For comfort & safety -Hospital beds

Hospital beds, over the years, have transformed to be more patient and caregiver centric- By Team HR

 

Hospital bed design has undergone a sea change as beds are now considered an  important equipment facilitating faster recovery and providing a healing environment.  According to Naresh Tahiliani, head-marketing and sales, B2B business, Godrej Interio, “Utmost importance is now given to ergonomics, safety of the patients and the comfort of the caregivers for hospital beds. Designs are also facilitating the ‘C’ shaped mobile X-ray and other equipments which may be required to be bought over to the patients. Various features are incorporated in the design to aid patient movement for comfort and observation.”According to analysts, a hospital bed has evolved from a basic cot on four legs to sophisticated therapeutic platform assisting in early mobility with many clinical positions, automatic controls, safety, monitoring and aesthetic features.

Says Sumeet Aggarwal, COO and MD, Midmark (India) Pvt. Ltd (formerly Janak Healthcare Private Limited), “A basic cot offered adjustable backrest on a manually operated ratchet or crank. It was grossly laborious process and significant patient handling was involved to offer even basic movements like getting off the bed. In the 70’s, we launched the first ICU bed in India. It offered useful clinical positions like Trendelenburg, Reverse Trendelenburg, Height adjustment and others on a dual frame design with smoother manually operated cranks. It also ensured patient safety with addition of side rails as well as casters at the base for easy transfer.”

Medical beds, over the years, have transformed to be more patient and caregiver centric. Ease of use is an important aspect of medical beds from patient and caregiver safety aspect.  Pre and post surgery patient migration in critically ill patients can be complicated and must be handled with utmost care. Patient migration towards the foot-end of the bed is a common cause of pressure ulcers (PU). This is also known to commonly cause lower back injuries amongst caregivers.As the practice of medicine and technology has evolved, hospital beds turned into more sophisticated medical devices especially from comfort and safety standpoints. “We launched the first motorised bed in India during 90’s. It offered automation with electromechanical actuators which replaced the manually operated cranks. Thus, operating a bed became simply a press of key on a handset. The bed looked trendier and cheerful with polymer molded panels and side railings,” says Sumeet.

Today, hospital beds became lighter, stronger and effective with increased use of polymer, superior synthetic casters, emergency positions like CPR and application specific positions like cardiac chair, etc. The generation 2020 therapeutic platforms offer more sophistication with user friendly designs. The new platforms offer more insights with monitoring of vital parameters like patient weight, revealing contouring angles, positions, etc on a digital display. More advanced positions like lateral tilt effectively assists in early recovery and mobility and thus help in reduced average length of stay. Mattress and fabric are specially designed to offer maximum patient comfort. Thoughtfully designed features like handy control panels, night lamp and others improve patient experience.

What has driven these changes? Says Rajesh Babu, head institutional business, Stryker India Private Ltd, “With increasing incidence of acute and chronic ailments, there is an increased emphasis on patient comfort and safety as well as functionality and ease of handling. Stryker’s versatile SV series of beds are designed to deliver value driven features that keep in mind the design needs of a hospital planner and some patients and hospital staffs need reliability while enhancing the aesthetics of a modern hospital set up.”oday, hospital beds became lighter, stronger and effective with increased use of polymer, superior synthetic casters, emergency positions like CPR and application specific positions like cardiac chair, etc. The generation 2020 therapeutic platforms offer more sophistication with user friendly designs. The new platforms offer more insights with monitoring of vital parameters like patient weight, revealing contouring angles, positions, etc on a digital display. More advanced positions like lateral tilt effectively assists in early recovery and mobility and thus help in reduced average length of stay. Mattress and fabric are specially designed to offer maximum patient comfort. Thoughtfully designed features like handy control panels, night lamp and others improve patient experience.

Hospital beds have started complimenting hospital’s interior theme with choice of colours. The International Electro-technical Committee (IEC) introduced the first international standard for hospital beds which guided manufacturers to elevate safety and performance standards. But are IEC standards followed in India? “IEC 60601-2-52 is the latest standard for the hospital beds with very stringent design and testing parameters. Complying with this standard means a thorough engineering and design acumen to make stronger platforms and validation of the standards with a fully equipped quality lab. However, the Indian healthcare market remains very price sensitive which gives a leeway to local manufacturers to produce and sell medical devices without complying standards like IEC, ISO or OHSAS standards,” says Sumeet.

To facilitate its use as a medical device, various features of its movements have been stretched significantly. Today, the height to which lowest beds can be lowered to is 300mm, while the highest height is 760 mm which significantly helps early mobilization of the patient. Today, beds can have backrest activation till 70 degree. And head foot part of the bed can be tilted up to 18 degree and down by 12 degree. The lateral tilt of some beds can be done till 30 degree to avoid fluids getting accumulated in the pulmonary cavity.

The formation of a thrombus, or a blood clot, is caused by deep vein thrombosis (DVT) in the deep leg vein. This is a very serious condition that may cause damage to the leg that is permanent. It may also cause a life-threatening pulmonary embolism, or blood clot in the lungs. Every year, 600,000 new cases are diagnosed. Of every 100 people who have DVT, one can die. After surgery or while on bed rest, the surgeon will know if DVT could be a problem. Sometimes, the risk is greatest right after surgery and for about 10 days afterward. “The tip to prevent a DVT overnight is to raise the foot of the bed at night a few inches. For this to work, legs need to be higher than the hips. Godrej Interio ICU motorised beds have a feature where easily the bed platform can be adjusted in such a position to suit the patients comfort. It can also be adjusted in a cardiac chair sitting position with a single touch,” says Tahiliani.

There has been a strong emphasis on automation/ actuator-driven beds – 4/5 actuators performing between seven and eight different patient profiling in a hospital environment. Crank levers have been replaced by automated embedded controls, remote controls driving the actuators, column lift mechanisms for stretchers and use of melamine for hospital furniture for over-bed tables and lockers. Stretcher and bed castors with single-button locking and a steering function for maneuvering has also been a major enabler for enhancing patient care through design upgrades.

Patient’s early mobility has gained importance with caregivers. Cardiac chair is aimed at this key milestone. It is attained with an underlying complicated programme that moves all actuators simultaneously and intermittently at precise speeds to transform a flat mattress platform into an upright chair position, simply at a press of key! The programme introduces intervals for sequential movement of chair for a better patient compliance.Hospital beds offer various attachment/ provisions for vital accessories used in hospital environment like infusion pump, cylinder cage, IV stand, monitors, etc. These are peripheral equipment around a hospital bed. “Hospital beds are designed to have slots to mount IV poles or monitoring poles at multiple locations on the bed. Two stage/four stage adjustable IV poles offer flexibility of mounting of IV fluids at the desired heights. Angled IV poles prevent the chances of tube entanglement during movement. The IV poles are stronger enough to carry multiple infusion pumps. The beds can also carry O2 bottle with a specially designed O2 cylinder cages. As these accessories add weight to the bed frame, it needs to be better engineered with more powerful actuators,” says Sumeet.

In the coming years, analysts predict that hospital beds will continue to become more efficient and effective with lighter designs, advanced clinical positions and monitoring features. Patient and caregiver safety and comfort will continue to challenge the manufacturers. IOT and connectedness will inspire new advancements. “The new National Health Policy envisions to add 1.8 million new hospital beds in next 10 years in order to improve accessibility of healthcare. We estimate that demand for hospital beds will continue to be strong. However, the price competitiveness will the hold the key for success,” says Sumeet.

While the growth of new infrastructure will drive majority of the demand, replacement and expansion of infrastructure in existing facilities will continue to also be an important factor.

“In the past, not as much attention was paid to purchase of medical furniture and the future buying is expected to be more sophisticated and informed, as buyers consider the total cost of ownership (TCO) over the utilise lifecycle and not just the initial purchase price of beds. Ease and accessibility to reliable service and modularity will become increasingly important as well,” adds Babu.

With advances in technology, the incorporation of embedded control panels, nurse alarms, weighing scales, etc are more becoming a norm already. “Beds will provide 24/7 touch-free, non-intrusive monitoring of biometric health data and trends. This will be on an ‘invisible’ platform that does not require invasive wires or electrodes to be connected to the patient. The touchless solution will analyse and transform big data into information, helping staff easily detect anomalies and assess over-all wellness. This smart bed technology will work in the cloud, offering caregivers applications to analyse and display health data in a user-friendly format via a mobile device or computer anywhere in the world,” says Tahiliani. It’s one more way the internet will connect machines to improve healthcare.

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