Hospital Bed Type, the Electronic Medical Record, and Safe Bed Elevation in the Intensive Care Setting

Zachary W. Fitch, Damon Duquaine, Rika Ohkuma, Eric B. Schneider, Glenn J.R. Whitman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


In mechanically ventilated patients, head of bed (HOB) elevation above 30° decreases the risk of ventilator-associated pneumonia. The research team studied (a) compliance with proper HOB elevation in their cardiac surgical intensive care unit, (b) the accuracy of HOB angles recorded in the electronic medical record (EMR), and (c) the effect of bed type on (a) and (b). Nurses were polled to discover how HOB angles were measured in practice. HOB angles were compliant in 80% of observations. Compliance was more frequent in beds with side-of-bed angle indicators (SBI) than beds with under-bed angle indicators (UBI; 88% vs 77%, P =.04). Charting in the EMR was accurate in 50% of SBI bed observations but only 20% of UBI bed observations (P 003C;.0001). Sixty-seven percent of nurses used the SBI; 27% used the UBI; 6% used estimation alone. Though compliance was suboptimal, compliance and EMR accuracy were significantly associated with bed type. Bedside indicators are underutilized.

Original languageEnglish (US)
Pages (from-to)69-72
Number of pages4
JournalAmerican Journal of Medical Quality
Issue number1
StatePublished - Jan 1 2016


  • cardiac surgery
  • electronic medical record
  • head-of-bed angle
  • heart surgery
  • mechanical ventilation
  • quality improvement

ASJC Scopus subject areas

  • Health Policy


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