Mechanical Turning Beds: Why might we need them?

In 2009, a working party of the Multidisciplinary Association of Spinal Cord Injury Professionals (MASCIP), in collaboration with the Spinal Injuries Association (SIA) Academy, produced a set of clinical guidelines for Moving and Handling Trainers (www.mascip.co.uk/guidelines.aspx).

These guidelines established a common clinical consensus regarding techniques and equipment appropriate for handling and transferring actual or suspected SCI patients across a range of clinical scenarios. As part of these guidelines, the working party illustrated the use of mechanical turning beds for the management of SCI patients, particularly those with complex multiple injuries.

At the time of publication there were a number of companies producing mechanical turning beds for use within the NHS but soon after publication of the 2009 MASCIP guidelines the two main providers of mechanical turning beds to the NHS ceased production and those beds still in use will soon become unserviceable. This came as a shock to those NHS acute care providers with an established utilisation of mechanical turning beds within their patient care pathways.

The need for, and use of, mechanical turning beds within the NHS has evolved over many decades for the benefit of both patient and staff wellbeing. In addition, much of the design and development of this equipment had occurred in partnership with NHS healthcare providers.

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MASCIP was concerned over this development because the NHS was about to embark upon a definitive national care pathway for SCI patients and the need for the appropriate provision of specialist equipment such as mechanical turning beds was a core concept within this plan.

In addition, the potential need to provide for mechanical patient turning was also identified as a resourcing need within the establishment of Major Trauma Centres as all traumatic SCI patients would initially be admitted to a local Major Trauma Centre pending fitness to transfer to their local SCI Centre (NHS Clinical Advisory Group on Trauma 2010).

The MASCIP Committee was made aware that a new design concept for a mechanical spinal turning bed was being developed by Nexus DMS Ltd with the support of multidisciplinary teams from the SCI Centres at Oswestry, Stoke Mandeville and Sheffield and recognised that there was an opportunity for MASCIP to influence the future design and development of this new bed so that it could be utilised for complex care patients.

MASCIP believed that this would be the best approach to secure the future availability of mechanical turning beds for SCI patients. The MASCIP project team was established in February 2011 to critically review the design concepts and establish parameters for use and testing during a 2-day residential workshop in June 2011 and a series of equipment evaluation trials within a variety of NHS hospital departments during 2012.

The project team is also grateful for the support and advice provided by the National Back Exchange (NBE) and Designing for Dignity (D4D).

An example of a mechanised turning bed

An example of a mechanised turning bed

The core objectives established by the MASCIP project team for the use of mechanical turning beds were:

1) To review the evidence base which supports the current use of mechanical turning beds.

2) To establish the continuing level of need for mechanical turning beds within the current  management of SCI patients and associated complex conditions.

3) To explore how traditional turning bed design parameters and care practices could be revised  in accordance with the patient and user experience as well as innovations in clinical engineering, material design and product development.

4) To ensure that the contribution of mechanical turning beds in the management of SCI  patients within NHS hospitals was assured for the future.

5) To consider the need for bed manufacturers to provide turning beds appropriate for multiple complex conditions rather than just the niche spinal/SCI patient markets and whether this should be established as a parameter for the NHS Purchasing Agency.

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References

National Spinal Cord Injury Strategy Board. (2010) Meeting the Needs of People with Spinal Cord Injury in Planning for Trauma. NSCISB. London.

NHS Clinical Advisory Group on Trauma (2010) Regional Networks for Major Trauma. http://www.excellence.eastmidlands.nhs.uk/welcome/improving-care/emergency-urgent-care/major- trauma/nhs-clinical-advisory-group/

Multidisciplinary Association of Spinal Cord Injury Professionals (MASCIP) (2009) Moving and Handling Patients with Actual or Suspected Spinal Cord Injuries. MASCIP. London.