GUIDELINES FOR THE USE OF ASSISTIVE TECHNOLOGY EQUIPMENT IN COMMUNITY INPATIENT UNITS

Transcription

1 GUIDELINES FOR THE USE OF ASSISTIVE TECHNOLOGY EQUIPMENT IN COMMUNITY INPATIENT UNITS Guideline Reference: 1666 Version: 2.1 Status: Adopted Type: Clinical Guideline Guideline applies to (Staff Group) All West Suffolk NHS Foundation Trust Employed SCH Staff As part of transition to the new service contract this Suffolk Community Healthcare (Serco) procedural document has been adopted by The West Suffolk NHS Foundation Trust NHS with the following amendments: Pg. 4 Removal of Serco UK Equality and Diversity Impact Statement Version change to 2.1 minor amendment as above Where the procedural documents refer to Suffolk Community Healthcare (SCH) this is referring to those staff employed by The West Suffolk NHS Foundation Trust NHS as part of the Suffolk Community Healthcare Consortia, with The Ipswich Hospital and rfolk Community Healthcare and Care Trust. Following a 30 day settling in period, a programme of review for all SCH procedural documents aligned with The West Suffolk NHS Foundation Trust will be reviewed in consultation with subject matter experts and Suffolk Community Healthcare staff. Date Adopted: 30 September 2015 Review Date: later than 31 March 2016

2 GUIDELINES FOR THE USE OF ASSISTIVE TECHNOLOGY EQUIPMENT IN COMMUNITY INPATIENT UNITS Guideline Reference: SCH Serco CP5 Version: 2.0 Status: Approved Type: Clinical Guideline applies to : Adult services Guideline applies to (Staff Groups): Community Inpatient Unit Staff Required compliance: This policy must be complied with fully at all times by the appropriate staff. Where it is found that this policy cannot be complied with fully, this must be notified immediately to the owner through the waiver process Guideline owner: Guideline author: Other contact: Director of Nursing, Therapies and Governance Falls Prevention Co-ordinators, Modern Matrons Head of Nursing and Professional Practice Date this version adopted August 2015 Last review date April 2015 Reviewer Falls Prevention Co-ordinators Next review date August 2018 Location of electronic master SCH Intranet AGREED GUIDELINE REVIEW / RATIFICATION / ADOPTION PATH: Level 1: Agreed by: Modern Matrons Group Date: April 2015 Level 3: Agreed by: Clinical Quality & Safety Assurance Group Date: July 2015 Name and Title of people who carried out the EQIA: Jane Benten, Quality Improvement Lead Date EQIA completed: 15/6/15 Level 2: Agreed by: Clinical Policy, Audit Steering & Documentation Group Date: May 2015 Level 4: ted by: SLT Date: August 2015 Name of Director who signed EQIA: Pamela Chappell Signature of Director: Date EQIA signed: 12/08/15

3 CONTENTS 1. Introduction Risk Assessment/ Documentation Types of Equipment Ethical Consideration For The Use Of Assistive Technology Equipment Ongoing Use Of Assistive Technology On Discharge Maintenance Training Links to other Policies References... 3 Appendix A: Risk Rating Matrix... 4 Appendix B: Information Regarding Equipment Available For Use In Community Hospitals... 5

4 GUIDANCE FOR THE SAFE USE OF ASSISTIVE TECHNOLOGY EQUIPMENT IN COMMUNITY INPATIENT UNITS 1. Introduction 1.1. Assistive Technology equipment consists of items of additional equipment that can be used to support the patients interventions and management to prevent falls and injury whilst an inpatient Assistive Technology should only be used following a comprehensive falls and fracture risk assessment where it can support falls and fracture risk prevention and management interventions within the Community Inpatient Unit setting. If identified as part of the care plan it can be used for patients preparing for discharge to ensure that they are fully aware of how to use the equipment, its implications for use and its benefits to support independent living in a community inpatient setting Assistive Technology equipment available for use in the Community Inpatient Units comprises of bed and chair sensor pads and infra - red monitors which alarm/chime (either audibly or activate an individual nurse bleep) or offer a voice alert when activated by the patient (See Appendix B). Matrons please advise what available 1.4. Their intention is to alert staff that the patient may be attempting to mobilise/transfer and may require assistance to do so safely. As a result of this application they can be successfully used to prevent falls and possible injury for patients. They can also be used to prevent accidental slipping, sliding, rolling out of bed/chair A thorough risk assessment for Falls and Bone Health is required before issuing this equipment to ensure that all other falls prevention and bone health interventions have been considered and that patient consent and mental capacity has been assessed and understood. 2. Risk Assessment/ Documentation 2.1. It is essential that the patient has an individual Stage 2 Falls Assessment and that all other falls management and interventions have been implemented prior to the use of Assistive Technology Equipment. It is essential that the appropriate equipment is identified to meet the need. As the patient s condition changes it will be necessary to reassess the patient s need for the Assistive Technology equipment and consider whether it is still required or needs to be adjusted accordingly Individuals who require Assistive Technology Equipment should have a written plan of care as part of the falls and mobility care plan identifying the proposed falls and fracture prevention interventions To identify patients who are at high risk of falls and falls related injuries, ensure all possible causes of falls are explored and minimised. High risk categories include conditions such as: Parkinson s disease Stroke Confusion unknown origin Dementia Cognitive impairment Osteoporosis 3. Types of Equipment (Matrons please advise) 3.1. The type of Assistive Technology Equipment available for the use within the Community Hospitals is: a) Falls X Sentinel Monitor S/Internal/AssistiveTech Guidelines/Mar15/V2.0

5 b) Bed sensor pad, c) Chair sensor pad and the universal bed bracket d) Infra-red Monitor (PIR Monitor) e) Pager and Paging Transmitter (See Appendix B) 3.2. The identification of falls and fracture risk factors, management and interventions should be considered as the first option before the provision of Assistive Technology Equipment Assistive Technology Equipment should not be used as a form of restraint Assistive Technology Equipment should not be used to alleviate a care situation but only as a means of reducing the patient s risk of falling and injury. For example: a) Is the person unable to call for assistance when getting out of bed and likely to fall? b) Is the person unable to call for assistance when getting up from a chair and likely to fall? c) Is the person at risk of falling due to cognitive impairment? d) Is the person at risk of falling due to frailty and their lack of awareness about their personal safety? 4. Ethical Consideration For The Use Of Assistive Technology Equipment 4.1. When considering the use of assistive technology equipment, staff should always inform the patient and/ or next of kin prior to installing the equipment. When an individual lacks capacity, the Mental Capacity Act and Deprivation of Liberty Act (2009) should be implemented. It should be acknowledged as part of the rationale that the installation of the equipment is in the best interests of the patient If the patient is non-concordant then this should also be documented in the patient records and an alternative measure considered to reduce the risk of harm. 5. On-going Use Of Assistive Technology On Discharge 5.1. If the use of assistive technology is highlighted as being necessary after discharge, the clinical staff should sign-post and provide information to appropriate organisations Staff must ensure that equipment is functioning correctly every time the equipment is used. 6. Maintenance 6.1. All Assistive Technology Equipment used in Suffolk Community Inpatient Units must be recorded on the organisation s database of currently used medical equipment. (where/ what is this) The equipment must be serviced in accordance with manufacturer s/ supplier s recommendations. 7. Training Suffolk Community Healthcare will ensure that all employees who are responsible for selecting, fitting and checking Assistive Technology equipment have received appropriate training from the company providing the equipment. Managers will be responsible for ensuring their staff have the appropriate skills to safely provide such management. 8. Links to other Policies 8.1. Record Keeping Policy 8.2. Mental Capacity Act and Deprivation of Liberty Guidelines 8.3. Bedrail Policy

6 8.4. Hoists and Slings Guidelines 9. References 9.1. Department of Health (2009) The Mental Capacity Act Deprivation of Liberty Safeguards (MCA DOLS) London: The Department of Health Publications 9.2. Department of Health (2001) National Service Framework for Older People ENABLE project (2004). Enabling Technologies for People with Dementia (2004). Cross-national Analysis report. ENABLE (http/ NICE (2004) Falls: the assessment and prevention of falls in older people (Clinical Guidance 21) 9.5. Suffolk Community Healthcare: 2013, Stage 2 Falls and Fracture Assessment Checklist efault.aspx

7 Appendix A: Risk Rating Matrix Use the following risk matrix to plot the likelihood and impact from the Risk Assessment by multiplying the scores. Likely Impact Llikelihood of Occurrence Assessed Score 1 Insignificant 2 Minor 3 Moderate 4 Major 5 Catastrophic 1 Extremely unlikely 2 Unlikely Possible Likely Almost certain

8 Appendix B: Information Regarding Equipment Available For Use in Community Hospitals Matrons please provide pictures of your equipment and information that goes with it if different from below FallsX easy-to-use bed and chair alarm system. The monitors alert the staff when an individual identified at risk of falling leaves a bed or chair. The FallsX Sentinel Monitor is used with a FallsX Bed Sensor Pad or Chair Sensor Pad that discretely detects the weight of the individual at risk of falling. When an individual leaves the bed or chair and moves off the sensor pad, an alarm is sounded to alert the staff. This can either be via a nurse pager or audibly from the sentinel monitor itself. Another monitoring method involves attaching a magnetic pull string from the monitor to the individual s clothing. The alarm sounds if the person moves and disconnects the pull string from the alarm. The FallsX Sentinel Monitor can also be connected to most existing nurse call systems. It is powered by a 9-volt battery for complete portability. An optional mains power adapter is also available. Each FallsX Sentinel monitor has a built-in rubber cushion for added durability. The FallsX bed and chair alarm monitoring system is not a substitute for staff or staff vigilance. It is an effective tool to help care givers keep fall risk individuals safer. The FallsX InfraRed Bedside Monitor uses infrared detection technology to determine when a patient identified at risk of falling leaves bed. The monitor sounds an alarm to alert the staff when the patient breaks an infrared beam eliminating the need for sensor pads or strings attached to the patient. This monitor is battery powered (not included) making it completely portable and particularly useful where the presence of cords or strings is undesirable. Beeping or chime alarm options sound locally at the bedside, or via a nurse pager. The monitor also has a nurse call output allowing for connection to most nurse call systems when used with the optional nurse call cable. The FallsX InfraRed Bedside Monitor comes with a C-clamp and Velcro strips for easy mounting on

9 the bed frame or on the headboard or footboard of the bed. An optional sturdy extension bracket is also available along with an optional mains power adapter. This monitor comes with a low battery alert, one year limited warranty and has been used successfully in thousands of care homes as an aid to help caregivers improve the safety of fall risk residents. Bed Monitor Chair monitor Universal Bed Bracket

10 Equality Impact Assessment Tool Any identified a potential discriminatory impact must be identified with a mitigating action plan to address avoidance/reduction of this impact. This tool must be completed and attached to any SCH approved document when submitted to the appropriate committee for consideration and approval. Name of Policy: Equality Impact Assessment Tool Yes/ Comments 1. Does the policy affect one group less or more favourably than another on the basis of: Race Ethnic origins (including gypsies and travellers) Nationality Gender Culture Religion or belief Sexual orientation including lesbian, gay and bisexual people Age Disability - learning disabilities, physical disability, sensory impairment and mental health problems 2. Is there any evidence that some groups are affected differently? 3. If you have identified potential discrimination, are any exceptions valid, legal and/or justifiable? 4. Is the impact of the policy/guidance likely to be negative? 5. If so can the impact be avoided? N/A 6. What alternatives are there to achieving the policy/guidance without the impact? 7. Can we reduce the impact by taking different action? N/A N/A An electronic version of this tool is available at: