May 13, 2019 | Healthcare Risk, Quality, & Safety Guidance
The hospital bed is a ubiquitous device in most healthcare settings, and it can be seen as a centerpiece for medicine—almost all inpatient care revolves around the patient in the bed. According to the American Hospital Association, there are approximately 931,000 staffed hospital beds in the United States, based on data from a 2017 survey. Therefore, ensuring adequate maintenance and safety of hospital bed systems—defined by the U.S. Food and Drug Administration (FDA) Hospital Bed Safety Workgroup (HBSW) as "a bed frame, mattress, bed rails, as well as other accessories that are compatible with each other"—is an important part of patient care and requires careful planning.
The major safety issues associated with bed system technology comprise four general areas: improper or ineffective inspection and preventive maintenance (IPM), infection control, entrapment risks, and the misuse of bedrails or other accessories.
Because bed systems are used often and for a relatively long amount of time in healthcare facilities, all bed system components must be well maintained throughout the product life cycle. Various components may need more or less inspection and maintenance than the bed frame itself—for example, surfaces tend to be replaced much more frequently than bed frames because they are more often damaged or soiled beyond repair. Additionally, if proper care is not taken when evaluating and fitting new or modified bed components, risks to patients may be increased, including the risk of entrapment or falls. Finally, altering the bed system may take the bed out of its tested compliance, which may increase liability for the facility (Kramer-Jackman and Kramer).
This article focuses primarily on risks associated with bed system technology—however, these risks are not the only ones associated with hospital beds.
Bed systems and surfaces can be vectors through which infectious materials can spread to patients. Wear and tear on certain components, such as the surface, can contribute to the risk of contamination because body fluids can penetrate holes, tears, or cuts that have appeared on beds during years of use. Such fluids can later leak out of the mattress when another patient is placed on the bed, posing a risk of infection (FDA "Covers"). In addition, the use of incompatible cleaning solutions to clean mattresses and covers may compromise the integrity of the surface.
The issue of fluid ingress and microbiological contamination in bed and stretcher support surfaces ranks as #2...