specialty beds for patients

[sediaz]

Embarrassed myself and got hauled into my directors office because I didn't follow procedure re how my facility utilizes air mattresses.

I have started shifts with patients already on specialty beds but have never put one on a bed for a patient myself. I had rec'd report on a patient and no mention was made about a specialty mattress and I was puzzled when I saw one in a blue nylon bag on a chair int the patient's room. I checked and didn't see an order for one. My charge clarified for me that I don't need an order for an air mattress and asked me why the patient had been admitted. I told her the pts age and admitting diagnosis and she suggested I go ahead and put it on the bed. I delegated this to my NT and asked her to let me know when she would do this and I would help her so that I could get the experience. Next time I went into the room the mattress was already under the patient. A few hours later I got a call from the oncoming charge nurse who asked me where the mattress was. When I told her she quietly said, "It's dirty". Turns out that our clean specialty mattresses are stored in transparent plastic bags and when the patient is d/c'd the mattress is placed in a blue nylon bag and stored in our dirty utility room until the contract company picks it up. That particular mattress had been in my patient's room almost 24 hours when I noticed it and incorrectly decided to utillize it for my patient:banghead:.

Ok. Now I know. I'm not trying to pass responsibility to charge nurse or tech; I made the call.

There is going to be a time when I ascess a patient and determine that a specialty mattress is needed. I'm hesitant to ask about this, though, because of this recent flub of mine. I know that it has to do with skin assessment (pressure ulcers) and the patient's physical condition (stroke, contractures). I was thinking that this was done once a patient was admitted to the floor and the primary nurse did the admission assessment but yesterday I saw a nurse setting up a mattress prior to an admission.

I'm hoping someone can give me some insight into criteria for specialty mattresses so that I can stop feeling awkward and embarrassesed.

Thanks in advance!!!

[ZooMommyRN, ADN, RN]

Ours is based on the pt's Braden score, however we have several frequent flyers that we know will meet criteria before they even hit the floor, so if I see their name pop up in the census I'll go ahead and put it on ahead of time, sometimes you can get the ER nurse to tell you if the patient is mobile or not, most likely if they are immobile for any reason it's an air mattress automatically, if they already have a skin breakdown of stage II or more than we put an air mattress on until we can get a treatment mattress ordered, I love the treatment mattress since they rotate the patient automatically, and you can use them to your advantage when cleaning the pt as well since you can manually drop one side of the mattress down while the other is still up.

[R*Star*RN, BSN, RN]

Ours is based on the Braden score, and then we have a flowsheet to determine which specialty bed the patient needs. We have about 5 different mattresses for varying degrees of need.

As for knowing that the mattress was dirty, how were you to know? No one told you the difference. Thank goodness at our hospital I just have to order the bed and someone else installs it and makes sure it's working correctly. . . those matresses get pretty complicated!!