TITLE

DETERMINING EFFECTIVENESS AND EASE OF USE OF TRANSFORMER BED

IN PREVENTING BED RIDDEN COMPLICATIONS : A PILOT STUDY

Guide:
Dr. Abhishek Sharma ,MPT Neurology
Faculty, Physiotherapy, SRHU
 INTRODUCTION
• A Bed-ridden patients are those that for some reason have to stay in bed for a long
period of time, such patients might quickly develop serious complications that are not
directly linked with the bed ridden state.

• Immobility is independently associated with the development of a series of

complications including : Musculoskeletal , Cardiorespiratory, Dermatological etc.

• Many Studies have shown that complications of immobility could result in numerous
deleterious consequences including increased morbidity and mortality, prolonged
length of hospital stay, increased hospital cost and thus contribution to global
disease burden.
INTRODUCTION
• Common causes that can result in a bed ridden state includes but are not
limited to conditions like head injury, stroke, brain tumors, multiple
sclerosis, motor neuron disease, spinal cord Injury, GBS etc.

• Considering the above it can be stated that a lot of health care workforce
as well as funds are being utilized in managing such patients in the Indian
health care scenario.

• The current treatment plan to prevent bed ridden complications includes

ROM exercises, two hourly turning regimen, sitting mobilizations and
standing mobilization on tilt table etc.
INTRODUCTION
• Inspite of the above measures, the percentage of patients developing bed
ridden compilations is quite high and also the mobilization protocols that are
used involves high risk of injuries to patients, care givers and health care
professional during transferring of patient from bed to wheel chair and tilt
table etc.

• Also the current scenario poses challenges towards meeting of the ideal
mobilization dosage due to dependency of caregivers upon the health care
professionals.

• Considering the above challenges to mobilization of bed ridden patients, the

transformed bed has been designed and developed.
INTRODUCTION
• Therefore this research study intends to find and establish whether
the usage of transformer bed can significantly reduce the risk of
developing bed ridden complications and significantly minimize the
injuries to care givers and patients during the mobilization process.

• Also the study will include the feedbacks from patients, care givers
and health care professionals regarding the ease of use of the bed.
STATEMENT OF QUESTION

• NEED OF THE STUDY :-

1. To improve the quality of health care for bed-ridden patients.

2. To significantly reduce man power involving care of bed-ridden patients.

STATEMENT OF QUESTION

• AIM OF STUDY :-

➢To establish the effectiveness and ease of use of a (Transformer Bed)

in managing Bed-ridden complications.

➢To Assess and compare bed ridden complications between patients

managed on transformer bed and hospital bed.
RESEARCH HYPOTHESIS

➢ Experimental Hypothesis :–
Patients managed on Transformer Bed will show significantly less
Bed-ridden complication as compared to control group.

➢ Null Hypothesis :-
Patients managed on Transformer Bed may not show significantly less
Bed-ridden complication as compared to control group.
 METHODOLOGY
• STUDY POPULATION :
Bed-ridden patients in Neuro-Surgery Ward of Himalayan Hospital.

• SAMPLE SIZE : 5
METHODOLOGY
• Inclusion criteria :-
1. Bed-ridden Patients.
2. Both Male & Female.

• Exclusion criteria :-
Any critical Neurological condition/pathology in which Mobilization is
contraindicated.
STUDY DESIGN
• Case Control (Pilot) Study.
INSTRUMENTATION
1. BED RIDDEN COMPLICATIONS will be assessed and objective scores will be taken as
follows:-

• Pressure Sore – 0 , 1 , 2 , 3 , 4 ( Grading )

• Postural Hypotension
0 – Absent | 1 – Present

• DVT
0 - Absent | 1 – Present

• Constipation
0 – Absent | 1 – Present
INSTRUMENTATION
• Deformity - 0 – Absent | 1 – abnormal tightness | 2- contracture
Ankle -
Knee -
Hip -
Shoulder -
Elbow -
Hand –

• UTI –
0 – Absent | 1 – Present
 INSTRUMENTATION
• Disuse Atrophy – 0 – Absent | 1 – Present
Calf
Thigh
Biceps
Forearm

• Respiratory Complications – 0 – Absent | 1 – Present

• Secretion Retention – 0 – Absent | 1 – Present

• Urinary Incontinence/ Retention – 0 – Absent | 1 – Present

OUTCOME VARIABLE
• BED RIDDEN COMPLICATION SCORE = _____ / 27.

• Experimental Group = _____ / 27.

• Control Group = _____ / 27.

PROTOCOL
SELECTION OF BED-RIDDEN PATIENTS FROM NEURO SURGERY WARD
(BASED ON INCLUSION & EXCLUSION CRITERIA)

SIGNING OF INFORMED CONSENT

PRE-TEST READINGS / SCORE FOR BRCS

PATIENT MANAGEMENT ON TRANSFORMER BED

( WEEKLY)
1st wk - ____
POST- TEST READINGS / BRCS SCORE 2nd wk- ____
3rd wk- _____
4th wk - _____
COMPARISON WITH THE CONTROL GROUP

RESULT
PROCEDURE
• The subjects for the study will be selected from the NSW of Himalayan Hospital based
on Inclusion & Exclusion Criteria.

• After signing the informed consent, the subject selected for the Experimental group
will be provided ‘Transformer Bed’ as a replacement for traditional hospital Bed.
• Pre-Treatment score (BRCS) will be taken on day-1.

• The Caregivers and the Nursing staff will be provided education regarding the
operation of Transformer Bed and practical training will be provided to them to use
the bed as Portable Chair and Tilt Table.

• Patients sitting and standing mobilization time will be matched with the average
standing and sitting time for the respective age of the patient.
PROCEDURE
• The initial sessions of mobilization to sitting and standing will be
supervised by the Physiotherapist.

• Any signs of intolerance to mobilization will be noted and explained to

care givers.

➢This will include any sharp drop or Rise in BP

o( < 10mmHg diastolic & > 20mmHg systolic ).
o Heart Rate (220bpm – Age). { Target Heart Rate = btw. 64% and 76% }.
o Faintness, Dizziness, Vomiting etc.
PROCEDURE
• Caregiver training will be continued in next few sessions until the
Physiotherapist feels confident that the caregivers can mobilize the
patient safely, the required number of times.

• Post-test (BRCS) will be taken at the end of 1st, 2nd,3rd and 4th week and
will be compared with the control group.

• The Control group will include Bed-ridden patients being treated in the
same facility with the existing traditional protocols.

• This usually involves, 2hrly ‘Turning in Bed’, Passive limb movements,

sitting (out of bed) if indicated.
CONSENT
I/Caregiver of _________S/D/W/o ________admitted in Neuro-Surgery Ward,
Himalayan Hospital, have been informed about the advantages of Transformer
Bed over the normal Hospital Bed.
I understand that my participation will have no financial benefit & information
provided by me will be kept confidential.
Information provided by me will be used only for research purpose where
anonymity will be maintained by the researcher. I am also aware of fact that I can
quit from the study anytime I want.
I am hereby consciously giving my consent for the study and to be part of study.

Patient’s Name _______________

Signature___________

Date : __________
Ease of Use Questionnaire/Survey
Strongly
Agree Disagree
Agree

1. I did not have any Back/Neck Pain during patient Handling.

2. I Did not suffer from any casualty/ injury during patient

Handling.

3. The patient was mobilized adequately throughout the day.

( >= 6hrs ). ( 2hrs of standing & 5-6hrs of sitting).

4. I was single handedly able to mobilize patient to sitting and

standing

5. I was not dependent on Nursing Staff for mobilizing the

patient.

6. I would recommend use of this bed for patient care at

home settings.
FEEDBACK FORM
• Kindly provide your valuable feedback regarding the advantages and short comings of
the Transformer Bed :-

• Patient / Caregiver Feedback:-

__________________________________________________________
__________________________________________________________
__________________________________________________________

• Nursing Staff Feedback:-

__________________________________________________________
__________________________________________________________
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