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Patient Indication MD Available through
INTERFERENCE WITH Order Indications APPENDIX D Care Stores Product Code
MEDICAL/MONITORING DEVICES Required Yes/No
Machine washable items are to be done in special laundry. Must be placed in a clear plastic bag and marked with unit.
Skin Sleeves (Arm) NO To assist in preventing the disruption of medical treatment by camouflaging IV and wound sites. Single Use NO – On cart Small - 6000S
Regular - 6000
Large –- 6000L
Dark Tone - 6003
Freedom Splint YES Prevents elbow flexion to prevent access to upper body medical interventions (O2, NG-tube etc) Machine Washable Yes Small – 8168S
Medium – 8168M
Large – 8168L
Clips - 8161
Mitt YES Prevents the ability to hand grip objects while maintaining full arm mobility. Machine Washable Yes 2811
Limb Holder (Quilted) YES Prevents flexion and mobility of upper limb. Cuff secures with hook & loop fastener & quick release buckle. Single straps secure to Machine Washable Yes 2552
bed with quick release buckles.
Wrist Restraint YES Prevents flexion and mobility of upper limb. Machine Washable Yes
Patient Indication MD Indications
UNASSISTED BED EXIT Order
Required
Landing Strips NO Provides cushioned landing for patients at risk of rolling or falling out of bed. House - keeping Special Order
Low Bed NO To reduce the falling distance between mattress and floor. House - keeping Special Order
Non Slip Cloth NO Slip resistant surface matting. Single Use See O.T
Bed side-rail (1-2 rails up only) NO Aids in turning and repositioning within bed; provides a hand-hold for getting into or out of bed; provides a feeling of security; House - keeping
provides easy access to bed controls and personal care items.
Waist/Pelvic Restraint YES Prevents patient from sitting up; significantly restricts movement. Machine Washable Special Order
Wrist &/or Ankle Restraint YES Prevents patient from sitting up; severely limits movement. Machine Washable Special Order
Posey Jacket YES Patient at risk for falls or those requiring a restraint to assist with medical treatment. Posey jackets pose a high risk in the Machine Yes
agitated patient. Washable
Bed side-rails (upper and lower) up YES For the patient at risk of rolling off the edge of the bed. Do not use for patients who climb. House -keeping
Side-rail Padding NO Helps deter patient exit through side rails. MD order needed if all 4 bed rails are up to accommodate padding. House - Keeping Special Order
5-point Restraints YES For patients at risk of injuring themselves or others; severely limits movement. House - Keeping
Patient Indication MD Indications
WHEELCHAIR FORWARD Order
SLIDING OR UNASSISTED EXIT Required
Wedge Cushion NO Aids against forward sliding and promotes proper hip alignment. House - keeping See O.T
Seat Belt and/or Shoulder Strap NO Stabilizes hips and thighs and/or shoulders to provide lateral support and prevent forward sliding. House - keeping See O.T for
(Self-releasing) seatbelt.
Shoulder Strap –
Special Order
Geriatric Wheelchair NO Stabilizes upper body for those with poor sitting balance and at risk for falling forward. House - keeping Special Order
Lap Belt YES Reminds the impulsive patient to remain seated. House - keeping Special Order
Seat belt that cannot be loosened YES Help position patient in bed or chair. House- keeping Special Order
by patient
Chair with trays that cannot be YES Prevents patient from sliding fully forward. House - keeping Special Order
removed by patient.
Patient Indication MD Indications
OTHER Order
Required
Wandercare YES For the wandering patient.
