30 Degree Angle. Administrator: Mr. Scott Lindsey. Cogburn Health & Rehabilitation Facility 148 Tuscaloosa Street Mobile, Alabama (251)

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1 30 Degree Angle Administrator: Mr. Scott Lindsey Cogburn Health & Rehabilitation Facility 148 Tuscaloosa Street Mobile, Alabama (251) Sponsored By: 13

2 30 Degree Angle In 100 words or less, briefly describe your Best Practice. Our Best Practice is a leveling device used to determine the 30 degree angle used to position the bed for residents who receive enteral nutrition. What problem (s) does your best practice address, and what is its primary purpose? For residents who receive nutrition by an enteral tube the head of the bed must be at a 30 degree angle at all times. This device will allow staff to quickly and accurately determine the correct angle. What group(s) of residents and others are involved in your Best Practice, and how does it work (who and how many are helped, what are the benefits to these people and what methods or procedures /protocols are used to get results)? Residents requiring enteral nutrition and nursing staff are involved in our Best Practice. Here are a few quotes from staff using this device. RN Before, you had to guess at 30 degrees. Now it reassures you that the bed is in a 30 degree angle. LPN It s like a double check, you know without a doubt the bed is positioned at a 30 degree angle. CNA We don t have to guess anymore. We just roll the bed up until the bubble is in the middle, then we know it s in a 30 degree angle. The Best Practice works by having the head of bed raised until the bubble is centered between black lines on the leveler and this indicates the bed is at a 30 degree angle. An angle finder was used to determine the 30 degree pitch. The angler was magnetically attached temporarily to the bed to determine 30 degrees. Once determined, the leveler was permanently attached to the bed at 30 degrees and the angler was removed. What has your Best Practice accomplished, and how have you been able to tell this (you may give numbers and/or specific before and after examples)? This Best Practice allows nursing staff to do their job more efficiently by using a quick and accurate measurement. This leveling device insures that the bed is positioned properly to reduce the risk of complications related to enteral nutrition. What problems, obstacles or challenges might other facilities face in replicating part or all of your innovation? The only problem/obstacle our Best Practice had was that the rail pads were at first not taken into account. We began by mounting the leveler on the side bed frame and realized that the rail pads 14

3 could not be installed without breaking the device and due to that, another location was chosen to mount the device. The device was then mounted underneath the frame of the bed, therefore being free of obstruction. We had no adverse effects, and we do not know of any other facilities with this or a similar Best Practice. What was the cost to implement your Best Practice? How did you pay for it? The cost of our Best Practice device is $4.50 per device for hardware. A power drill, screwdriver and pliers were used. These items were already in use at the facility. There is no cost for staff they are already in place. What are the reasons you consider the Best Practice to be excellent and innovative? Our Best Practice is excellent because in lieu of purchasing new and expensive beds with built in levelers, this is more cost effective. This Best Practice is excellent because it will provide a safer environment for our residents who receive enteral nutrition by reducing the risk of aspiration. This Best Practice will also help to prevent the F322 tag. A resident who is fed by an enteral tube receives the appropriate treatment and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and to restore, if possible, normal eating skills. Assembly of bed levels: Contents of Bed Level one black mounting disc, one yellow level, one red wire, one L bracket, four machine screws, several nuts & washers, one degree angle measuring device. 15

4 Step 1: Place level on round disk by pushing leveler ends through drilled holes on disk. Step 2: To secure level, slide red wire through the two end holes of level and tie wire off. Step 3: Slide L bracket under wire, lining up with holes located on top side of disk. Place screws through the two holes followed by washer then nut to secure L bracket. 16

5 Step 4: Using Degree Angle Finder place bed at 30, then secure L bracket to bed frame. Make sure the level (bubble) is in between black lines evenly in center. Finished product, mounted on bed. 17

A Closer Look at the Revised Nursing Facility Regulations. Quality of Care

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