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Hill-Rom aims to provide the services required to
support the improvement of clinical outcomes:
- Risk assessment tools
- Therapy decision guides and protocols
- Integrated therapeutic alarm systems
- Patient specific therapy history
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Risk tools can be utilised to assist in identifying
patients at risk whilst therapy protocols are available to enable rapid
decision making in determining the right therapy for the right patient at the
right time.
Hill-Rom are happy to work with your team to optimise, customise
and continuously improve our risk assessment tools, protocols and decision
guides.
Click here to review the various protocols and decision guides
How long do your patients spend above 30º?
Head Angle elevation above 30º is an important component of the Ventilator Care Bundle.
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Many
departments are looking to implement programmes to ensure patients are nursed
at either 30 or 45 degrees of head elevation.
This is a simple non-invasive
technique, which is now being adopted by most of the leading Critical Care
expert groups such as the ESICM /AACN and the Institute for Healthcare
Improvement Saving 100k lives campaign. This position has been suggested to help to
prevent the aspiration of stomach contents into the lungs1,2, which,
is a major cause of many of the infections and also has been shown to improve
lung function and gas exchange.
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However whilst it appears to be a
simple concept applying it in practice is proving more difficult for the
critical care multi disciplinary team. Recent studies suggest that the Multi
Disciplinary Team’s perception of how high 300 elevation is is
actually very poor- in one recent study patients spent approximately only 20%
of the ventilation period the time above 300 elevation. In this same
report caregivers misinterpreted the 30 degree position for between
15-20degrees.3 This report is by no means unique, a prospective
audit carried out over a 2 week period found that the bed elevation was 30
degrees in 86% of occasions with a mean of just 23 degrees4. The
authors then reviewed their team’s perception of 30 degrees elevation:
- 50% medics, 34% nurses correctly
identified 450
- 44% medics, 34% nurses correctly
identified 300
Importantly it has also been
reported that when the MDT are educated of the
importance of the correct positioning mean backrest elevations increased and
subsequently VAP incidence reduced.5
Often the
implementation and execution of initiatives such as a 300 Head of
Bed elevation target can be fraught with difficulty, therefore, Hill-Rom have
developed a series of tools within the TotalCare frame to support the caregiver
team in this initiative.
1.Angle indicator located on upper side rail are
designed to be very visible even when the side rail is lowered
2. Head of Bed Elevation Alarm – a
unique specialised alarm system within the TotalCare® Bed will alert the
caregiver whenever the patient position falls below the selected level.
3.
Additionally at the touch of a
button the caregiver team can access a detailed review of the patient’s therapy
history including duration of head elevation.
References
1.
Torres A et al Ann.
Intern Med 1992; 116 (7): 540-543
2.
Drakulovic M B, et al Lancet
1999; 354(9193):1851-1858
3.
Fox et al Critical Care Nurse
2006
4.
Thomas M et al ESICM Congress October 7-10 2007, Berlin, Germany, Poster 0966
5.
Mourvillier et al ESICM
Congress 24-27 September 2006, Barcelona, Spain, Poster 0832
Click here for more information on the 30 degree head of bed alarm
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