A smooth operator: adherence to usage instructions for bathing equipment is easier said than done

If there is one piece of advice long-term care facility operators can rely on for the extended life and continued performance of bathing equipment, it might well be a phrase coined long ago by the pharmaceutical industry: “Use as directed.”

While bathing and lift manufacturers insist there is no magic formula providers can use for product longevity, they acknowledge adhering to usage instructions and keeping up with routine maintenance on a regular basis is easier said than done.

Consumers have a reasonable expectation that the products they buy will perform as advertised and it is incumbent upon manufacturers to deliver, asserts Kirk Penner, vice president of Aurora, NE-based Penner Manufacturing.

“If a spa requires trained service representatives, service contracts or a long list of items the maintenance department needs to be addressing, then the manufacturer has failed to provide a dependable product to the facility,” Penner says.

“The answers to the questions of maintenance begin in the design and development of the spas. We use proven and reliable components that have been successful in their applications for many years before incorporating them into our products. All components are placed for easy accessibility and our spas are able to be maintained by staff at the facility.”

Collectively, bathing and lifts manufacturers have made great strides in improving the value and functionality of new generations of products, says David Anderson, product manager for Somerset, WI-based Apollo Bath.

“The quality of bathing and lift systems has improved considerably over the last 10 to 20 years,” he says. “Due to demands in the marketplace, manufacturers have had to produce products that appear less institutional, provide optimum safety for residents, lower liability risk for facilities and provide extended warranties.”

Among the ways Apollo has improved its products, Anderson says, is water purification. The Remedy ultraviolet light water purification system kills bacteria and other pathogens during the bath, lessening exposure to residents.

“This system can help reduce infections among residents by as much as 50 percent,” he says. “Other innovations include improving the door system to virtually eliminate water leaks, removable side panel so maintenance staff can easily access the whole system and keeping the system basic enough so that many parts can still be purchased at local hardware stores.”

A focus on safe patient handling is behind the latest product innovations, says Tom Herceg, president of Pine Island, NY-based SureHands Lift & Care Systems. He explains this as: “Motorized equipment that promotes proper body mechanics and safe patient handling techniques for the staff as well as the comfort and safety of the patient.

“Height-adjustable bathing units and lift systems with a variety of accessories are designed to accommodate the specific needs of the user,” he adds.

Look around and you’ll see bathing systems that fit in tight quarters and feature either side- or end-opening access doors. These reduce the likelihood of falls and more easily accommodate chair lifts for those residents who require extra assistance.

The design of lifts, meanwhile, allows caregivers to quickly, easily and safely transport residents from bedroom to bathroom. For small bathrooms, ceiling- and wall-mounted lifts can maximize square footage.

Maintenance techniques

Successful upkeep of bathing and lift equipment depends on two areas of emphasis, Anderson says. They are: 1) Proper training and care by the staff who use the system and 2) a comprehensive periodic maintenance schedule by plant facility staff.

“We have found facilities that utilize ‘bathing specialists’ incur much less wear and tear on their equipment than facilities that mandate all staff provide baths,” he explains. “By putting one or two people on each shift in charge of the bathing system, they take ownership of the equipment, and subsequently, the equipment is better maintained.”

Anderson recommends that maintenance staff at the facility familiarize themselves with bathing and lift equipment and use a preventative maintenance schedule that is provided by the manufacturer to keep the equipment running smoothly. 

“Much like a car one drives for personal use, if equipment is not maintained, it is more prone to breakdown,” he says. “In most cases, it does not take much to conduct preventative maintenance on capital equipment.”

The new generations of spas are much more leak-resistant than older models, says Vicky Wenzel, the health center manager at Evergreen Retirement Communities in Oshkosh, WI. She said she has used Apollo bathing equipment since the mid-1980s.

Because bathing and lift equipment represents a substantial capital outlay, Evergreen has taken proactive measures to protect its investment, she adds.

“We have found that making sure preventative maintenance is scheduled for such items like gaskets on doors, chair rails and calibrating the weight scale of the chair assists with maximizing the longevity of the tub,” according to Wenzel.

Best and worst practices

Based on mistakes they’ve seen, bathing and lift manufacturers say they are definitely wary of long-term care facilities that deviate from established preventative maintenance routines.

“Bad maintenance practices primarily consist of staff refusing to adapt to new ways of doing things, such as not treating bathing equipment as an investment by the facility as well as outright abuse,” Anderson says. “We have seen new bathing systems—both ours and other brands—being used as storage bins for shower chairs, slings, boxes and other supplies. One facility even used an older bathing system to wash out bed pans.”

Conversely, the best practices for bathing system maintenance are where a facility works within the recommended preventative maintenance schedule on an overall organization-wide maintenance program, Anderson notes.

“This way, regardless of turnover, the next person who comes on board knows that certain tasks need to be done at certain times,” he explains. “If they have questions, our technical support staff is always willing to help them.”
Apart from product-oriented practices, Wenzel says she has been spearheading a new culture of bathing at Evergreen.

“I facilitated a team that pushed some changes,” she explains. “Residents were frustrated with the old system of bathing and wanted to eliminate those frustrations while increasing resident choice.”

Basically, residents were irritated about regimented scheduling and brief bathing sessions, so Wenzel implemented a looser schedule that allows residents to choose their bath time and take a longer soak in the tub if they want.

“Some residents like to take 45 minutes or longer,” she notes. “Most want the tub experience instead of a shower because they love the one-on-one time with the staff. The staff likes spending more time with the residents, as well.”

Wear, tear and decline

Manufacturers agree that facilities should expect at least 10 good years of viability for bathing and lift equipment with proper maintenance and care. Eventually, though, the products will start showing noticeable signs of decline, Anderson explains.

“The most significant sign of irreparable decline would be damage or wear related to the tub shell itself,” he says. “On other brands of tubs that lift residents up and over the side of the tub, gouges in the fiberglass can also prompt state inspectors to label the units as non-usable. At that point, the system would need to be replaced.”
The staff at Evergreen looks for initial indicators on the inside of the tub, Wenzel says.

“The finish on the inside eventually starts to become pitted from usage,” she notes. “What’s more, technology grows old over time, becoming less reliable and inefficient and ultimately needing replacement.”

It’s all part of the cycle.

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Maintenance pointers

Do:

Adhere to manufacturer usage instructions.
Establish regularly scheduled preventative maintenance.
Check potential problem areas, such as door gaskets, chair rails and weight scales.
Provide hands-on training to bathing staff.
Review the product manual regularly.
Invite annual inspections by factory-trained specialists.
Consider designating bathing specialists who take ownership of the system.

Don’t:

Ignore problem warning signs.
Allow untrained employees to use equipment.
Use tubs for purposes other than bathing, such as storage or as a sink.
Deprive residents of scheduling their own baths or cut short bathing sessions before the resident is ready.