KA525, KA526, KA527: is permitted under the following circumstances:1. A Bed Stick/ Pole Risk Assessment Tool has been completed (available on Clinical Forms

register), and2. The patient (and where appropriate their family/carer) has been educated (including

practical demonstration) on the safe and appropriate use of the bed stick and the risks involved in its use.

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Section 2 – Risk assessment

The Bed Stick/Pole Risk Assessment Tool should be completed by the treating health practitioner in conjunction with the patient/carer and filed in the clinical record prior to recommending or providing the bed stick/pole. The treating health professional must also consider any documented safe working loads prescribed by the manufacturer/supplier for the bed stick/pole being recommended and ensure that this is compatible with the patient’s current and usual weight. The safe working loads will vary between bed sticks/poles.

The following aspects of a patient’s situation must, at a minimum, be considered and documented in the clinical record. Please note that this is not a definitive list of all potential risks.

Assessment of these risks can include self-reported information from the patient or from a third party, such as family member: Does the patient report/ have a history of falls out of bed over the last 6 months? Does the patient report/ have a physical impairment which may affect their ability to

use the bed stick/pole independently and safely? Does the patient report/ have a cognitive or perceptual difficulty (i.e. dementia,

confusion, or learning difficulties) that may impede their ability to use a bed stick/aid safely?

What level/type of assistance does the patient require and what is the availability of assistance?

Does the patient take any medications that may compromise their ability to use a bed stick/pole safely? Symptoms may include an impact on cognition, increased confusion, drowsiness or fatigue.

Does the patient have any attachments that may become entangled with the bed stick/pole (Intravenous lines, oxygen tubing, etc.)?

Are there any other risks or potential risks?

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Section 3 – Environmental Considerations

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In-home assessmentIt is recommended that wherever possible the risk assessment and/or user and family training and education on the safe and appropriate use of a bed stick/pole is completed in the patient’s residential environment, including the bed in which the patient is going to be using the bed stick/pole. In this situation an observational assessment must be completed and hands on training provided within the home environment.

Off-site assessmentIn situations where an onsite (home visit) risk assessment and/or training and education cannot be completed, the risk assessment can be undertaken verbally either with the patient and/or a third party, for example, family member. The patient or their representative will need to have adequate cognitive abilities to answer questions pertaining to their bed and home environment, and the ability to transfer the training and education to the home environment. A demonstration and assessment on a bed is required. When a bed with power options (i.e. a hospital bed) is the only bed available for demonstration, it should be placed in a flat position and the power turned off prior to assessment and training with the bed stick/pole.

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Section 4 – Training and Education

StaffAll staff prior to recommending, providing or installing a bed stick/pole must familiarise themselves with this procedure and undertake training in the safe use and installation of bed sticks/poles. It is highly recommended that this occur as an integral component of orientation to a staff member’s position and is provided by their supervisor or other appropriate team member.

Overview of Training and Education The safe and appropriate use of a bed stick/pole must be demonstrated to the patient

(and where appropriate their carer/family) at the time of installation. The Canberra Hospital and Health Services Single Bed Stick/Pole Information Sheet must

be provided when prescribing under mattress bed sticks/poles (i.e. those on static/standard beds). This is available on policy register under consumer handouts

The risks involved in the use of a bed stick/pole have been explained and accepted by the patient and this is documented in their clinical file.

The patient (and where appropriate their carer/family) must be invited to ask questions; Clinical Documentation should note that training, education and information were

provided and should include the environmental context in which it was provided. Staff providing training and education to the patient must have been provided with

training and education from their supervisor or other appropriate staff member before installing bed sticks/ poles without direct supervision.

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Section 5 – Correct Positioning of Bed Stick/Pole

Correct positioning of bed stick/pole for non-adjustable beds The bed stick/pole is positioned between the patient’s shoulder and hip, approximately

600mm down from the bed head, with patient lying down in the bed. The angled section of the bed stick that sits below the mattress must be positioned

underneath where the patient’s bottom would generally be located on the bed. Ensure there is no foreseeable risk of entrapment by checking the following:

o The base of the bed stick/pole is positioned firmly underneath the mattress. Do not tie or fix the bed stick/pole to the bed (unless it is specifically designed for this purpose) as the mattress may still move over the top of the bed stick/pole creating a larger gap between mattress and bed stick/pole

o The maximum gap between the bed stick and mattress should be less than 60mm (calculated when the mattress is pushed as far as possible to the opposite side of the bed).

o There is a high edge on the bed that the mattress sits below, and/or the mattress is of sufficient weight to maintain the bed stick/pole in the correct position.

o If the bed base is sprung, the bed stick/pole maintains its vertical position when used with maximum force both when transferring and when used within the bed for re-positioning.

Alert: Under mattress bed sticks/poles are not suitable for water beds, beds with an elevating bed head or metal based beds with springs.

Correct positioning for adjustable beds ONLY use clamp on bed sticks with adjustable beds. Clamp on bed stick to be positioned between the patients shoulder and hip when they

are lying on the bed. Ensure rail is clamped firmly onto a non-moving section of the bed. Ensure a gap no larger than 60mm is present between the bed stick and the mattress.

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Related Policies, Procedures, Guidelines and Legislation

National Guidelines Occupational Therapy Australia. (2015) Position Statement: Provision of Bed Stick and

Poles. Accessed online, 23 May 2017. Occupational Therapy Australia. (2015). Practical guide for safe and effective use: Bed

sticks and rails for community, acute and residential care use. Accessed online, 23 May 2017.

Occupational Therapy Australia. (2015). Fact Sheet: Bed sticks and rails. Accessed online, 23 May 2017.

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References

1. Australian Government, Department of Health and Ageing (3 April 2012). Industry feedback alert: Bed poles.

2. State Coroner, Olivia McTaggart (September 2016). Inquest into the death of Barbara Westcott. Hobart, TAS.

3. Magistrate Robyn Denes. (August 2011). Inquest into the death of Martha McKee. Lismore NSW.

4. Deputy State Coroner, Anthony Ernest Schapel (May 2010). Inquest into the death of Arthur John Hutton. Adelaide SA.

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Search Terms

Adjustable Bed, Assistive technology, Bed stick, Bed pole, Entrapment, Equipment, Non-adjustable bed, Use and provision of bed stick, Use and provision of bed poles

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Attachments

Attachment 1 - Appropriate Bed Sticks and Poles

Disclaimer: This document has been developed by ACT Health, Canberra Hospital and Health Service specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.

Date Amended Section Amended Approved ByEg: 17 August 2014 Section 1 ED/CHHSPC Chair

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CHHS17/252

Attachment 1 - Appropriate Bed Sticks and Poles Bed sticks appropriate to recommend include, but are not limited to the following types:

KA525Cobra

KA526Hook or Grip Handle

KA527King Cobra

Provides support to the user when positioning in bed and/or moving into a sitting position.

Clamp on bed stick

Clamps on to the static side rails on profiling (hospital) beds, which ensures it cannot move. (SWL 150kg – Alrick model)

ALERT - Bed Sticks/PolesALERT - DO NOT USE/ DISCONTINUE USE KA524

A lightweight bed pole made from anodised aluminium tubing. It has a 'U' shaped base to fit under the mattress with two posts on either side of the bed. It can also be reversed and used as a safety rail. Designed to assist in transferring and bed mobility. Available in two sizes for single and double beds

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register