Hospital Acquired Infections Infographic

Hospital Acquired Infections

 

 

The majority of people in North America that work in the Healthcare Industry understand that Hospital Acquired Infections (HAIs) can have a substantial effect on patients, staff  or anyone else that enters through the doors of a hospital or medical center. The number of deaths resulting from HAIs can be reduced by implementing a few simple suggestions from the infographic below. 

 

In your own facilities how prevalent do you think HAIs are? Do you have any additional thoughts or suggestions on how to reduce the number of HAIs in North America?

 

 CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

 

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How to Manage the Risks of Patient Wandering

Patients living with dementia or Alzheimer’s can be prone to wandering. Unfamiliar environments like the hospital can increase the likelihood of wandering, which can create a challenge for hospitals to manage at-risk patients and ensure their safety at all times.

One of the biggest concerns for wandering patients in the hospital is falling, either when getting out of bed or when wandering. Exiting the hospital bed without nurse assistance can cause patients to trip or fall especially when experiencing altered perception at unfamiliar heights. Wandering through the hallways can lead to stumbling and tripping caused by weakness and disorientation. When patients fall, serious injury such as fractures, lacerations, or brain injuries can occur.

Most wandering prevention programs are put in place when a patient has been identified as a wandering risk. If a patient has not been diagnosed with dementia or Alzheimer’s, hospital staff may not realize immediately that the patient could be prone to wandering.

As a result, elderly patients should be screened for any signs of a memory problem or disorientation upon admission. This process can be similar to a fall risk assessment and should look for signs of memory loss or cognitive impairment. Since a patient’s condition can change throughout a patient’s stay, staff should continually observe patients for changes in functioning, mood, or awareness while simultaneously assessing fall risk.

If a patient’s mental condition changes, or if the patient has been assessed as a wandering risk upon admission, staff will need to ensure that there is regular supervision to minimize risk. Hospitals can use any combination of the following strategies to reduce wandering:

·         Sitters

·         Bed-exit alarms

·         Locating the patient’s room near the nurses’ station

·         Hourly nurse rounding

·         Watching for indications that the patient is trying to leave

Sitters can be a costly method to reduce patient wandering, but does employ constant supervision to eliminate wandering. A more cost-efficient solution would be to use a bed-exit alarm to monitor when a patient is exiting the hospital bed or showing signs of movement. When a patient is located close to the nurses’ station, staff can quickly respond and return the patient to bed or provide help if a patient requires toileting assistance.

Hourly nurse rounding can be used alongside a bed-exit alarm for regular supervision of wandering patients. Each hour, nurses can check in on patients and assess the patient’s condition and mental state. If a patient is confused and is asking about family members, this may indicate that a patient may be looking to leave the hospital bed to find his loved ones. When a patient is tying up shoes or putting on a coat, this is also an indication of wandering that should be addressed through intervention.

However, since patient wandering is not always entirely preventable by nurse intervention, staff should ensure that safety measures are put in place for when a patient wanders:

1.       Use a low hospital bed to reduce falls and injury when patients get out of bed unassisted

2.       Ensure patients are located far away from exits, stairs, and other hazards

3.       Outfit patients in appropriate footwear for safe wandering and slip/fall prevention

If a patient does leave the bed without nurse intervention, low hospital beds can provide a safe resting height that can minimize the risk of injury from trips and falls out of bed. Assuring that the patient is located far away from exits, stairs, and other dangerous areas can limit the adverse events that can occur when a patient wanders. Appropriate footwear should be worn by the patient at all times to minimize the risks of slips and falls.

Maintaining a safe environment for patients is the key to creating a wandering management and prevention program in your facility. Implementing the necessary steps to identify patients who are at-risk of wandering can prevent slips, trips, falls, or other adverse events that can occur when a patient wanders.

CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

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5 Reasons Why Patient Falls Should be Your Facility’s Top Priority

5 Reasons Why Patient Falls Should be Your Facility’s Top Priority

1.       Keeping patients safe from fall injuries is one of The Joint Commission’s Hospital Accreditation Standards

Initially a National Patient Safety Goal created by The Joint Commission, addressing and managing patients’ risk for falls became a Hospital Accreditation Standard in 2010.

Standard PC.01.02.08
The hospital addresses and manages the patient’s risk for falls.

This means that critical access hospitals must act in accordance with this standard, and facilities looking to become accredited by The Joint Commission must also satisfy these standards.

Patients often look to ratings, reviews, and accreditations when choosing a hospital for care. Meeting The Joint Commission’s Hospital Accreditation Standards gives patients peace of mind and helps ensure that hospitals are providing safe and effective care in accordance with nationally recognized standards.

2.       Falls from the hospital bed are associated with serious complications

Falls from the hospital bed can result in serious injuries including fractures, dislocations, and brain injuries. It should be a facility’s top priority to provide a patient with a safe environment and reduce the risk of falls and associated injuries.

A patient fall can also result in a loss of self-confidence, which can lead to uncertainty in a patient’s abilities and cause repeat falls. A patient may be unwilling to be active and mobile after a devastating fall, which can further increase the risk of repeated falls.

Patients who have experienced a fall in the past are 3 times more likely to experience future falls. By minimizing the initial risk, hospitals can prevent complications from injuries and self-confidence that can increase the prevalence of patient falls.

3.       Hospitals are no longer reimbursed by the Centers for Medicare and Medicaid for patient falls

As of October 1, 2008, the Centers for Medicare and Medicaid (CMS) has stopped reimbursing hospitals for the additional cost of care when treating a patient harmed by a Hospital Acquired Condition (HAC). Patient fall injuries including fractures, dislocations, and brain injuries are classified as reasonably preventable errors that will no longer be paid for by the CMS.

The average Medicare payment for the treatment of injuries from a patient fall was $24,962. Given the frequency of patient falls, this HAC could add up to hundreds of thousands of dollars in treatment costs alone for individual hospitals each year.

Reducing the rate of falls in your facility could not only save millions of dollars over the span of a decade, but it will improve patient safety throughout your facility.

4.       Patients who fall stay in the hospital longer

Patient falls are the most common Hospital Acquired Condition in the United States, accounting for 75% of all inpatient incidents. On average, patients who experience a fall in the hospital are treated for 12.3 days longer than patients who did not experience a fall.

By reducing the number of falls that occur in the hospital, patient turnover can increase. Not only do hospital-acquired falls cost hospitals money, but treating patients who have experienced falls reduces bed availability. Hospitals can improve efficiency and reduce patient wait times by implementing fall reduction strategies and creating a safer environment for patients.

5.       Seniors are more likely to experience falls

Today, 1 in 5 senior patients are expected to experience a fall in a hospital setting. By 2030, it is expected that seniors will account for over 50% of all hospital admissions and will occupy 59% of available hospital beds. Consequently, more seniors in the hospital means more falls will occur in the hospital setting.

Every year, millions of baby boomers are turning 65 and become part of the prime demographic of falls. Creating strategies to minimize the risk of patient falls today will help reduce the number of expected senior falls in the future.

http://www.americannursetoday.com/article.aspx?id=7634&fid=7364

http://www.jcrinc.com/common/PDFs/fpdfs/pubs/pdfs/JCReqs/JCP-12-09-S6.pdf

CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

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Nurse Burnout: Causing the Spread of Infection?

Nurse Burnout: Causing the Spread of Infection?

Each year, over 2 million patients are affected by a Hospital Acquired Infection in the United States. Over 100,000 patients die every year of complications from Hospital Acquired Infections like MRSA, E. coli, and C. difficile. A new study published by the American Journal of Infection Control has found that nurses may be a contributor to the spread of infection, especially when working long hours and caring for too many patients at a time.

When nurses are overworked, infection control can sometimes be ignored. Nurse-to-patient ratios and the increasing hours of nursing care per patient can actually contribute to an increased rate of infection in the hospital.

The American Journal of Infection Control observed the effect on nurse staffing and burnout on Hospital Acquired Infections like urinary tract infections and surgical site infections, but the implications can be similar for nosocomial infections like MRSA and E. coli. Increasing a nurses’ workload by only 1 patient was found to increase the likelihood of a patient contracting an infection.

This 1 extra patient requires extra time out of the nurse’s day to monitor, provide medication and other bedside care, on top of caring for other patients. Burned-out and overworked nurses can sometimes forget, or become too busy, to ensure proper hand washing throughout the day. When time is at a premium and nurses are caring for multiple patients, infection control may not be a top priority – especially when a patient is in distress.

The Cost of Understaffing

Hospital Acquired Infections cost over $5 billion each year. Since 2008, the Centers for Medicare and Medicaid (CMS) no longer pays the cost to treat urinary tract infections or surgical site infections. As the CMS continues to reduce payments for preventable conditions, nosocomial infections from MRSA or E. coli bacteria could eventually be added to the list of Hospital Acquired Conditions that are no longer paid for by Medicare or Medicaid. Understaffing hospitals will become costly in the long run if the cost of treating Hospital Acquired Infections is no longer covered.

The best solution to improving infection control and reducing nurse workload is to increase staffing, but this solution is not always possible. Other solutions to reduce nurse burn-out and create a safer environment for infection control include:

1.       Implementing infection control programs for staff

With an increase in patient workload, the stress of caring for and monitoring patients on an on-going basis can overshadow basic infection control procedures like hand washing. Reminding nurses to pause during their busy day to observe infection control procedures through workshops or shift report reminders can have a lasting impact on patient safety and infection control protocol2.       Using technology to help reduce nurse workload

Fall-risk and wandering patients can put a strain on nurses. Using a bed-exit alarm can help reduce a nurse’s workload by alerting nurses to bed-exiting behaviour before a patient wanders or experiences an adverse event like a fall from bed. Hospitals should implement bed-exit alarms that reduce false alarms and alarm fatigue by resetting when a patient returns to bed, without the need for nurse intervention.

Similar technologies exist in many aspects of patient care and should be used when possible. Alleviating a nurse’s workload can increase the likelihood of following through on infection control procedures and creates a better atmosphere for nurse and patient safety.

3.       Using equipment that features anti-bacterial surfaces

Anti-bacterial surfaces can be a major component in reducing the spread of Hospital Acquired Infection. The hospital bed is a critical area to observe patient safety and infection control. Using anti-bacterial solutions within the hospital bed’s surface can eliminate most of the harmful bacteria that can cause infection. This line of defense against infection control can reduce the spread of MRSA and E. coli for a safer patient environment.

Hand washing is an important step in infection control, and special care needs to be taken to ensure nurses have the proper support to implement infection control measures. Creating a reduced workload and using tools that help address infection control, such as anti-bacterial surfaces, can make a considerable impact on patient safety and reduce your facility’s cost of treating Hospital Acquired Infections.

CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

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 References:

http://www.nursing.upenn.edu/chopr/Documents/Nurse%20staffing,%20burnout,%20and%20health%20care%20associated%20infection.pdf

http://www.nursezone.com/Nursing-News-Events/more-news/Study-Links-Nurse-Staffing-and-Burnout-to-Hospital-Infections_40308.aspx

 

Noisy Hospitals = Patient and Staff Distress

Noisy Hospitals Cause Alarm Fatigue and Patient Distress

A recent study from the University of Chicago revealed that hospital noise is reaching 67 decibels in some environments, which is considerably higher than the World Health Organization’s (WHO) recommendation of 30 decibels in the patient room. Each year, the noise level in hospitals rises by an average of 0.35 decibels. An increasing number of devices are being hooked up to monitors every year, which is creating a sea of constant beeping and numerous patient safety concerns.

When the level of noise increases in the hospital because of high-pitched alarms, a patient’s sleep is more likely to be disturbed. The beeping of patient monitors has been found to be more disruptive to patients that the sounds of human voices or environmental noises like traffic.

Every hour of sleep that is lost can cause a patient’s blood pressure to rise by up to 6 points. Even if a patient’s sleep was not disturbed, high frequency noise can still cause a patient’s heart rate to rise. Hospital noise can also cause higher rates of heart disease, impaired immune function, and increased memory problems and depression in patients.

The effects of hospital noise can lead to other complications. Using sedatives to combat the effects of the sounds could create a higher risk of patient falls. If a patient experiences a fall, he could face an extended hospital stay, causing the patient to experience the noisy environment for even longer.

Nurses and Alarm Fatigue

Nurses experience the constant beeping and high-pitched noises of the hospital on an almost daily basis. The volume (both sound- and number-wise) of alarms has made it difficult for nurses to respond or assess which patients need immediate attention, if any at all. In fact, almost 95% of alarms are said to be alerting nurses to non-actionable events including false alarms.

Alarm fatigue is becoming a growing concern in the health care environment. Because so many devices are hooked up to alarms and the noise is so frequent, nurses are becoming desensitized to the sounds of monitoring alarms. Desensitization can lead to missed alerts or a delayed response in addressing the cause of the alarm, affecting a patient’s quality of care.

Reducing hospital noise is not just an issue of comfort, but an issue of safety for patients and staff. Considering only 5% of alarms are alerting nurses to actionable events, there is little evidence to suggest that alarms should be sounding off 24/7, except when triggering actionable alerts.

There are exceptions, however, as intensive care and cardiac care units require constant patient monitoring due to the delicate nature of the unit.

Patients at risk of falling or wandering also require the use of bed-exit alarms, and are in most instances, actionable. The best solution to minimizing alarm fatigue and the annoyance of bed-exit alarms is to implement an alarm that automatically resets when a patient repositions or gets back into bed.

By silencing and reinstating the alarm without nurse intervention, noise levels can be reduced and false alarms can be eliminated.

Curbing the noise level can help patients rest and recover in the hospital without fearing noise-related adverse effects like insomnia or heart complications. Nurses can benefit from a focused work environment without the distraction of unnecessary beeping and alarms. Reducing the noise level by limiting the number of alarms can help hospitals meet the 30 decibel range suggested by the WHO.

http://viewer.zmags.com/publication/cde0997d#/cde0997d/1

CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

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The 5 Major Causes of Patient Falls

The 5 Major Causes of Patient Falls

 

Patient falls don’t just happen because of intrinsic risk factors like chronic illness or previous fall history. Most often, patient falls are caused by a multitude of factors:

1.       Patients do not call for nurse assistance

Disoriented or confused patients may not realize they are in an unfamiliar environment and may not use the nurse call button when exiting the bed. Similarly, prideful patients may choose not to use nurse assistance and will try to get out of bed themselves, despite their abilities.

When patients overestimate their abilities and do not call for help, falls can occur. Weak or disoriented patients may not be able to get out of bed safely, or may stumble when walking. Nurse assistance can minimize the occurrence of falls by transferring the patient or offering other assistance when needed.

Bed-exit alarms should be used when patients refuse to call for nurse assistance.

2.       The bed-exit alarm is not set

Reinstating the bed-exit alarm on a hospital bed can be a forgotten task in a busy hospital unit. When a nurse or staff member does not initiate or reactivate an alarm once the patient has returned to bed or after receiving bedside care, patients can be exposed to risk.

Bed-exit alarms help alert staff to bed-exiting behaviour in fall-risk patients such as getting out of bed or moving positioning. Patients who are prone to wandering or who exit the bed for reasons like incontinence may choose to exit the bed without assistance, which can result in trips or falls out of the bed or when ambulatory. Bed-exit alarms also alert staff to rolling or unwanted movement towards the edge of the hospital bed, which can occur in limited mobility patients, and cause a patient to fall.

When a bed-exit alarm is not reset, a patient’s exit from bed or repositioning can go unnoticed and result in trips or falls. Preventative measures like bed-exit alarms can ensure that patients are assisted out of bed or are repositioned when they are too close to the edge of the hospital bed.

Bed-exit alarms that automatically restore settings should be used when monitoring patients.

3.       The patient is on high-risk medications

High-risk medications including sedatives and anti-depressants significantly increase a patient’s risk of falling. Dizziness, confusion, or impaired mobility can occur as a result of medication, and because of the numerous effects, patients on high-risk medications commonly experience falls.

Patients on high-risk medications should be assessed at the highest fall risk. Preventative measures include using adjustable low hospital beds, bed-exit alarms, and scheduled toileting can help reduce the occurrence of medicated patient falls.

4.       The patient assessment was inadequate

Sometimes a patient may not be assessed for fall risk on intake. In other instances, a patient may be assessed for a low fall risk, when in reality; a patient may be overestimating his ability or may be experiencing incontinence.

As a result, the patient may not be identified as a fall risk and does not benefit from the hospital’s preventative measures for patient falls. This increases the likelihood of falling, as the unidentified fall risk patient is not placed in a low hospital bed, not given non-slip footwear, nor is he moved closer to the nurses station for toileting assistance – common preventative measures for fall risk patients.

As a preventative measure, low hospital beds are recommended for use with all acute care patients to minimize falls and fall injury. Fall risk assessment should be routinely performed in order to address changes in a patient’s condition throughout the patient care.

5.       There was a delayed response to the nurse call bell

Incontinent or agitated patients may not be willing to wait for a nurse’s response to the call bell. Instead, these patients may attempt to leave the bed, wander, or use the bathroom unassisted. Much like the patients who refuse to use nurse call assistance, these impatient patients are at a greater risk of falls because they are unassisted when exiting the hospital bed.

Highly agitated or incontinent patients should be moved to closer to the nurses’ station in order to minimize the wait time for nurse assistance. Bed-exit alarms should also be used to alert nurses to patients exiting the bed.

http://patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2012/Jun;9(2)/Pages/37.aspx

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CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

What is a Low Hospital Bed?

What is a Low Hospital Bed?

 

You’ve read our 5 Reasons to Use a Low Hospital Bed (http://chgbeds.blogspot.ca/2012/07/5-reasons-to-use-low-hospital-bed.html ) and our follow-up, 5 More Reasons to Use a Low Hospital Bed ( http://chgbeds.blogspot.com/2012/08/5-more-reasons-to-use-low-hospital-bed.html ), but maybe you’re still wondering: what exactly is a low hospital bed?

With origins in the long-term care field, low hospital beds were created with fall prevention and patient safety in mind. Long-term care facilities realized that bed height was a major factor in patient falls and complications such as fractures, dislocations, and brain injuries, and created the low bed as a solution.

Later, hospitals began to implement their own fall prevention strategies for the aging population and new patient safety initiatives, “borrowing” the concept of the low bed.

The Low Hospital Bed Definition

Not every bed that can go high and low can be classified as a low hospital bed. For patient safety reasons, there is a height standard that hospital bed manufacturers must follow. A hospital bed that goes 15 inches low cannot be lumped into the same category as a bed that is 10 inches low to the ground – that extra 5 inches makes all the difference in low hospital beds.

The Hospital Bed Safety Workgroup, created by the FDA and a number of patient safety and national health care organizations, offers a definition to classify low hospital beds:

… The bed is considered “low” if, when the patient is sitting on the side of the bed with feet on the floor, the angle of the patient’s bent knees is 90 degrees or less.

Since the average female leg measures 15 inches from the knee to the foot, and the average male lower leg measures 16.3 inches, the mattress deck height of a hospital bed will need to be between 9 inches and 10.3 inches low to fit this definition. Low hospital beds must consider the height of the mattress, which is often 6 inches thick.

The Centers for Medicare and Medicaid Services simply considers the height of a low hospital bed to be between 8 -10 inches off the floor.

Standard hospital beds, at their lowest height, range from 15 inches to 22 inches. Though the extra 5 inches may not seem like much, studies show that a higher bed height can increase a patient’s risk of head and brain injuries from falls.

Low hospital beds are recommended by The Joint Commission, the FDA, and the VA National Center for Patient Safety as a top strategy to reduce patient fall injuries. The low height provides a safe resting height for patients and can minimize the risk of fall injuries such as fractures and dislocations. Patients who have experienced a fall in the past often feel more confident sleeping in a low hospital bed, which can reduce the risk of future falls.

Though typically recommended for use in cases when a patient is at risk of falls, low hospital beds can be used in any acute patient care area. Every patient can feel confident, comfortable and secure when resting at a low height.

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CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.