HYBRID EVENT: You can participate in person at Baltimore, Maryland, USA or Virtually from your home or work.

8th Edition of Nursing World Conference

October 17-19, 2024 | Baltimore, USA

October 17 -19, 2024 | Baltimore, USA
NWC 2019

Anita Rush

Speaker at Nursing Conferences - Anita Rush
Wokingham Hospital, United Kingdom
Title : Can the design and articulation of the bed frame positively influence patient migration, heel travel and consequently help to reduce heel pressure ulcers


Pressure ulcers are the single most costly chronic wounds in the NHS, estimated to cost £1.4-£2.2 billion annually, which is 4% of the NHS total expenditure1. Apart from causing pain and discomfort to the patient, tissue damage places a major burden on healthcare through increased nursing time, hospitalisation, equipment provision, consumables and pharmaceuticals.

Pressure, shear and friction are the main external factors that contribute to the development of tissue damage. Positioning a patient in bed has the potential to cause shear and friction, particularly when the Head of bed (HOB) is elevated to improve patient comfort and to facilitate respiratory and nutritional function. This HOB movement has the potential to migrate the patient down the bed over time. The negative effect of this action results in two common adverse events. Firstly, there is an increase in shear and friction as the patient migrates across the mattress, which can lead to pressure ulcers, particularly on heels. Secondly, the migration can have an effect on the patient’s torso. The elevation and therapeutic angle of the torso decreases and tends to flatten to the extent that it no longer receives the benefits of the HOB as this position diminishes respiratory function and increases patient discomfort.

The impact of patient migration down the bed in both the acute and community setting is not fully understood by nurses/carers and manufacturers. Preventing migration will not only improve a patient’s outcomes, but may also reduce the incidence of tissue damage and musculoskeletal disorders experienced by the nurse/carers when repositioning the patient back up the bed several times a shift. Understanding the effects of patient migration might encourage better bed design and provide objective data to enable an organisation to make informed decisions when specifying and procuring hospital beds.

Take Away Notes:

• How patient migration down the bed will improve patient outcomes

• How equipment evaluation provide objective data that enables organisations to make informed decisions when procuring hospital beds

• The prevention of patient migration down the bed can reduce the incidences of tissue damage and musculoskeletal disorders experienced by the nurse/carers when repositioning the patient back up the bed several times a shift


Anita is a highly experienced Clinical Lead for equipment working in the NHS. She undertakes complex patient assessment to ensure that equipment provided is fit for purpose. Anita has published a number of articles and co-authored two book publications Chapter 12, in ‘The Guide to the Handling of People, a Systems Approach’ - 6th edition reprinted May 2013, published by Backcare The second publication ‘Moving and Handling of Plus Size People - an illustrated guide’ was published by the National Back Exchange in 2013. She has lectured for the Disabled Living Foundation, spoken at many national conferences on various topics Tissues Viability and Plus Size Management.