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To explore the safety of the standard and the low hospital bed, we report on a microanalysis of 15 patients’ ability to ingress, move about the bed, and egress. The 15 participants were purposefully selected with various disabilities. Bed conditions were randomized with side rails up or down and one low bed with side rails down. We explored the patients’ use of the side rails, bed height, ability to lift their legs onto the mattress, and ability to turn, egress, and walk back to the chair. The standard bed was too high for some participants, both for ingress and egress. Side rails were used by most participants when entering, turning in bed, and exiting. We recommend that side rails be reconsidered as a means to facilitate in-bed movement, ingress, and egress. Furthermore, single deck height settings for all patients are not optimal. Low beds as a safety measure must be re-evaluated.
Keywords:
safety, patient, falls / falling, health care, long-term, nursing, gerontological, observation, risk, behaviors
Estimates for the number of falls in hospital range from 20% from the bed (Healey & Scobie, 2007) to approximately 60% to 70% “from bed or bedside chair” (Oliver, 2002, p. 415). This variation depends on the amount of time a patient occupies the bed (for instance, fall rates are lower if the patient is out of bed for a number of hours per day: They have less opportunity to fall from the bed). Other considerations are the patient’s condition, the quality of the nursing care (falls are now a nurse-sensitive measure; Williams, 2004), and the nurse-to-patient ratio (Dunton, Gajewski, Taunton, & Moore, 2004). Analysis of type and number of falls in a community hospital recorded 51% of falls occurred getting into or out of bed; 95% of these resulted in minor injury, and 4.95% resulted in major injury (Tzeng, 2010). However, how the fall was recorded alters our count of “falls from the bed.” If, for instance, the fall was recorded as “patient found on floor” and the activity was “going to the bathroom,” the fall may actually be a “getting-out-of-bed” fall, with the forward trajectory of the fall resulting in the patient found on the floor some distance from the bed. Nevertheless, although fall rates vary considerably, it is apparent that the bed is a major factor in patient falls. Falls occur frequently when the patient is getting into bed, is reaching from the bed, rolls out of bed, is transferring from a wheelchair, or is getting into or climbing out of bed.
Our professional response to this phenomenon is extraordinary: We continually ask the patient to use the call bell, to stay in bed until the nurse arrives, and not to get out of bed without assistance. Unfortunately, those we ask are ill, confused, overestimate their abilities, are unable to stand and walk safely, and/or need to get to the bathroom urgently. Their beds are at a substantial distance from the bathroom, and the distance from the bed to the bathroom in some institutions was measured to be as much as 16 feet, and usually without a handhold or support.
And, we still wonder why patients fall.
The responsibility for fall intervention has been placed squarely on the shoulders of nurses: We ask nurses to observe, yet patients are in individual rooms and out of nurses’ direct line of sight; we ask nurses to respond to bed alarms, yet the delay before alarm sounds (once the patient is off the bed deck) is a up to 9 seconds. Moreover, the sound of the bed alarm may be muted by ambient noise in the unit, or the nurse may be occupied with other essential tasks, hence unable to immediately rescue the patient. We ask nurses to do hourly toileting rounds (when they are caring for six or eight patients); we ask nurses to assist the patient out of bed (and injuries to nurses’ backs are at epidemic levels).
It should be noted that most of the research exploring patient falls from the bed lacks precision. Most falls are not witnessed; they are sometimes reported by patients, and sometimes reported by nurses or relatives, having heard the fall or found the patient on the floor.
The common denominator for hospital fall causation is the bed, and the common theme for intervention is the nurse. It is time for a safe environment for patients, and the first step is to determine the risks to patient safety that involves the bed.
The purpose of this project was to examine the safety of the bed and the patient’s ability to ingress, egress, and to move about the bed. We asked these questions:
Research Question 1: How are the side rails used, and do they enable the patient to enter and exit the bed, to lie down, to sit up, and to turn over in bed more easily?
Research Question 2: Is the bed height (from the floor to the top of the mattress) a factor in influencing the ease of entering and exiting the bed and the stability of the patient’s gait?
Research Question 3: Can patients turn over easily and move about safely in a hospital bed?
Research Question 4: Are low beds safer than a standard bed height both for ingress and egress?
This descriptive exploratory study used a one-group design, with participants randomly assigned (block design; Urbaniak & Plous, 1997–2003) to the bed and side rail position. The three conditions were a standard medical-surgical hospital bed1 in lowest position (23″ mattress height) with (a) all side rails down, (b) top side rails up and lower side rails down, and (c) a low hospital bed (15″ mattress height) with no side rails. Participant observational methods were used to analyze data. Participants’ macro- and micro-analytic movements were coded and recorded.
We tested two bed heights, 23″ mattress height with standard side rails and 15″ mattress height.2 A floor mat with a beveled edge, was in place for high-risk patients, until a tripping risk was observed, and the mat was subsequently discontinued for Participants 11, 13, 14, and 15 (see Doig & Morse, 2010). If the patient had a Morse Fall Scale (MFS; Morse, 2009) score of 55 or above, hip protectors were used as a safety measure.
The study was conducted in a nursing simulation laboratory, organized for videotaping using four digital cameras. Prior to daily taping, the room was calibrated to construct a 3D grid for analysis, and recalibrated as necessary throughout the study. Markings on the floor indicated the placement of the position of the bed’s wheels, so that the beds could be interchanged between trials, and replaced in the same position.
Three cameras were used for taping the participants’ body movements (two lateral and one central), and the fourth camera was set at floor level, to determine how the foot struck the floor. These four cameras were synchronized by flashing a laser pointer at a target at the beginning of taping for each participant ( for camera placement).
Open in a separate windowThe assumption underlying this study was that nursing staff had little control over adult patients’ assignment to a particular bed in a unit. As all beds are usually identical in a unit (same type, make and model), all beds therefore, must be safe for all patients. Hence, in this study, we used maximum variation sampling and purposefully selected 15 patients with a range of abilities and disabilities, as follows:
Three surgical acute care patients with abdominal wounds, to determine the effect of pain on movement. These participants had an IV, normal gait; two with a MFS score of 20 and one with a MFS score of 35;
Four patients with Parkinson disease (one used a cane and one used a walker), MFS score 35, 65, and two with a score of 75;
Two patients with hemiplegia. Both used a cane and one an assist belt (MFS scores: 50 and 75, respectively);
Three nursing home patients with a “weak and impaired” gait, two of whom used a walker (MFS scores: 40, 50, and 65); and
Three elderly patients (MFS < 25, with a normal gait; Participants 1, 2, and 10) were used as a comparison group.
At the beginning of the trial, participants were seated in a chair 10 feet from the bed. They were asked to walk to the bed, to sit on the bed, and to lie down. They were then asked to turn toward the camera, and then to lie on their backs. Finally, they were asked to sit, to get out of the bed, to stand, walk back to the chair, and to sit down. This sequence was repeated for each of the three randomly assigned conditions: Standard bed with side rails, standard bed with no side rails, and low bed with no side rails. All participants were asked to perform tasks using the walking aids that they normally used.
All trials were videotaped, to macro- and micro-analyze the participants’ movements. Two researchers independently coded the videotapes, using the coding guide (see ).
Permissions for the study were obtained from the University of Alberta, the University of Utah, and from the Alberta Health Authority, as well as the institutions involved. All participants were consented to the study and provided photographic releases. Participants were paid $25 CDN for participation, and reimbursed for expenses.
Appropriate fall protective devices (hip protectors) were provided for those with an impaired gait. Participants wore their “usual” footwear, and used their everyday walking aids (cane or walker). Registered nurses (RNs) provided assistance if needed, and they intervened when necessary. If the participant clearly had difficulty with sit-to-stand, assistance was provided.
As these data were collected in 2003, beds have been developed with variable mattress heights, and some offer controlled rising of the deck to assist with standing. Furthermore, side rail design has changed on newer models, so that the top rail is shorter, and “moving around the rail” for ingress or egress is less difficult. However, as many institutions continue to use the models of beds used in this study, the findings remain pertinent and significant.
In this study, although the sample size did not represent all disabilities of all patients at risk, the variation of participants was adequate to demonstrate problems with bed design that placed patients at risk of fall. Although videotaping in the hospital setting may produce more naturalistic results, it is not feasible. Studies such as these must be conducted in a laboratory, with adequate lighting and the space for all the necessary cameras.
From this study, the following findings are suggested:
A. Side rails were used by participants to aid entry, in-bed movement and bed exiting
When turning in bed, the side rails were used by 10 participants to pull and assist with in-bed mobility; 2 were unable to turn, and only 3 turned without the rails ( ). When the rails were not in position, 2 pulled on the mattress or the head of the bed, and 2 were unable to turn over. Given the significance of in-bed mobility, this is an important use of side rails.
B. If the top side rail extends mid-way along the deck (or further), it will impede the bed entry and exit of the patient
Patients must move around the rail and up and down the bed. This action poses the patient at risk of skin damage to the sacrum and hips, and if the patient is too weak to move up the bed, requires staff lifting and places staff at risk of back injuries. More recent models have reduced the length of the top rail, so that when the patient is sitting on the side of the bed and lies down, his or her head is on the pillow. A second lower rail (or another partial rail) is installed on some models for patients who require longer rails (but not rails that are the full length of the bed). Full-length side rails do not provide a safe route from the bed, and should never be used.
C. No side rails
When the side rails were down, participants did not have a handhold for support as they entered or exited the bed. Two participants even reached over the side of the bed searching for a handhold to pull themselves onto their sides.
One unexpected finding was that the side rail served as a visual cue when getting into bed. It served as a “target” that indicated participants with an impaired gait should sit on the bed. In this study, with this bed, the rail was too long and the position not optimal, and the participant lay down on the bed too close to the foot of the bed. When the rail was down, participants selected any position on the side of the bed to sit, and to lie down, and often this was too close to the head of the bed. Both of these events resulted in considerable effort for patients to move up or down the bed to put their head on the pillow. If it was necessary for the staff to lift the patient into position with the patient’s head on the pillow, this placed the staff at risk of back injury, or the patient at risk of a skin “shearing” injury, with subsequent risk of pressure ulcers. With beds that have the top side-rail positioned so that patients may situate their buttocks in a position, so that when they lie down they are positioned correctly in the bed, both patients and staff safety would be enhanced, with considerable cost savings to hospitals and the health care system. Patients with an impaired gait had difficulty in judging the optimal place to sit on the side of the bed, so they would be able to lie with their head on the pillow: This was an unexpected finding. In Scandinavia, there is an indicator of impaired gait, “stops talking when walking” (Lundin-Olsson, Nyberg, & Gustafson, 1997). It is possible that for participants who have an impaired gait, the effort of walking requires such concentration to walk, that the elderly may not have the ability both to walk and to cognitively determine specific placement on the side of the bed during ingress. One possible intervention would be to place a stripe across the center of the sheets, to provide the patients with a visual cue to show them where to sit when getting into bed.
D. Bed height
One clear finding is that, as patients are of different heights and abilities, then ideally the bed height should be adjustable to the patients’ needs, so that the bed “fits” the patient. Entering low beds is dangerous for patients with limited hip flexion, and increased effort is needed to rise out of the low bed. This is particularly difficult for patients with impaired balance, and additional assistance is needed from staff. This study confirms the findings of Capezuti et al. (2008) that the 23″ mattress height bed, even in its lowest position, was too high for some patients when entering.
The difference in performance of participants entering and exiting the bed suggests that two deck heights are required: one for safe ingress and a different height for egress. It is unrealistic to retain the present model of one deck height “fits all,” and a safety goal must be the development of a bed that is adjusted to “fit” the patient, providing automatic “reset” to the predetermined safest height for ingress or egress.
In this study, we did not measure patient leg strength or arm strength, and were unable to correlate participant strength measures with ability to lift legs onto the bed and to calculate the forces required on the side rails during ingress, turning, and egress. Also, we did not have adequate luminous markers to evaluate balance and gait from an ergonomic perspective, hence the observational nature of this study. Was the sample size of 15 patients adequate? We used theoretical maximum variation sampling, but for Institutional Review Board (IRB) consent concerns, excluded the cognitively impaired patient. Yet regardless of patients’ cognitive status (and their inability to follow instructions to “stay in bed”), it remains our responsibility to provide a bed that is as safe as possible for ingress and egress, and we must find a way to explore bed safety within this group. Future studies should also determine the forces required on the side rails during ingress, turning, and egress. It is recommended that the study be replicated, to evaluate bed height and side rails according to patients’ disabilities.
While the physical characteristics of patients who fall have been extensively investigated, factors related to the hospital bed (from which they frequently fall) has not been investigated. From this study, it was determined that not all elderly and disabled patients can safely enter, exit and move about a standard medical/surgical hospital bed. We showed that all patients were not able to lift their legs onto the bed. Side rails, when they extended beyond the midpoint of the bed, became an obstacle to move around, forcing the patient to scoot up the bed, or resulted in the patient lying down too close to the end of the bed. When side rails were removed, patients were unable to judge where they should sit on the bed, and sometimes lay down too high in the bed. When turning in bed, most used side rails to assist with the maneuver. The clinical implications of these findings are summarized in Box 1.
Clinical implications
Deck height: As it is usual standard protocol to maintain occupied beds in the low position, it is recommended that staff assess the patient’s ability to move in and out of bed. For some patients, the low position may not be the safest position, and they may require assistance either to get into bed, or out of bed, or required the bed to be slightly higher than the low setting.
Low beds: These are intended to reduce the distance of the top of the mattress and the floor, and therefore reduce injury if a patient should roll out of bed. However, this study shows that even beds with 15inch mattress height were unsafe for getting in and out.
Ingress: Assess the patient’s ability to safely enter the bed. Patients with an inflexible hip joint may experience an “uncontrolled sit.”
Egress: Assess the patient’s ability to rise from the bed. The patient may lack strength or the balance necessary to stand. Once standing, often there is nothing to hold onto. If a low-low bed must be used (perhaps because of patient confusions and restlessness) it is recommended that a bed alarm also be used so that the staff know when the patient rises from the bed. A walker should also be placed at the bedside.
Side rails
As side rails have been redesigned, and the risk of entrapment has been removed. From this observational study, it is recommended that side rails be used to assist with patient mobility:
Inbed: Side rails assist with turning, and lifting self up and down the bed.
Ingress: Side rails assist with the standing turn-to-sit, and provide a stable handhold when sitting on the side of the bed.
Top side rails, assist the patient with an impaired gait to correctly position their buttocks as they turn to sit on the side of the bed, so that when they lie down, their head is on the pillow.
Egress: Side rails are used to enhance balance with the patient sits to stand, and begins to move away from the bed.
Haines et al. (2010) noted that low-low beds were used for two reasons: (a) to minimize injury, should the patient roll from the bed (and therefore also reduce the need for restraints); and (b) to “limit the ability of the cognitively confused impaired patient to stand from the bed, and therefore not place themselves at risk of falling” (pp. 435–436). We conclude that low-low beds, while they may reduce injury if the patient rolls out of bed (this was not explored in this study), may actually cause injury on ingress and egress. The cognitively impaired patient may attempt to stand, and because of impaired balance and the lack of a handhold, fall. Furthermore, on ingress, patients who lack hip flexibility will “fall” onto the low bed in an uncontrolled descent, which may also result in an incident as they roll over the bed and out the other side.
In this study, the side rails appeared to be an asset, enhancing ingress, in-bed mobility, and egress. Side rails manufactured for use on hospital beds have been redesigned and are no longer a threat to patient entrapment. No longer considering side rails as a risk, Healey, Oliver, Milne, and Connelly (2008) now attribute this problem to the “use of outmoded designs and incorrect assembly” (p. 368). Full-length side rails are not used. Always having a safe route out of the bed reduces the possibility of a patient climbing over the rails or over the end of the bed. As these design threats to patients safety have now been corrected, it is recommended that side rails be reintroduced to increase in-bed mobility, and safe ingress and egress. Furthermore, Healey et al. (2008) suggest that research examining the effect of side rails is “uninformed by a current and comprehensive critique of the empirical evidence on bedrails” (p. 369) on increasing falls and injury severity is inconclusive. Two cohort studies located in Healey et al.’s (2008) review found “no significant difference in fall rates with or without bed rails” (p. 375). Our present study had a different focus. Rather than investigating side rail falls over the top of the rail, we explored side rails as a necessary assistant for mobility. We recommend that side rails be used clinically for the support of in-bed mobility, ingress, and egress, and this approach must be further investigated.
Presently, because all beds have many features in common, the implicit assumption is that all beds are safe for all patients. In this study, we attempted to replicate clinical conditions. Our patients were selected because of differing gait and problems, but were generally considered “mobile” without nursing assistance. Yet, the standard bed height was too high for safe egress for all patients. The side rails or walking aides were used as support for sit-to-stand. Patients were unable to sit with control on ingress with the low bed (which is 4.5″ “higher” than the deck of the low-low bed now available), and resulted in a near incidents with two patients in uncontrolled descents. When egressing, patients were unable to sit-to-stand and maintain balance; six participants required assistance to stand and one patient refused the trial.
All beds were not safe for all patients.
This study was not a test of a specific bed, but rather, an examination of performance of hospital beds with specifications that are shared by many manufacturers. Of importance were the ideas regarding bed height: that beds do not need to be adjusted to meet individual patient needs, and that the bed in the low position is optimal for patient safety. Our study revealed that the low position may not be the safest position for all patients. Yet, we are aware that even if the low bed height position could be adjusted to meet patients’ needs, two problems remain: (a) we must counter the present belief and recommendation that, when occupied, all beds must be in the low position must be abandoned; and (b) if there is an ideal individualized bed height according to patient ability and stature, a determination must be made as to what that height is, how to calculate it, and how to modify the design of beds, so that bed height may be individualized accordingly. Such an advance would greatly reduce patient falls.
Patient injury has reached epidemic proportions, and the iatrogenic environment in hospitals: In particular, the risks for patients when entering or exiting the hospital bed must be addressed. Nursing has the main responsibility for fall prevention, both in vigilance and in monitoring (Shaw, Connelly, & McWilliam, 2014), and also in implementing best practice guidelines (Boblin, Ireland, Kirkpatrick, & Robertson, 2013). It is time to extend the responsibility of preventing patient falls beyond nursing surveillance, and to involve researchers with expertise in human movement analysis, biomechanics, and ergonomics to develop safe environments to prevent patient falls.
We thank Tracii Haynes, Steve LeBlanc, Dan Given, and Kara Granzow for their assistance with this project.
Janice Morse is a Professor and Barnes Presidential Chair at the University of Utah College of Nursing, and Professor Emeritus, Faculty of Nursing, University of Alberta, Canada.
Pierre Gervais, PhD, is a Professor Emeritus, Faculty of Physical Education, University of Alberta.
Charlotte Pooler, RN, PhD, is a Clinician Scientist, Faculty of Nursing, University of Alberta, & Edmonton Zone, Alberta Health Services
Andrew Merryweather, PhD is an Assistant Professor of Mechanical Engineering, University of Utah
Alea K. Doig, RN. PhD is an Associate Professor and Director, College of Nursing, University of Utah
Donald Bloswick, PhD is a Professor of Mechanical Engineering, University of Utah
1.The bed was a Hill-RomTM Advanta©. The deck height is unchanged with the new models; the top side rail was shortened and redesigned with the Advanta2©, which has three split rails on each side.
2.Since this study was conducted, a low-low bed is now available with a deck height as low as 9.5″. This does not discount the findings of the low bed in this study—we must assume that the low-low beds extend these findings, increasing the risk to patients.
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Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Hill-Rom Safety Center.
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Note: Head board not shown
Note: Head board not shown
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All components are of the highest quality. All moving parts use stainless steel pins housed in composite mounts that eliminate the need for scheduled maintenance. All fasteners are stainless steel. The bed frame utilizes strong lightweight aluminum and steel sections for long-term structural integrity. All finishes are a baked-on powder coat finish for durability and ease of cleaning.
The headboard and footboard are made of wood for aesthetic purposes and all drive components and mechanisms are totally enclosed in the headboard and footboard to provide excellent soundproofing and to ensure that there is no risk to the user or caregiver. The air-powered torso and leg raising systems are constructed from welded, clinical grade fabric and have undergone exhaustive testing and peer review.
The Freedom Bed™ is powered by a low voltage system (12 V DC) that eliminates the risk of shock to the bed user or their caregiver. The bed’s built-in batteries can power the bed for a number of days to continue repositioning in the event of power failures (the number of days varies depending on the turning schedule). A 12 V “smart charger” system ensures that the batteries are always fully charged. The Freedom Bed™ has CSA, UL544, and FCC approvals for its electrical systems.
The Freedom Bed is available with a Voice-Activated Control System, allowing every function of the Freedom Bed to be controlled by voice commands.
The operating costs of the Freedom Bed™ are significantly lower than other options since regular maintenance or replacement of consumables is not required. In addition the use of DC power systems reduces power costs to about 3 to 5 cents per day or an economical $1.00 to $1.50 per month.
The high quality construction of the Freedom beds allow us to offer the following warranty:
Mechanical and Electrical Components:
3 years
Mattress:
2 years
Warranty does not apply to woodwork, batteries, fuses or to any component which, in ProBed’s opinion, has been misused, altered, neglected or damaged by accident, presence of abnormal conditions of operation or handling.
Benefits for the Bed User
The many features of the Freedom Bed™ provide a number of key benefits to immobilized bed-users such as:
The physical and mental tasks associated with caring for immobilized persons can place a considerable burden on spouses, parents, etc. The physical requirements of manually turning an immobile person frequently mean that family members become unable, through age and/or infirmity, to provide the required assistance. This results in institutionalization of the family member.
The Freedom Bed™ has been designed with the caregiver very much in mind and provides considerable benefits along with the ability to provide a significantly better quality of home-based care.
The Freedom Bed™ automatically turns the bed user during the night thus eliminating the need for the caregiver to get up every two hours. Sleep deprivation is considerably reduced and thus caregiver physical and mental fatigue are decreased
There is a reduced need to manually turn or reposition the user and thus a decreased chance of the caregiver developing neck, shoulder or back injuries
Head-raising and leg-raising system, and bed height adjustment assists in positioning the user for personal care and for transfer to and from a wheelchair
There are a number of significant benefits that accrue to institutions as a result of investing in the Freedom Bed™. These include:
For an industry struggling to get its costs under control the Freedom Bed™ offers significant savings by focusing on a strategy of prevention of the problems before they occur. It offers:
A mobile person generally turns approximately once every 10-12 minutes while sleeping. This action provides for healthy blood circulation, stimulation of body organs and movement of body fluids. When a person becomes temporarily or permanently immobilized, however, the blood supply to that part of the body that is under pressure is restricted. If that pressure is not regularly relieved, and the blood supply restored, the affected tissue dies and sloughs off and a pressure or decubitus ulcer (i.e. bedsore) begins to form. These occur most commonly on the buttocks, sacrum, hips and heels and can be life-threatening if they become infected.
If that isn’t bad enough there are many other medical complications associated with immobility. These include:
Decubitus ulcers are of major concern to the sufferers, their caregivers, and the medical community. The scale of the problem is immense. It is estimated that approximately 1.2 million people are suffering from bedsores at any one time in the United States alone and almost 70% of sufferers are over 65. It is reported that there are 60,000 deaths annually from complications arising from bedsores and the current cost to the US Health Care System to treat these and other associated conditions is estimated at anywhere from US$15 - $40 billion annually.
The traditional way to avoid the formation of bedsores is for a family member, caregiver or institutional employee to regularly turn (it is recommended that this be done every two hours) and stabilize the patient in a new position to relieve tissue compression and re-establish blood flow. This has to be done around the clock and unfortunately this manual process has a considerable number of drawbacks that include:
Many years of intensive research and development have allowed us to create what we believe is simply the best rotation therapy system for the immobilized sector of the community. The company was established in 1989 and versions of the Freedom Bed™ have been marketed since 1994. The most recent versions of the Freedom Bed™, complete with their unique air-powered head and leg raising feature, have been available (and receiving “rave” reviews) since the spring of 2001. We feel privileged to build and supply this exceptional bed to the immobilized amongst us.
A healthy, mobile person turns several times an hour while sleeping. This movement relieves pressure, stimulates the body, improves circulation, and prevents problems associated with immobility. Immobilized people who are not turned, or rotated, frequently enough are at significant risk of developing pressure ulcers (also known as bed sores), kidney and bladder infections, and pulmonary / respiratory infections, including pneumonia. Any one of these problems associated with immobility can have serious consequences for the person, including death. The Freedom Bed™, through its ability to provide frequent rotation, and complex positioning, addresses these conditions while improving comfort, independence, control, and quality of life.
The horizontal surface of the bed (the platform) that supports the mattress is hinged into three longitudinal sections. The user of the bed is positioned on his/her back in the centre of the three-part platform (the sleeping platform).
As the bed smoothly and quietly rotates to one side the outer section of the three-part platform on the lower side turns up to form a “wing” which supports the body along its entire length from the ankle to the shoulder. Thus the bed-user is carefully cradled by the bed’s structure to prevent sliding and shear forces that can increase the potential of developing bedsores. Any pressure transferred to this side of the user is thus dispersed along the entire frame of the body. The wing on the upper side of the platform lowers during this process to properly balance the entire platform and provide integral strength throughout the structure. As the bed reverses the rotation the lower wing rises as the higher wing lowers so that, at the horizontal position, all three sections of the platform are horizontal. The bed then automatically rotates to the other side to complete the cycle.
The Freedom Bed™ has a 60° range of rotation - 30° left and 30° right- from the horizontal position. Rotation can be programmed to stop at any degree to meet clinical or specific comfort and positioning requirements of the user. The Freedom Bed’s rotation system is a sophisticated mechanical device that ensures accuracy and consistency of turning.
The bed can be programmed to stay in any of the positions (left, right or center) for a time period from 1 minute to 4 hours. Each position can have a different time setting, allowing for a totally adjustable schedule to suit the user. For example, the user could move to 20 degrees on the left side for 1 hour, then 30 minutes at center (horizontal), then to the right side to 27 degrees for 2 hours. The schedule would then repeat through the night. You can also set the bed to not stop at a position by setting that time to “0” minutes. This is commonly done by people who do not like, or are not able, to sleep flat on their backs, but prefer to turn from side to side. NOTE: Your medical professional should be consulted to determine the optimal rotation schedule to meet your specific requirements.
ProBed Medical Technologies Inc. has developed four models of the Freedom Bed™. Each model is built on the foundation of the company’s unique, patented, well-proven lateral rotation system. Enhancements to the basic model include a variable height (High-Low) platform, Trendelenburg positioning and a unique air-powered head and leg elevation system that provides extremely comfortable seating while reducing seating pressure.
FEATURE PAR3-A2 PAR3-A3 PAR3-A2F PAR3-A3F PAR3-A3FX Automatic or Manual Lateral Rotation Three Sectional Wound Care Mattress Head and Foot Boards Dynamic Side Rails Heavy-Duty Casters Battery Backup with “Smart” Charger Air Powered Head and Leg Elevations Powered Hi -Lo Elevations Trendelenburg / Reverse Trendelenburg Standard Length - 78" Sleeping Surface 8" Extended Length for Tall Users - 86"
Note: ProBed offers a longer model (PAR3-A3FX) of the bed for tall persons over 6’1”. Clients with foot drop may also benefit from this model. Contact your representative to discuss if this may be an issue.
Yes. Models PAR3-A2F and PAR3-A3F come equipped with the head and leg elevation system that allows the user to be in a full-sitting position and in an infinite number of different positions to suit his or her individual needs or preferences.
Yes. Models PAR3-A3 and PAR3-A3F come equipped with a variable height (High-Low) platform that allows the positioning of the platform at any height from 22 inches (wheelchair transfer height) up to 34 inches off the ground (at the level of the top of the mattress). This feature is extremely helpful when moving the user to or from a wheelchair or other item of medical equipment and is, most certainly, of significant benefit to caregivers who can adjust the platform height to provide for comfortable and safe administration of care. It should be noted that approximately 80% of care-giver injuries involve back, neck, and shoulder problems as a result of moving, repositioning or otherwise caring for patients.
Yes it does. Models PAR3-A3, PAR3-A3F, and PAR3-A3FX offer Trendelenburg positioning. This position results when the entire bed platform is “tilted” along a level plane with the foot end being raised higher than the head end. Reverse Trendelenburg results when the entire bed is ”tilted” along a level plane with the head end raised higher than the foot end. There are numerous medical reasons for requiring Trendelenburg and/or Reverse Trendelenburg positioning and such requirements should be discussed with your medical professional. The turning function of the bed is not affected by the angle of Trendelenburg or Reverse Trendelenburg selected.
The Freedom Bed™ comes equipped with “dynamic side-rails”. We call them “dynamic” because they move in unison with the rotational platform to provide an extra level of comfort and safety. Recognizing that many users of the Freedom Bed™ spend many extra hours in bed, the rails have been designed to provide an optimum viewing area around the user and to minimize any feelings of containment. Transparent side rail covers made of clear, tough lexan provide added safety and protection, while allowing clear visibility.
Yes. In fact, the Freedom Bed™ runs on a 12-volt DC system that is “topped-up” as required by an automatic smart charge system to ensure that the batteries are always fully charged. With many Freedom Beds being used in residential situations, where emergency power is not usually available, users, care-givers and family members can all get a good night’s sleep knowing that the Freedom Bed™ will operate seamlessly in the event of power disruptions, black-outs, brown-outs etc. This low voltage system also has the added benefits of patient / care-giver safety and substantially reduced operating costs.
The Freedom Bed™ has been designed with the user in mind and can best be described as “whisper quiet” when turning. Rotation is also exceptionally smooth allowing users to sleep through rotations and throughout the night providing them with a “good night’s sleep”. Some operational noise associated with the air-powered head and leg elevating system is noticeable, but this is minimized as much as possible with insulation.
The Freedom Bed™ is the only completely integrated mechanical full bed turning system on the market today. It provides many years of safe, comfortable and reliable service to users. Its unique mechanical rotation system is contained within the framework of the bed. It is important to note that, unlike air mattress systems where replacement is a major capital expense, replacement of the Freedom Bed™ mattress, in the event that this is required in the future, is an inexpensive consideration.
The Freedom Bed™ comes equipped with a high quality, three section, multi density foam mattress, which is hinged longitudinally to follow the contours of the bed. It has a pocket on the head end, which should be slid over the reaction board in the center of the bed. This will keep the mattress in its preferred position while the bed is in motion.
Each of the three sections of the mattress has its own zipper. This allows the removal of the foam for laundering the cover if required. It also allows the changing of a foam section to suit a specific requirement. Note that while the rotation provides very good pressure relief, the bed can be used with specialty foams, gel pads, Roho type inserts etc. if the client requires a custom surface. Contact your ProBed representative to determine what customization is available to meet your specific requirements.
The latest mattress design incorporates three densities of foam laminated together with 2” of visco-elastic foam on top, providing increased levels of pressure distribution and comfort. Visco-elastic foam was originally developed at NASA in an effort to relieve astronauts of the incredible g-forces experienced during lift-off. The cellular structure of visco-elastic foam is completely different. It's made up of billions of high-density spherical memory cells that are very durable and temperature sensitive. The cells in contact with the warm areas of the body will literally soften, shift position and reorganize to conform to body contours.
The foam sections are covered by a medical grade polyurethane coated polyester stretchable wound care fabric. This is an anti-fungal, anti-bacterial, fluid resistant and vapor permeable material that is fire retardant and meets CAL 117 and other specifications for fire retardancy.
The Freedom Bed institutional mattress has also been tested and complies with California TB129 Flammability Test for Mattresses for use in Public Buildings. There is no extra charge for this mattress, but please let us know if your application will be in a public building, thus requiring this certification.
Yes. In fact one of the compelling reasons for using the Freedom Bed™ is its user-friendly programming system that ensures extremely reliable and comfortable automatic rotation for the user and restful nights for family members and care-givers. Easy to follow programming instructions are included in the Users Manual that comes with each Freedom Bed™.
It should be noted that the training session that takes place upon the delivery of each new Freedom Bed™ provides ample opportunity for family members, care-givers and, if appropriate, users, to become fully acquainted and comfortable with programming and the full range of functions to be found on the Freedom Bed™. The automatic rotation program is simple to activate with the push of a single button.
Depending on the user’s personal circumstances he or she may be able to have full, or partial, control over the many functions of the Freedom Bed™. The company presently offers a hand-held wand for those with full manual dexterity and an override button for those with some movement capability.
The company also offers a “Voice Activation” system to give full control. Please refer back to our web-site from time to time for more information on new products and enhancements to our range of Freedom Beds.
The following chart lists sizes and weights are for each model of the bed. Weights include mattress and woodwork.
DESCRIPTION PAR3-A2 PAR3-A2F PAR3-A3 PAR3-A3F PAR3-A3FX Weight including mattress 250 lbsNo problem at all. The bed is designed to be easily disassembled to allow it to be moved up stairs and elevators, and along hallways without problem. Also, the weight is much lower than many specialty beds, so no extra work to floors or doorways is required.
ProBed also offers a 'Bed Delivery Wheel Kit' that assists in delivery, installation, and moving of beds without having to lift. The kit consists of a set of 2 wheels that bolt to the side of the bed, one at each end. The bed can then be turned on its side and rolled easily through any standard width door or hallway.
The clinically proven Freedom Bed™ is recommended for persons suffering from temporary or permanent immobility resulting from:
NOTE: The Freedom Bed™ is suitable for persons who are tube fed and/or on ventilators, where they require constant head elevation up to 30°. The bed has a safety feature which prevents rotation when the head is elevated above this angle.
Most Freedom Beds are used in residential settings. The reason is that the Freedom Bed’s unique rotation system permits many people to live at home rather than in nursing homes or care facilities, as it solves a care-giving function that is too difficult for many family members due to age, physical strength or their own infirmity. It allows families to remain together and provides for the user and all family members to get a good, uninterrupted, night’s sleep which is a solid foundation for good health for all concerned.
Freedom Bed™ is also designed to be used in extended care facilities and hospitals where it is seen as a benefit to nursing and support staff, in that it reduces the incidence of back injuries caused by turning or repositioning and allows them more time to carry out other necessary and important patient care procedures.
Certain people may have difficulty using an automatic turning bed of this nature. Issues of concern are:
The bed is rated to support a person weighing up to 400 lbs. However, there are practical limitations on the beds abil
For more electric rotating nursing bedinformation, please contact us. We will provide professional answers.