PATIENT SAFETY


and adds to the pressure on the unit. “The indignity, prolonged effort,


discomfort and fear of damaging skin associated with manual hoisting may cause patients to panic at the prospect of being moved in this manner. Many would need to rest or stop completely after 10 minutes or so. All in all, the use of the hoist was clearly an area that we needed to address but not at the expense of patient mobilisation.”


Investigating a new system for assisted early mobilisation


In early 2016 Leicester Hospital’s clinical contract review team visited Medstrom Healthcare in Castle Donington, Derbyshire to view a new range of ultra-low and assisted mobilisation beds. During the visit the team was introduced to the MMO 6000 low bed, which has the feature of sitting the patient up, progressing them into a full cardiac chair position, then, if required, lowering them down so their feet are positioned on the floor. Using the height adjustment control, the patient can then be assisted to a standing position with minimal caregiver intervention. This was immediately identified of potential value in ITU as an alternative to hoisting. The MMO 6000 had other features that


were identified as being of interest to the team, including a custom height setting to promote safer mobilisation, a ‘safe stop’ backrest feature that ensures correct backrest angle positioning and a lengthening backrest that eliminates heel travel completely. Also, the fact that the bed lowered to a height much lower than a standard bed was also perceived to be advantageous for shorter patients when sitting at the side of the bed, enabling their feet to be placed safely on the floor.


The system is supplied with a semi-


integrated therapeutic AeroSpacer mattress which has been evidenced1 to reduce temperature, moisture and humidity, reduce shear strain, provide effective pressure redistribution and improve comfort levels. This surface was perceived to be of interest as an alternative to traditional dynamic mattresses, particularly as it can be laundered, presenting infection prevention benefits. The clinical contract review agreed to


identify a suitable patient in ITU to trial the MMO 6000. In November 2016 Leicester General


Hospital’s ITU started a clinical evaluation of the MMO 6000 and AeroSpacer. The goal of the pilot was to establish what value investment in innovative new bed and


surface technologies could deliver to patients, clinicians and the Trust itself. The clinical evaluation needed to consider


three core areas of focus: tissue viability, early mobilisation and manual handling. From a patient perspective, the bed and


surface combination delivered notable benefits to their sense of dignity and independence as they could significantly reduce, if not eliminate, their reliance upon nurses to help them mobilise. The fear, discomfort and effort usually associated with moving from bed to chair was completely removed, which increased the likelihood of patients taking a pro-active and positive approach to their mobilisation and recovery. Karen Weafer, tissue viability nurse for the


Trust, said: “During the trial, we were treating a patient diagnosed with necrotising fasciitis around his genital area, who was unable to sit out in a chair due to the obvious risk posed to skin integrity and comfort. The patient had psychological issues in addition to physical healthcare needs, which often made the patient difficult to manage. “The fact that this patient could control


his own safe and comfortable mobilisation, whilst benefiting from a therapeutic surface to support his treatment, met his needs from a physio, tissue viability and manual handling perspective. He was suffering with a large, complex wound and despite not being concordant, the patient did not experience any other skin issues which was a very positive outcome. “All patients using the bed experienced significantly increased ease when mobilising. It clearly provided more dignity, independence and comfort, enabling them to sit up, communicate and eat more easily. Overall, the MMO 6000 and AeroSpacer surface provided real benefits for the ward and the staff and patients on it.” According to Karen, the benefits of the


MMO 6000 from a physiotherapy context were also significant. Each patient who participated in the clinical evaluation was deemed at risk of respiratory complications so enabling patients to sit out as many times per day as they liked, compared with the previous standard once or twice per day using hoisting protocols, contributed to a decreased risk of respiratory complications and quicker, more positive recoveries. The reduction in caregiver intervention also facilitated improved levels of nursing efficiency and provided more time and resource for care routines. Anna Makower, a respiratory physiotherapist within Leicester Hospitals,


With the age of the nursing workforce rising nationally, anything that removes this additional level of risk whilst better supporting patients can only be a good thing. Andy Lewitt, manual handling advisor, Leicester Hospitals


36 I WWW.CLINICALSERVICESJOURNAL.COM


described the equipment trialled as ‘the future of ITU’, and explained the impact the clinical evaluation had on her patients: “One of the great things about the MMO 6000 from a physio point of view is the head of bed angle ‘safe stop’ feature which means the backrest pauses at 30˚ and 45˚. “Before the evaluation, we had to


estimate the correct angle, which was far from ideal. This feature helps to minimise instances of ventilated acquired pneumonia. The bed has been incorporated into our rhythm and routine, as we record and document angles every time we see patients, which in turn is facilitating enhanced compliance with care bundle objectives and helping nurses more effectively conduct weaning programmes. “The difference in patients’ wellbeing was


staggering. It’s amazing how sitting up in a regular chair position can transform patients and the environment around them; everything suddenly feels far less clinical and controlled. People would walk past a patient sitting up in an MMO 6000 and comment on how much better and how very different they looked.” The evaluation also freed up considerable


time and resource for the physio team on the ITU, as Anna observed: “Nurses are now more involved in patients’ rehab and patients themselves are able to take more control over their mobilisation and recovery. This no doubt leads to patients being ready to be safely transferred to wards more quickly. “Risk has been reduced as hoists and


manual handling are less necessary. The AeroSpacer supports mobility better than any other high-risk mattresses I’ve worked with and patients found it to be much more comfortable than the dynamic mattress. There is no negative to having these beds and surfaces available to patients. As far as I’m concerned, they represent the future of ITU.” Andy Lewitt, a manual handling advisor at


Leicester Hospitals, believes that the use of the MMO 6000 can also reduce staff injury associated with hoisting patients. Andy noted: “Not only is the bed helping patients mobilise with greater dignity and independence – and less discomfort and apprehension – it is also helping take away the risk of occupational injury for staff. With the age of the nursing workforce rising nationally, anything that removes this additional level of risk whilst better supporting patients can only be a good thing.” According to Robert Russell, charge nurse


at LGH ITU, one of the most notable benefits of the trial is the way the MMO 6000 and AeroSpacer surface relate to the nursing world, as both products weave into the nursing flow to support better patient care. “Put simply,” he said, “if a piece of equipment doesn’t fit into the nursing flow, it’s not going to get used. “The real winner for me is the chair


position with feet on the floor. The easy, supported transition to standing is a genuine innovation, as the drastic loss of muscle mass is a serious issue facing patients in ITU, so to


SEPTEMBER 2018


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