AGING AND DISABILITY SERVICES ADMINISTRATION

2009 AFH "Dear Provider" Letters

September 15, 2009

ADSA:  AFH 2009-0017
SAFETY RISK OF MEDICAL DEVICES

Dear Adult Family Home Provider:

Recently we have observed an increase in the use of medical devices in our long-term care settings.  Some of the increased use is due to residents being older and more medically fragile.  However, the purpose of this letter is to remind you there are also safety risks associated with the use of most of these devices.

Licensors have observed that resident assessments seem to focus on justifying the use of the device rather than on assessing the resident’s needs and providing interventions that support those needs.  Some examples of providing supportive interventions for a resident who is at risk of, or afraid of, falling might be:

• Lowering the bed or providing some padding on the floor by the bed as long as this does not increase the risk of accident.
• If the assessment indicates that weakness and balance are issues, strength and balance training may be needed, or someone may need to walk with the resident.
• If the assessment indicates that the falls always occur around a certain time of night and the resident is found to have been incontinent at the time, perhaps staff need to assist the resident to the bathroom at scheduled times.

Examples of medical devices with known safety risks when used include transfer poles, Posey or lap belts, and side bedrails. Potential risks of medical devices may include strangling, suffocating, bodily injury, skin bruising, cuts, scrapes, agitation, feeling isolated or unnecessarily restricted.  If you are using or are considering the use of medical devices for your residents, please remember the following:

• Review the resident assessment to determine the resident’s need for and use of a medical device.  The assessment is not to justify the use of the device.
• Ensure the resident negotiated care plan includes the resident’s use of a medical device or devices.
• Provide interventions that support the needs of the resident and how best to keep the resident safe.
• Less restrictive alternatives that are safer should be tried before using any medical device.
• Residents and/or family members must be provided with enough information about the significance and level of the safety risk of use of the device to enable them to make an informed decision about whether or not to use the device.

It is always important to evaluate the safety of each resident and recognize the risks of using medical devices.  If you have any questions, please contact your RCS Field Manager.

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services