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TotalCare® Duo® 2 Connect Therapy System
The Complications of Immobility
Complications of immobility such as nosocomial pneumonia are amongst the most commonly acquired infections in critical care (1) with statistics showing affected patients have higher morbidity and mortality rates (2). However, the effects reach far beyond the patient, increasing caregiver workload with higher dependency rates, and exacerbating the financial burden on the hospital as the costs of caring for the patient rise with length of stay in both the critical care department and the hospital increasing. (3)
Progressive Mobility™ Therapy programmes
For many years healthcare professionals have recognised the importance of positioning techniques particularly for the prevention of tissue damage. In more recent years however the concept of positioning has become more accepted as the potential impact becomes more deeply understood by the multidisciplinary team. In many situations repositioning a critically ill patient is challenging – in one study 49.5% of patients did not move during an 8-hour period. (4)
However caregivers are increasingly recognising that with a Progressive Mobility™ Therapy programme health care facilities can reduce the incidence of nosocomial infections, reduce hospital length of stay and treatment costs.
Progressive Mobility™ Therapy refers to the concept of employing appropriate positioning techniques in order to:
- Assist in the prevention of complications of immobility such as ventilator associated pneumonia
- Assist in the treatment of complications of immobility
- Improve weaning success
- Improve patient psychological status
- Provide opportunities for orthostatic hypotension training
The TotalCare® Connect family of products are the only specialised support systems available to day which can offer important mobilisation therapies necessary to assist your patient through increasing levels of mobility from Continuous Lateral Rotation Therapy to assisting them to standing:
Continuous Lateral Rotation Therapy
Preliminary tilt table
Sitting upright – from supine through 30° head of bed elevation to FullChair® position
Chair Egress™ position
TotalCare® Duo® 2 Therapy System
New for TotalCare® Connect.
With this latest version of the TotalCare® Bed Hill-Rom have developed the most easy to use caregiver interface – a colour touch screen interface with improved graphical representation of key data. In one survey 90% of caregivers could immediately use the interface without additional training. In addition within the recording of data Hill-Rom have, at the request of our customers, enhanced the data collection by including the FullChair information and by providing a choice of settings for popular head of bed alarm.
Head of Bed Alarm and Trending
Many researchers have cited the importance of 30 0-45 0 head of bed elevation in the prevention of ventilated associated pneumonia (VAP). In order to support VAP reduction protocols Hill-Rom introduced a unique 30 0 head of bed elevation alarm for the TotalCare ® family of products which alerts caregivers if the bed drops below 30 0 allowing caregivers to quickly respond. In the most recent version, TotalCare ® Connect Hill-Rom have further improved this unique alarm facility at the request of our customers to allow a choice to set the alarm at either 30 0 or 45 0. Additionally, the Head Angle indicator can monitor how long (hours and minutes) the Head Angle is above 30º or 45 º – for up to eight days – assisting hospitals to comply with VAP prevention protocols and guidelines.
FullChair® position
The FullChair® position optimises pulmonary efficiency and improves the patient’s psychological status especially in comparison to traditional Cardiac Chair positions. The FullChair® position, as provided by the TotalCare ® Connect family of products, meets the up in chair recommendations in the Progressive Mobility™ Therapy Guidelines for Critically Ill Patients (5). Achieved at the touch of a button Hill-Rom have built on their years of experience to design the next generation of FullChair® position incorporating a new Cradle Transition to provide a secure feeling and reduced migration to the foot end of the bed as they move into FullChair® position.
Chair egress position
This simple mechanism facilitates earlier and safer mobilisation, enabling patients to achieve functional mobility sooner in the care process with reduced risk of injury to themselves and caregivers. Based on the patient’s condition, the patient has the option of side or foot end of bed egress.
Integrated Duo® 2 surface
The integral Duo® 2 support surface offers two clinically accepted therapies in one proven product.
- Continuous low pressure mode – achieves lowest tissue interface pressures in its category (6,7) providing maximum distribution of patient weight
- Alternating low pressure mode – a 1 in 4 alternating cycle in the body zone supporting 75% of the patient at all times, this in combination with the De-Teq® concept eliminates the peak pressures found in traditional alternating pressure systems 2 7 . The head zone remains in continuous low pressure mode for comfort and safety. (8,9)
Duo® 2 incorporates unique pressure control technology called De-Teq®. This system constantly monitors the patient ’s weight and position providing the lowest possible pressures to optimise pressure redistribution for all patients in all positions.
X-ray Cover and Intermediate Air Pocket Accessories
Recent feedback from our customers tells us that in an Intensive Care Unit most patients undergo daily chest X-rays. X-ray cassette positioning usually takes 2-3 nursing staff plus a radiographer - this involves significant manual handling of the patients which is a risk to the caregiver and places added stress on the patient often causing additional sensory overload.
Therefore Hill-Rom has recently introduced a new accessory for the TotalCare® Duo® 2 Connect Therapy System which includes a specially developed cover and air cushion designed to allow an X-ray cassette to be easily and quickly inserted to take a portable chest X-rays. This is designed to improve the patient and caregiver radiological experience from both a comfort and workload perspective
Key advantages of the new TotalCare® Duo 2® Connect Therapy System X-ray facility:
- X-ray cassette is directly below the patient's body thus ensuring clarity of the X-ray image is of a high level
- Reduction in number of staff required to place the cassette and carry out X-ray procedure
- Easy to visually see position of X-ray cassette - reducing the need to reposition the X-ray cassette once inserted. This repositioning adds more time to the procedure creating additional stress and discomfort to the patient and potentially causing damage to delicate skin tissue on the patients back .
- X-ray pocket access is from either side of the Therapy System - this side access ensures cassette positioning is easier for the caregivers
Shearless Pivot® Patient Positioning
The unique mechanism combines the articulation of the frame and the integrated surface thereby minimising shear forces, reducing migration of the patient towards the foot of the bed. Repositioning is minimised and patient comfort maximised
FlexAfoot® Retractable Foot Mechanism
Caregivers can customise the overall length of the bed. The retracted footboard provides support to the patient’s feet, reducing the need for additional foot support devices. The overall surface can be retracted up to 12” (30.5 cm), which also aids the caregiver during transport in tight spaces.
Integrated Scale
The integrated scale option allows for easy-to-use, repeatable weighing accuracy with weight trending.
Boost™ Feature
New for the TotalCare® Connect frame the Boost feature is designed to position the patient into the ideal position for repositioning by putting the patient into a slight head down tilt.
Intellidrive ® Power Transport System with variable Speed Control
Transporting patients in an acute care environment is a challenging task. With the IntelliDrive® system, a touch of a button and minimal effort, one caregiver can effortlessly transport a patient.
Mobility of the TotalCare® Connect bed system during transfer can be greatly increased with the addition of the optional IntelliDrive® system. This feature also helps minimise the need to transfer patients to stretchers for transport. When transport is required, simply unplug the bed, release the brake, grip the handles and go.
With little effort, one caregiver can move even heavier patients on a carpeted surface; perform 180° turns with ease; navigate through obstacles, and achieve 90° turns with a hospital bed.
References
1. Vincent J.L., et al The Prevalence of nosocomial infection in intensive care units in Europe: Results of the European Prevalence of Infection in Intensive Care (EPIC) Study, JAMA 1995 274:8 639-644
2. Kappenstein I., et al Prolongation of hospital stay and extra costs due to ventilator associated pneumonia in an intensive care unit. Eur J Clin Microbiol Infect Dis 1992
3. CDC Guidelines for Prevention of Nosocomial Pneumonia 1997 MMWR 46(RR-1) 1-79
4. Krishnagopalan S. Body positioning of intensive care patients, clinical practice versus standards. Critical Care Medicine. 2002
5.Ahrens T., et al Progressive Mobility™ Therapy Guidelines for Critically Ill Patients. Advancing Nursing. 2005
6.Colin D., Clinical Evaluation of an Innovative Mattress. 7 th European Congress on Advances in Wound Management. 1997
7. 6.Colin D., Evaluation of a Pressure Relieving Air Mattress. 7 th European Congress on Advances in Wound Management. 1997
8. Grindley A., Alternating Pressure Mattresses: comfort and quality of sleep. BJN., 1996
9. Ballard K.,The Effect of Two Alternating Pressure Mattresses on Patient Comfort. Professional Nurse. 1997
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