Bed type issues

[marydc]

I work on an inpatient acute care psychiatric unit. We recently exchanged our nonelectric, crank style hospital beds for platform beds. I understand that this is best practice in promoting a safe environment. Hospital beds with side rails are a suicide risk.

We do occasionally have patients with medical needs on our unit and even the overflow from the geriatric unit. We are finding the platform beds make it difficult to provide care for these patients when you can't raise the bed. Plus some need to have the head of the bed raised for their own comfort needs.

How is this handled on your unit? Do you have some hospital beds available for this type of patient? Is there some type of wedge that can be used with the platform mattress to raise the head? We are trying to find a way to resolve this issue and still maintain safety. I would appreciate input about the beds on your units.

[Meriwhen, ASN, BSN, MSN, RN]

If we have to raise the head/foot of the bed for a patient's comfort, we use foam wedges. I've seen them in use in a lot of faciltiies...we just put them right on top of the mattress and under the pillow (or sheet if it's the feet). That's worked pretty well for us...and to be honest, if we have to elevate the HOB to the point that the patient is pretty much sitting upright or tripod, they are likely too medically unstable for us and would shortly be on their way to a medical facility for evaluation.

One hospital I worked at did keep one medical-style bed on hand for patients who had severe medical issues but were manageable.