Guide
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Page 1
Caregiver Information: Achieving optimum surface performance from the Hill-Rom Progressa™ and TotalCare™ Bed Systems. The Hill-Rom Progressa and TotalCare Bed Systems have been designed to: x x x
Reduce risk of or treat Pulmonary or other complications associated with immobility Treat or Reduce risk of Pressure Injuries Use where medical benefits may be derived from either Continuous Lateral Rotation Therapy ( CLRT) or Percussion/Vibration Therapy
There are three primary surfaces:
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Prevention – Foam with non-powered air cylinders Dynamic Therapy – Continuous Low Pressure air therapy surface with MicroClimate Management® (MCM) Pulmonary (also known as SpO2RT with TotalCare) –Dynamic Therapy Surface, with the addition of Rotation, Percussion and Vibration, and Opti-Rest features. All three surfaces are not a substitute for good nursing practices. The surfaces should be used in conjunction with thorough assessment and protocol. In accordance with NPUAP/EPUAP/PPPIA Prevention & Treatment of Pressure Injuries¹, consideration should be given to the individual’s: • Tissue tolerance • Level of activity and mobility • General medical condition • Overall treatment objectives • Skin condition • Comfort Frequent assessment of the individual’s skin condition is necessary to identify the early signs of pressure damage and, as such, their tolerance of the planned repositioning schedule. If changes in skin condition should occur, the repositioning care plan needs to be re-evaluated.¹ Consideration of nutritional status and continence should also be assessed regularly. The reduction of pressure and shear at the heel is an important point of interest in clinical practice. The posterior prominence of the heel sustains intense pressure, even when a pressure redistribution surface is used. ¹ Ideally, heels should be free of all pressure - a state sometimes called ‘floating heels’.¹ Pressure Injuries in sub-dermal tissues under bony prominences very likely occur approximately between the first hour and 4-6 hours after sustained loading. ² The traditional 2-hourly repositioning regime may provide a useful starting point from which frequency can be adjusted. ³
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Normal Mode The Dynamic and Pulmonary Surfaces provide continuous full-body pressure redistribution by providing optimum Immersion and Envelopment based on the Pt’s body morphology – not just weight. Pressures automatically adjust the air system to accommodate changes in weight distribution. Loose fitting sheets must be used for correct operation of the sleep surface. Caregivers should try to limit the presence of linens on the surfaces to products that are absolutely necessary.⁴ ⁵ Pressure Redistribution is always active unless one of the following occurs: • Max-Inflate is active (see Max-Inflate section) • AC power is not available – the bed should always be plugged into an appropriate power source when available. • An error with the product – if malfunction is detected the service required indicator is illuminated (Figure1). Malfunctions can directly alter surface performance. Patients may need to be placed on another product until corrected.
Max-Inflate: The Max-Inflate mode maximises the firmness of the primary section of the patient surface. This mode assists in patient surface-to-surface transfers and/or repositioning. It can be activated on the Progressa in two ways; upper side rail operation (Figure 2) or via the Surface Tab in the Graphical Caregiver Interface (GCI) (Figure 3).
Figure 3
On the TotalCare, Max-Inflate can be activated on the GCI in the Surface Tab (Figure 4).
TotalCare Figure 4
The Progressa and TotalCare Therapy Surface will automatically exit the Max-Inflate mode and return to normal mode after 30 minutes. After 28 minutes, a beep will sound and a message will show on the GCI that there are 2 minutes left. The caregiver has the option of keeping the surface in Max-Inflate or let it return to normal mode. Caution: Therapeutic pressure redistribution is not active during Max Inflate. Only use when the functionality is required to assist the caregiver. Seat Deflate The Seat Deflate feature allows for easier bedpan placement and side egress. It is activated via the GCI (Figure 4). Seat deflate is not recommended for extended side-sitting.
Figure 4
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Turn Assist The Turn Assist mode will activate the mattress assisting the Caregiver to turn the patient for repositioning, linen changes, dressing changes, skin assessment, bed pan placement, back care, and other nursing procedures. TurnAssist mode is activated via the GCI – Graphical Caregiver Interface (Surface Tab)
Progressa
TotalCare
In addition to activating the TurnAssist function, patient positioning is important and facility manual handling protocol should be followed. For enhanced posterior patient access, Max-Inflate may be used once the patient has been turned to the desired side. The siderail the patient is turning towards MUST be in the up position to activate Turn Assist. If the siderail is down, a triple beep will sound and a message will appear on the GCI indicating the rail must be up to initiate. Once the patient has started to turn, the siderail the patient is turning away from can be lowered for easier patient access.
Additional surface information for Optimum Pressure Management on Progressa and TotalCare Surfaces: The Therapy and Pulmonary Surfaces are most effective when air circulation to the patient's skin is unimpeded. Avoid use of plastic linen savers or plastic-lined incontinence pads which obstruct air flow and allow moisture to remain in contact with the skin for prolonged periods of time, contributing to skin breakdown. Any incontinence pads or bed-protecting linens used in conjunction with these surfaces should be highly absorbent and air permeable. Foot Section – The foot board should always be positioned as close as possible to the Pt’s. feet to ensure optimum heel Immersion and Envelopment through the dedicated heel section of the surface. For comprehensive training on the use of Progressa and TotalCare Bed Systems, please contact your local Hill-Rom representative. The information in the data sheet is intended to complement (not replace) the User Manual. References: 1. NPUAP/EPUAP/PPPIA Prevention & Treatment of Pressure Injuries. Second Edition, 2014. 2. Gefen A. How Much Time Does it Take to Get a Pressure Injury? Integrated Evidence from Human, Animal, and In Vitro Studies. Ostomy Wound Management,2008;54(10):26-35 3. PRESSURE INJURY PREVENTION Consensus document. Wounds International, 2010. 4. Williamson R. A Laboratory Study Examining the Impact of Linen Use on Low-air-loss Support Surface Heat and Water Vapor Transmission Rates. Ostomy Wound Management, August 2013. 5. Williamson R. The Effect of Multiple Layers of Linens on Surface Interface Pressure: Results of a Laboratory Study. June 2013
www.hill-rom.com ©2016 Hill‑Rom Services, Inc. ALL RIGHTS RESERVED. Doc. No: 5EN125825-01, 13 April 2016