FALLS MANAGEMENT Education, Rehabilitative and Environmental Interventions

Transcription

1 FALLS MANAGEMENT Education, Rehabilitative and Environmental Interventions Comprehensive Falls Management Program included with qualifying purchases

2 Falls Management: A Growing Concern Each year one-third of adults 65 and older experiences a fall. 1 Among those who fall, 20 to 30 percent suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death. 2 Recent compliance regulations, as outlined by the Joint Commission s Patient Safety Goals and the Centers for Medicare and Medicaid Services (CMS) guidelines, have created increased urgency for the prevention of patient and resident falls. 3, 4 EDUCATION AND PRODUCT INTERVENTIONS TO HELP REDUCE FALLS Medline can help healthcare facilities improve falls management by providing a number of useful products to be used in conjunction with a comprehensive falls management program. We hope you will find this guide useful in learning more about falls and helping your facility select appropriate falls safety products. We also welcome you to consider participating in Medline's Falls Management Program.

3 TABLE O F C O N T E N T S Program and Education 6 Falls Management Program 8 Falls Management Kits Rehabilitative Interventions 14 Patient Safety Wear 18 Mobility Aids 24 Patient Handling 31 Rehab And Strength Training Environmental Interventions 35 Patient Safety Alarms 41 Bath Safety 47 Bed-Related Safety Products 3

4 THE CAUSES OF FALLS ARE KNOWN AS RISK FACTORS. Different types of fall risks can be grouped into two categories deemed Intrinsic and Extrinsic Risk Factors. When multiple risk factors exist for a single person, the risk of falling increases. In addition, the greater number of risk factors the more likely a fall may result in injury that could threaten a person's life. We can provide solutions through the implementation of a falls management Program that provides Education in addition to a variety of Rehabilitative and Environmental interventions that address specific fall risks. By identifying specific risk factors, appropriate interventions aimed at minimizing the risk can be identified and implemented. Intrinsic Fall Risk Factors Age-related changes Change in vision Change in balance Change in mobility History of falling Cognitive or emotional dsyfunction Medications The associated side effects can lead to an increase risk in falls. Risk of falls goes up with an increase in the number of medications a person is taking. Lower extremity weakness Gait or balance disorders Bladder dysfunction Communication disorders Extrinsic Fall Risk Factors Physical environment Equipment issues Improper use of devices Floor surface Raised beds Unstable or improper furnishings Time of fall 4

5 THREE PILLARS OF FALLS MANAGEMENT Program and Education Preventing falls and fall injuries cannot be fixed overnight. Specific products can help to reduce specific risk factors, but only a comprehensive program paired with valuable education can truly make an impact when fully implemented. A program that is used across your entire organization will help change attitudes and results. Rehabilitative Interventions These interventions are most often geared to benefit a specific individual who has displayed intrinsic risk factors. Rehabilitative interventions such as gait belts help to reduce falls risk on the patient level. The use of these products can help patients stay active while keeping them safe. Environmental Interventions Falls that result from an outside factor can potentially be eliminated by making alterations to the environment. Environmental interventions such as grab bars or bedside commodes help to reduce extrinsic risk factors in a certain area. When a facility reduces the extrinsic risk factors they can reduce their number of falls. Intervention Goals Falls Management Technologies are designed to reduce the hazards associated with falls. Different falls management products have different goals in helping with your overall program to help reduce injuries from falls. Look for the symbols below at the beginning of each section to learn how the technologies help with falls management. Reduce Risk of Falls Assitive devices Reduce Risk of Injury Injury protection devices Warn Caregivers Warning devices 5

6 Program and Education Falls Management Program Enhance Your Safety Efforts with Medline s Falls Management Program With proper communication, interventions, and education, falls can be reduced. The Falls Management Program combined with an extensive list of product interventions makes Medline a great choice to partner with to help your facility reduce falls. Get started today and find out where your facility has room for product improvement by going through the Falls Management Assessment Guide inside this catalog (PG 10). Medline s Falls Management Program includes the following components: Online falls management courses to provide continuous education to your staff Instructions showing how to organize your falls team Tools to monitor falls risks and monitor outcomes 6

7 Falls Management Education Program and Education Contact your Medline sales representative for additional information about the Falls Management Program. Learn more about Falls Management and receive FREE CE credits on Medline University. aspecific courses related to Fall Prevention a Flexible access: PC, Iphone, IPAD a Free Registration With the help of Medline's comprehensive Falls Management How-To Guide and continuous online education, your facility can begin reducing falls rates today! 7

8 Program and Education FALLS MANAGEMENT KITS Warn Caregivers Once education and assessment criteria have been determined the next step will be acquiring falls management kits to benefit the falls program. Kits can be implemented quickly and efficiently, helping to get a full-fledged falls management program off to the right start. The elements within the kit act as visual reminders for patients and visitors of the risk factors for falls. The use of the kits will help provide a universally understood warning for the staff that will minimize confusion. The components in the falls management kits serve as a simple and quick reminder of the risk for falls. Falls Management Q&A Q: What are other ways to alert staff that a patient is at risk other than items the patient physically wears? Bookmarks or stickers can be placed in the patient s chart. Signage will remind staff as well as patients of the fall risk; in addition to necessary preventative actions they need to take. Q: Who else should be educated in addition to staff? Patients need to be educated after being identified as being at risk. They need to follow safe practices to minimize their risk of falling, such as using their call buttons for assistance. Family members and visiting friends also need to be educated so they understand the necessary precautions and practices that are implemented for the safety of their loved ones and can assist the patient in complying.

9 Program and Education Falls Management Kits The Institute of Healthcare Improvement has recommended the use of yellow to identify a person at risk of falling. Medline has created kits for your facility that combine yellow patient wearables and yellow signage to help your staff quickly identify those patients at risk of falling. The use of these products in tandem with a falls management program can help build awareness of falls management for patients, staff, and visitors to your facility. DYKMALEFPYL (Acute Care) Fall Management Kits Medline has created two different falls management kits designed specifically for different facilities; acute care and long-term care. Acute Care kit includes a quick, snap-on yellow identification band and glow-and-flow urinal. Long Term Care kit includes a durable, slip-on yellow identification band made of silicone DYKLTCFALLFM (Long Term Care) Fall Management Kit Components Acute Care Long Term Care DYKMALEFPYL DYKFEMALEFPY DYKLTCFALLM DYKLTCFALLFM 20/cs 15/cs 20/cs 15/cs Double tread yellow slippers Fall Risk Identification Band CALL DON T FALL wall sign RESET BED ALARM wall sign Yellow door magnet Glow and let flow urinal (glow in the dark lid) Packaged in a resealable bag with a write-on block Fall Risk Identification Silicone Wristband 9

10 Falls Management Assessment Guide The following Falls Management Assessment Guide presents 50 questions that will help you detect deficiencies at your facility. This comprehensive tool guides you through different locations at your facility and helps you determine where current fall risks exist. Interventions are separated into three categories: Program, Rehabilitative and Environmental. After completing the checklist, carefully review your answers. Any no answers present opportunities for new products. Pair the completed list with Medline's Falls Management Catalog to help you determine which products can help meet your facility s needs. Top 10 Questions Education and Awareness Yes No Suggested Intervention Product Item # Pg # 1 Does facility offer educational courses on the subject of falls management? A key component to running a succesful falls management program is taking the time to educate your staff on falls management. Medline offers various courses on this topic online at Medline University. Medline s Falls Management Program N/A Pg 6 2 Does every employee in the facility understand the goal to reduce falls and how to reach that goal? Falls management should be understood and valued by everyone from the nurses in a facility to the maintenance workers. Proper education and awareness should be provided to all employees who could effect the outcome. Medline s Falls Management Program N/A Pg 6 3 Once a patient completes a fall risk assesment test are they easily identifiable to the entire staff? The Institute of Healthcare Improvement has recommended the use of yellow to identify a person at risk of falling. Patient ID bands of the same color can help staff quickly identify a patient at high risk for falls. Falls Management Kits DYKMALEFPYL Pg 9 4 Does facility have a schedule to audit mobility equipment to ensure all devices are maintained in good working order? Walking aid devices should be evaluated when first provided to the user and should be continually monitored. N/A N/A N/A 5 Are patient lifting devices used at your facility to facilitate safe patient transfers? A stand assist device can help safely get patients up from the seated position and allow them to stay active. Using lifts properly can also help reduce caregiver injuries. Manual Stand Assist STA182 Pg 26 6 Are patients/residents at risk of falling participating in physical therapy programs? An exercise program geared toward strength training, endurance, and flexibility can help reduce the risk of falls in the elderly. To help with endurance and strength patients can use peddle exercisers even while seated. Peddle Exerciser MDS100 Pg 33 7 Does facility have a system to alert staff when a patient at risk has wandered out of their room? An infrared alarm can be placed near the doorway to let nursing staff know that the patient at risk has wandered out of the room. Infrared alarm MDTIRM1 Pg 39 8 Does facility provide equipment for patients who have previously fallen in the shower? Provide adjustable shower chairs for someone who has previously fallen in the shower or shows trouble standing without support. It is important to ensure shower chairs are sized appropriately to the individual. Shower chair with back MDS89745A Pg 43 9 Is call equipment within the reach of the patient? Provide another level of security by using patient safety alarms that alert staff when patient is at risk of falling. Pressure sensing alarms MDT8175 Pg Does facility use bedside safety products to help reduce the impact in the case of falls? The use of fall safety mats can provide a soft landing surface thereby reducing the trauma from impact. Use the Advantage fall mats for patients who have already fallen from bed or with high risk assesment scores. Advantage fall mat MDTFM24662BI Pg 53

11 Falls Management Assessment Guide Program and Education Education and Awareness Yes No Suggested Intervention Product Item # Pg # Has facility implemented a company wide falls management program? Does facility use adequate signs in patient/resident rooms to alert staff of a person at risk of falling? An effective falls management program should be implemented across an entire organization with one universal goal. To make the biggest impact an organization needs a designed program that will address all facets of falls management. Quick recognition of a person at risk can be achieved through bright colorful signs that constantly remind staff and the patient/resident of a fall risk. Medline s Falls Management Program Falls Management Kits N/A Pg 6 DYKMALEFPYL Pg 9 Rehabilitative Interventions Patient Safety Wear Yes No Suggested Intervention Product Item # Pg # Are patients/residents at risk identifiable when they are away from their rooms? Does facility provide wearable products to help provide traction? Does facility use gait belts for patients who display difficulty when walking? Do patients/residents at risk wear products that can potentially reduce the impact of a fall? Medline carries a stylish yellow patient gown that provides caregivers with clear, but discreet identification of fall risk patients. Patient Slippers with treads on top and bottom provide grip even if slipper rotates on foot. Available in the color yellow. Gait belts provide a steady handle to grasp when a person is beginning to fall. Gait belts may also provide a feeling of security for someone who has developed a fear of falling. When assesment suggests that an indiviudal is at high risk to expereince a fall, facilities should provide hip protectors. Extra padding can potentially reduce the severity of a fall injury. Fall Prevention Gown MDTPG7ITSHRG Pg 15 Falls Risk Slippers MDTPS4B04FPY Pg 15 Yellow Gait Belt MDT821203Y Pg 16 Hip Protectors ALI76224 Pg 17 Mobility Aids Yes No Suggested Intervention Product Item # Pg # Are brakes and tips checked to make sure wearable parts are in working order on all mobility aid devices? Are the mobility aids checked for correct sizing for the user? Have patients been through proper training from a PT or Medical professional on how to use the Mobility aid? Does facility have adequate space for storage of mobility aids when not in use? Does facility have a device that can help patients stand-up and get going? Medline carries replacement cane tips and walker tips to help restore mobility aids to a safe and operable condition. Walking aids that are too tall will limit the user's weight bearing capabilities and when sized too small will result in users falling forward and developing bad posture. Various mobility aid devices are designed to benefit different gait deficiencies. Make sure users have the device that will work best for their needs. Folding mobility aids take up less space when not in use and store away easily. The Stand Assist walker has bi-level grips that can help a user who struggles to move from the sitting to standing position get up. Once standing this device works as a standard walker. Cane Tips Quad Cane Tips Walker Tips See Medline s Walking Aids Sizing Guide in the Walking Aids and Bath Safety Catalog G30561-PC G02162 G01202 LIT 124R N/A N/A Mobility aids N/A Pg 18 2-Button folding walker Stand Assist Walker Patient Lifting and Handling Yes No Suggested Intervention Product Item # Does facility have patient lifting equipment for bariatric patients? Does facility have multiple slings to ensure the appropriate size is being used for all lifts? Has facility implemented a complete patient handling and lifting program? Lifting equipment will not be effective or safe if the weight bearing capabilites do not fit the patients needs. Ensure your facility is equipped with the appropriate bariatric lifting equipment. Fall management interventions should be geared around the individual, so it is important to carry all the necessary sizes for lifting slings. Reference the Sling Specification Chart on page 23. To ensure safety when lifting patients facilities should implement a complete patient handling program to keep both patients and staff safe. A quality program should include education, implemention plans, and assesment tools. Bariatric, batterypowered stand assist Large, full-body sling Patient Handling Solutions MDS Pg 21 MDS86410UR Pg 22 Page # MDS600SA Pg 25 Medline Sling Pg 27 N/A Pg 30

12 Falls Management Assessment Guide Rehabilitative Interventions Rehab and Strength Training Yes No Suggested Intervention Product Item # Pg # 25 Are persons at risk of falling limiting their activity and displaying a fear of falling? Aids for daily living products help people regain independence with day to day activities while minimizing the risk. Reachers provide extra length to help users grab items that would normally require an unsafe amount of reaching. Resistive exercise bands allow users to participate in a variety of different therapeutic exercises that will help them improve their strength and balance. These products can be used to build strength in upper extremities or improve balance in lower extremties. The use of cuff weights during simple rehab exercises can help increase a patients strength and therefore improve balance. Provide indiviudals with the ability to progress from lighter to heavier cuff weights by carrying a whole set. Medline Reacher MDS86031RCE Pg Do patients/residents participate in exercises that can help improve their balance? Resistive Exercise Bands MDSHXR1H Pg Does facility have rehab equipment that allows indiviudals to increase their exercise regiment? Cuff weights MDSP Pg 34 Environmental Interventions Patient Safety Alarms Yes No Suggested Intervention Product Item # Pg # Are patients who display fall risk factors monitored closely to help reduce future falls? Do patient safety alarms connect to a nearby nurse call station? Does facility have specific interventions for patients/residents who are at risk of falling and also suffer dementia? Bathrooms Yes No Suggested Intervention Product Item # Pg # Are there hand rails in shower and near toilet? Does staff check shower chair and transfer bench tips to ensure they are in good working condition? Does facility use PVC shower chairs or shower gurneys when bathing patients? Have patients been at risk from falling due to low height of the toilet seats in the bathroom? Does your facility take precautions for patients who take multiple nocturnal bathroom visits or struggle making it to the bathroom alone? Provide an extra grip for a resident at risk of falling by installing grab bars in the bathroom. Grab bars should be a contrasting color to the wall for easy visibilty. Medline carries replacement shower chair, transfer bench, and commode tips to help restore bath safety equipment. PVC shower products are warm to the touch, easy to manuever and have anti-slip grips which provide safety and comfort for patients. Locking casters provide safety when in use. Elevated toilet seats increase the height of the seat allowing patients who experience trouble bending an easier task of getting on and off the toilet. Units with locking devices provide a more secure grip. Commodes placed near the bed can provide a short trip when needing to use the restroom without assistance. Drop arm commodes allow for safer transfers from an adjustable bed. Wall grab bars MDS86018CHR Pg 42 Utility tips G01202 N/A PVC shower chair Elevated locking toilet seat Drop-arm commode PVCM1183 Pg 44 G30270A Pg 46 G98202 Pg 46 Bedrooms Yes No Suggested Intervention Technology Item # Pg # Is the bed at a low height that is appropriate for the patients? Does staff check low beds to ensure that locking casters are in proper working order? The use of patient safety alarms can help the staff monitor patients at risk. Alarms can alert the staff to help them get to a patient who is at risk before a fall occurs. Alarms that are compatible with nurse call systems help alert nurses when they cannot hear an alarm from the room. Patients with higher risk of falling should be placed closer to the nurse call station. An alarm noise may startle patients with cognitive dsyfunction and cause panic. Alarms with voice recording capabilities allow staff to create a freindly reminder message that can remind the patient to wait for assistance. When a bed is at the appropriate height for the individual the entire foot should be flat on the floor with legs bent at 90 degrees. The use of an adjustable Hi-Low bed can allow for staff to adjust the height to the patient s needs. The Alterra Low bed comes with 4 locking casters. Check casters on regular basis to ensure they still work. Quick Alert Ultra II alarm Tamper-resistant alarm Safety alarm w/ voice Low bed FCE1232B Pg 48 Repl. locking casters MDT8175 Pg 36 MDT8400 Pg 37 MICR81860 Pg 37 FCE Pg 48

13 Falls Management Assessment Guide Environmental Interventions (cont d) Bedrooms Yes No Suggested Intervention Product Item # Pg # 38 Is all clutter that could cause a fall out of the patient s pathway? Assist bars and Half Bedrails can be used to ensure exits take place on the desired side of the bed away from clutter. Avoid the use of double full-length rails which can cause falls when patients attempt to climb over. Standard Assist Rails Soft-Touch Assist Rails Assist Bar FCE1232RSR FCE1232RSRN FCE1232ABN Pg Are specially designed mattresses used to help reduce the potential of patients rolling out of bed? Provide these patients with mattresses that conform to the body making it more difficult to get out of bed. Medline Advantage 1000 mattresses are available with raised edges as well. Advantage 1000 mattress MSCADV1076FR Pg 50 Hallways/Floors Yes No Suggested Intervention Product Item # Pg # Is signage readily available to remind those at risk of falling to call for assistance? Does facility have non-slip surfaces in all patient areas? Signs provided in the Fall Management Kits can also be used outside patient rooms to remind patients of their own limitations. Fall risk slippers with 360 degree tread provide a better grip even when the slipper rotates on the foot. Slippers are available in the color yellow. Fall management kits DYKMALEFPYL Pg 9 Fall risk slippers MDTPS4B03FPY Pg Are there additional seats in your hallways for mobile patients who get tired? A rollator is a walking aid with a seat and breaks that can convert to a comfortable seat for those who need a rest. The Comfort Glide rollator has a memory foam seat for comfortable seating. Educate users to apply breaks when sitting. Comfort Glide Rollator MDS86826W Pg Are patient alarms set in place for patients that may wander into hallways who are at risk? An infrared alarm can be placed near the doorway to let nursing staff know that the patient at risk has wandered out of the room. Infrared alarm MDTIRM1 Pg Are there handrails in the hallways to help those who are not using their walking aids? Grab bars can be installed along various parts of hallway walls to provide assistance to wandering patients. Wall Grab Bars MDS86018CHRG Pg Does facility use any products around the bed that can help reduce the impact when falling out of bed? Place fall mats on the side of the bed the patient exits to provide a softer landing in case a fall occurs during a transfer. Low profile fall mats provide added safety while also helping to reduce tripping hazards. Bedside fall mat MDTFALLMATB Pg 53 External Areas Yes No Suggested Intervention Product Item # Pg # 46 Are patients/residents still easily identifiable as being at risk of falling while outside? In addition to wearing a yellow ID band at all times, the use of a yellow blanket for wheelchair users can discreetly help with fall risk identification. Fall prevention yellow blanket DYKBLANKETYL Pg Does the outside area have a sufficient number of seats for resting? A combination rollator and transport chair can allow patients to stay active and walk until they need a rest. If they do not have the strength to walk back the unit can convert to a transport chair. Excel Translator MDS808200TR Pg Are pathways clear of weeds, moss and leaves which can all intiate a fall? Suggest using walking aid devices with larger wheels for outside use as they more easily roll over uneven surfaces. Walker with 5 wheels MDS86410W54 Pg Does facility have an intervention that can help improve a patients fear of falling when going outside? Progressive resistive exercise bands can help promote strength and balance. Physical exercise has also been shown to increase self confidence. Resistive Exercise Bands MDSHXG1H Pg Are patient alarms in place to alert staff when patients at risk have wandered outside? An infrared alarm can be placed near the doorway to let nursing staff know that the patient at risk has wandered out of the building. Infrared alarm MDTIRM1 Pg 39 Medline Industries, Inc. One Medline Place Mundelein, IL Medline Industries, Inc. Medline is a registered trademark of Medline Industries, Inc

14 Rehabilitative Interventions PATient SAFETY WEAR Reduce Risk of Falls Reduce Risk of Injury Warn Caregivers The red and yellow slippers and yellow gowns featured in this section help to visually identify individuals at risk of falling while also promoting falls awareness among staff, patients/ residents and their families. Every member of the healthcare team should be educated to recognize these cues. All family and visitors also should be educated to recognize and understand the identifiers and be aware of how to obtain help from appropriate staff in case someone gets up from their bed or chair or falls. 5 Safety Wear Q&A Q: Other than education of staff, what steps can be taken to help identify patients who have displayed common risk factors of falling? The IHI (institute for Healthcare Improvement) has recommended the universal use of the color yellow to identify patients at risk of falling. The use of a yellow wristband could remind both the staff and the patient that they are at risk. A yellow blanket or gown for patients in bed or in wheelchairs will remind staff to take the necessary precautions during transfers. Yellow socks with non-skid treads will alert staff to a patient who is at risk of falling if they are mobile and not taking the necessary precautions. Q: What could patients wear to help protect them from future falls? If a patient requires assistance to ambulate, nursing staff can use a yellow gait belt as a handle to grasp in the beginning stage of a fall. Keep one hand on the gait belt with your other hand on the shoulder to help if a patient falls forward or backward. If a person is using a cane with a gait belt, staff should stand on the opposite side of the cane. Gait belts also may provide added security for patients who have developed a fear of falling.

15 Rehabilitative Interventions Falls Risk Slippers With innovative tread on the top and bottom, this slipper provides a continuous grip for patients even if the slipper rotates on the foot. Sizing is on the bottom of the slipper for easy identification by staff Supple terrycloth on the inside absorbs perspiration and provides comfort and warmth Easy to slip on and off Item # Description Color pkg MDTPS4B01FPY Child Yellow 48 pr/cs MDTPS4B03FPY Medium Yellow 48 pr/cs MDTPS4B04FPY Large Yellow 48 pr/cs MDTPS4B05FPY X-Large Yellow 48 pr/cs MDTPS4B06FPY XX-Large Yellow 48 pr/cs MDT211218R One-Size-Fits-Most Red 48 pr/cs MDT211218RXL X-Large Red 48 pr/cs Patient Safety Wear PerforMAX Fall Prevention IV Gown The bright yellow color of this IV gown helps caregivers with clear, but discreet identification of fall risk patients. Attractive spectrum print and red binding at the sleeve Fade resistant - This will allow the identifiable yellow color of the gown to last the life of the gown. Shrink resistant - This will keep this gown s full tie side closure intact, maximizing patient modesty. Item # Description Color Pkg MDTPG7ITSHRG PerforMAX Fall Prevention IV Gown, OSFM Yellow 6 DZ 15 15

16 Rehabilitative Interventions Resident SAFETY WEAR Patient Safety Wear Gait Belts Gait belts are designed to aid caregivers as they assist patients with walking. Belts fit securely around the patient s waist and provide caregivers with a surface to grab when helping patients ambulate or transfer. Aids with lifting and transferring patients Helps reduce the risk of caregiver back injuries Machine washable Item # Design Length material Buckle Pkg MDT821203DLXH Deluxe Gait belt with Handles 28"-55" (71cm-140cm) Nylon Plastic Each MDT821203DLX Deluxe Gait belt with Handles 28"-55" (71cm-140cm) Nylon Plastic 10/cs MDT821203YS Solid Yellow Fall Management 54" (137 cm) Cotton Metal Each MDT821203Y Solid Yellow Fall Management 60" (152 cm) Cotton Metal Each MDT821203YL Solid Yellow Fall Management 72" (183 cm) Cotton Metal Each MDT White with Blue & Red Pin Stripes 60" (152 cm) Cotton Metal Each MDT White with Blue & Red Pin Stripes 60" (152 cm) Cotton Metal 6/cs MDT821203L White with Blue & Red Pin Stripes 72" (183 cm) Cotton Metal Each MDT Pastel Stripes 60" (152 cm) Cotton Metal Each MDT828204C Pastel Stripes 60" (152 cm) Cotton Metal 6/cs MDT821203BS Solid Black 54" (137 cm) Cotton Metal Each MDT821203B Solid Black 60" (152 cm) Cotton Metal Each MDT821203BL Solid Black 72" (183 cm) Cotton Metal Each MDT821208NAT White with Blue Stripes 60" (152 cm) Cotton Plastic Each MDT821208PAS Pastel Stripes 60" (152 cm) Cotton Plastic Each FALL STATISTICS One out of five hip fracture patients dies within a year of their injury. Leibson CL, Toteson ANA, Gabriel SE, Ransom JE, Melton JL III. Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. Journal of the American Geriatrics Society 2002;50:

17 Rehabilitative Interventions Security/Safety Belts These products can be used by patients who are at risk of falling out of wheelchairs because they don t have the strength to keep themselves upright. IMPORTANT: Products that are restraints should only be used when it is in the best interest of the patient or resident and only when administered and used under proper medical supervision. All models are one size fits all and do not require multiple sizes Soft belts create comfortable security for patients at risk of falling Soft security belts have a polyester strap Patient Safety Wear Item # Description pkg MDT Soft security belt with foam inner pad 1 piece, Each MDT Soft security belt with foam inner pad 2 piece, Each MDT Soft security belt, quick release with foam inner pad 2 piece, Each MDT Nylon wheelchair belt, hook and loop design 1 piece, Each MDT Nylon wheelchair belt, quick release buckle 1 piece, Each MDT Stretcher belt, 74 with quick release buckle 1 piece, Each QualCare HipShield Brief An economical way to guard against the possibility of a hip fracture with closed cell foam protection pads on each side to absorb the impact of falls. Pads are perforated so that skin can breathe Briefs are made of cotton/spandex and are washable Unisex design accommodates all residents Item No. Description pkg. HIPPREMIUMS Extra Small, 30"- 38" (76cm - 97cm) Waist 6/cs HIPPREMIUMM Small, 35"- 43" (89cm - 109cm) Waist 6/cs HIPPREMIUML Medium, 40"- 48" (102cm - 122cm) Waist 6/cs HIPPREMIUMXL Large, 44"- 54" (112cm - 137cm) Waist 6/cs HIPPREMIUMXXL Extra Large, 48"- 60" (122cm - 152cm) waist 6/cs ALI76223 Small, 30"- 32" (76cm - 81cm) Waist Each ALI76224 Medium, 32"- 34" (81cm - 86cm) Waist Each ALI76225 Large, 36"- 38" (91cm - 97cm) Waist Each ALI76226 Extra Large, 38"- 42" (97cm - 107cm) Waist Each Fall Prevention Yellow Blanket The yellow fall prevention blanket is a great way to discretely identify a person at risk of falling. Use the blankets when the individual is in a wheelchair or in bed to remind staff that proper precautions and care should be taken when transferring. Soft micro-fleece 38" x 28" (96.5 x 71 cm) Item # Description pkg DYKBLANKETYL Fall Prevention Yellow Blanket 20/cs 17

18 Rehabilitative Interventions MOBILITY AIDS Reduce Risk of Falls Staying active helps maintain strength and balance, which can help reduce falls. Walking devices themselves can help prevent falls when properly fitted and recommended by a physician or physical therapist. 6 In addition, the Institute for Clinical Systems Improvement (ICSI) falls prevention guidelines recommend the use of walking aids to help prevent falls. 5 Mobility Aids Q&A Q: How do walking aids help reduce falls in patients with poor balance and/or a poor gait? Balance is achieved by the body s continued positioning of its center of gravity over a base of support. Walking aids increase the base of support by adding additional points of contact on the ground, which makes balancing easier. Walking devices also provide visual support that instills confidence during ambulation, helping reduce a patient s fear of falling. Q: How can we get patients to use their walking devices to help reduce the risk of falls? Make sure their walking device is working properly and also sized properly. Make sure the patient knows how to use the walking device properly. Different walking devices are designed to help with various gait problems. Patients should work with a physical therapist to make sure they are prescribed the right type of device.

19 Rehabilitative Interventions Off-Set Handle Canes For individuals that have slight mobility and gait difficulties a single point cane will provide an additional point of support to their stance. Offset handle design centers the user s weight over the strongest part of the cane Ergonomically designed to provide comfort and support for partial weight-bearing users Push-button, height-adjustable to find the perfect height Mobility Aids weight Cap Height adj. CAne weight Item grip STYLE Color Lbs (kg) Inch (cm) Lbs (kg) Pkg MDS86420 Foam Hand Grip Black 250 (113) ( ) 0.8 (0.4) 6/cs MDS86420BRZW Foam Hand Grip Bronze 250 (113) ( ) 0.8 (0.4) 6/cs MDS86420CHRW Foam Hand Grip Chrome 250 (113) ( ) 0.8 (0.4) 6/cs Quad Canes Canes with four feet allow for greater weight-bearing and stability than a single-point cane. Small base design allows for easier maneuverability; large base design gives more stability Quad canes stand up on their own Bariatric quad canes are designed with reinforced tubing for greater weight bearing capabilities weight cap height adj. footprint cane weight Item Base size Color Lbs (kg) Inch (cm) Inch (cm) Lbs (kg) Pkg MDS86222W Small Base Black 250 (113) (74-97) 6 x 8 (15 x 20) 2.0 (1) 2/cs MDS86222BRZ Small Base Bronze 250 (113) (74-97) 6 x 8 (15 x 20) 2.0 (1) 2/cs MDS86222CHR Small Base Chrome 250 (113) (74-97) 6 x 8 (15 x 20) 2.0 (1) 2/cs MDS86228 Large Base Black 250 (113) (76-99) 8 x 12 (20 x 30) 2.6 (1) 2/cs MDS86228BRZ Large Base Bronze 250 (113) (76-99) 8 x 12 (20 x 30) 2.6 (1) 2/cs MDS86228CHR Large Base Chrome 250 (113) (76-99) 8 x 12 (20 x 30) 2.6 (1) 2/cs MDS86222XW Small Base Black 500 (227) ( ) 6 x 8 (15 x 20) 3.6 (2) Each MDS86228XW Large Base Black 500 (227) ( ) 8 x 12 (20 x 30) 4.6 (2) Each Hemi Sidesteppers Wider base provides more stability and weight-bearing ability than a quad cane. Sidestepper provides support and stability to those with limited dexterity in one arm or hand. Lightweight design allows the hemi sidestepper to be maneuvered easily with just one arm Hemi sidestepper is height-adjustable in 1" (2.5 cm) increments height folded weight Cap Adjustment Width Item Description Wheels Lbs (kg) Inch (cm) Inch (cm) pkg MDS86620 Standard Hemi None 250 (113) (76-89) 3 (7.6) Each G07770 Adult None 250 (113) (81-91) 3 (7.6) 2/cs G07771 Junior None 250 (113) (72-81) 3 (7.6) 2/cs 19

20 Rehabilitative Interventions MOBILITY AIDS Mobility Aids Excel Translator Combination Transport Chair and Rollator In just seconds, our Excel Translator easily converts from a rollator to a transport chair and vice-versa. Comes with a convenient cup holder, under-the-seat basket, zippered side carrying case, and easy-to-adjust push-button foot rests. You will be delighted with the comfortable, spacious seat which is more than 75% roomier than an average rollator seat. Comfort Glide Rollator with Memory Foam Seat Find comfortable seating and smooth operation in one model. Extra thick, memory foam seat contours comfortably to create an ideal cushion for tired users while the large, 8" (20 cm) wheels glide smoothly over most surfaces. Convenient cup holder and cane holder come standard. Freedom Ultra Light Rollator Weighing only 11 lbs. (5 kg), the Freedom rollator is the lightest model on the market. Light weight and folding capabilities make this the ideal model to get in and out of the car/storage. Heightadjustable arms and legs let users find a perfect fit as this rollator accommodates users 4'11"-6'4" ( cm). Distance Seat Height Height Product wt. Cap. wheels Between Min./Max. min./max. weight Item name Color Lbs (kg) Inch (cm) Handles Inch (cm) Inch (cm) Lbs (kg) Pkg MDS808200TR Translator Blue 250 (113) 8 (20) 18 (46) 19 (48) (81-93) 18 (8) Each MDS808200TRR Translator Red 250 (113) 8 (20) 18 (46) 19.5 (50) (81-93) 18 (8) Each MDS86826W Comfort Glide Blue 300 (136) 8 (20) 17 (43) 23 (58) (83-95) 17 (8) Each MDS86825SLR Freedom Burgundy 250 (113) 6 (15) 17 (43) (46-58) (74-91) 11 (5) Each MDS86825SLB Freedom Smoky Blue 250 (113) 6 (15) 17 (43) (46-58) (74-91) 11 (5) Each MDS86825SLBLK Freedom Black 250 (113) 6 (15) 17 (43) (46-58) (74-91) 11 (5) Each MDS86825SLT Freedom Titanium 250 (113) 6 (15) 17 (43) (46-58) (74-91) 11 (5) Each MDS86825SLWT Freedom White 250 (113) 6 (15) 17 (43) (46-58) (74-91) 11 (5) Each 20

21 Rehabilitative Interventions Two-button Folding Walkers Designed for people who need additional support to maintain balance or stability while walking. Easy-to-use, push button mechanism lets walker fold Each side of the two-button model folds independently to allow easy movement through narrow spaces Side cross braces provide extra stability Height-adjustable legs in 1" (2.5 cm) increments Mobility Aids Weight Approximate Width Inside HeighT folded CapACITY user Height Hand Grip Adjustment Width Item Description Wheels Lbs (kg) Inch (cm) Inch (cm) Inch (cm) Inch (cm) Pkg MDS Adult None 300 (136) 5'5"-6'4" ( ) (43) (81-99) 4.5 (11) 4/cs MDS86410W4 Adult 3 (8) 300 (136) 5'5"-6'4" ( ) (43) (81-99) 4.5 (11) 4/cs MDS86410W54 Adult 5 (13) 300 (136) 5'5"-6'4" ( ) (43) (82-100) 4.5 (11) 4/cs MDS86410J4 Junior None 300 (136) 4'6"-5'5" ( ) (43) (64-81) 4.5 (11) 4/cs MDS86410JW4 Junior 3 (8) 300 (136) 4'6"-5'5" ( ) (43) (64-81) 4.5 (11) 4/cs MDS86410JW54 Junior 5 (13) 300 (136) 4'6"-5'5" ( ) (43) (65-83) 4.5 (11) 4/cs FALL STATISTICS Muscle weakness and walking or gait problems are the most common causes of falls among nursing home patients. These problems account for about 24% of the falls in nursing homes. Rubenstein LZ. Preventing falls in the nursing home. Journal of the American Medical Association 1997;278(7):

22 Rehabilitative Interventions MOBILITY AIDS Mobility Aids Bariatric Walkers It is important to ensure that individuals using walking aids are using a device that can support their weight. For larger patients, Medline has bariatric walkers that are stable and still remain lightweight and easy to use. Higher weight capacities keep patients active and moving Extra-wide frames give patients a more comfortable fit Two-button folding capabilities let patients receive support through narrow spaces weight Approximate Width Inside Height Adj. wheels CapACITY user Height Hand Grip Width folded Item Inch (cm) Lbs (kg) Inch (cm) Inch (cm) Inch (cm) Inch (cm) pkg G30754B None 650 (295) 5'5"-6'4" ( ) 22 (56) (81-99) 4.5 (11) 2/cs MDS86410XWW 5 (13) 500 (227) 5'5"-6'4" ( ) 20 (51) (85-110) 4.5 (11) Each Stand Assist Walker Get patients standing upright and ready-to-go with the Stand Assist walker. Seated users can gradually progress from the lower level of handles to the top level to help stand more easily. Bi-level handles also allow user to position walker over the toilet and use as a toilet safety frame for use in the rest room when away from home. Approximate Width Inside Height Adjustment Folded weight Cap User Height Hand Grip Upper/Lower width Item Description Wheels Lbs (kg) Inches (cm) Inches (cm) Inches (cm) Inch (cm) Pkg MDS86410UR Stand Assist Walker None 300 (136) 5'5"-6'4" ( ) 17 (43) 32-39/22-29 (81-99/56-74) 5 (13) 2/cs Help patients get up easier with bi-level hand grips. 22

23 3 2 1 Rehabilitative Interventions WALKING AIDS AND BATH SAFETY Don t Just Sell, Up-Sell! Medline s customizable Cross-Sell and Up-Sell Guides are designed to be used by your delivery drivers as well as customer service staff. Medline carries Featuring a the full most common line Medicare of reimbursable walking products as well as applicable cash sale items that encourage bundled sales. Leave these behind with patients to order directly from your website! aids and bath safety items to help find the best fit for your facility. The catalog includes a bathroom safety map for Customized Sell Sheets: product placement, a walking Homecare aids Beds Wheelchairs Walkers sizing guide and more valuable information for your staff. Just type in your name, address, phone number, website, pricing, and even your company logo! Contact your account representative to get started today! Medline Industries, Inc. One Medline Place Ask your Mundelein, IL representative Medline United States Medline Canada Medline México MEDLINE ( ) for a copy of the [email protected] catalog [email protected] (LIT124R) or call MEDLINE. [email protected] Some products may not be available for sale in Mexico or Canada. Please contact your Account Representative for additional information. We reserve the right to correct any errors that may occur within this brochure Medline Industries, Inc. Medline, Excel, Guardian and Guardian Signature are registered trademarks of Medline Industries, Inc. Linak is a registered trademark of Linak A/S Corporation Denmark. ColdSpot is a trademark of and Be Better, Cando, HotSpot and Point Relief are registered trademarks of Elliott Goldberg. MKT / LIT124R / 7.5M / QG / 10 MEDLINE DURABLE MEDICAL EQUIPMENT CATALOG Durable Medical Equipment Effective Programs, Quality Products, Superior Customer Service Mobility Aids Bath Safety Placement Map Bath Safety Use the guide below to understand where Medline s bath safety products can be located in and around the bathroom to help provide security and stability. Handheld Shower Hand held showers should be used for anyone who bathes with a shower chair or transfer bench. The 86" (218 cm) long hose allows a person to remain seated while bathing. Item: G98035 (see page 47) Transfer Bench When getting in and out of the tub becomes a difficult and potentially dangerous task, transfer benches are a safe alternative. The person bathing can sit down on the outside of the bathtub, swing their legs over the wall, and then easily slide across the seat while holding onto a hand rail mounted on the opposite side. Item: G98309G (See pages for full line) Elevated Toilet Seat When bending is difficult, using the toilet can present a potential fall risk. Using a raised toilet seat will reduce the degree of required bending, thereby reducing fall risk. Item: G30270A (See page 56 for full line) Measuring and Sizing Walking Aids Bathroom Grab Bars and Assist Bars Install grab bars in your bathroom to offer support in areas where falls are most likely to occur. These areas include anywhere that might have a wet surface or anywhere people tend to bend frequently. A grab bar s primary use is to steady the user and may not support the weight of a falling individual. Sizing Guide for Rollators, Walkers, Crutches and Canes Axillary Pad Bathtub Assist Bar Clamps directly onto the tub wall. 44 The assist bar makes entry and exit safer. Item: G98006 Wall-Mounted Grab Bars (not shown) Mounts directly to your wall to provide an extra grip when standing or sitting in the tub. (See page 57 for full line) Rollators Rollators provide users with both a mobility aid and a seat to rest on when tired. These two functions require two measurements be taken to accurately size a rollator. Some rollators only allow for adjustments on the handles, while other rollators adjust at both the handles and on the legs for a more custom fit. 45 Axillary Crutches Crutches are the traditional mobility aid for when one leg is almost entirely non-weight-bearing. Aluminum or wooden axillary (under the arm) models can be adjusted easily to both key measures: your overall height and hand height. Hand grip Adjustment Bath Safety Map 1. Measure from the ground to the crease in the back of the knee. (See Dimension A, page 15) 2. Adjust the rollator legs accordingly so the seat is at same height as A. 3. Keeping arms at your side with a natural bend at the elbow, measure from the ground to the center of the wrist. (See Dimension B, page 15) Select a pair of crutches that is appropriate to the weight of the patient. 2. When sizing for axillary crutches, first measure from the ground to near the bottom of the axilla, or armpit. The crutch cushion should be two to three inches below the axilla. When standing straight, the cushion should not be touching the axilla. This measurement will be the overall crutch height. (See Dimension C) 3. Keeping arms at your side with a natural bend at the elbow, measure from the ground to the center of the wrist. This measurement will be the hand grip height. (See Dimension B) Adjustable Center Post B C Canes Walkers Proper walker sizing can help prevent poor posture and prevent injury from misuse or falling. Medline s walkers all use push-button mechanisms that let the walkers adjust to various heights. 1. Select a walker that is appropriate to the weight of the patient. 2. Keeping arms at your side with a natural bend at the elbow, measure from the ground to the center of the wrist. (See Dimension B, page 15) 3. Adjust all four legs to the same height so that the handgrips match the same height as the wrist. Handgrips Push Button Adjustment Holes Locking Collar Cane Tip Standard canes with a single tip should only be used for those looking for help with balance. Quad canes are useful for those looking to bear weight as they have a wider base. When sizing a cane, follow the steps below. 1. Select a cane that is appropriate to the weight of the patient. 2. Keeping arms at your side with a natural bend at the elbow, measure from the ground to the center of the wrist. This measurement will determine the ideal cane height. (See Dimension B) 3. Loosen the collar on the cane and press the push-button lock, slide the lower tube into or out of the body of the cane until you get to the wrist-height measurement, and let the push button click into the closest hole to the measurement. Tighten the collar (check and re-tighten the collar regularly). A MEDLINE 15 Sizing Guide 23

24 Rehabilitative Interventions MOBILITY AIDS PATIENT HANDLING & LIFTING Reduce Risk of Falls Reduce Risk of Injury The lifting and transferring of patients or residents can present a high risk for falls. When used properly, mechanical lifting equipment and transfer aids can greatly reduce this risk and provide additional benefits, such as: Improved quality of care Improved safety and comfort Improved patient or resident satisfaction Less chance of the patient or resident being dropped, or incurring friction burns, dislocated shoulders, skin tears or bruises Reduced risk of injury and improved job satisfaction for staff Handling and Lifting Q&A Q: How can a safe patient handling program help reduce the risk of falls? For heavier lifting situations, mechanical lifts can help reduce the potential for patient and staff injuries. Injuries are reduced because mechanical lifts protect patients from being dropped and can help reduce skin tears and bruises. Q: How many lifts should be used and how do you know if a patient needs a lift? Facilities should have one lift for every eight patients who require a lift. 7 A proper assessment including the patient s complete medical history, current physical condition, and cognitive state should be completed to determine the need for lifting equipment. 24

25 Rehabilitative Interventions Total Floor Lifts Used for lifting and transferring non-weight bearing and partially weight bearing patients along with a six-point cradle. Base legs on powered lifts spread with a reliable, easy-to-operate foot pedal Low-profile base legs easily move under beds and other furniture Six-point sling cradles provide flexibility for maximum comfort and safety 24V DC battery with an average of lifts per charge Three-year warranty on mechanical/electrical components, one year for battery and scale Item # Wt Cap. pkg MDS400EL 400 lbs (181 kg) Each MDS600EL 600 lbs (272 kg) Each MDS600EL Patient Handling & Lifting Ask your Medline sales rep how to get a free washable sling with your electric lift purchase! MDSELSCALE For use on any elevating floor lift (MDS400EL, MDS600EL) Battery-Powered Stand Assist Used for assisting individuals from a sitting to a standing position. Attractive white finish with removable foot platform. Appropriate for partial weight-bearing patients with some upper body strength Removable foot platform for gait training Battery-powered stand assist Controls are easy to operate Three-year warranty on mechanical/electrical components, one-year warranty for battery MDS600SA Item # Wt Cap. Pkg MDS400SA 400 lbs (181 kg) Each MDS600SA 600 lbs (272 kg) Each 25

26 Rehabilitative Interventions MOBILITY AIDS Patient Handling & Lifting Bath Lift Our Medline Bath Lift is easy-to-use and has the quality features you expect from Medline, taking you safely in and out of your bathtub. Comfortable soft foam seat and contoured backrest Simple and secure installation: in 4 easy steps, you ll have your Medline Bath Lift ready to enjoy! Quick 1-hour rechargeable hand control, built to float Industry leading efficiency: 60% more baths per charge than competitive bath lifts Item # Wt Cap. pkg MDS300BL Bath Lift Each Manual Stand Assist A more affordable alternative to the battery-powered stand assist. The individual grabs onto an assist bar and pulls up using their own strength. Used to assist individuals from a sitting to standing position. Appropriate for partial weight-bearing patients with some upper body strength Perfect for functional rehabilitation therapy Item # Wt Cap. pkg STA lbs (181 kg) Each A B Hydraulic 400 Lb (181 Kg) Lift A budget-friendly total lift solution designed with homecare needs in mind. Lift height is adjusted with a convenient hand-operated hydraulic cylinder. Elevating lift, hydraulic Base opens with an easy hand lever Lift comes with a FREE full-body sling packaged inside box 6 point cradle 3 year warranty Item # MDS88200D Description 400 lb (181 kg) Hydraulic Lift (with sling) MDS88200DSL 26

27 Rehabilitative Interventions Full Body Slings Designed with comfort and safety in mind, these slings feature unique, fully padded fabric that forms a soft yet supportive surface. Four-point hookup creates the advantage of fewer loops to connect to the cradle Slings can be used with either four-point or six-point lift cradles Washable Full body mesh slings have commode opening Item # wt Cap. size Pkg Full Body Solid Fabric Sling MDSMR lbs (204 kg) Medium Each MDSMR lbs (204 kg) Large Each MDSR lbs (204 kg) X-large Each MDSMR113 Patient Handling & Lifting Full Body Mesh Sling MDSMR lbs (204 kg) Medium Each MDSMR lbs (204 kg) Large Each MDSMR lbs (272 kg) X -large Each Full Body Mesh Sling w/commode Opening MDSMR lbs (204 kg) Medium Each MDSMR lbs (204 kg) Large Each MDSMR lbs (204 kg) X-large Each MDSR lbs (272 kg) XX-large Each MDSMR115 Stand Assist Padded Slings For use with Medline s stand assist lifts, these slings provide the extra support the individual needs to stand. Extra padding in the lumbar area for improved comfort Extra padding in the underarm area for improved comfort Washable MDSSA3 Item # wt Cap. size Pkg MDSSA1 400 lbs (181 kg) Small Each MDSMSA2 400 lbs (181 kg) Medium Each MDSSA3 400 lbs (181 kg) Large Each MDSSA4 600 lbs (272 kg) Bariatric Each FALL STATISTICS Among older adults (those 65 or older), falls are the leading cause of injury death. They are also the most common cause of nonfatal injuries and hospital admissions for trauma. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web based Injury Statistics Query and Reporting System (WISQARS) < [online]. Accessed November 30,

28 Rehabilitative Interventions Patient Handling & Lifting Sling Specifications Chart Small Medium Large Bariatric A - Circumference in inches around the shoulders U-Shaped 28"-45" 37"-57" 47"-67" 57"-80" A Universal Slings ( cm) ( cm) ( cm) ( cm) B B - Circumference in inches around the chest Toileting Slings 26"-42" 30"-48" 38"-60" 58"-73" ( cm) ( cm) ( cm) ( cm) Stand Assist Slings 28"-42" 30"-48" 36"-60" 50"-79" ( cm) ( cm) ( cm) ( cm) Body Weight Full-Body Slings N/A lb lb lb (45-82 kg) ( kg) ( kg) Above dimensions are guidelines and may vary by user Transfer Boards Transfer boards are used to assist individuals who have good sitting balance, but have limited mobility to transfer from one surface to another of similar height. Transfer boards can be used to help facilitate a patient transfer from bed to wheelchair, wheelchair to toilet, wheelchair to car seat and more. Smooth and strong, allowing for quick and effective transfers Made of high density polyethylene Easy to clean PVCM600A PVCM600H Item # Description Dimensions wt Cap. Pkg PVCM600H Half Length w/ 6 Handles 31"L x 23"W (79 x 58 cm) 500 lbs (226 kg) Each PVCM600A Full Length w/ 8 Handles 71"L x 23.5"W (180 x 56.7 cm) 500 lbs (226 kg) Each PVCM600N Narrow, Full Length w/ 8 Handles 71"L x 15.75"W (180 x 40 cm) 500 lbs (226 kg) Each PVCM600W Wide, Full Length w/ 8 Handles 71"L x 35.5"W (180 x cm) 500 lbs (226 kg) Each 28

29 Rehabilitative Interventions PolyGlide Transfer Sheets Transfer sheets can be used for a variety of transfer movements including repositioning and boosting to reduce the potential of patient or caregiver injury. The application of transfer sheets makes movements easier by reducing surface friction. Helps reduce the potential of patient and caregiver injury PolyGlide transfer sheets minimize manual patient handling during lateral transfers and repositioning, thereby increasing patient comfort. For the caregivers, transfer sheets reduce the effort required during lateral transfers and repositioning and hence minimizes potential caregiver back injuries. Positioning Patient Handling & Lifting Autoclavable for use in the OR! Can be autoclaved providing sterility for OR use. Long lasting PolyGlide transfer sheets can be washed up to 150 times without losing the Anti-Bacterial finish.* Provides barrier protection Constructed of Polyester and Taffeta with a Silicon finish. PolyGlide transfer sheets have a Micro Barrier and finish. Turning Promotes safe handling procedures Optional storage bag can be attached to bed or stretcher making sheets easy to access, which may increase compliance. * Recommended washing is 149 to 167 F and drying from 122 to 149 F. Chlorine bleach is not recommended, but hydrogen peroxide or peracetic acid can be used instead. This product does not protect users or others, from disease causing bacteria. Putting patient to bed FSS6072BH FSS6072RH Lateral Transferring Item # Description Dimensions wt Cap. Color pkg FSS6072BH Polyglide Transfer Sheet w/ Handles 60" x 72" (152 x 182 cm) 500 lbs (226 kg) Blue Each FSS6072RH Polyglide Transfer Sheet w/ Handles 60" x 72" (152 x 182 cm) 700 lbs (317 kg) Burgundy Each FSSBAGB Polyglide Transfer Sheet Bag N/A N/A Blue Each 29

30 28 Always include: 9/06/06 12:00 pm Nancy Nurse 29 Rehabilitative Interventions Patient Handling & Lifting SAFE 'N EASY LIFTING PROGRAM A $1,000 Value Safe n Easy Lifting Program is included with the purchase of two or more powered lifts/stand assists! Medline is dedicated to providing a safe environment to all facilities using their equipment. Protect patients and staff with Medline s Safe n Easy Lifting Program. Our program is evidencebased, reflecting the best thinking and practices in patient lifting. This includes, for example, work accomplished by the 2001 Technical Advisory Group (a collaboration of the VHA Public Health and Environmental Hazards, the Patient Safety Center Inquiry, and the Healthcare Analysis and Information Group), as well as the 2005 National Task Force (representatives from the American Association of Rehabilitation Nurses, the American Physical Therapy Association, and the Veterans Administration). Medline s Safe n Easy Lifting Program Includes: Falls Management Program HOW-TO GUIDE Falls Management Program HOW-TO GUIDE Safe n Easy Lift Policy Safe Patient Handling and Movement Algorithms Appendix d Debriefing Tool Post Fall Assessment Tool the debriefing tool is used to understand why, where, when and how patients fall has occurred. once the form is complete and the reason has been identified, it is crucial for the team to make sure the appropriate interventions have been implemented to reduce the risk of another fall occurring. 1. the team should have an immediate huddle post patient fall. identify any changes needed in plan of care. 2. debrief with the Falls Management team with hours post falls to evaluate trends such as intrinsic or extrinsic factors. it is important to include all multi-disciplinary team members (examples include: Physical therapy, Pharmacy, Nursing, transportation, Certified Nurse Assistants, Radiology, dietary, environmental Services, Risk management). debriefing. it is imperative for units that have reported patient falls to implement an action plan to help keep falls prevention top of mind for all staff. 3. each unit should bring copies of completed debriefing tools to discuss plans and actions related to 4. Falls Management should be included as a yearly core competency in the organization. Appendix d Debriefing Tool Falls Nursing Assessment and Documentation Expectations: immediately perform a physical assessment of patient. include a quick, visual assessment: vital signs, (including pulse oximetry), Neuro status (include pupil checks), visual inspection of extremities for possible fractures. if nursing judgment determines it is safe to move the patient, do so. if not, contact provider immediately and leave patient where found. Perform a more detailed assessment once the patient is in bed. include checking for skin abrasions, skin tears/lacerations, bumps, swelling. if provider orders given, carry out all orders promptly. Remember to document event in a narrative note in the medial record. Date, time, location of fall How patient was found and any circumstances surrounding the fall that were evident. Add any subjective statements immediately after the event from patient/family in quotes within the narrative note. Chart fall score before fall. Re-evaluate the patient fall score after the event and chart. overall condition of patient that includes assessment, vital signs, Neuro checks and mental status. Safe patient/patient lifting policy is one part of a comprehensive program to reduce musculoskeletal injuries to frontline caregivers, one of our most valuable resources. The policy recommends guidelines to ensure that the transferring needs of all patients/patients are assessed. All healthcare personnel responsible for transferring patients shall be aware and trained on the correct procedures for lifting and moving patients. Adherence to this policy ensures that patients/patients are being liftedand transferred safely while encouraging patient mobility and independence. Safe patient/patient lifting policy is one part of a comprehensive program to reduce musculoskeletal injuries to frontline caregivers, one of our most valuable resources. The policy recommends guidelines to ensure that the transferring needs of all patients/patients are assessed. All healthcare personnel responsible for transferring patients shall be aware and trained on the correct procedures for lifting and moving patients. Adherence to this policy ensures that patients/patients are being liftedand transferred safely while encouraging patient mobility and independence. Safe patient/patient lifting policy is one part of a comprehensive program to reduce musculoskeletal injuries to frontline caregivers, one of our most valuable resources. The policy recommends guidelines to ensure that the transferring needs of all patients/patients are assessed. All healthcare personnel responsible for transferring patients shall be aware and trained on the correct procedures for lifting and moving patients. Adherence to this policy ensures that patients/patients are being liftedand transferred safely while encouraging patient mobility and independence. Developed By: VISN 8 Patient Safety Center N. Nebraska Avenue 673/118M Tampa, FL Center Director: Audrey Nelson, PhD, RN, FAAN Phone: The name of the provider notified and any orders given and when implemented. Strategies put in place to prevent future occurrence. Submit an incident report. Notify the clinical leader/charge nurse and nursing supervisor of the fall event. Define Tool: When, What, Where, Why Medial Record Save Nursing staff member heard a loud noise in room entered patient room and found patient lying on the floor next to bedside stand. Alert and oriented X 3 and stated, i am sorry. i was getting up to the bathroom and felt dizzy. i must have fallen. Pupils equal and reacting to light. BP 134/80, P100, R 24, oxygen saturation 94% on room air. No obvious injuries noted. Patient assisted back to bed with 3 staff member assist. dr. Smartie notified and up to see patient at Right leg X-ray ordered stat due to patient complaint of leg discomfort. Portable X-ray performed at Fall score prior to the event: 6. Reassessment falls score: 10. Green dot protocol implemented Patient remains alert and oriented X 3. PeRLA. Family present. Call bell in reach. Vital signs stable. Awaiting X-ray report. No further complaints of pain R leg X-ray report sent to unit. dr. Smartie aware. Patient may be out of bed with assistance only. No further orders at this time. the patient is resting comfortably. Inservicing Video Train your employees in the proper operation and maintenance of patient lifting equipment. This short DVD reviews all the basic moves to ensure your employees are competent in moving and repositioning patients. Customizable Lift Policy Ensures you have a thorough policy on record, covering all aspects of your lift program. Responsibilities, equipment requirements, and maintenance procedures are all addressed in this customizable policy. Implementation Plan Manage implementation of your formal lifting program through an easy-to-use checklist. You can designate who is responsible and stay on track. Assessment Tools Assess your incoming patients to ensure you have the proper lifting protocols in place. Consider all physical and cognitive factors to ensure you make the right decision maximizing patient care and employee safety. 30

31 Rehabilitative Interventions REHAB & STRENGTH TRAINING Reduce Risk of Falls Reduce Risk of Injury The products in this section assist with activities of daily living that might have become more difficult for individuals who have limited range of motion or who are at risk for falls. Strengthening exercises, when done properly and through the full range of motion, help improve a person s flexibility and balance, which may decrease the likelihood and severity of falls. One study in New Zealand in women 80 years of age and older showed a 40 percent reduction in falls with simple strength and balance training. 8 The Centers for Disease Control and Prevention recommend the use of dumbbells and ankle weights as part of a strength training program for older adults. 9 Safety Wear Q&A Q: How can physical activity help reduce fall risk? A well-regimented exercise/rehab program can help to strengthen lower extremities and improve poor balance. A regular exercise program can also improve a patients confidence and reduce their fear of falling, allowing them to regain independence. Q: What types of activities are beneficial to help reduce the risk of falling? Muscle weakness and poor balance are underlying patient risk factors for many falls that can result in injuries, especially in the elderly. An exercise program to lower the risk of falling should promote strength, balance and endurance. Pilates, yoga, tai chi and weight training are excellent choices. Activities initially should be led by a physiotherapist or trained professional to ensure proper technique and avoid injury.

32 Rehabilitative Interventions Rehab & Strength Training Sock and Stocking Aid with Ridges Reduce an individual s need to bend when putting on socks and stockings. Alleviates stress and the potential for a fall. Sock stays open as the three fingers gently bend to accommodate the contours of the heel and foot Loop strap can be manipulated with only one hand and is length adjustable Item Description pkg MDSD1220 Mboss ridged sock aid Each MDSD1230 Compression sock aid, heel guide Each MDSD1210 Deluxe sock aid Each Stick-to-Stand The Stick-to-Stand is a measuring stick used to ensure that adjustable furniture (beds, chairs, commodes, etc.) is set at the correct height to reduce the risk of falls. The Stick-to-Stand System enables you to correctly measure an individual s lower leg length, and then determine the correct furniture height for the individual simply by following the color-coded lines on the stick. Maintains independent transfer and mobility skills by ensuring proper height of equipment Reduces risk of transfer-related falls and injuries Item Description pkg MDSSTICK Stick-to-Stand System Each Medline Reacher Reduce the distance an individual has to reach for objects from their bed or wheelchair in order to avoid a potential fall. Low cost, durable, lightweight Provides a tight grip on even the smallest objects 24 (61cm) long Weighs only 6 oz. (170gm) Item Description Length Weight PKG MDS86031RCE Ultra Reacher 24" (61 cm) 6 lbs (170 kg) 6/cs 32

33 Rehabilitative Interventions Pedal Exerciser Lightweight and easy to use, the pedal exerciser is a great alternative to the stationary bike. Can be used anywhere to help to increase mobility, flexibility and endurance in both the upper and lower body. Electronic display denotes exercise time, revolution count, RPMs and calories burned Folds up for compact storage when not in use Non-slip pedals grip shoe bottoms for ease of use Item # Description P pkg MDS100 Lightweight, economy exerciser 2/cs Resistive Exercise Bands The use of strength training products for individuals at risk for falls has been shown to promote increased strength and improved balance. A rehabilitation program structured to help rebuild strength, balance, range of motion, and gait can help individuals reduce the likelihood of falling and from suffering injuries associated with falls. Cost-effective bands color-coded by strength in bright, vibrant colors Low powder and low protein bands minimize discomfort during handling Larger width (6 ) provides less tension per square inch of force for a more durable product Rehab & Strength Training 6-Yard (5.4 m) Bands Item Color Resistance MDSHXY1H Peach Extra Light MDSHXR1H Orange Light MDSHXG1H Green Medium MDSHXBL1H Blue Heavy MDSHXP1H Plum Extra Heavy MDSHXS1H Gray Heavy 50-Yard (45.7 m) Bands Item Color Resistance MDSHXY1BH Peach Extra-Light MDSHXR1BH Orange Light MDSHXG1BH Green Medium MDSHXBL1BH Blue Heavy MDSHXP1BH Plum Extra Heavy MDSHXS1BH Gray Heavy Note: Resistance bands are also available individually packaged and precut into 5-foot lengths. Contact your Medline sales representative for ordering information. FALL STATISTICS Roughly one-third of elderly people who have experienced a fall develop a fear of falling. This fear may cause them to limit their activities leading to reduced mobility and loss of physical fitness, which in turn increases their actual risk of falling. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing 1997;26:

34 Rehabilitative Interventions Rehab & Strength Training Cuff Weights Flexible weight contours to snugly fit the ankle, wrist and even the thigh to be used in exercises. Focus on exercises that target the major muscles in the leg to help build balance and strength, which can reduce the chance of falls in at-risk individuals. Long closure strap for comfortable secure fit Color-coded weight levels for quick recognition Grommeted for hanging on any weight rack Item# weight Color PKG Cuff Weights MDSP lbs (0.5) Blue Each MDSP lbs (0.9) White Each MDSP lbs (1.4) Gold Each MDSP lbs (1.8) Turquoise Each MDSP lbs (2.3) Black Each MDSP lbs (2.7) Beige Each MDSP lbs (3.2) Lemon Each MDSP lbs (4.5) Brown Each Adjustable Weight Pack Cuffs MDSP lbs ( kg) Black Each MDSP lbs ( kg) Brown Each Item# DESCRIPTION Wrist and Ankle Weight Sets MDSP Cuff Weight Set (1, 2, 3, 4, 5, 7.5, and 10 lbs) Vinyl-Coated Dumbbells Vinyl-coated, color-coded cast iron dumbbells are ideal for upper body exercise. Coated weights give a comfortable feel and prevent floor scratches. Coating provides weight with a more comfortable feel than steel Marked in both pounds and kilograms Item# Weight Color PKG MDSP lbs (0.5 kg) Pink Each MDSP lbs (0.9 kg) Purple Each MDSP lbs (1.4 kg) Green Each MDSP lbs (1.8 kg) Silver Each MDSP lbs (2.3 kg) Blue Each MDSP lbs (2.7 kg) Pink Each MDSP lbs (3.2 kg) Purple Each MDSP lbs (4.5 kg) Orange Each MDSP Full set of dumbbells N/A (2 of each weight) 34

35 Environmental Interventions PATIENT SAFETY ALARMS Warn Caregivers Most falls in nursing homes occur in the patient s room, especially during attempts to get in or out of bed. 10 Alarms can aid in monitoring individuals at risk of falling and alert staff that these patients are on the move and at risk of falling. The Institute for Clinical Systems Improvement falls prevention guidelines recommend the use of a chair or bed alarm for individuals at risk for falling. 5 The Hartford Institute for Geriatric Nursing s Nursing Standard of Practice Protocol: Fall Prevention also recommends use of personal or pressure sensing alarms as part of a falls management program. 11 Safety Alarms Q&A Q: What risk factors would suggest the use of a patient alarm system to help reduce falls? Patient has experienced a fall from bed in the past. Patient has experienced a fall while ambulating in the bedroom or bathroom shortly after leaving a bed. Patient has a history of excessive urination at night. Patient has demonstrated unsafe bed transfers. Q: Should you use a patient alarm system in patients with dementia who are also at risk for falling? Patients with cognitive dysfunction (dementia, depression, delirium) are at particular risk for falls because cognitive losses can cause errors in judgment. These patients may be confused or agitated by alarms that attach to the body. It may be better to use a pressure sensitive system that rests out of view. 35

36 Environmental Interventions Patient Safety Alarms Premium Pressure-Sensing Safety Alarms Quick Alert alarms have been Medline s best-selling pressure-sensing alarms for over 5 years. They are self-activated, auto-sensing systems that are always working. Each monitor is constructed from heavy-duty plastics that securely house sophisticated electronics. Two-Year Warranty. Quick Alert Ultra II Five options for delayed alarm settings help to limit false alarms Five levels of volume adjustment Protective silicone cover reduces breakage Adjustable strap for use with beds or chairs Power indicator light and low battery indicator light Item Description pkg MDT8175 Quick Alert Ultra II Each Quick Alert Ultra Contains all of the great standard features of the Quick Alert Ultra II, without volume control, delayed alarm and nurse call Perfect for wheelchair monitoring Item Description pkg MDT8100 Quick Alert Ultra Each Quick Alert Ultra Pressure Mats & Accessories ITEM # DESCRIPTIon pkg MDT81180C5 Chair sensor mat, 180-day warranty 5/cs MDT81180B5 Bed sensor mat, 180-day warranty 5/cs MDT8190C* Chair sensor mat, 90-day warranty Each or 5/cs MDT8190B* Bed sensor mat, 90-day warranty Each or 5/cs MDT8130C* Chair sensor mat, 30-day warranty Each or 5/cs MDT8130B* Bed sensor mat, 30-day warranty Each or 5/cs MDT8150NURSE Nurse call cable for Quick Alert Ultra II Each *Items may be ordered by adding 1 for a single mat or 5 in a case FALL STATISTICS In 2008, over 19,700 older adults died from unexpected fall injuries. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web based Injury Statistics Query and Reporting System (WISQARS) < wisqars> [online]. Accessed November 30, 2010) 36

37 Environmental Interventions Pressure-Sensing Safety Alarms All the features you need at a great price. The alarms found in this section come packed with some of the most sought-after technological features typically found on more expensive alarms, including auto-sensing without the need for an on/off switch. Tamper-Resistant Personal Safety Alarm Tamper-resistant two-button design limits patient interference Optional delayed alarm setting helps to limit false alarms Low battery indicator light and volume control Extra-durable wheelchair attachment clip included Patient Safety Alarms Item Description pkg MDT8200 UMP Personal Safety Monitor - Economy Each MDT8400 UMP Personal Safety Monitor - Standard Each MDT8450 UMP Personal Safety Monitor - Deluxe Each Deluxe Multi-Purpose Safety Alarm with Voice Multi-purpose alarm can be used as a pull-cord system, pressure sensing system or both at the same time! Tamper-resistant controls are concealed inside the battery compartment MICR81860 Only - Personalized voice recording option helps increase patient responsiveness when alarm is sounding Item Description PKG MICR81850 Micro-Tech Alarm Each MICR81860 Micro-Tech Alarm Each with Personalized Voice Option Personal Safety Monitor Pressure Mats & Accessories ITEM # DESCRIPTIon pkg MDT84365C* Chair sensor mat, 365-day warranty Each or 6/cs MDT84365B* Bed sensor mat, 365-day warranty Each or 6/cs MDT84180C* Chair sensor mat, 180-day warranty Each or 6/cs MDT84180B* Bed sensor mat, 180-day warranty Each or 6/cs MDT8445C* Chair sensor mat, 45-day warranty Each or 6/cs MDT8445B* Bed sensor mat, 45-day warranty Each or 6/cs MDT84NURSE Nurse call cable N/A Each MDT84BRKT Optional Bed Bracket N/A *Items may be ordered by adding 1 for a single mat or 6 in a case 37

38 Environmental Interventions Patient Safety Alarms Pull Cord Personal Safety Alarms Medline offers a variety of pull cord alarms with numerous features for varying situations. Choose the exact feature(s) you want in a proven safety alarm. Elite Personal Safety Alarm Pacemaker-safe pull-cord style alarm Magnet-free plastic tab on activation cord makes for safe use near pacemakers Volume adjustment Interlocking cradle and bracket for easy installation Five alarm tone options Battery tester button Hook and loop fastenerr option Item # Description pkg MDT N Elite Personal Safety Alarm Each MDT Elite Personal Safety Alarm 6/cs MDT829900XC Replacement pull cord Each MDT MDT N Advantage Magnetic Alarm Value-priced yet very dependable! Lowest cost per unit in its class. Works from any angle Cradle and adjustable strap included Battery tester button MDT5000 MDT5000Z Item # Description pkg MDT5000Z Advantage Magnetic Alarm Each MDT5000 Advantage Magnetic Alarm 5/cs MDT5000XCD Replacement pull cords 3/bg Safety Sentry Alarm No on/off switch prevents tampering Volume control Tamper-resistant safety locking clip Item # Description pkg MDT5100 Safety Sentry Alarm Each MICRXCORD Replacement Pull Cord Each MDT5100CP Protective Cover Each Deluxe Personal Safety Alarm Unique magnetic pull cord alarm with nurse call compatibility No on/off switch prevents tampering Volume control Tamper-resistant safety locking clip MDT5100 MDT5200 Item # Description pkg MDT5200 Deluxe Personal Safety Alarm Each MDT5200CP Protective Cover Each MDT84BRKT Bed Bracket Each 38

39 Environmental Interventions Specialty Safety Alarms Velcro Seatbelt Alarm Provides reliable patient monitoring plus added security Notifies caregivers of attempts of unassisted wheelchair exits Non-restrictive self-release design Shock-absorbing protective cover Adjustable wheelchair attachment strap Seatbelt mounting ties Low battery indicator light Patient Safety Alarms Item # Description size pkg MDT5500 Velcro Seatbelt alarm 36"-46" (91 cm 117 cm) Each MDT5500L Velcro Seatbelt alarm 46"-58" (117 cm 147 cm) Each Optional accessories for Velcro Seatbelt alarm MDT5500BELT Replacement belt 36"-46" (91 cm 117 cm) Each MDT5500BELTL Replacement belt 46"-58" (117 cm 147 cm) Each Infrared Alarm Zero contact monitoring Motion-detecting infrared beam Bedside or headboard positioning Nurse call compatible Two alarm tone options Item # Description size pkg MDTIRM1 Infared Alarm N/A Each Optional accessories for Infared Alarm MDTIRM1BRKT Metal mounting bracket N/A Each MDTIRM1NURSE Nurse call cable N/A Each Floor Sensor Pad Use alone or as a backup. Alarm activates upon stepping onto mat Works with Tamper-Resistant Deluxe Personal Safety Monitor MDT8450 Item # Description pkg UMPFSM1 Floor Sensor Pad Each 39

40 Environmental Interventions Resident HANDLING & LIFTING Patient Safety Alarms The following Patient Safety Alarm Selection Guide can be used as a helpful tool to find the Patient Safety Alarm that best meets your needs. See pages for detailed product information on all the Patient Safety Alarms listed below. Pressure Mat Sensing Systems Included Multiple Multiple Shock- Volume Delayed Nurse Call 2-Year Absorbing Control Alarm Compatible Warranty Protective Choices Choices Cover MDT8175 X X X X X MDT8100 X X MDT8450 X X X X MDT8400 X X X Pull Cord Systems Volume Control Choices Multiple Alarm Tone Options Low Battery Indicator Light Bed Mounting Hardware Chair Mounting Hardware Pacemaker Safe (No Magnet) Nurse Call Compatible No On/ Off Switch MDT & MDT N X X X X X X MDT5200 X X X X X MDT5100 X X X X MDT5000 & MDT5000Z X X X 40

41 Environmental Interventions BATH SAFETY Reduce Risk of Falls Finding the right products can help make using the bathroom less of a risk for individuals prone to falls. In 2008, an estimated 234,094 non-fatal bathroom injuries among persons 15 years and older were treated in U.S. emergency departments. Injury rates increased with age, and most injuries (81.1%) were caused by falls. 12 The Institute for Clinical Systems Improvement (ICSI) falls prevention guidelines recommend the use of handrails in the bathroom. 5 The Hartford Institute for Geriatric Nursing s Nursing Standard of Practice Protocol: Fall Prevention also recommends installing grab rails and grab bars for bathroom safety. 11 Bath Safety Q&A Q: What interventions can be implemented to help reduce falls for a patient with a history of falling who takes frequent trips to the bathroom during the night? Placing a commode on the exit side of the bed provides a safe option for toileting during the night. For maximum safety, staff must ensure that the commode is at the proper height for the patient. Q: What devices can be put in our existing bathroom to help patients with lower extremity weakness from falling in the bathroom? Place grab bars around the perimeter of the room and strategically around the sink and toilet to provide balance support. Use grab bars that contrast with the color of the wall so patients with vision issues can easily locate the bars. 41

42 Environmental Interventions Resident HANDLING & LIFTING Bath Safety Wall Grab Bars Locate grab bars at any angle in the bathroom to help reduce falls by providing extra support in high-risk areas. Combine grab bars with an elevated toilet seat or transfer bench for additional stability Knurled-texture steel bars are easy to grip even in wet bathing areas Also available in white painted steel with white screws to match most bathroom decors Item # Description Diameter Pkg MDS86012CHRG 12" (30.5 cm) Knurled Chrome 1" (2.5 cm) 3/cs MDS86016CHRG 16" (41 cm) Knurled Chrome 1" (2.5 cm) 3/cs MDS86018CHRG 18" (46 cm) Knurled Chrome 1" (2.5 cm) 3/cs MDS86024CHRG 24 (61 cm) Knurled Chrome 1" (2.5 cm) 3/cs MDS86032CHRG 32" (81 cm) Knurled Chrome 1" (2.5 cm) 3/cs G " (30.5 cm) White 1" (2.5 cm) 3/cs G " (41 cm) White 1" (2.5 cm) 3/cs G " (46 cm) White 1" (2.5 cm) 3/cs G " (30.5 cm) White 1" (2.5 cm) 3/cs G " (81 cm) White 1" (2.5 cm) 3/cs G " (91 cm) White 1" (2.5 cm) 3/cs Knurled Chrome White Bath Tub Grab Bars Provide an extra grip for individuals at risk of falling when getting in and out of the bathing area. Tool free installation with Deluxe Tub Assist bar Padded mounting device on both models prevents mars on the tub surface Item # Description fits Tub wall Sizes Pkg G98006 Deluxe Tub Assist Bar 2.75"-6.25" (7-16 cm) 3/cs G98080 Bathtub Safety Rail 3.5"- 6" (9-15 cm) 3/cs G98080 G

43 Environmental Interventions Transfer Benches Allow patients who may struggle balancing on one leg while getting into a bathtub to sit on the outside and then swing legs over the tub wall from a seated position. Direction of seat back can be reversed easily without tools Suction-cup tips on two legs in tub for extra security Anodized aluminum frame adjusts in 1 (3 cm) increments Fits bathtubs 11" (28 cm) to 24" (61 cm) deep MDS86952XW Bath Safety seat seat Seat Item # Description height Depth Width Wt Cap. Pkg MDS86952 Transfer Bench 16.5"-21.5" 16.5" 17" 300lbs 2/cs ( cm) (41.9 cm) (43.2 cm) (136 kg) MDS86952XW Bariatric Transfer Bench 16"- 20" 16" 17" 550lbs Each ( cm) (40.6 cm) (43.2 cm) (249 kg) MDS89745A Bath Benches Provide a safe, sturdy seat in the shower assisting individuals who may have balance issues or trouble standing for long periods of time. Non-slip tips on all four legs provide extra stability and safety High density polyethylene seat and back Durable aluminum frame is corrosion resistant Angled legs distribute weight over a larger area to increase patient stability Height adjusts in 1 (3 cm) increments seat S seat Seat Item # Description Color Height Depth Width Wt Cap. Pkg MDS89740A Without Back, Assembled White 14.5"-19.5" 12" 20" 250lb 2/cs ( cm) (30.4 cm) (50.8 cm) (113 kg) MDS89745A With Back, Assembled White 14.5"-19.5" 12" 20" 250lb 2/cs ( cm) (30.4 cm) (50.8 cm) (113 kg) MDS89740AXW Without back, Bariatric White 14"-17" 12" 20" 550lb Each ( cm) (30.4 cm) (50.8 cm) (249 kg) MDS89745RW With Back, Bariatric White 16.5"-20.5" 21.5" 18" 550lb Each ( cm) (30.4 cm) (45.7 cm) (249 kg) 43

44 Environmental Interventions Bath Safety PVC Shower Chairs with Commode Opening and Gurney's Comes standard with locking casters making transportation easier and can eliminate an additional transfer. PVC bath safety equipment is strong, lightweight and easy to clean. Anti-slip grips provide secure grip in a slippery environment Ideal for use in bathing since PVC won t rust, stain, or fade color Products are long lasting with 5 year warranty on the frame PVCM910 PVC chairs are warm to the touch for added patient comfort Reclining chair has adjustable headrest and footrest for multiple bathing positions PVCM1183 Item # Description overall Dimensions Internal wt Cap. Pkg PVC Shower Chairs PVCM1183 Standard Shower Chair 22"W x18"d x 40"H 18" 300lbs Each (55.9 x 45.7 x 101 cm) (45.7 cm) (136 kg) PVCM1223 Wide Seat Shower Chair 26"W x 18"D x 40" H 22" 375lbs Each (66 x 45.7 x 101 cm) (55.9 cm) (170 kg) PVCM193 Reclining Shower Chair 24"W x 62"D x 48"H 20" 325lbs Each (61 x 157 x 122 cm) (50.8 cm) (147 kg) weight CapACITY overall Length Overall Width Overall Height Height with Rails Up Item Description Lbs (kg) Inch (cm) Inch (cm) Inch (cm) Inch (cm) pkg PVC Shower Gurney PVCM910 Standard 450 (204) 79 (201) 30 (76) 33.5 (85) 40 (102) Each PVCM910B Bariatric 600 (272) 79 (201) 32 (81) 31.5 (80) 40 (102) Each Safe-T-Pole This floor-to-ceiling pole safely assists with standing, sitting, climbing stairs or transferring. Pole diameter of 1.5 (4cm) Height adjustment ( cm) Weight: 14lbs (6.3 kg) Order both items to get complete unit Item # Description Diameter Pkg G98120B Base for the Safe-T-Pole 1.5" (4cm) Each G98120P Pole portion for the Safe-T-Pole Each FALL STATISTICS In 2009, emergency departments treated 2.2 million nonfatal fall injuries among older adults; more than 582,000 of these patients had to be hospitalized. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web based Injury Statistics Query and Reporting System (WISQARS) < 44

45 Environmental Interventions Folding Commodes Folding commodes can be used at the bedside for those who may not be mobile enough to walk to the bathroom. Folding frame design assembles in seconds without tools Commodes fold flat to reduce storage space by 35 percent Includes pail, lid and splash guard Gray powder-coated steel commodes are rust resistant and durable Aluminum commodes are lightweight and rust-proof G F Bath Safety Item # Description Wt Cap. seat Height Seat Depth Width Between Overall Pkg range Arms width G F Steel 350 lbs 16.5"-22.5" 16" 19" 21.25" 4/cs (158 kg) ( cm) (40.6 cm) (48.3 cm) (53.3 cm) G F Aluminum 250 lbs 17.5"-21.5" 16" 19" 22" 4/cs (113 kg) ( cm) (40.6 cm) (48.3 cm) (55.9 cm) MDS89664EL Elongated 400 lbs 17"-23" 16.5" 19" 21.25" 4/cs (181 kg) ( cm) (41.9 cm) (48.3 cm) (53.3 cm) Non-Folding Commodes Commodes can be used at the bedside for those who may not be mobile enough to walk to the bathroom. They can also be used in the bathroom as an elevated toilet seat Also useful as toilet safety rails for added stability Includes pail, lid and splash guard Gray powder-coated steel commodes are rust resistant and durable MDS89664 Item # Description Weight Seat Height Seat Width overall Pkg CApACITY range Depth Between Arms Width MDS89664 Basic Steel 350 lbs 15"-21" 15" 19" 24" 4/cs (158 kg) ( cm) (38.1 cm) (48.3 cm) (61 cm) MDS89664XW Bariatric 650 lbs 18.25"-23.5" 15" 24" 28" Each (294 kg) ( cm) (38.1 cm) (58 cm) (71.1 cm) G30216B Platform 500 lbs 16.5"-23.5" 18.5" 23.5" 27" 2/cs (226 kg) ( cm) (45.7 cm) (56.7 cm) (68.6 cm) Falls can occur when furnishings, including bath safety equipment, are not specifically sized for the patient using that device. For quick measurement that can easily help to size bath safety equipment properly check out the "stick-to-stand" device on page 27. MDSSTICK 45

46 Environmental Interventions BED-RELATED SAFETY PRODUCTS Bath Safety Drop Arm Commodes These commodes can be used at the bedside for those who may not be mobile enough to walk to the bathroom. Arms swing out of the way for easier lateral transfers on and off the commode Place near the bed with closest arm down for patients transferring at night Includes pail, lid and splash guard G98202 Item # Description Wt Cap. Seat Height Seat Depth Width Between Overall Pkg Range Arms Width MDS89668 Basic Steel 250 lbs 17"-21" 15" 17.5" 25.5" Each (113 kg) ( cm) (38.1 cm) (44.5 cm) (64.7 cm) G98202 Premium 350 lbs 18.25"-23.5" 18"-20" 18.5" 22" Each (136 kg) ( cm) ( cm) (45.7 cm) (55.8 cm) MDS89668XW Platform 850 lbs 19.25" 19" 28" 29" Each (385 kg) (48.9 cm) (48.3 cm) (71 cm) (73.6 cm) Elevated Toilet Seats When bending is difficult, using the toilet can present a potential fall risk. Using a raised toilet seat will reduce the degree of required bending, thereby reducing the risk. Locking mechanisms create a clamp on the seat for extra stability Toilet safety frame mounts to standard toilet and provides arms to help with getting on and off the toilet G30270A G30300 Item # Description S seat ElevATIon Wt Cap. pkg G30270A Locking with Padded arms 5" (12cm) 300 (136 kg) 3/cs G30260 Locking raised 5" (12cm) 300 (136 kg) 3/cs G30250 Basic Raised Seat 5" (12cm) 250 (113 kg) 3/cs G30300 Toilet Safety Frame N/A 250 (113 kg) 2/cs FALL STATISTICS The chances of falling and of being seriously injured in a fall increase with age. In 2009, the rate of fall injuries for adults 85 and older was almost four times that for adults 65 to Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web based Injury Statistics Query and Reporting System (WISQARS) < gov/injury/wisqars> [online]. 46

47 Environmental Interventions BED-RELATED SAFETY PRODUCTS Reduce Risk of Falls Reduce Risk of Injury The patient or resident room is another area where falls commonly occur, particularly with individuals falling when attempting to get out of bed. Low height beds have been associated with falls reduction. One large healthcare system reported that using beds with pressure redistribution surfaces, built-in alarms and the ability to get within eight to 10 inches off the floor was linked to a nine percent falls rate reduction within five months. The average falls rate after bed integration of 2.43 falls/1,000 patient days is one of the lowest reported falls rates in the literature. 5 Also, the Hartford Institute for Geriatric Nursing s Nursing Standard of Practice Protocol: Fall Prevention recommends use of low height beds, as well as floor mats as part of a falls management program. 11 Bed-Related Safety Products Q&A Q: Our facility experiences a number of falls in the bedroom as patients attempt to get out of bed. What can we do to reduce these falls? The use of a hi-low bed can ensure the appropriate height for patients to make a safe transfer, allowing their knees to bend at a 90-degree angle with their feet flat on the floor. A transfer bar or split bed rails add support during bed transfers for patients with poor balance. Q: What interventions can be used to help minimize injuries in patients who have experienced repeated falls when making transfers from the bed? Some fall management devices primary function is to reduce the risk of injury with a fall. Patients who fall during bed transfers can be put in an adjustable bed at the lowest height (preferably 7-13 inches from the floor) to reduce the length and impact of a fall. You could also use a cushioned fall mat on the floor next to a low bed to absorb the impact of a fall. 47

48 Environmental Interventions BED-RELATED SAFETY PRODUCTS Bed-Related Safety Products Alterra 1232 Hi-Low Bed (For Long-Term Care) Safety and Comfort for the Patient Low height of 7.25" (18cm) makes Alterra 1232 bed ideal for Alzheimer s patients and any other patient at risk of falling. Four ultra-quiet, dependable DC motors deliver a smooth, quiet performance and offer a multitude of comfortable positioning options. Unique grid/rib deck for enhanced comfort. Ease of Use for the Caregiver High height of 26" (66cm) makes it easy to care for patients while helping to reduce the risk of back injuries. Bed moves from lowest to highest height without any horizontal movement, eliminating wall damage. Battery backup keeps the bed functioning in the event of power outage. Item No. Description FCE1232QO Alterra 1232 Bed Package (includes Alterra 1232 hi-low bed, standard assist rails, head/footboards in Solar Oak finish, mounting hardware, 4 mattress retainers) FCE1232B FCE1232RSR FCE1232RSRN FCE1232ABN Alterra 1232 hi-low bed only Standard assist rails, 29" long Soft-touch assist rails (These assist rails can be mounted either on head (21" long) section or on foot section of the bed deck.) Assist bar FCE1232RHFQO2 Traditional head and footboards in Solar Oak finish FCE1232HDW MAX height of 26" LOW height of 7.25" Mounting hardware for head and footboards Specifications: Height range: 7.25" to 26" (18cm to 66cm) Bed deck dimensions: 80" (203cm) L, 34.5" (88cm) W Overall length: 87.5" (222cm) Weight capacity: 450 lb. (204kg) Movement styles: Head, knee hinge, high/low Deck style: Combination grid/rib Rolling position: Move at any height Motors: 4 DC Casters: 8 total, 4 locking Accessories available: Custom head/footboards, head and foot section assist rails, assist bars, staff control Warranty information: Electrical components: 4 years Bed frame: 15 years Welds: lifetime warranty Head & Footboard Options FCET01RHF* Traditional MDRT01HFB* Modern FCET01RHFAV* Avalon FCET01RHFCL* Transitional FCET01RHFTR* Classic FCET01RHFTR* Cottonwood * Custom head and footboards, must order FCE1232HDW mounting hardware. Head & Footboard Finish Options Solar Oak Kensington Maple American Cherry Empire Mahogany Gunstock Walnut 48

49 Competitor Medline inch drop Floor Competitor Medline 18 inch drop Environmental Interventions MedLite Full-Electric Low Bed (For Homecare) Help reduce falling injuries! This bed can be lowered to 9.5" (24 cm) off the floor. Low height helps minimize the possibility of injuries for patients who are at risk of falling out of bed Premium, quiet Linak motors provide dynamic movement without disturbing other family members Recessed headspring supports and foot assembly reduce the chance of pinching and injuries An extra steel plate is welded to the middle of the frame ensuring strong and stable support Bed-Related Safety Products Only 9.5" from floor to bed deck in lowest position! Specifications Height range 9.5"-22.5" (24-57 cm) Assembled weight 145 lbs. (66 kg) Weight capacity Casters Warranty 450 lbs. (204 kg) Four casters (2 locking) 5 years for electrical and mechanical components; lifetime for the bed frame Item No. MDR107003LO Description Full-Electric Bed with Low-Rise Feature SUPPORT SURFACES For Long-Term Care Medline Bedside Fall Mats Medline s popular floor mats have protected countless nursing-home residents from fall-related injuries. Shock-absorbent mats help reduce impact Skid-preventing material prevents mat from sliding on floor Low profile and beveled edges reduce tripping hazards BEDSIDE SAFETY PRODUCTS Item Description Color MDTFALLMATB 68" x 23" x 1" (172.7 cm x 58.4 cm x 2.54 cm) Burgundy MDTFALLMATG 68" x 23" x 1" (172.7 cm x 58.4 cm x 2.54 cm) Gray Third-Party Tested Horizontal Force Test Impact Testing For a complete listing of Medline s Bedside Safety (LIT 162) products ask your Medline representative or call MEDLINE. Horizontal Pull Force (lbs.) In an independent non-skid test, a greater amount of pressure (lbs.) was needed to make the Medline mat move than with a competitor. Peak (g) level Medline mat absorbs more impact than competitors mat. Medline Advantage Fall Mats Our most economical fall mats help reduce risk of injury from a fall from the bed Made of absorbent high-compression foam Durable, easy-to-clean vinyl cover Choose from two styles: folding and non-folding Item (Folding) Item (Non-Folding) Description MDTFM24662BI MDTFM " x 66" x 2" (61 cm x cm x 5.1 cm) MDTFM36662BI MDTFM " x 66" x 2" (91.4 cm x cm x 5.1 cm) MDTFM48662BI MDTFM " x 66" x 2" (122 cm x cm x 5.1 cm) MDTFM24663BI MDTFM " x 66" x 3" (61 cm x cm x 7.6 cm) Bedside Safety 33 49

50 Environmental Interventions BED-RELATED SAFETY PRODUCTS Bed-Related Safety Products Medline Advantage Select PE Mattress Our most advanced pressure redistribution mattress features our thickest three-layered design to completely conform to the body. The soft, sculpted top layer is anatomically designed to better redistribute pressure Premium stretch cover is fluid proof, antimicrobial, flame retardant, low-friction and anti-shear Visco elastic heel section cradles the bony heels to provide maximum pressure relief Available with 3.5" safety side raised edges with easy exit-entry cutout 15-year warranty on mattress 450-lb weight capacity MSCADVPE80FR Item (w/ raised edge) Item (w/o raised edge) Dimensions MSCADVPE76FR MSCADVPE76F 36" x 76" x 6.75" (91 x 193 x 17cm) MSCADVPE80FR MSCADVPE80F 36" x 80" x 6.75" (91 x 203 x 17cm MSCADVPE84FR MSCADVPE84F 36" x 84" x 6.75" (91 x 213 x 17cm) Medline Advantage 1000 Mattresses The Advantage 1000 features an Octa-Zoned Surface Sculpted topper is anatomically designed for excellent pressure redistribution. Variable depth sculpting creates horizontal airflow channels to lower surface temperatures and reduce moisture Nylex top fabric is fluid proof, antimicrobial, flame retardant, low-friction, and anti-shear Available with 3.5" safety side raised edges with easy exit-entry cutout 5-year warranty 350-lb weight capacity Item (w/ raised edge) Item (w/o raised edge) Dimensions MSCADV1076FR MSCADV1076F 36" x 76" x 6" (91 x 193 x 15cm) MSCADV1080FR MSCADV1080F 36" x 80" x 6" (91 x 203 x 15cm) MSCADV1084FR MSCADV1084F 36" x 84" x 6" (91 x 213 x 15cm) MSCADV1080FR 50

51 Environmental Interventions Medline Supra DPS Alternating Pressure and Low Air-Loss Therapy Medline's state-of-the-art Supra DPS mattress is our most feature-driven mattress replacement system. Functions include alternating pressure, low air-loss, static float, auto firm and seat inflation Cell-on-cell design prevents bottoming out during a power outage Digital pump with choice of four alternating pressure cycle times Upgraded low-friction, anti-shear stretch cover Low-pressure alarm with audio and visual indicators Item 400-lb. weight capacity Also available with 4" raised air bolsters to help reduce the risk of patient falls and entrapment MDT24SUPRADPS MDT24DPSRE Description Supra DPS Mattress Replacement System Supra DPS Mattress Replacement System with Raised Edges MDT24SUPRADPS Bed-Related Safety Products MDT24DPSRE Quick connector allows for easy setup. User-friendly digital pump allows you to make adjustments with the press of a button. Comes with nylon carry bag for storage or easy transport. Ventilated low air-loss cells help manage moisture. Cell-on-cell design prevents bottoming out. 51

52 Environmental Interventions BED-RELATED SAFETY PRODUCTS Bed-Related Safety Products Medline Medtech Air Our most advanced specialty support surface, the Medtech Air True Low Air Loss mattress replacement systems effectively manage moisture and provide exceptional protection against pressure, shear, and friction. Blower based pump offers rapid inflation for quick and easy setup. Raised edge safety enhancement system helps reduce the risk of patient falls. The unique built-in bolsters help promote a safer sleeping environment without compromising the patient s sleeping area. Make standard Medtech Air or Medtech Air Max mattresses into a raised edge mattress by adding an optional raised edge cover #MDT24MEDRCVR. Medtech Air Max Pump Medtech Air Pump MDT24MEDAIR MDT24MEDAIRMX Medline Medtech Air Our blower-based system effectively manages moisture, shear and friction while redistributing pressure. Functions include true low air-loss, auto firm and seat inflation Rapid inflation (less than 60 seconds) for quick-and-easy setup User-friendly digital pump Low-shear, low-friction cover is easy to clean and fully encases the air cells 400-lb. weight capacity 5-year warranty Also available with 4" raised bolsters to help reduce the risk of patient falls and entrapment Item MDT24MEDAIR MDT24MEDRE Description Medtech Air Mattress Replacement System Medtech Air System with Raised Edges Medline Medtech Air MAX Medtech Air Max provides all the benefits of the Medtech Air plus these special features: System Lock Secures the control panel and pressure settings preventing accidental adjustments Auto Comfort When activated, senses patient s weight distribution and automatically adjusts pump to optimal pressure settings Alternating Pressure (pulsation) Provides three cycle settings that continually readjust the system to ensure patient comfort 400-lb. weight capacity 5-year warranty Also available with 4" raised bolsters to help reduce the risk of patient falls and entrapment Item MDT24MEDAIRMX MDT24MEDMXRE Description Medtech Air MAX Mattress Replacement System Medtech Air Max System with Raised Edges 52

53 Environmental Interventions Medline Bedside Fall Mat Medline's popular floor mats protect against fall-related injuries. Shock-absorbent mats help reduce impact Skid-preventing bottom prevents mat from sliding on floor Low profile and beveled edges reduce tripping hazards Item # Dimensions Color pkg MDTFALLMATB 23" x 68" x ¾" (58 x 173 x 2 cm) Brown Each MDTFALLMATG 23" x 68" x ¾" (58 x 173 x 2 cm) Gray Each Third-Party Tested Horizontal Force Test Impact Testing MDTFALLMATG MDTFALLMATB Bed-Related Safety Products 900 Competitor 800 Floor Medline 700 Peak (g) level Competitor Medline Horizontal Pull Force (lbs.) 0 12 inch drop 18 inch drop In an independent non-skid test, a greater amount of pressure (lbs.) was needed to make the Medline mat move than with a competitor. Medline mat absorbs more impact than competitors mat. Medline Advantage Fall Mat Our most economical fall mats help reduce risk of injury from a fall from bed. Made of absorbent high-compression foam Durable, easy-to-clean vinyl cover Choose from two styles: folding and non-folding Item (Folding) Item (Non-Folding) Description MDTFM24662BI MDTFM " x 66" x 2" (61 x 168 x 5cm) MDTFM36662BI MDTFM " x 66" x 2" (91 x 168 x 5cm) MDTFM48662BI MDTFM " x 66" x 2" (122 x 168 x 5cm) MDTFM24663BI MDTFM " x 66" x 3" (61 x 168 x 8cm) MDTFM24662Bl 53

54 Environmental Interventions BED-RELATED SAFETY PRODUCTS Bed-Related Safety Products Advantage Mattress Bolster Transform any mattress to a raised edge mattress 8" bolsters help prevent patient falls and lower the risk of entrapment Quick installation and removal Easy-to-clean waterproof, nylon cover reduces shear and friction Item # Description PKG MDTMATBOLST 8" Bolsters Pair Bed Side Rails and Assist Bar Assists patients who can independently get out of bed with an extra grip. Also helps prevent mattress movement and gaps in the most critical bed zones. Halo Safety Ring reduces entrapment concerns and provides exit points for the neck, chest, and head Tool Free Installation Item # Description pkg MDT77101 One Halo Ring with Mounting Hardware and Each Stay Bar To Secure Mattress MDT77102 Two Halo Rings with Mounting Hardware Each MDS6800BA Bed Assist Bar, Height Adjustable 3/cs 54

55 References 1. Centers for Disease Control and Prevention. Falls Among Older Adults: An Overview. Available at: adultfalls.html. Accessed December 28, Centers for Disease Control and Prevention. Costs of Falls Among Older Adults. Available at: cdc.gov/homeandrecreationalsafety/falls/fallcost. html. Accessed December 28, The Joint Commission Patient Safety Goals. Available at: org/assets/1/18/ _npsg_presentation_final_ pdf. Accessed December 29, Sharon K. Inouye SK, Brown CJ and Tinetti ME. Medicare nonpayment, hospital falls, and unintended consequences. New England Journal of Medicine. 2009; 360: Available at: org/doi/full/ /nejmp Accessed December 29, Institute for Clinical Systems Improvement (ICSI) Guidelines. Prevention of Falls (Acute Care). Available at: Accessed November 2, National Institutes of Health. NIH SeniorHealth. Falls and Older Adults: Devices to Help Prevent Falls. Available at: Accessed November 2, Centers for Disease Control and Prevention. Growing Stronger Strength Training for Older Adults. Equipment. Available at: growingstronger/preparation/equipment.html. Accessed November 4, Centers for Disease Control and Prevention. Growing Stronger Strength Training for Older Adults. Why strength training? Available at: physicalactivity/growingstronger/why/index.html. Accessed November 4, Capezuti E, Brush B, Lane S, Rabinowitz HU & Secice M. Bed-exit alarm effectiveness. Arch Gerontol Geriatr. 2009; 49(1): Available at: ncbi.nlm.nih.gov/pmc/articles/pmc Accessed November 2, Gray-Micelli D. Nursing Standard of Practice Protocol: Fall Prevention. Hartford Institute for Geriatric Nursing. Available at: falls/want_to_know_more/#item_5. Accessed November 2, Centers for Disease Control and Prevention (CDC). Morbidity and Mortality Weekly Report. June 10, Nonfatal Bathroom Injuries Among Persons Aged 15 Years --- United States, Available at: cdc.gov/mmwr/preview/mmwrhtml/mm6022a1.htm?s_ cid=mm6022a1_w. Accessed November 2, Department of Health and Human Services. Safe lifting and movement of nursing home patients. Available at: pdfs/ pdf. Accessed December 21 < pdf.%20accessed%20december%2021>,

56 Is your Facility Dedicated to Preventing Falls? Falls are a major concern no matter what healthcare segment- acute care, long-term care, and homecare. Each year, one in every three adults age 65 and older falls. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death 1. Fortunately, falls are a problem that may be avoidable and Medline has a program to help! The Falls Management Program combined with an extensive list of product interventions makes Medline a great choice to partner with to help your facility reduce falls. Program Includes: a An overview of team roles and responsibilities a Information on hourly patient rounding a Staff education a Post falls assessment tools a Tips for environmental concerns Get started today and find out where your facility has room for product improvement by going through the Falls Management Assessment Guide inside this catalog (PG 10). Ask your Medline Sales rep about the Falls Management Program or call Medline. Medline Industries, Inc. One Medline Place Mundelein, IL Medline United States Medline Canada Medline México MEDLINE ( ) [email protected] [email protected] [email protected] Some products may not be available for sale in Mexico or Canada. We reserve the right to correct any errors that may occur within this brochure Medline Industries Inc. Advantage, Excel Translator, Medline, Medline University and Quick Alert are registered trademarks of Medline Industries, Inc. PerforMAX is a trademark of Medline Industries, Inc. Velcro is a registered trademark of Velcro Industries B.V. Halo Safety Ring is a registered trademark of Kunde Healthcare Services MKT / LIT191R / 2M / AL / 15