The Patient Gown, Safety for Our Seniors

Falls are the main causal factor as to why seniors fall. Routinely health care facilities evaluate the reasons that contribute to these events to prevent reoccurrence. Hospital gowns, due to their current length and ill-fitting size have been known to catch on objects such as the end of the bed, or a chair as a patient attempts to get up unassisted and then only to pull an elderly patient to the ground. However, as HCP’s, we routinely only evaluate the foot wear the patient may or may not be wearing as a causal factor and not realize the traditional patient gown is “screaming” for a change in its design to better meet the needs of its customers. As our population ages, we need a patient gown that is sleek in its design, appropriately modified to meet the functional abilities of INTERGENERATIONAL development-incontinence, mobility, activities of daily living, skin care, and be of high-quality, and safe for all to wear. Our society is not getting any younger, a change in the delivery of care is what is needed at the bedside with a patient centered approach, as well as a readiness to change the standardized APPEARANCE of the patient gown. Just take a look at the advertisements of the elderly patient in the ill-fitting gown….Any thoughts come to your mind? Seniors account for 13% of the current U.S. population according to the Census Bureau. They also stated the number of people in the United States age 65 and older will exceed the number of people age 18 and younger for the first time in the year 2056 (20%). As we age, our motor skills decrease, it is difficult for our seniors to tie or snap the traditional patient gown. Also, most of them suffer from loss of balance and coordination, and the length of the traditional patient gown poses a risk as a potential for them falling as they get tangled in the ill-fitting attire. Seniors also suffer from decreased visual acuity and locating the tiny snaps can be a challenge and usually requires the assistance of a caregiver as they lack the dexterity to actually snap the gown. Not to mention the lack of privacy as the exposed back-side remains open for all to 👀 as they ambulate in the hallways with their walkers, canes, etc. to improve their functional mobility. I could continue with my list, but I believe you get the gist…The important factors for our seniors is functionality and simplification when considering redesigning a patient gown. I still stand firm that my redesigned patient gown-CII has all of the necessary elements to accomplish what is needed to meet the needs of our patients and the needs of our seniors receiving care. CII resolves these issues mentioned above in comparison to the traditional patient gown. Improve the lives of the frail elderly population, make a difference in the quality of care, Choose CII! Request CII!!                          © 2017  Tracey L. Kennedy, RN “All Rights Reserved”

The Patient Gown, the Old is New Again and the Direct Link to Nursing Theory

The nurse’s role is to protect the patient and keep them safe from harm. I also utilized these basic principles when I redesigned the patient gown. The spring of this year marked the finalization of my patent with the USPTO for the redesigned patient gown which I named CII (Catastrophic Illness & Injury). I designed the gown to open effortlessly (from the side, left to right) to be able to facilitate HCP’s to be able to better and safely care for patients. The unique design permits easy access to the thoracic cavity for patients that may need CPR or quick access to the chest area (breathing), I provided an additional port/pocket on the front of the gown to allow for a gastrostomy tube (eating and drinking) to be able to allow for enteral feedings to occur for those that cannot eat or drink. Again, the gown opens from left to right making care less restrictive for patients and staff to assist with bowel or bladder (elimination) if necessary. CII’s length, sweep, and weight of the gown adjustments make patients more comfortable so they may rest, be repositioned more easily, and avoid potential falls in the environment as compared to the current ill-fitting gowns in the marketplace (position, rest, avoid danger). I strongly believe the current traditional patient gown is a fall hazard due to the length, sweep and weight of the gown and contributes to patient falls on a regular basis due to these factors. CII’s specialty fabric selection helps to control body temperature and has wicking properties to protect the patient’s skin (maintain body temperature and protect skin). Currently, patient’s openly express (communication) their dissatisfaction with the care they receive as they feel their privacy and dignity is an issue and often care is awkward with the current traditional patient gown (suitable clothes). The constant “lifting” of the gown and backside exposure is a privacy and dignity issue for most patients. CII allows for most of the care to be performed on the outside of the gown with its many built-in port/pockets and the backside of the gown is closed, eliminating the constant “lifting” of the patient gown as an added feature. Next, CII is more culturally appropriate than most gowns in the marketplace as it provides appropriate coverage (faith). Finally, patients can have a sense of accomplishment as far as reaching basic goals (accomplishments or participation in care) for the day as care and treatments can be easily administered on the outside of the gown through the various ports/pockets and/or by quickly opening the gown allowing quick access to the patient for care (wearable technology) with the enhancements of the principles of Virginia Henderson (Black, 2014) built into the gown. As CII grows in the marketplace, patients will choose to want to receive care in a healthcare facility where safety and quality of care are a priority and CII is the patient gown of choice (learn, discover, and satisfy). This is my vision for my virtual prototype and, I believe my practices are most congruent with those of Virginia Henderson’s nursing philosophy as these fourteen basic needs (p. 270) shape the fundamental elements of nursing care that I most closely follow in my entrepreneurial nursing practice. #BuildaBetter Patient Gown #Choose CII  Copyright © 2017  Tracey L. Kennedy RN

Wearable Technology

We live in a faced past environment, and healthcare is no different when it comes to technology. But what about taking technology to the next level and incorporating those elements into the patient gown to make the gown a more useful device to not only the patient but the provider? Most patients bring their smartphones with them to the hospital. Why should patients not have a secure pocket on the front of the gown to carry their phones with them? Quite often these electronic devices are misplaced and lost in the linens only for the clinical staff to spend wasted time attempting to locate these devices. Patients want access to their electronic devices and to keep in contact with their families and to have access to information. Besides, patients want to keep their smartphones close. This practice of patients bringing this type of technology to the bedside is not going to change anytime soon. Secondly, Why do HCP’s have to struggle to gain access to newer technologies such as the life vest, iTBra, and the Health Patch, just to name a few because the traditional patient gown continues to not meet the needs of the patients with the traditional design; you have to almost completely remove the garment in order to gain access to anyone of these items. But yet, the traditional patient gown still continues to be mass produced? CII is the solution and the RIGHT choice for both of theses issues. Easy access and versatility of the gowns ability to open and the cleverness to adjust to the changing needs of the patients is what sets CII apart from the traditional patient gown. CII is a unique patient gown in the marketplace offering a variety of solutions to common problems found in the healthcare industry, and the redesigned patient gown provides comfort, dignity, quality, and safety all in one mystical design setting it apart from all the other traditional patient gowns currently in the marketplace. #BuildaBetter Patient Gown #ChooseCII  Copyright © 2017 Tracey L. Kennedy RN

The Patient Gown and Adverse Events

Adverse events occur every day in healthcare that are attributed, in my opinion, to the use of the traditional patient gown. My redesigned patient gown-CII (Catastrophic Illness & Injury) can assist with this process in many ways through its unique design elements, and its ability to assist in improving quality of care and safety for patients. Currently, the traditional patient gown extends far below the knees and is a safety hazard, and quite possibly contributes to patient falls due to the current weight, length, and sweep of the gown. The ill-fitted garment literally just “hangs on” the patient’s frail bodies at times. Does anybody really notice this but me? Secondly, the traditional patient gown conceals lines, tubes, and drains, and does not allow for quick visualization and reconciliation of these items for the clinical team and can contribute to tubing misconnections or dislodgements (peg tubes, PICC lines, etc.). The sleeves on the gown which need to be much shorter can also impede care at times making it difficult when dealing with intravenous lines and BP cuffs, etc. Next, the fabric selection is currently not well matched to assist in temperature control or in helping to prevent infections or pressure ulcers (reducing friction or shear). Frequently, pressure ulcers develop in common areas such as the shoulders, buttocks, lower back, inner aspect of the knees, and hips, etc. The traditional gown does not lend itself to any wicking properties by helping to control moisture or body temperature which is problematic for patients with various disease states. The traditional gown certainly was not created as a skin barrier or preventative therapy with its original design when reviewing its history. Then, we have the issue of the exposed back-side area which remains a constant complaint among those that have had the opportunity to wear the iconic garment. CII is different from the traditional gown as it has a unique design! It opens easily (from the side) for care and treatment, and the back side remains closed. Debilitating injuries should decrease secondary to manual patient handling as the gown “breaks away” to provide the needed care for the patient. Quite often gowns are cut away due to emergencies; CII eliminates this issue, as well as, the issue of a drafty backside. Ease of use of the gown for both the patient and the clinical team is an added bonus to CII’s design. Safety considerations were incorporated into the dimensions of the light weight gown with the addition of the ports and pockets to provide care and treatment. An eyelet was also added to CII to anchor or stabilize a g-tube which is something new to the marketplace. Finally, fabric selection and the ability to provide temperature control and wicking properties to help in the prevention of pressure ulcers and infection was added to further reduce risk to the patient. The patient gown will always be worn in most healthcare settings and remain the constant factor in the delivery of care, as it has DIRECT contact with the patient’s skin in most instances. Changing the properties and the design of the patient gown in the foreseeable future can only challenge us to change the things we have not been able to accept in the present and finally give patients what they have been asking for! #BuildaBetterPatientGown #ChooseCII.                                                     Copyright © 2017 Tracey L. Kennedy

The Patient Gown, A Century Old Problem…

The traditional patient gown has been around for what seems to be at least a century or more, but yet the traditional patient gown continues to be imposed on patients with no regard to clinical care or safety. Healthcare continues to be caught up in being SLOW to change and being caught in the rut of doing things the same way because it has always been done that way. A few organizations have taken on the challenge of changing the gown without much success, and I applaud their great efforts. The traditional patient gown will always remain an iconic symbol but I wish someone would actually take the time and track and trend data for the number of adverse events that are associated with wearing the traditional patient gown, as I still firmly believe the traditional patient gown causes many issues: 1) it conceals lines and tubes for the clinical staff potentially leading to adverse events, 2) the weight and length of the gown are bulky for an aging patient population placing patients at a greater risk for falling, 3) the material used to manufacture the gown is not well matched to maintain skin integrity, 4) and of course, the backside exposure remains a huge issue. So what will it take? A major mistake to go down in history for the realization of a newly redesigned patient gown? Patient safety should be at the forefront of every healthcare organization. This is an opportunity for healthcare and textile manufacturing to take on this challenge and lead the way to a better safer healthcare system. In my heart’s desire, I truly believe my redesigned patient gown-CII has all the basic elements of a successful patient gown to replace the traditional gown. The most notable feature of my redesigned hospital gown is that the back of the gown is closed, eliminating the most common complaint patients have about the patient gown. CII (catastropheic illness and injury) opens from the side allowing the gown to be EASILY worn by patients and allowing quick visualization by the clinical team when needed. CII also allows for lines and tubes to be visible outside of the gown allowing for care and treatment to be rendered, and lines to be easily reconciled during care. The redesigned gown has an eyelet to anchor tubes and drains above the centralized surgical pocket, which is one of three ports/pockets also making the gown unique to the marketplace. Change can be difficult, but sometimes you have to dream the unimaginable if you want something different to occur. Finding opportunities where no one else seems to be looking.…#BuildaBetterPatientGown                     Copyright © 2017 Tracey L. Kennedy

The Patient Gown, An Iconic Symbol

So glad the the holiday rush has now ended so I can refocus my efforts to CII. The New Year began with me watching a very iconic parade full of tradition, the Rose Bowl Parade. I also watched a light bulb commercial during the parade which brought me to blog about this article on iconic symbols, like the light bulb, the patient gown, are beautifully crafted pieces of art work that have withstood the tests of time. The light bulb was created with its original purpose, just the same as the patient gown, but along came inventor/scientist Nick Holonyak from GE to to make the light bulb more efficient by creating the LED bulb. It took small phases for the LED bulb to be adopted, forward thinking and about 50 years later before the LED’s true potential would be realized, but the light bulb still remains an American icon today. It still has purpose, it is just more efficient, and is slightly different in appearance. So why should the patient gown be any different? Why do so many keep trying to dramatically change the design of a healthcare icon? The patient gown will always be an iconic symbol in healthcare and be part of the tradition that lives on in patient’s lives everywhere all over the globe. The patient gown still has a purpose, and in my opinion, the gown will never go away completely as it is embedded forever in time. What I can tell you is CII (my redesigned patient gown) was created to make the basic patient gown more efficient by opening easily and creating the safety and privacy patient’s ask for. CII also helps meet some of the core regulatory requirements hospitals and ICF’s are struggling with; also CII is slightly different in appearance as it has built in ports and pockets, as well as an eyelet to anchor drains and tubes (CMS requirement). So again, these two iconic symbols have much in common, and are beautiful just the way they are! I just hope it does not take 50 years for someone other than myself to realize CII’s true potential so that we may Build a Better Patient Gown. Tracey L. Kennedy © 2017 All Rights Reserved.

Butts and Guts

Lately I have posted quite a few cartoons and images on my social media (FB, Pinterest, LinkedIn) outlets of what reality is like in the healthcare settings for patients with lines/tubes. Certainly there is no room for modesty as you will take note of all of the breaches in privacy. The most notorious example, “butts” hanging out of the back of the gowns for all to see, 👀 but why have we settled for mediocrity when consumers continue to complain about their “butts” hanging out? Yet we continue to not listen to the consumer’s primary concern? My number two example, most bed bound patients and their “guts” exposed for all to be viewed by passers by, as the design of the traditional hospital gown does not lend itself to the needs and challenges of the medical complexities of today’s healthcare. Other than those that are in healthcare, does anyone really realize that a bed bound patient lays in the bed almost fully exposed when they have a feeding tube (gastrostomy) in place as there is no easy way to get to the tube without inconveniencing the patient and without lifting the traditional patient gown to connect the enteral feeding to the gastrostomy tube? Yet on a daily basis, we continue to use a product that does not meet the needs of patients or assist in delivering care more efficiently to support health care professionals to perform the needed care for patients. The traditional hospital gown by design conceals medical mishaps on a daily basis. Patient’s will continue to have many line/tubes hidden underneath a traditional patient gown, so are we helping or hindering the process by continuing to use an outdated product or because nobody wants to take on the challenge of a niche redesigned patient gown to improve safety and quality? This is a process that cannot be rushed. I truly believe those in healthcare would like to nothing better to see a newly redesigned patient gown that incorporates some of the CMS elements to improve quality and safety. Until a collaboration between textile manufacturing and healthcare occurs will the puzzle finally be solved to Build a Better Patient Gown.  © 2016 “All Rights Reserved.”

The Processes on How to Wear a Patient Gown

I have read many articles on how to wear the basic traditional patient gown, again, still requiring the assistance of nursing personnel to either tie or snap the back of the gown. I believe this accounts for approximately 74% of the patient population. So what about the remaining 26% of patients that are medically complex that still need to wear a patient gown? These patients have a right to privacy and dignity just the same as any other patient. Just because patients have complex needs such as multiple lines and tubes, etc. does not mean they need to be exposed unnecessarily, but unfortunately it has become accepted practice because the traditional patient gown does not easily allow for care and treatment to be delivered to patients. Hospitals throughout the nation unintentionally expose patients during their stays because of the use of the dreaded traditional patient gown, as currently there is no better alternative. Multiple disruptions through out the day lifting and tugging at a garment that has rendered itself to be problematic day after day. Does anyone realize the process for wearing a patient gown is much DIFFERENT for those patients that are medically complex, debilitated, or bedbound? These patients are dependent on the clinical team to “drape” the gown onto the patient. More times than not, I would say the traditional gown may or may not even get tied or snapped due to the complexity of care that needs to be delivered to the patient. And the ugly truth nobody want to talk about…lines and tubes sticking out of the gown leaving the patients usually partially if not almost fully exposed at times. It happens every day as the traditional patient gown continues to not meet the current demands of complex patient care needs. There are many chronic patients in hospitals, skilled nursing care, long term acute care hospitals, etc. that need a specialty gown to meet the needs of patients with specific catastrophic conditions. We NEED an alternative high performing patient garment to meet the every day needs of a changing, highly complex and challenging medical environment. An opportunity exists to deliver care to this niche market. The time has come to change how we think about how care can be delivered through an innovative, pioneering, and newly designed patient gown called CII-Catatrophic Illness & Injury. A gown uniquely reverse engineered to open easily for care and treatments, a gown with increased motility creating efficiency in the clinical workflow, in addition to reducing risk to the healthcare workers for back injuries. To build a better patient gown means listening to the demands of the PATIENT population being served, observation of the PROCESS as it is remarkably different in this niche market so that we may arrive at a final PRODUCT and “breathe new life into an old project.” cii the SOLUTION. ©2016 Tracey L. Kennedy  “All Rights Reserved.”

Snaps & Stitching

My new mantra is “a new day, a new way,” so let’s talk about the snaps and the stitching on the traditional patient gown. The snaps need to be slightly larger due to the aging patient population and their decrease in fine motor skills that accompany life. It is very difficult for patients to locate and snap these tiny eyelets together when they are not acutely ill, so you can just imagine the nightmare and dissatisfaction that is causes when someone is debilitated and in the hospital for a prolonged period of time and not even have control of snapping a basic patient gown. A gown that currently ties in the back or sometimes snaps which patients are not able to extend their arms and reach to tie or snap without the assistance of a nurse in most instances. I was not able to do this for myself after my breast cancer surgery either and I was under the age of 50 at the time, very frustrating, and I felt a sense of a loss of control which I expect other patients feel the same. Now the snaps…the GAPS between the snaps! Talk about your privacy being invaded and feeling like a “peep show.” These gaps between the snaps along with loose stitching make the gowns very drafty in my opinion. There are some cultures that simply do not want any exposure of the body at all and simply the traditional gown does not measure up. The insane piece of this puzzle is we continue to use the traditional patient gown which continues to be a major patient dissatisfier even with issues being identified with the traditional patient gown. CII can offer patients the ability of a quick slip on fit, the ability of the front panel to open easily for care, larger snaps on the sleeves so the gown can break-away from front to back if necessary, larger snaps symmetrically placed on the left side of the gown with tight stitching in between the snaps, and a fabric that wicks away moisture. CII is an opportunity to build a better patient gown to achieve optimal patient outcomes 🙂 © 2016 Tracey L. Kennedy “All Rights Reserved.”

Sizing-One Size Fits Most

During my breast cancer journey, I had the opportunity many times to wear the dreadful traditional patient gown. So let’s talk about size, as size does matter and the “one size fits most” approach needs to change or be adjusted to those of you that manufacture and distribute the patient gown. This was a major dissatisfier for me as I put on the crunchy, oversized, and drafty garment. Not to mention the oversized sleeves which need to be shortened so lines can be better visualized by clinical staff. Also, patients frequently complain of being warm or too hot in the traditional gown made of cotton and polyester. Wearing an oversized gown on a petite frame was more than annoying, I cannot imagine having to had worn the traditional patient gown for an extended period of time as it also seemed heavy to me. My advice as an experienced Director of Clinical Quality, CMS collects data on the current height and weight of all inpatient admissions through the Quality Reporting Programs (as well as other data), so do you not think it is time to readjust the length and sweep of the gown based on the average height and weight of the patients currently being seen across healthcare organizations if you are going to take this “one size fits most” approach? Why not consider how care is delivered to better meet the needs of patients as most do wear a patient gown all day long and would like to be comfortable in a garment that fits appropriately by offering sizes based on height and weight again as an option. This could be a workable solution for PATIENTS but we need to rethink how to breathe new life into an old project. Manufacturers and distributors of the patient gown, you need to view your pictures on your websites and on my website (video) the gowns sweep the calves and/or ankles, patients look and feel ridiculous… Patients want to be comfortable, to have privacy in a gown, and finally, NO HARM to come to them during their stay, I do not believe the current traditional gown accomplishes this and is in fact dangerous to the delivery of care (CMS fall data, pressure ulcers, dislodgments). Building a better patient gown needs to incorporate a fabric that is light weight and soft, fits according to size, opens easily for care, incorporates the elements of safety and privacy, and is easily laundered and safe for the environment. Can we finally fix this…:) © 2016 Tracey L. Kennedy “All Rights Reserved.”