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foot stools, foot rests on dialysis chairs

Most of the dialysis chairs have a foot rest/foot stool that can be pulled out for patients to place their feet on e.g. the bottom of patient's feet are on this foot stool. This is especially great because when patients are sitting versus lying in the chair they can rest their feet on the stool if they do not reach the floor thereby preventing a patient's legs from just hanging and being uncomfortable.

Recently many FMC units removed this foot stool from the chairs. Has anyone at an FMC unit experienced this and what is the reason for removal?

traumaRUs, MSN, APRN, CNS

Has 27 years experience. Specializes in Nephrology, Cardiology, ER, ICU.

Yep - and I was told the reason was someone fell and "Had a bad outcome."

Yep - and I was told the reason was someone fell and "Had a bad outcome."

What state are you in?

I wish someone would tell FMC Corporate that it is more dangerous NOT to have these foot stool than to have them. Just because there was one bad outcome? Does that mean each time there is a 'bad outcome' that a policy will be changed? Perhaps they should focus on preventive rather than 'after the fact'... It would be interesting to learn more about what the 'bad outcome' was? Did a patient get injured? If so, WHY? So, because there was, we are assuming, 'one bad outcome', all patients must suffer and be uncomfortable, from what I have been told.

Just does not make sense.

traumaRUs, MSN, APRN, CNS

Has 27 years experience. Specializes in Nephrology, Cardiology, ER, ICU.

I'm in IL.

There was more than one bad outcome.

And...the lawyers run our healthcare system as a whole.

Yep we were told there had been several trips, falls and one death. Of course thats what they always tell us when they wish to change something. The question is why were these patients not being escorted? Oh yeah thats right because everyone is in such a hurry they slap a bp cuff on the patient and then walk away to try to take another patient off or put one on at the same time. Thats the price you pay for trying to get home 15 minutes earlier than usual.

Personally I find this offensive. Corporate should understand that there is just as much liability in NOT having foot stools as there is in having them. If staff are not present and helping patients when getting off of chairs, well, we know the outcomes. I wonder exactly just what 'bad outcome' took place and what the investigation showed as far as how it happened, why it happened, etc..............there must have been alot for the policy to change.. truly ridiculous.

maybe they should get some lower chairs and avoid the pull out foot step problem entirely? can i have the address of the unit you work at that has time to escort their patients out! we have 15 to 20 minutes before one goes off and the other comes on pray there isn't a complication.

Or, maybe they should find out what the cause was and re-educate all staff... why should patients be uncomfortable without proper body positioning if there is no stool to rest their legs on.. what about their circulation when legs are just hanging without support?

traumaRUs, MSN, APRN, CNS

Has 27 years experience. Specializes in Nephrology, Cardiology, ER, ICU.

The problem is that pts stand on the pull out step instead of the floor. (That would be my guess) as I've seen this scenario happen.

You just seem so unhappy at in-center hemo - have you considered PD or home hemo? That would give you the control you desire as well as allowing you more flexibility.

Believe me, if I ever need dialysis, I will go with PD or home hemo. As an alternative, you can choose to stick yourself if in-center is the only way you can go -t hat way you can more easily control the infection risk.

Am not sure but I think you are under the impression that I am a patient???? I am an advocate for patients .. and many patients complain about 'real' concerns......and, believe me there are real concerns in the units... don't fool yourself :)

traumaRUs, MSN, APRN, CNS

Has 27 years experience. Specializes in Nephrology, Cardiology, ER, ICU.

Sorry, yes I did think you were a patient.

I guess I just don't see the issues the same way.

That's okay, we can agree to disagree.

I seem so unhappy at incenter hemo????????????????????????? I am advocating for patients (not a patient) who are strapped to chairs who have valid concerns..... So a few patients fall and all have to do without a stool... in all due respect to our differing opinions......don't you think that if staff were aware, or more aware, they would have stools pushed back prior to patients getting up?? That is a safety aspect that should have taken place in training.

traumaRUs, MSN, APRN, CNS

Has 27 years experience. Specializes in Nephrology, Cardiology, ER, ICU.

Are you some type of employee of the regulating board of HDU's? I guess I just don't see how or why you are so interested in this since you aren't a pt or provider.

And...I've never seen a pt "strapped to a chair."

There are many options if the pts don't want or can't tolerate in-center hemo:

1. PD - at home

2. Hemo - at home thru various modalities.

3. Transplant

I'm sincerely trying to understand where you are coming from. I've never seen a "patient advocate" in any of the HDUs that I go to. There are governmental agencies that oversee HDUs and if there is a valid complaint, then of course that is where one should go.

traumaRUs, MSN, APRN, CNS

Has 27 years experience. Specializes in Nephrology, Cardiology, ER, ICU.

I've always been honest about who I am, my credentials and my bias.

Can I ask the same of you? Telling me you are a "patient advocate" doesn't say anything.

The HDUs where I see pts are all locked and secure - there are no "pt advocates" wondering around. Where do you get your information? Who do you talk to?

Everyone has a bias when they post on the internet - I freely admit that my bias is that of the provider, what's yours?

I am not a patient, just fyi.. but a patient advocate in all respects.

Bias on part of the provider - please explain that statement. Does that mean you side with the provider?

I always wonder why one does not post their 'real' name? I would like to hear that for that is honesty through and through --(pls, do not take offense as not to mean such).

ps my real name is not disclosed as no one else here does so.. Advocating for patients occurs when patients contact a representative to help them solve problems at their unit. If you read the dialysis survey findings you will note that there are many problems in many units. It sounds as if the units you are affiliated with are, by far, superior. Over the many years, as you know, there have been congressional hearings focused on such as misuse of Epogen, involuntary discharges, etc. Many patients are discharged and inappropriately so.. a patient advocate steps in to help them. Many patients have suffered injuries due to untrained technicians, etc. I am sorry that you have not seen those units that delivery substandard care, but, believe me, they are out there. Patients advocates, as myself, get involved in state and federal legislative issues surrounding dialysis care, including but not limited to the new prospective payment system and prior newly revised Conditions. You are very, very fortunate to have not ever experienced a dialysis setting where patients receive substandard care. There are many problems and not all units delivery quality safe care. And, as you know, even the providers have identified problems that result in harm, including death e.g. not following physician orders, negative outcomes as a result of such, just for an example. In review of hundreds of facility surveys I found most infractions related to infection control, reuse, incorrect implementation of MD orders e.g. BFR. I hope this clarifies. I work with patients individually who have problems in units. Again, you are so very lucky to have never experienced that which occurs that affects patients negatively.

UPDATE: Rumor has it that those FMC units, that have not yet removed their foot platforms from the chairs , will suspend with removing these.I now wonder if FMC realized there is more potential danger with nothing for the patient to rest their feet on...

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