Home Safety

Using Heaters, Clothes Dryers & Electrical Blankets Safely

Preventing Bed Entrapment

(Information provided by SA Department of Health)

A report has been received of an incident where a child in an adult hospital bed, asphyxiated after becoming entrapped in a gap between the side rail and the mattress. Reviews of reports indicate that bed entrapment is a widely reported recurrent issue.  No standard exists to specify the safe design of adult beds that are used by children. The following advice is based on a report from the SA Department of Health Epidemiology Branch and others that preventative measures must be taken to minimize any potential entrapment hazard, particularly when an adult bed is being used by a child.

Recommendations

• Inspect bed mattress, bed frames and head and foot boards as part of a regular maintenance program to identify possible areas of entrapment.
• Ensure that mattresses are compatible with bed frames and that no gaps are present.  Side gaps should just be big enough to allow the raising of adjustable side rails, but no bigger.  The tighter the fit of the mattress between the two side rails, the better.
• The use of removable spacers to fill side, head and foot gaps should be avoided in preference to using a correctly sized mattress that fits tightly all round.
• Be aware that gaps can be created by movement or compression of the mattress due to the patient’s weight.  Firm mattresses are preferred, and in particular mattresses that cannot be significantly compressed (i.e. narrowed) by a horizontal force from the side.
• Beds should not be pulled (i.e. Manoeuvred) using the side rails as a handy grip,   as such action tends to bend, distort or weaken the rail and rail mounting, thereby increasing the potential for lateral play in the rail and the resulting gap size.

Bathroom Safety

Maintaining safety in the bathroom is very important, as the combination of slippery floors and hard surfaces can sometimes make for a hazardous environment. Some simple suggestions include:

For the shower:

• Shower stools or chairs (with or without lockable castors) allow showering from a seated position, preventing fatigue and eliminating falls risks. Arm rests and height adjustable legs provide additional support while transferring.
• Permanent shower benches can be fixed to a wall and can be flipped out of the way when not needed.
• Grab rails provide a safe means of support for transferring in/out and while using the shower. It is important to consider the location of the rail and to ensure that it is installed securely and with the appropriate fasteners. Refer to Australian Standard 1428 for guidelines. A variety of slip resistant rails are available.
• Slip-resistant flooring, mats or tiles placed on the shower floor assist in preventing falls. It is important to ensure that all loose corners are secured to prevent tripping.
• Hand held showers can be used to direct water where required while sitting or standing.  Different styles include permanent options which replace the existing shower head or temporary options which fit onto existing fittings with push on cups or rubber tightened with metal bands. Permanent hand held showers may be mounted on a secure grab rail or bracket to allow different height adjustments.
• It is important to check the compatibility of the hand held shower with the type of hot water system as certain situations may create the risk of sudden and extreme fluctuations in water temperature. Not all gravity fed hot water systems are compatible with all hand held showers.
• Consider the type of handset for hand held showers; think about weight, type of grip and placement within easy reach. The shower hose should allow length for use while seated. It is important that water spray is not directed towards power outlets.
• Other considerations include a wooden shower platform to eliminate the step into the shower and the use of a shower curtain over a shower screen.
• A long handled back sponge or toe washer, soap on a rope, or soap placed in a wash mitten can also help eliminate unnecessary bending and potential falls hazards.

For the bath:

• Some homes have a combined shower over the bath which can create a potential safety concern. Using a bath board across the top of the bath allows the user to have a seated shower over the bath, and assists when getting in and out.
• If a bath board does not fit, a height adjustable bath bench which sits on free standing legs may be an option.
• An electric bath hoist can make it easier to lower into and out of the bath and may come with a reclining backrest.
• Fixed grab rails provide support when transferring to and from the bath. If installation is not possible, clamp on hand rails may be attached onto the side of the bath for extra assistance.
• Slip resistant mats, liquid applications and adhesive strips may be applied to the bath to reduce the risk of slipping.

Thermostatic Mixers:

Thermostatic mixers are designed to prevent scalding through incorrect water temperature adjustment or inability to manipulate conventional taps. Thermostatic mixers have a single control for adjusting the temperature and/or the volume of water passing through the units. They can be used to control one outlet or the entire house.

• If scalding is a concern, adjusting the hot water system at the thermostat may be an option. On some hot water systems, the maximum water temperature can be adjusted and lowered.
• Anti-scald devices can also be fitted to the hot water supply piping. These devices have a valve which reacts to water temperature at a certain level; if a rise in temperature is detected by the valve it automatically reduces water flow.

Taps:

Turning taps on and off may be difficult for a number of reasons; including painful hands, weak grasp, taps turned off too tightly or the style of tap may simply be too difficult to grip. Options include:

• Quarter turn taps feature a ceramic disc operation which enables the tap to be turned on and off within 90 degrees, decreasing the amount of hand twisting required.
• A lever style handle is often easier to manage and can sometimes be extended   to enable use with the side of the hand or elbow, reducing the pressure placed on small joints of the hand. These can be quarter turn or standard.
• More expensive options include foot controlled taps which involve pedal valves which control the flow of water when pressed.  Infra-red/electronic sensor taps operate via a radar-sensing transmitter which is sensitive to movement, so when hands are placed in the basin the water flow commences.
• Replacing or installing new taps is not always practical, therefore options for modifying existing taps may be considered. The first step may be to replace existing rubber washers with an ‘o’ ring or hydro-seal. Less force is then required to turn the tap on and off.
• A ‘tap turner’, a device which fits over the existing tap head creating a lever tap, may be the answer. These are available in a large range of options to suit various tap heads. It is important to know exactly which tap head you have before looking into this option. Some tap turners are adjustable to fit a number of different heads. In some cases a piece of slip resistant material may be enough to provide extra grip.
• When designing a new bathroom it is important to take the style of taps into consideration, as future difficulties may be eliminated with a bit of forward planning. Attention should be paid to the ability of the user to reach and use the taps effectively and safely e.g. a person in a wheelchair must be able to reach and use taps from a seated position. Ensure that there is adequate clearance space between tap handles, especially if using a lever handle, and nearby walls, bench tops, basins or other plumbing fixtures.

For the toilet:

• ‘Donut style’ toilet seat raisers can be attached to the top of the toilet bowl to assist in sitting and standing.
• Height adjustable frames can be placed around the toilet to provide hand rails for support and assistance when moving on/off the toilet. These are available with or without an attached toilet seat, commode pan & splash guard.
• Fixed raised toilet seat replacement systems, with or without flip away armrests, provide a more permanent and stable option but can be more expensive.
• Grab rails can be attached to the walls near the toilet to assist with sitting and rising. These can be fixed or swing away.

Slip resistant flooring:

• When designing a bathroom there are ways to make flooring safer by installing slip resistant tiles. However, there are also methods which can be used with the existing floor covering, such as slip resistant mats/tape and chemical floor        treatments.
• It is important to consider the ease of application, cleaning and maintenance, the finished appearance, durability and whether some treatments may be too abrasive for bare feet or create a tripping hazard, in the case of adhesive strips or mats.

Other ideas to make your bathroom safer include:

• Replacing towel rails with fixed grab rails for extra support.
• Using a height adjustable bathroom chair/stool to sit on while drying to avoid loosing balance.
• Installing childproof locks for bathroom cabinets to avoid the accidental consumption of potentially harmful products.
• Scald warning devices which change colour when water goes above the specified temperature.
• Plastic inflatable covers to surround the water spouts in bathtubs to protect from head injury.
• A plug with an in-built pressure activated mechanism which allows water to release down the plug prior to overflowing.

Independent Living Centre, 11 Blacks Road, GILLES PLAINS SA 5086
Ph: 1300 885 886 (SA/NT callers only)
Ph: (08) 8266 5260 Fax: (08) 8266 5263
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Web: www.ilc.asn.au
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