Design and use of medical bed control panels...

[RMCS]

I am not a nurse; I'm a designer - but would appreciate any comments. We're currently working on a novel medical bed with an extended range of movements and I've been tasked on the handset design. Having spent several weeks looking at existing products (not for inspiration, but rather to understand what's wrong with existing designs), it's clear that there are many questions that can't be answered from the isolation of a design studio!

It'd be very useful to find out from the nurses / carers that reposition medical beds on a day-to-day basis what their requirements are. Finding out what you like / dislike about current products would be hugely useful and hopefully drive a better design. I've seen beds with 4 up to different handsets - and some of these become unusable when the patient is in certain positions (mainly reverse trendelenburg / some fowlers positions) - understanding any annoyances (including patient control of bed positioning!) will be great.

Sorry if this post is inappropriate for this discussion area, but I'd rather get feedback from as many users of existing products as possible, because simply visiting 2 or 3 local hospitals will give me a very narrow insight into the real problems to be solved. I was recently reading a topic on this forum about an IV pole design - the comments made would have been so useful to the design team if only they'd received them prior to launching the product!

Thanks for your time reading this.

[truey85]

One problem that I have encountered a lot is that elderly people or those with sight problems cannot differentiate between the different buttons on the controls. This is especially hard because the nurse call light button is hard (or impossible) for them to find. Maybe if the buttons are raised and different shapes it would be possible for patients to feel the difference between the buttons.

[Music in My Heart]

What I've seen is that the buttons start to break over time. Be sure you've considered modularity and ease of replacement. Please don't make it necessary to replace the whole control panel when all that's wrong is one button or it's never going to happen.

A bit OT but perhaps you could make sure your design folks realize that not all nurses are 5'6" or shorter. Even when raised full-height I find that many beds and isolettes can't be raised high enough for someone who's nearly 6'.

[tconlgirl]

I do also find that the buttons tend to break over time. I also dislike how you have to press a combination of buttons to get trendelenberg position or use the scale. I feel one "dedicated" button to those functions somewhere on the bed, out of reach of patients would be better.

Just my

Sally

[Music in My Heart]

I do also find that the buttons tend to break over time. I also dislike how you have to press a combination of buttons to get trendelenberg position or use the scale. I feel one "dedicated" button to those functions somewhere on the bed, out of reach of patients would be better.

Just my

Sally

Good point. I know it's cheaper to combo up on buttons and the use chip logic to multiply functions but remember that the nurse is likely to have one hand holding something else, something tucked under his/her arm, and be trying to keep an eye on the patient at the same time that s/he's pushing the button(s).

Also, why don't y'all consider bringing in a few senior staff nurses to your early design reviews - before you start making molds and boards. Pay 'em $200 each and buy 'em lunch... it'll be the best money you ever spent. Think how happy your marketing folks will be when they can put "Nurse Designed" on the product sheets. You think that'll grab some attention by the browsers at the trade shows?

[canoehead, BSN, RN]

Buttons lose their pictures (they wear off) over time.

Buttons on side rails are hard to reach when the patient is lying on their back. A handset would fix that, with a cord (they get lost), and a speaker for the TV (so the roommate doesn't have to listen too). White noise options/nature sounds for the speaker would be great.

Sides of the bed going up and down would help with positioning. We wouldn't need a second person as often for moving and washing, and wouldn't have to stuff pillows behind backs. Can you put some kind of inflatable pillow on the side so we can inflate/deflate for patient comfort?

I love bedscales, and tilt functions for the whole bed.

Wire frames that raise at the foot to hold the covers up off the body.

IV poles that raise up, and don't remove (they get lost), and are sturdy enough to hold a couple of pumps.

Our patients would like heated/cooled mattress pads. Not hot. Just a little extra for the little old ladies that always get the chills. They have no control over the room heat usually, and LOVE heated blankets.

Beds that go really, really low for the wanderers, and short, gnarled elderly.

All of this must be sturdy enough to be peed and pooped on, and hosed off.

[canoehead, BSN, RN]

Good point. I know it's cheaper to combo up on buttons and the use chip logic to multiply functions but remember that the nurse is likely to have one hand holding something else, something tucked under his/her arm, and be trying to keep an eye on the patient at the same time that s/he's pushing the button(s).

If you have too many combinations and codes most nurses won't remember, or find the time to learn all the different ciphers. We know on/off and dimmer switches. And it's wise to put the button on the part of the bed that will be adjusted. Lockouts on the foot too. An ICU or OB bed should have a battery pack so adjustments can be made in transport.

the worst part of a hospital bed is the rubber sheeting that makes everyone sweat, and feels so cold and clinical. If you can fix that and still make it durable and washable you'll have a very well selling bed.

[RMCS]

Thanks for the replies everybody! The bed design is under control - it'll be an interesting project, and has had a lot of research / iterative development to get it to this stage.

Some of the insights are very helpful here - getting a better idea of the way these things are used (whilst doing a million and one other tasks) will really help; and the way the existing products are failing is equally as useful.

Would preset position buttons be useful, or more of an annoyance (i.e. supine / CPR, fowlers (or semi / high fowlers), bed exit etc.)?

Thanks again for the replies - all comments are being noted!

[Roy Fokker, BSN, RN]

A few thoughts:

* I'm generally not in 'favor' of more wires/cords. We have too many at the bedside as it is and the contstant tangling/untangling is a chore and a half! If we must have cords, anyway we can make them 'retractable' like the kind we have on some vaccum cleaners? (You know? Pull out as much as you need and it stays there and when you're done, it retracts and snaps back into place?)

* Too many buttons is a bad idea - please keep it simple. And like others have pointed out - big, clear, easy to read/see would be a huge bonus... not only for those with impaired vision but also for easy during night time :)

* Some of our beds have "heel rest" functions (depending on the need, the mattress inflates the heel of the bed to three kinds of preset modes). I like the idea of using a similar combination for the head/pillow as well!

* The interface jack. Currently, nearly ALL remote systems I've seen plug into some kind of wall interface (or are connected to the bed, but the bed then connects to the wall interface). The interfaces are the size of old LPT connectors (those who've used old computers know what I'm talking about). The problem is that beds get moved all the time - be it room to room or floor to floor. The constant plugging and unplugging of these jacks (with their dozens and dozens of contact pins) ends up bending/destroying the pins on the male socket... which means they don't connect well with the female socket ergo "non functioning bed". A sturdier connection system would help... immensely!

* Built in scales (especially the scales!) and bed alarms (added bonus if you can design wander alarms with different sensitivities).

* Redesign of the 'steering mechanism'. I don't know about y'all but transporting patients on a hospital bed is a real challenge. Beds simply don't 'turn' when we want them to, especially around corners!

* While we're talking about steering and scales - please let us have beds with higher pt. weight tolerance. Let's face it - the days when the average pt. weight was 200 lbs is long gone. If we are to safely care for our patients, the primary resting surface for them should be able to handle their weight.

* I second the 'attached IV pole' idea - sturdy enough to at least handle two IV pumps. My ER stretchers have these and they're an absolute godsend when you have no place to park an IV pump on a patient (especially if you have to transfer them to and fro departments/floors etc.)

* Sensible "restraint points" and "foley bag" holders.

Would preset position buttons be useful, or more of an annoyance (i.e. supine / CPR, fowlers (or semi / high fowlers), bed exit etc.)?

If the addition of 'preset buttons' ends up cluttering the interface then I'm not in favor of it.

How about "splitting" the controls? Let patients have basic control over their bed functions... but for 'preset functions' like you mention, how about adding it to (say) the foot of the bed (for example) where the nurse can control them? That way the interface won't be cluttered.

cheers,

PS: I'm just glad that someone involved with designing something that will be used almost extensively by nurses actually solicited our opinion. Kudos to you!

[justiceforjoy]

Are you developing the whole bed, or just the controls? If you're doing the whole bed, please, please make sure it raises up high. Where I'm at right now, the bed only raises up to my mid-thigh area and I end up hunched over all day. It's only been two weeks there and my back is just killing me.

[tconlgirl]

Another thing that bugs me about hospital beds, not just about the design, is that people constantly need to be scooted up. I know we should be repositioning q 2 hr but it irks me that people keep scooting down.

[Music in My Heart]

Regarding the pendant or controls: It would be great if you could make them flat, with no nooks, crannies, and crevices in which germs can hang out. I'm thinking covered membrane switches instead of conventional mechanical switches.

It would make routine disinfecting much easier.