Assistive Technology and Equipment in the Sleeping Environment

SDMS Id Number:	P2010/1083-001
Effective From:	15 March 2018
Replaces Doc. No:	DC008
Custodian and Review Responsibility	Housing, Disability and Community Services - Disability and Community Service
Contact:	Manager, Disability Services Policy and Programs
Applies to:	All disability providers funded by Disability and Community Services
Policy Type:	Statewide Policy
Review Date:	15 March 2021
Keywords	bed, bed rails, bed features, bed pole, bed stick, restrictive, practices, falls preventions, sleep environment, entrapment, mattress
Routine Disclosure:	Yes

Approval

Prepared by	Senior Project Officer	1300 135 513	15 March 2018
Through	Manager, Disability Services Policy and Programs	1300 135 513	16 March 2018
Through	DCS Executive Group	1300 135 513	21 March 2018
Cleared by	Director, DCS	1300 135 513	21 March 2018

Revision History

Version	Approved by name	Approved by title	Amendment notes
	Name	Position Title
	Name	Position Title
	Name	Position Title

Purpose

Ensure beds, bed features and other assistive technology in the sleeping environment are selected and used safely and appropriately for people who are considered at risk of injury whilst in bed.
Describe the process that must be followed when an alternative bed or a bed feature is being proposed for a client.
Address issues of bed safety broadly by taking into account factors such as the need for increased supervision and monitoring of some people with disability, ease of transfer on/off bed, the ability of a person to change positions in bed, alternatives to bed rails and safety considerations for staff and clients as per Tasmanian Work Health and Safety Act 2012.
At present there are no Australian Standards specifically relating to the selection of beds or bed rails. Occupational Therapy Australia is in the process of developing practice guidelines for Occupational Therapists in assessing the sleep environment and prescribing equipment. [1]This policy reflects responses to incidents that have occurred in the past, current research about bed safety and guidelines relating to least restrictive practices.

Mandatory requirements

This is a statewide policy and must not be re-interpreted so that subordinate policies exist. Should discrete operational differences exist, these should be expressed in the form of an operating procedure or protocol.
This policy must be read in conjunction with the Tasmanian Disability Services Act 2011.
The Tasmanian Disability Services Act 2011 provides the legislative basis for the provision of specialist disability services.
This policy relates directly to disability service providers funded by Disability and Community Services.
All disability services providers or funded private persons must ensure that a type of restrictive intervention is not carried out in relation to a person with disability who is under the care or control of a disability services provider or a funded private person. DHHS wide Policy Restrictive Intervention in Services for People with Disability and its accompanying guidelines provides further information.
Failure to comply with this policy, without providing a good reason for doing so, may lead to disciplinary action.

Roles and Responsibilities/Delegations

Role	Responsibility
Disability and Community Services Area Managers	Communicate policy and guideline to area office staff, particularly Disability Assessment and Advisory Teams Ensure compliance of policy
Senior Practitioner	Use of assistive technology and equipment in the sleep environment including bed rails, can potentially restrict the freedom of a person and can be considered a form of restraint and would be considered a restrictive practice under the Disability Services Act. Please refer to DHHS wide policy on Restrictive Intervention in Services for People with Disability. Ensure that any potential restriction is the last resort after all other options have been trialled, is in the best interests of the person and is the least restrictive option available (Disability Services Act 2011).
Occupational Therapist	Must be involved in the assessment and selection process of any proposed bed and bed features where the equipment has the potential to restrict freedom of movement. Must follow OT Australia’s Practice Guidelines and recommendations regarding use of assistive technology in the sleeping environment.[2] Ensure selection meets best practice for the clients’ needs and occupational health and safety requirements of the organisation Educate consumers, their families and service providers regarding safe use of equipment in accordance with the manufacturer’s guidelines and rationale of prescription of equipment; manual handling and occupational health and safety requirements along with the risks of entrapment and use of restrictive practices
Disability Service Providers funded by Disability and Community Services	Communicate this policy to relevant employees Ensure compliance with this policy and guidelines Ensure that restrictive practices are reported to Senior Practitioner Provide a safe environment for all clients and staff Initiating referral to Occupational Therapist and Senior Practitioner if consumer’s sleeping environment is unsafe and/or restrictive Compliance with recommendations from Occupational Therapist and Senior Practitioner Consider if Guardianship and Administration Board may also need to be consulted
People with disability requiring bed selection and bed features	Provide informed consent as per DHHS policy Consent by Clients to use of recommendations provided by Occupational Therapist People have the right to choose their own style of bed, including the features of a bed unless: The person cannot give informed consent or The person’s choice presents an unacceptable occupational health and safety issue to support staff (eg a low bed for a client who needs assistance to turn in bed) which is not resolvable through training.
Family / Guardians	Provide informed consent as per DHHS policy Consent by Clients, to use of recommendations provided by Occupational Therapist if consumer unable to do so.

Risk Implications

Non-compliance with this policy will result in a breach under the Tasmanian Disability Services Act 2011
Interests of all parties not being maintained and any potential risks to those interests are not being mitigated. There are documented deaths and significant injuries attributed to incorrect selection of beds and bed features.
Not meeting the requirements of the Quality and Safety Framework

Training

Disability services provider or a funded private person are to ensure that all staff, whether employees or volunteers are appropriately qualified and skilled and where appropriate credentialed and registered
All staff, whether employees or volunteers are to be provided with adequate support, training, debriefing and directions to enable them to perform their duties safely.

Audit

This policy will be included in the work program of the DHHS Internal Audit function. This work program is approved by the Audit and Risk Committee and will assess underlying systems and procedures for compliance with the requirements of this policy. The overall focus of this assessment will be one of continuous improvement to DHHS activities.

Attachments

[1] These practice guidelines will be published on the OT Australia Website in April-May 2018.

This Policy may be varied, withdrawn or replaced at any time. Compliance with this directive is mandatory for the Department. PLEASE DESTROY PRINTED COPIES. The electronic version of this Policy is the approved and current version and is located on the Department's Strategic Document Management System. Any printed version is uncontrolled and therefore not current.

Printable Version

Divisions

Contact Details