Key issues for selection of hospital furniture

Walk in to any hospital today and you are likely to find a mixture of ward furniture, sourced over many years and from a growing number of NHS contract approved suppliers. But hospitals like the spectacular new Queen Elizabeth Hospital Birmingham, equipped with individual rooms, or four-bed rooms with en-suite facilities are well placed to equip with new furniture, including patient seating throughout. So which factors are influential in the furniture selection process for both refurbishment or new build projects?

Effective cleaning services
According to NHS Evidence tackling cleanliness and infection control is the responsibility of everyone who comes into contact with the NHS – from visitors to managers to nurses to surgeons. Healthcare Associated Infections (HCAI) continue to receive high priority and more action has been announced to tackle HCAI, with reporting processes to trust boards by matrons and clinical directors on infection control and cleanliness. Further action will involve specialist inspectors and tough new powers to inspect, investigate and intervene where hospitals are failing to meet hygiene and infection control standards. Given this background, infection control practitioners play an increasingly important role in influencing those involved in the procurement of furniture for hospital environments. It has been argued that routes to infection are diverse.

Wood finishes & vinyls
To aid infection control, surfaces and furniture need to be both durable and easily cleaned. Wood finishes should be sealed using a high quality clear lacquer, which is not only durable but incorporates antimicrobial agents that suppress the growth of micro organisms.
    
In the fight against HCAIs fabric choice also plays an integral part. High performance vinyls are ideal in extreme hospital environments, with their anti-microbial and anti-fungal protection (tested to NHS specified requirement AATCC147) that prohibits growth of bacteria and associated odours, infection and cross-contamination.         

The fabric does not absorb spills and is easily wiped clean, making it ideal for use in high risk infection control areas. Regular cleaning with warm soapy water and clean water rinse is sufficient to retain the fabric’s appearance and durability.

The upholstery maintains its appearance over long periods of time, provided it is cleaned in line with the vinyl manufacturer’s instructions.

Bariatric products

The Health and Safety Executive reports that 40-70 per cent of Trusts do not have a bariatric policy in place, an important process which helps amongst other things to manage manual handling risks when dealing with bariatric patients. Specialist bariatric seating, designed and tested to handle patients up to 300+ kilos (50 stones) is available with fixed and drop arms and in a choice of seat heights dependent on client and carer requirements. Integral housekeeping wheels, allow what are essentially large, bulky items of furniture to be repositioned, without the need for manual handling. BB pressure cushions aid pressure relief and comfort.

Pressure relief & comfort

To meet the needs of a variety of client groups, patient seating can be supplied in a number of seat grades, depending on the risk of tissue breakdown, following a clinical assessment.
    
High grade polyurethane foams are often supplied as standard, with the option to upgrade to a low/medium risk comfort cushion, or for high risk environments to pressure relieving foams, such as Reflexion foam, which helps prevent the development of pressure ulcers, but also reduce sliding and improve posture. This is achieved by helping to distribute body weight across a greater surface area, avoiding localised interface pressure by responding to body heat and forming to the body’s shape.

Reflexion foam features two layers (the upper layer is Vasco, a Visco elastic which is both temperature sensitive and energy absorbing, while the lower layer is Reflex, providing support and flexibility for the upper layer).

Seat height & depth adjustment
How do you ensure that the patient seating provided for clients in specialist units or at ward level have the correct seat height to suit a variety of clients? Clients with varying posture, leg lengths and physical abilities mean that a standard seat height may not be appropriate in all situations. Simple accessories such as height adjusters can provide the answer, offering a variable seat height, with adjustment in increments up to 100mm (4”) maximum, allowing bespoke seat heights to be created, along a preset range.

Housekeeping wheels can also be added to seat height adjusters, which offer height adjustment, but with the added benefit of improved mobility, allowing the chair to be easily positioned and without the need for manual handling.
    
Many NHS Trusts in specialist areas such as admissions, mental health, oncology or in more general ward applications choose to order chairs both with and without seat height adjusters, to suit a variety of clients. A simple pin adjustment allows for seat height adjustment in-situ, helping to avoid situations where the seat is too high and the clients’ feet are not in contact with the floor, or where the seat is too low, making it difficult to get out of the chair for those with impaired strength or mobility. Clients encouraged out of bed during a period of recuperation may also spend extended lengths of time in a patient chair. For this reason correct height adjustment and ergonomically designed furniture to ensure correct support and posture are also important factors. A removable seat option can also provide seat depth adjustment and with a wipe down rigid base it allows for easy cleaning and hygiene control. Similarly, a removable seat platform allows seat cushions to be interchanged for specific pressure reducing needs and can be used in conjunction with suitably inflated air cushions.

Cleaning & decontamination
Removable seat bases allow seats soiled with bodily fluids including urine, mild acids and alkalis, drinks and beverages to be changed and cleaned in line with current guidelines to prevent and manage the spread of infection. Effective cleaning services always need to be available and a piece of equipment used for more than one patient should be decontaminated according to current guidelines following each use. Clinical teams must ensure that equipment is clean, maintained and fit for purpose.

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