Bathing innovations meeting new resident needs.

Nursing home bathing systems are becoming increasingly state-of-the-art as vendors respond to facilities' needs for resident comfort, caregiver safety, scrupulous disinfection and easy access for a range of residents. However, the decision to replace or upgrade an entire system or even a single tub requires a major monetary commitment, and sorting through the vast array of products on the market has become increasingly complex.

To give our readers a sample of the "latest and greatest" in nursing home bathing systems, NURSING HOMES asked four tub and bathing system vendors to respond to the following questions:

1) What is your most innovative product or product line and what makes it unique?

2) What do you view as the future trends/greatest needs in nursing home bathing?

Marianne H. McGinn, Marketing Communications Manager, Arjo, Inc.:

Most innovative product/line: "What stands out as state-of-the art is our Carousel [TM] Bathing System because it offers a solution to the problems encountered in bathing the range of nursing home residents, from ambulatory to partially dependent.

"Carousel is similar to a 'door tub', although it doesn't truly have a door with a seal. The tub portion of the unit swivels out 230 degrees which provides ambulatory access to enter the system from a wide variety of angles. The ambulatory resident can enter the tub and sit on the seat independently. Once the resident is seated, the door swings closed and full-immersion bathing can begin. The well of the tub can be prefilled, saving staff time. For the resident who needs assistance, the Carousel system works with two of our different types of lift system, the Lift Hygiene Chair or Sara [TM] Lift. The rotational entry virtually eliminates the potential for shearing of residents' skin and reduces the risk of staff back injury.

"This design also addresses the fear some residents may have of getting on a lift and being raised up and into a tub.

"A built-in disinfection system regulates the amount of disinfectant used and its mixture with water. Carousel features a disinfection hose which is used to disinfect and rinse the internal portions of the tub and lift."

Future trends/needs: "As health care suppliers, we need to address the changing needs in the marketplace arising from the trend toward assisted living and other levels of care. As partners with nursing facilities, we need to offer the products, services and programs required for a diverse resident population as they move through the continuum of care."

Lenora Ragan, Sales Coordinator, Parker Bath Developments, Inc.:

Most innovative product/line: "That would definitely be the Parker Bath, a reclining whirlpool tub we introduced in the 1980s, and which still remains one of the most innovative bathing systems in the health care market. The bathtub is chair-shaped with a side-opening door and a footwell that allows the bath to be prefilled so that the resident doesn't have to wait. The upward-pivoting side-opening door allows the resident to be placed on the bath seat at wheelchair height. After the door is closed, the bath is gently reclined, allowing the warm water to flow around the body, which is cradled and supported by the bath's unique shape, which allows full-length immersion bathing. This recline is accomplished at the touch of a button electronically or by means of a hydraulic handle - it's the customer's choice.

"The tub has a choice of whirlpool jets of a 10-jet air spa system for whirlpool treatment. The tub can also be used in the upright position as a podiatry tank, so that foot and lower leg treatments can be provided without the need for special podiatry equipment.

"The bath is also designed for use with the Parker range of patient lifts, an important feature in an increasingly 'no-lift', back injury prevention environment."

Future trends/needs: "The number one need is for staff education, across the board. The physical needs of nursing home residents are a given. But emotional and psychological needs sometimes go unrecognized, and bathing is too often a prime example. We have an obligation to preserve the residents' dignity in what is inherently an undignified situation - being lifted into a tub and bathed by a virtual stranger. Vendors need to respond to those needs as well."

Brian Amato, Product Manager, Silcraft Corporation:

Most innovative product/line: "This would be our Access [TM] Series of side-opening tubs. Because the tub door lifts up and then swings out, it provides both ambulatory and nonambulatory access. The only transfer required is the transfer on to and off of the lift in the resident's room. The lift simply slides into the tub and the resident is bathed while sitting in the lift seat. When bathing is finished, the resident is removed from the tub without leaving the lift Seat and without exposing the staff to back injury.

"Because each disinfection typically requires 30 to 60 gallons of water and an entire bottle of disinfectant, we designed a closed-loop system that thoroughly disinfects with only 1 1/2 gallons of water and 3/4 ounce of disinfectant. We developed a way to isolate the pump and the associated pump-whirlpool plumbing and shut that system off so it literally becomes a closed or watertight loop. Rather than filling the tub with water, the caregiver injects disinfectant and water, in the correct proportions, into the pump loop, where the mixture completely surrounds and coats all of the tubing for ten minutes. In areas where water rationing is in effect, facilities say the system is a Godsend."

Future trends/needs (from John Kraft, President): "The greatest needs in the industry are those associated with resident handling and disinfection. Despite the growing diversity among nursing home residents, there is still a tendency to try to standardize equipment in the belief that one piece of equipment should meet the needs of all residents. The one need that is common to all residents is the need for technology that leaves the residents' dignity intact. As an industry, we should be developing better resident handling systems that address those needs. It's also important to realize that getting the job done as rapidly as possible may sometimes be less important than allowing residents to just sit and relax in the whirlpool.

"Technology also needs to - and will - improve in the area of disinfection, with an increased focus on proper aseptic technique, especially now, when more nursing homes are providing subacute services for patients with a range of pathogens."

Phil Floyd, Health Care Product Manager, Ferno Healthcare:

Most innovative product/line: "Recline-a-Bath Two[TM] is by far our most state-of-the-art product. We wanted a way to make bathing a more comfortable, dignified, pleasant experience, and the Recline-a-Bath Two, a prefillable side-entry tub, was the result. A standard bath can be given with 24 gallons of water (versus about 60 gallons in a standard supine or sit tub.) The foot well is filled first, the tub is tilted back and the water flows from the foot area to where the resident is seated. The resident is seated close to eye level with the caregiver, allowing the resident to converse and see out of the tub, both of which make bathing a more pleasant experience. And, because the caregiver has access to the resident's entire body, including the feet, there is no need for bending or stooping, which places staff at risk for back injury.

"The tub height and side-entry provide easy access for many different forms of transfer and transport devices, lifts and wheel chairs. Residents are never more than 28 inches above the floor when being placed in the tub.

"Disinfection is quite simple. The disinfection wand is used to spray the interior surfaces. The tub is tilted back and the disinfection wand is placed over the intake. As the valve is turned on, the water-disinfectant mixture is forced through the system, filling all the cavities and covering all the surfaces.

"The tub's versatility allows it to accommodate a wide range of lift products on the market and handle a wide variety of types and sizes of residents without restraints."

Future trends/needs: "Without question, economics is extremely important - providing the highest quality services at the lowest cost possible - but it's important to provide those services in a more pleasant atmosphere. It wasn't long ago that bathing products were decidedly institutional in appearance and bathing areas tended to be dark and dingey. Fortunately, all of that is changing and the trend is toward providing products that are more pleasant to look at and to use for the resident and the caregiver."