Observations on the role of hospital blankets as reservoirs of infection.
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Bedding and Linens↗
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[Prevention of decubitus ulcer: theory and practice].
In Spring 2001, the Department of Nursing Science, Humboldt-University in Berlin, conducted a pressure ulcer prevalence study on 3012 patients of eleven hospitals. The investigation revealed the use of pressure ulcer prevention on patients with different stages, or without a pressure ulcer. The study also focused on the use of interventions and bed-aids on patients both at risk and not at risk. Interventions without the use of bed-aids were used more often than interventions using bed-aids. The main type of intervention used was the mobilisation of the patient. This was found in all groups (at risk or not at risk; with or without a pressure ulcer). The bed-aids which were most frequently used were pressure-relieving cushions and heel-protectors. Because of the differences in pressure ulcer management among the hospitals, this article also shows evidence on bed-aids and the interventions as known from literature. In four of the interventions as used in practice, the highest degree of evidence could be found. However, in five cases no evidence could be found at all. The comparison of the use in practice and the literature revealed that interventions which are often used as pressure reduction are well tested and can be recommended. However, the (sheep-) skins, which are frequently used, are not reducing the pressure significantly.
Aged↗
Effectiveness of an intervention to reduce house dust mite allergen levels in children's beds.
BACKGROUND: In temperate climates, exposure to house dust mite (HDM) allergens is the strongest environmental risk factor for childhood asthma. Environmental modifications to limit exposure have the potential to reduce the prevalence of asthma. The aim of this study was to reduce allergen exposure for children at high risk of developing asthma. METHODS: A total of 616 pregnant women were randomized to HDM intervention and control groups. The control group had no special recommendations whereas the intervention group was given allergen impermeable mattress covers and an acaricidal washing detergent for bedding. Children were visited regularly until 18 months of age to have dust collected from their bed. RESULTS: Der p 1 concentrations in the control group increased from 5.20 microg/g at 1 month to 22.18 microg/g at 18 months but remained low in the intervention group, ranging from 3.27 microg/g at 1 month to 6.12 microg/g at 18 months. CONCLUSIONS: In a high HDM allergen environment, a combined approach using physical barriers and an acaricidal wash, is effective in reducing HDM allergen concentrations in bedding. However, even with these control measures in place, HDM allergen levels remained high by international standards.
Allergens↗
Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study.
BACKGROUND: Reduction of allergen exposure from birth may reduce sensitization and subsequent allergic disease. OBJECTIVE: To measure the influence of mite allergen-impermeable mattress encasings and cotton placebo encasings on the amount of dust and mite allergen in beds. METHODS: A total of 810 children with allergic mothers took part in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Allergen-impermeable and placebo mattress encasings were applied to the childrens' and the parents' beds before birth. Dust samples were taken from the beds of children and their parents before birth and 3 and 12 months after birth. Extracts of dust samples were analysed for mite allergens (Der p 1 and Der f 1). RESULTS: Active mattress encasings were significantly more effective in reducing dust and mite allergen levels than placebo encasings. Mite allergen levels were low in general and the treatment effect was modest. Twelve months after birth, mattresses with active mattress encasings had about half the amount of Der 1 (Der p 1 + Der f 1)/m2, compared to mattresses with placebo encasings, for the child's and the parental mattress. CONCLUSION: This study shows that mite-impermeable mattress encasings have a significant but modest effect on dust and mite allergen levels of mattresses with low initial mite allergen levels, compared to placebo.
Allergens↗
An association between plastic mattress covers and sheepskin underbedding use in infancy and house dust mite sensitization in childhood: a prospective study.
BACKGROUND: Higher house dust mite (HDM) allergen exposure during infancy has been associated with increased HDM sensitization. Infant bedding has been associated with the accumulation of varying levels of HDM. Prospective data on the relationship between infant bedding and the development of HDM sensitization has not been previously examined. OBJECTIVES: To determine if particular types of bedding used in infancy are associated with increased risk of house dust mite sensitization in childhood. METHODS: A population-based sample (n = 498) of children born in 1988 or 1989, and who were resident in Northern Tasmania in 1997, participated in this study. These children were part of a birth cohort study (1988-95), the Tasmanian Infant Health Survey. Data on infant underbedding and mattresses was available on 460 and 457 children, respectively. The main outcome measure was HDM sensitization defined as a skin prick test (SPT) reaction of 3 mm or more to the allergens of Dermatophagoides pteronyssinus and/or Dermatophagoides farinae. RESULTS: The use of either sheepskin underbedding or plastic mattress covers in infancy was associated with an increased risk of sensitization to HDM allergens at age 8 years. The adjusted risk ratio (RR) for sensitization to HDM with sheepskin in infancy was 2.27 (95% CI: 1.14, 4.55), P = 0.020. The adjusted RR for sensitization to HDM with the use of plastic mattress covers in infancy was 2.06 (95% CI: 1.22, 3.51), P = 0.007. The use of a foam mattress in infancy was not related to subsequent HDM sensitization. CONCLUSION: Infant's bedding plays a role in the development of HDM sensitization in childhood. Intervention studies to examine mite allergen levels and the role of underbedding on the development of HDM sensitization are required.
Animals↗
The staff's satisfaction with the hospital bed.
AIM: To determine how nurses experience the functions of hospital beds and the bedside equipment when performing specified common nursing tasks. BACKGROUND: The hospital bed is an important working tool for the nursing staff but few studies have focused on hospital beds at acute wards. METHOD: Data was collected with questionnaires answered by 74 registered and enrolled nurses from three Departments. FINDINGS: The bed was frequently used when performing nursing tasks with patients in bed, but the manoeuvring features were difficult to adjust, resulting in unsatisfactory working postures. Transporting the patient in bed and cleaning of the bed were the most troublesome tasks. The bed clothes were often experienced as unsatisfactory for their patients. CONCLUSIONS: The beds have serious deficiencies. It is imperative to improve them, as a good physical milieu positively influences the working conditions of the staff.
Adult↗
Comparison of three pyrethroid treatments of top-sheets for malaria control in emergencies: entomological and user acceptance studies in an Afghan refugee camp in Pakistan.
Insecticide-treated bedding materials (sheets and blankets) could be protective against vectors of malaria and leishmaniasis--especially in complex emergencies, epidemics and natural disasters where people are more likely to sleep in exposed situations. Comparison of cotton top-sheets impregnated with different pyrethroids (permethrin 500 mg/m2, deltamethrin 25 mg/m2 or alphacypermethrin 25 mg/m2) for effectiveness against mosquitoes (Diptera: Culicidae) was undertaken in a refugee camp in Pakistan. Predominant species encountered were Anopheles stephensi Liston, An. pulcherrimus Theobald, An. nigerrimus Giles, Culex quinquefasciatus Say, Cx. tritaeniorhynchus Giles and other culicine mosquitoes. All three pyrethroid treatments performed significantly better than the untreated sheets in deterrence and killing of mosquitoes. No significant differences were found between the three insecticides tested in terms of entomological effect. Washing of the treated sheets greatly reduced their effectiveness. In a user acceptance study conducted among 88 families (divided into four groups), six families complained of irritation of the skin and mucous membranes. Of these reports, one was from the placebo group (using untreated sheets) and the other five (5/22=23%) from families using deltamethrin-treated sheets. All families allocated to permethrin and alphacypermethrin groups declared an appreciation for the intervention and reported no side-effects. Ten of the placebo group disliked the intervention, citing no prevention of mosquito biting as the reason. Side-effects associated with deltamethrin indicate that alphacypermethrin and permethrin are more appropriate first choice insecticides for treatment of sheets and blankets.
Afghanistan↗
Sudden infant death syndrome in South Australia 1968-97. Part 3: is bed sharing safe for infants?
OBJECTIVE: To examine the risk of death for bed-sharing infants. METHODOLOGY: All unexpected infant deaths occurring in South Australia between 1970 and 1997, occurring after the infant was put to rest and diagnosed by after death scene investigation and autopsy as sudden death infant syndrome, accidental death, or 'undetermined' were studied. RESULTS: Accidents were the most likely cause of death for 5% of infants who died in designated infant containers (cots, cradles, etc), 24% of those who were sharing a bed or couch, and 72% of those who were placed alone on a bed or couch. CONCLUSIONS: While bed sharing showed an increased risk of dying accidentally, when compared with infants sleeping in designated infant containers, the risk of accidental death in this study was even greater for infants left alone on adult beds or couches.
Bedding and Linens↗
Rebreathing potential of infant mattresses and bedcovers.
OBJECTIVE: To establish the CO2 dispersion and retention properties of some mattresses and bed coverings commercially available in Australia. METHODS: Five mattresses were studied in (i) an in vivo model in which an infant's head was covered by a headbox, rebreathing was allowed to occur, and the final steady state CO2 concentration was measured; and (ii) an in vitro model in which 5% CO2 in a headbox was allowed to disperse, and the time taken for the concentration to reach 1% was measured. Five types of bedcover were studied in (i) an in vivo model in which an infant's head was covered by a bedcover and the final steady state CO2 concentration was measured; and (ii) an in vitro model in which 5% CO2 under a bedcover was allowed to disperse, and the time taken for the concentration to reach 1% was measured. RESULTS: The steady state CO2 concentrations ranged from 0.6% to 3.0% for the mattresses (P < 0.05). The time for CO2 to disperse ranged from 5.5 min to 30.4 min (P < 0.05). Steady state CO2 concentrations ranged from 2.5% to 3.6% for the bedcoverings (P > 0.05). The time for CO2 to disperse ranged from 5.4 min to 7.7 min (P > 0.05). CONCLUSIONS: Some commercial cot mattresses and bedcoverings allow high concentrations of CO2 to accumulate in rebreathing environments. Some mattress types studied were more diffusive to CO2, whereas there was no difference between the bedcovers studied. This may have implications for vulnerable infants at risk of sudden infant death syndrome.
Bedding and Linens↗
Effect of mattress encasings on atopic dermatitis outcome measures in a double-blind, placebo-controlled study: the Dutch mite avoidance study.
BACKGROUND: House dust mite (HDM) allergen might induce and maintain atopic dermatitis (AD). Reduction of allergen load by applying encasings might improve the clinical symptoms of AD. OBJECTIVE: We sought to investigate, in a randomized, double-blind, placebo-controlled study, whether reducing HDM allergen levels by using mattress, duvet, and pillow encasings for 12 months will result in improvement in AD symptoms. METHODS: Patients with AD (8-50 years old and allergic to HDM), having a Leicester sign score (a dermatitis score) of at least 1% extent and a severity score of 6 points or greater, were randomly allocated to an active (n = 45) or a placebo allergen-avoidance group (n = 41). Avoidance measures consisted of applying HDM-impermeable encasings for mattresses, pillows, and duvets for the active treatment group and cotton encasings for the placebo group. Effect on allergen concentrations (Der p 1 and Der p 1 plus Der f 1), Leicester sign score extent and severity, visual analogue scale scores for itching and sleeplessness, intradermal test results, atopy patch test results, total serum IgE levels, anti-Der p 1-specific IgE levels, and total blood eosinophil counts were studied. RESULTS: The active encasings reduced the Der p 1 allergen concentration in the mattress after 12 months with a factor 2.1 (P =.007) and the Der p 1 plus Der f 1 allergen concentration with a factor of 2.5 (P =.005); no significant change in allergen concentrations in mattresses was seen in the placebo group. Although the decrease in allergen load was significant, no differences in treatment-induced changes were seen between the placebo and active groups. CONCLUSIONS: Use of HDM-impermeable encasings resulted in a significant decrease in Der p 1 and Der p 1 plus Der f 1 allergen concentrations. However, this reduction in allergen load did not result in significant changes in clinical parameters between the groups. Reduction of allergens in other environments (work, school, and outdoors) might be equally important in improving symptoms of AD.
Adolescent↗
Sleep position and the use of soft bedding during bed sharing among African American infants at increased risk for sudden infant death syndrome.
UNLABELLED: Soft bedding increases the risk for death among prone infants. We compared the softness of beds and bedding and infant sleep position for infants sleeping alone and for those bed sharing. STUDY DESIGN: Questionnaires were used to record the bedding and sleep practices of 218 consecutive African American infants. Enrollment was prospective. Mechanical models were used in the homes of a subgroup to measure the softness of bedding and its propensity to cause rebreathing. Results were compared by using the Student t test, Mann-Whitney U test, and chi(2) analysis. RESULTS: In a cross-sectional sample of infants, at 8.2 +/- 3.3 weeks of age, 61% (133 of 218) had bed shared > or =1 of the previous 14 nights and 48.6% (106 of 218) had bed shared the night before. Breast-feeding rates were not different for bed sharers and those sleeping alone. The rates of maternal smoking for both groups were low (13.6% vs 11.8%). Comforters, pillows, and waterbeds were more commonly used beneath bed-sharing infants. Bed sharers were twice as likely to habitually be placed prone for sleep (18% vs 9%). In the subgroup studied in their homes (13 bed sharing, 19 alone), the shared beds were softer (P <.0001) and could cause more rebreathing (P =.007). CONCLUSIONS: Infants at increased risk for sudden infant death syndrome, by sociodemographic criteria, who also bed share are more likely to sleep prone and to use softer beds. These findings may explain part of the risk associated with bed sharing among US infants, a risk that appears to be independent of the effects of maternal smoking.
Black or African American↗
Moisture accumulation in sleeping bags at - 7 degrees C and - 20 degrees C in relation to cover material and method of use.
Moisture accumulation in sleeping bags during extended periods of use is detrimental to thermal comfort of the sleeper, and in extreme cases may lead to sleep loss and hypothermia. As sub-zero temperatures were expected to affect vapour resistance of microporous membranes, the effect of using semipermeable and impermeable rain covers for sleeping bags on the accumulation of moisture in the bags during 6 days of use at - 7 degrees C and 5 days at - 20 degrees C were investigated. In addition, the routine of shaking off hoarfrost from the inside of the cover after the sleep period as a preventive measure for moisture accumulation was studied. Moisture accumulation (ranging from 92 to 800 grams) was found to be related to the vapour resistance of the materials used. The best semipermeable material gave the same moisture build-up as no cover at - 7 degrees C, though build-up increased substantially at - 20 degrees C. Shaking off the hoarfrost from the inside of the cover after each use was beneficial in preventing a high moisture build-up. It was concluded that semi-permeable cover materials reduce moisture accumulation in sleeping bags at moderate sub-zero temperatures, but in more extreme cold (- 20 degrees C) the benefits are reduced in comparison to routinely shaking frost from impermeable covers. Compared to fixed impermeable covers, the benefits of all semi-permeable covers are large. For long-term use without drying facilities, the differences observed do favour the semi-permeable covers above impermeable ones, even when regularly removing the hoarfrost from the inside in the latter.
Bedding and Linens↗
Maximizing comfort and minimizing ischemia: a comparison of four methods of spinal immobilization.
OBJECTIVE: To determine which of four methods of spinal immobilization causes the least ischemic pain. METHODS: A prospective, nonblinded comparative trial was conducted at a statewide emergency medical services training facility using a convenience sample of emergency medical technician students. After lying motionless for 10 minutes, students evaluated each device using a 10-centimeter visual analog scale. Subjective comfort was used as a measure of ischemia. RESULTS: Comfort scores were significantly different for all methods (F = 101, p < 0.001). A backboard padded with a gurney mattress and eggcrate foam (the equivalent of a spinal rehabilitation bed) caused the least ischemic pain (9.6 cm, 95% CI, 8.9 to 9.8 cm). A backboard padded with a gurney mattress was the second most comfortable device (7.0 cm, 95%/CI, 6.4 to 7.4 cm). A backboard padded with a folded blanket was the third most comfortable (3.3 cm, 95% CI, 2.6 to 4.9 cm). The backboard alone caused the most pain (0.8 cm, 95% CI, 0.7 to 2.1 cm). CONCLUSION: Increasing the amount of padding on a backboard decreased the amount of ischemic pain caused by immobilization.
Analysis of Variance↗
Preventing pressure sores in elderly patients: a comparison of seven mattress overlays.
Long-term elderly patients at risk of pressure sores as shown by superficial skin breaks in the pressure areas were randomly allocated to seven low-priced mattress overlays, alternating pressure (AP): Large Cell Ripplebed; constant low pressure (CLP): Preventix, a 'Groove' prototype, Modular Propad (contoured foam); Ardo Watersoft; Spenco, Surgicgoods Hollowcore Mattress Pad (fibrefills). Assessments of the patients' medical condition, nursing management and pressure areas were carried out twice weekly for a mean of 17.7 days. If the pressure areas deteriorated significantly the trials were stopped and the patients were transferred to other supports. Thirteen per cent of trials on Ripplebeds had to be stopped compared with 32%, 35% and 37% respectively on contoured foam mattresses (p = 0.0005), 47% on the water mattress (p < 0.001) and 51% and 54% on fibrefills (p < 0.0001). Respective healing rates were: 45%, 37%, 24% and 20% (p = 0.001). Although the contoured foam mattresses provided better protection than the fibrefills (p < 0.01), only the AP mattress effectively prevented and healed sores in these patients who could not be regularly repositioned.
Aged↗
Prevention of hypothermia during orthotopic liver transplantation: comparison of three different intraoperative warming methods.
Hypothermia is a frequent and sometimes clinically important problem during orthotopic liver transplantation. Numerous methods have been suggested to reduce intraoperative heat loss and promote active warming. In this study we compared an electric under mattress, a warm air under mattress and a forced warm air convective heating blanket. The forced air convective warming system was shown to produce significantly higher patient temperatures than the two other systems.
Adolescent↗
Brain tumor risk in children in relation to use of electric blankets and water bed heaters. Results from the United States West Coast Childhood Brain Tumor Study.
The possible relation between the occurrence of brain tumors in children and exposure to electric blankets or electrically heated water beds was investigated in a multicenter, population-based case-control study conducted on the West Coast of the United States. Information on maternal exposure during pregnancy or direct exposure to the subject child was collected by in-person interview from the mothers of 540 case children and 801 control children. Cases were 19 years of age or younger and were diagnosed between 1984 and 1991. Controls were recruited using a random digit dialing procedure. The risk of brain tumor occurrence from in utero exposure to either electric blankets (odds ratio (OR) = 0.9, 95% confidence interval (Cl) 0.6-1.2) or heated water beds (OR = 0.9, 95% Cl 0.6-1.3) was not elevated. Brain cancer risk did not vary by use in any trimester of pregnancy, and children with mothers who reported use throughout their pregnancy had no increased risk. Similar results were observed for exposure to the child, in that no association between brain cancer and use of electric blankets (OR = 1.0, 95% Cl 0.6-1.7) or heated water beds (OR = 1.2, 95% Cl 0.7-2.0) was observed. Risks did not vary significantly by age, sex, race, socioeconomic status, or histologic category for either in utero exposure or child's exposure. This study provides no evidence to support the hypothesis that there is a relation between brain cancer occurrence in children and 50-/60-Hz magnetic field exposure from the use of electric blankets and heated water beds.
Adolescent↗
Re: "Use of electric blankets and risk of testicular cancer" and "Use of electric blankets and risk of postmenopausal breast cancer".
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Bedding and Linens↗