B ED SPACE MANAGEMENT
Optimising clinical bed space management
Wayne Moore looks at how better management of technology in the bed space can produce sustainable efficiencies in nursing time and reduce unnecessary equipment spend.
Currently, the patient bed space is provided with operational and technical support by a myriad of entities operating in silos. Nursing staff, medical engineering, porters, domestics, bed store, estates and facilities all work to different KPIs with different control mechanisms and differing levels of understanding of the others’ requirements. This structure inevitably leads to delays in the operational readiness of the patient bed space and consequently delays in delivery of patient care.
The result is a hospital exposed to risk from poor patient care and failure to meet operational service targets. It also places unnecessary strain on care teams due to poor technical support of patient specific technology requirements.
The inefficiencies inherent in the current methods employed in the management of technology in the patient bed space in most healthcare organisations have come about because of small operational changes
over time. The past 30 years has seen a dramatic increase in the number and types of technology used within the patient bed space; most of these technologies have been implemented with no real understanding of the support structures needed to deliver them in a manner that is compliant to regulations. For example, the hospital bed is a medical device operated by nurses who have a duty of care to the patient placed in that bed. To remain fully compliant, the bed must only be used by a nurse who has the necessary user competencies (with the necessary competency records), it must be cleaned between patients; it should be suitable for the patient for which it has been selected; it should be on a suitable maintenance programme and clearly identified as fit for use; and, of course, it needs to be in the right place, at the right time for the patient to use it. This one piece of equipment then
impacts:
l Training competencies. l Infection control. l PPM programme. l Porters.
An average medical ward bed space will have seven pieces of medical and furniture equipment for every patient, including: l Hospital bed. l Mattress. l O2
flow meter.
l Suction regulator. l Over bed table. l Patient chair. l Bedside cabinet.
Each item requires cleaning and checking for correct functioning between every patient. Some items will also require periodic planned preventative maintenance (PPM) which it is the user’s responsibility to ensure is carried out. To ensure that all this happens, the nurse in charge of the patient, therefore, must deal with the following agencies each time a patient is discharged or admitted: l Domestic team to clean the bed space, porters to deliver or remove equipment dependent on patient needs.
l Medical equipment library to deliver specialist equipment.
l External equipment hire company for specialist equipment not held by the healthcare organisation.
l Electronic and biomedical engineering (EBME) department to carry out PPM.
The nurse may also have to carry out cleaning and checking of any equipment. This inefficient and lengthy process is carried out between each, and every patient and can take up to 60 minutes.
Specialist equipment may not always be available in every healthcare organisation and may have to be rented for specific patients, but even this equipment will have an impact on training competencies, infection control and porters.
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WWW.CLINICALSERVICESJOURNAL.COM SEPTEMBER 2021
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