Nightingale ProAxis Plus User manual

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 1/24
Instruction for use and trouble shooting guide

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 2/24
Manufacturer’s name Nightingale Care Beds Ltd
Manufacturer’s address Unit 1 Ash Road South
Wrexham Industrial Estate
Wrexham
LL13 9UG, UK
Tel [phone]
Fax [phone]
E-Mail: [e-mail],
Website: www.nightingalebeds.co.uk
Nightingale Care Beds Ltd declares that the ProAxis
plus
™ Electric Profiling Bed and
Pressure Area Care System have been designed and manufactured to meet the following
standards:
CE for Medical Device Directive (93/42/CEE Class 1 medical device)
BS EN ISO 60601-1
BS EN ISO 60601-1-2
BS EN ISO 60601-1-4
BS EN 60601-2-38
All relevant criteria of the above standards are met with the exception that all systems are
manufactured extended as standard as we consider pull out extensions unsuitable with
mattress use.
ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System are intended for use
by adults from 70 kgs.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 3/24
Table of Contents
1. ProAxis
plus
™ Electric Profiling Bed & Pressure Area
System
1.1. Introducing ProAxis
plus
1.2. Achievable Positions
1.3. The Mattress
2. Operations and Safety
2.1. Installing the ProAxis
plus
2.2. Safety Precautions
2.3. ProAxis
plus
Features
2.4. Patient / Nurse Handset
2.5. Lockout Controls
2.6. Operating Instructions
3. Programmable Smart Control (optional)
4. Weight Indicator (optional)
5. Cleaning and Disinfection
6. Technical and Maintenance
6.1. Servicing, Care and Maintenance
6.2. Specifications and Accessories
7. Troubleshooting

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 4/24
1.1 ProAxis
plus
™ Electric Profiling Bed & Pressure Area Care
System
The ProAxis
plus
™ Electric Profiling Bed is a three sectional, electrically operated pressure
area care system that profiles to the contours of the human body by incorporating an
automatic knee break whilst dropping the sacral area.
This unique profiling movement alleviates three extrinsic factors, pressure, shear and
friction, which are considered the main contributing factors to pressure ulcer development.
A specially developed Smart Control (optional) plugs into the bed and can be programmed
to automatically adjust the mattress angles and thus provide additional pressure area care
for patients at high risk of pressure ulcer development.
Smart Control/Weight Indicator (optional)

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 5/24
1.2 Achievable Positions
ProAxis
plus
™ can achieve many positions by easy operation of a simple handset. Every
function is motorised for minimising the physical effort required by nursing staff. The
following positions are some examples;
Chair Position
Flat
Trendelenburg
Reverse Trendelenburg

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 6/24
1.3 The Mattress
The mattress is especially manufactured for the ProAxis
plus
™ and is a temperature
sensitive, anti-bacterial, Visco-Elastic type that easily and quickly conforms to the patient’s
body shape.
Having a gel-like feel and the ability to adjust and distribute load as evenly as possible, it
simulates a floatation effect whilst maximising the comfort level and so facilitating better
blood circulation.
It is capable of accommodating patients that are medium to high risk of developing
pressure ulcers and so when combined with the unique profiling action of the ProAxis
plus
™
Care bed, is suitable for very high risk patients.
The Visco material is breathable and non-irritating, and helps to dissipate moisture and
perspiration away from the body.
It is common for modern mattresses to have anti-bacterial covers, but the Nightingale
mattress now achieves the same standard internally.
The Visco-Elastic material is temperature sensitive memory foam that consistently
conforms to the patient’s body shape. The Visco-Elastic is “fast acting” and allows for
easier and faster re-adjustment as their position alters. The surface contact is increased
between the patient and mattress.
Shearing forces are minimised due to the contouring properties of the Visco-Elastic. The
contouring properties not only provide better pressure area care, but also maximise patient
comfort. Skin condition is improved as the Visco-Elastic aids the dissipation of moisture.
IMPORTANT INFORMATION
The mattress provided with the ProAxis
plus
is unique to the system. It is both wider and
longer than other beds available, therefore no other mattress should be used on the
ProAxis
plus
.
The mattress does NOT require turning and it is imperative that the mattress is positioned
with the information label facing UP and positioned at the FOOT end of the bed.
nursing staff. The following positions are some examples;

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 7/24
2.1 Operations and Safety
Installation
Please comply with the following installation instructions to ensure maximum benefit for
the patient and nurse.
- Ensure that the system has sufficient space for the complete range of operation and
movement that is required.
- Connect the power supply to the available power point on the wall and ensure that
the cable is clear from any risk of entrapment and possible damage or obstruction.
- When positioned as required, the brake pedal should be pressed down into the lock
position before any attempt is made to place a patient onto ProAxis
plus
.
- Before placing the patient onto ProAxis
plus
, the mattress platform should be profiled
slightly to enable the nurse to see exactly where the dropping hinge is and so be able
to position the patient correctly above it. Ensure the mattress provided with
ProAxis
plus
is used.
- It is advisable to leave the linen bottom sheet loose, as this will then allow it to
conform to the patient’s body and to the angle changes of the mattress platform.
- Only one or two pillows should be used. The backrest should be raised by use of the
handset and the patient should not be sat up by way of propping them up with pillows
as seen on older beds.
- If the patient requires the provision of additional pressure area care then the Smart
Control (optional) should be used [see Smart Control Operating Instructions] and not
an A/P mattress.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 8/24
2.2 Safety Precautions
Before using any electrically operated system for the nursing and care of patients, a full
risk assessment should be carried out and completed. The information gained from this
should then be used to control the details of the care and equipment provided.
The safety sides provided meet with the required standards and are designed to minimise
the chance of entrapment. However, care should be taken when assessing the patient, as
there is often an element of risk when using safety sides.
Although a lifting pole should not be required as the ProAxis
plus
™ profile will prevent the
patient from slipping down the platform by way of the unique profiling action, in the remote
case of one being required it will need to be of a free standing type.
Before the trendelenburg tilt facility is used, care should be taken to ensure that there are
no obstacles above or beneath the system that may come into contact with the system as
the angle changes. Care should also be taken to make sure there is sufficient clearance
between the frame and the wall.
Care should be taken when the system is being moved and the power supply cable must
be unplugged and stored with the system whilst in transit. Battery back up is available for
operation whilst mains power is not available.
If the batteries are allowed to discharge to within 50% of there capacity the system will
shut down to prevent permanent damage. The system can be reactivated by connecting
the power cable Depending on the charge left in the system will depend on when the
system will function again. Typical time is 30 minutes from flat.
The transformer unit is unique to the ProAxis
plus
system, it operates at 36v therefore it
must NOT be used with any other equipment, as damage may occur.
If for any reason the system is unused or stored, the system should be shut down. This is
achieved by pressing the Bed Up and Bed Down keys at the same time for 10 seconds,
ensuring the transformer is not plugged in. Please ensure the wall-mounted transformer is
stored with the bed at all times. To reactivate the system, simply plug in the transformer. If
the system is completely flat, it will take around an hour to recharge until operational.
The system is not to be used near flammable anaesthetics.
ProAxis
plus
™ Electric Profiling Bed is designed for persons over 127 kgs.
The mattress support system has been designed and tested for use with a maximum
patient weight of 318kg [700lbs/50 stone]; The safe working load is 353kg.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 9/24
Operating Instructions in Diagrammatic Format
2.3 Main Features
Backrest
Removable Head/Foot
Boards
Safety Buffers
Dropping Hinge
CPR and Lockout Control
Variable Height and
Trendelenburg Tilt
Central Locking Brake System
Smart Control Socket
Linen Tray
Smart Control
Footrest
Split Side Rails
Automatic Knee Break

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 10/24
2.4 Patient / Nurse Handset
The patient / nurse handset is permanently attached to the bed and is a simple control to
operate the basic functions.
Variable Height, Backrest and Footrest Buttons
Variable Height - The height of the platform can be raised or lowered by using the
handset control buttons that are shaped as arrows and marked Bed Up and Bed Down.
Backrest - To raise or lower the backrest of the platform the buttons marked Head Up and
Head Down should be used.
Footrest - To raise or lower the footrest the buttons marked Foot Up and Foot Down
should be used.
Preset Buttons
There are two preset positions available and are achieved by pressing the relevant buttons
on the handset control. The buttons have to be pressed continuously for position to be
achieved, only one button can be pressed at a time.
Chair Preset Position - To achieve a chair position with the platform profiled to the sitting
position and the frame tilted down at the footend, the button marked Chair should be
pressed.
Flat Preset Position – To make the bed go flat, press the Flat button.
Bed Up
Head Up
Foot Up
Foot Down Head Down
Bed Down
Preset Flat PositionPreset Chair Position

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 11/24
2.5 Lock Out Control
There is a Lockout control on both sides of the bed for easy access. The buttons are
colour coded for quick identification, with lights to depict mode.
CPR - The CPR operation is automatic. Press both CPR buttons simultaneously or within
3 seconds. It is important to check for obstructions under or around the bed, as once the
CPR mode is activated the bed quickly profiles to a flat position 600mm from the floor.
CPR can be stopped anytime after two seconds into the movement by pressing ONE of
the red CPR buttons once.
Tilt - The system can be tilted by pressing one of the two green buttons on the lockout
box, marked Tilt. 12.5 degree tilt is available both ways. To level the bed press the
opposite button until the bed stops and the green LEDS flash, at that point release the
button and the bed will be level.
Lockout Buttons - The movements that can be locked out are Backrest, Footrest, Tilt and
Height, and Preset positions. When locked out by the nurse a red light will show on the
lockout button that is chosen. If a hand pendant button is pressed whilst locked out the
Green LED on the pendant will flash, also the lockout red LED will flash. Press the relevant
lockout button to restore function, the red LED will extinguish.
Lockout footrest, tilt
& height, &
backrest
Trendelenburg both ways
Cardiopulmonary
Resuscitation
Position

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 12/24
2.6 Operating Instructions
Before using ProAxis
plus
, ensure the Operations and Safety Installation section has been
followed. Important: ProAxis
plus
should be plugged into the mains at all times, the battery
backups are for emergencies only.
Positioning the Patient
Use the patient / nurse handset to slightly profile the bed to identify the dropping hinge
section. Ensure the sacrum area is above the hinge between the back-rest and thigh
section of the platform.
This will ensure that when the backrest is raised, the hinge drops, the automatic knee-
break is operated, and the patient does not slip down the mattress.
In normal circumstances, it will be necessary to use no more than two pillows. If the patient
requires sitting up the backrest should be raised and the use of pillows for “propping” the
patient up should be avoided.
Safety Sides & Headboards
The system will normally be supplied with safety sides fitted and positioned either side of
the mattress platform. These are adjusted by pushing in the black button on the side rail
bracket. Lift or drop until they click into position. The safety sides should only be used after
full assessment of the patient has been completed, as their use may not be suitable in all
cases.
It is essential that the head and footboards are fitted when the system is to be tilted.
Braking System
The brakes have directional steer
and 4 way locking.
Directional
No Lock
4 Way Lock
The braking system is operated by pedals located at the foot end of the bed. When the
pedal is horizontal the brakes are off. With the pedal depressed towards the foot end the
brakes are locked on. With the pedal depressed towards the head end the steering lock is
activated to assist in moving the bed.
For pressure relief, use the Smart Control (optional. See Smart Control Operating
Instructions for instructions of use.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 13/24
3 Programmable Smart Control (optional)
Pressure area care for the bariatric patient will cause issues due to many factors, the
“SMART” system has been developed to address most of these.
On the principal that pressure cannot be totally removed, only “redistributed” the Smart
system achieves this by automatically profiling the sleep surface, and thus move the
pressure points.
Due to the unique ProAxis Plus dropping hinge there is no fixed point on the mattress
platform, this means that when the head section moves the thigh and foot sections move
also. Combining this movement with the proven capabilities of the Visco-Elastic mattress
gives the opportunity to offer a high degree of pressure area care even when the patient
has to be positioned more upright.
To operate the system it is necessary to set 4 parameters
1. Backrest start angle (0-45 degrees)
2. Backrest stop angle (15-60 degrees)
3. Number of steps between the two angles
4. Time between each step.
Simply follow the flow diagrams below to set the system, the whole process will only take a
few minutes. The angles chosen will depend on the amount of pressure redistribution
required and the particular conditions of the patient, however the greater the movement
the more effective the system will be..
Each patient is unique, therefore no “generic” programmesare
available. Please see the notes at the end of the chapter.
Display Screen
Function Buttons

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 14/24
Smart Operation Screen Identification
Home Screen
Press BLUE
function key below
Smart symbol
Accept previous
settin s
Chan e Settin s
Exit to Home
Screen
If this is displayed
the bed frame is
tilted, press and
hold to level.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 15/24
Smart Settin s
Set the number of
steps between the
accepted an les
1 - 10
Once desired
number is
achieved press
ACCEPT key
Set the number of
minutes between
steps
1 - 60
Once desired
number is
achieved press
ACCEPT key
CONFIRM the
settin s, and if
correct press
ACCEPT key
If the settin s are
wron , press the
REJECT key and
start a ain
Smart Settin s
From the Home
Screen press
SMART key
Set backrest LOW
position usin UP /
DOWN keys
0 – 45 de .
Once desired
an le is achieved
press ACCEPT
key
Set backrest HIGH
position usin UP /
DOWN keys
15 – 60 de .
Once desired
an le is achieved
press ACCEPT
key
If settin s
displayed are
correct press
ACCEPT
If settin s are
incorrect press
REJECT and
follow uide below
Screen turns
reen and system
is workin . Time to
next movement is
displayed.
Press EXIT key to
stop at any time.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 16/24
Notes on Setting the Smart System
1. There must be at least 15 degrees of movement for the system to be effective, in
practice the larger the angular changes the better the pressure redistribution.
Because of this the system will not allow settings of below 15 degrees.
2. The main screen uses colour coded backlights to assist in navigation.
Red = Smart is inoperative
Amber = Smart is being programmed.
Green = Smart is working.
3. If at any time during the setting sequence an error is made you can exit the system
by not pressing any keys for 15 seconds.
4. Smart will override all other functions on the bed whilst operating, however the CPR
function will still be available. Once activated the CPR function will disable Smart
until the programme is reactivated.
5. Please ensure that the patient is able to tolerate movement of the bed over long
periods of time. It is important to ensure that IV, breathing and drainage tubes are
positioned so they do not pull during the range of movements.
6. This system may not be suitable for patients with unstable spinal injuries.
7. Before carrying out any patient procedures check the Smart display to ensure there
is sufficient time to complete before the next movement. If in doubt stop the Smart
and re-enable after the procedure has been completed.
8. The patient should be checked on a regular basis to ensure there is no marking, the
programme may need to be changed if the patient’s condition deteriorates or
improves.
Programme Examples
Used for a medium to high risk patient, only 30 degrees of
movement and each of the 4 steps take 25 minutes.
Used for high risk patients, 40 degrees of movement and
each of the 6 steps takes 15 minutes.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 17/24
9. Weight Indicator (optional)
The Weight Indicator can be attached to any ProAxis
plus
™ System and used as an aid to
nursing staff to ensure that the patient does not exceed the safe working load of any
equipment utilised to prevent manual handling issues.
The system works by calculating the enery required to lift the patient up and down, as this
is directly proportional to there weight. It is important however that the system is plugged in
and kept charged at all times. Please note that the system must rest for 20 minutes
between weighs.
This function is an Indication ONLY, it must NOT be used for clinical purposes i.e.
calculating the amount of drugs to be administered.
Simply follow the on screen instructions and press the buttons according to what is
displayed on the screen.

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 18/24

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 19/24
5 Cleaning and disinfection
Sodium dichloroisocyanurate (NaDCC) and Sodium hypochlorite (NaOCL) are
recommended by the Public Health Laboratory Service as an effective means of
disinfection. NaDCC and NaOCL are chlorine releasing agents and are the disinfectants of
choice for Nightingale Care Beds Ltd for the disinfection of hard surfaces and laundry
items.
Blood and bodily fluids
High levels of available chlorine (10,000 parts per million) will inactivate most bacteria and
viruses. Nightingale treat blood or body fluid spills with NaDCC solution at 10,000 parts per
million available chlorine.
Routing Decontamination
NaDCC solution at 1000 parts per million available chlorine is recommended by the public
health laboratory for routine decontamination. Nightingale decontaminate all surfaces with
this solution where there is no evidence of blood or body fluids or surfaces have been
cleaned with detergent and water.
The following cleaning procedures should be adhered to, and a suitable cleaning solution
should be used;
To be cleaned every day:
Mattress platform sides
Headboard/footboard
Safety sides
Handset and cable
To be cleaned when patient is transferred from the system:
All of the above
Mattress platform
To be cleaned when infected patient is transferred from the system:
All of the above
Main framework of system
System base and castor axles including castors
To be cleaned every 6-8 weeks:

ProAxis
plus
™ Electric Profiling Bed and Pressure Area Care System
Instruction for use and trouble shooting guide
________________________________________________________________________________
ProAxis Plus Operating Instructions 3.1 Dated 18/05/11 20/24
All of the above
Important: If there is any doubt as to what solution of cleaning agent is required for the various cleaning
procedures, the Infection Control specialist within the hospital should be contacted. If information is still
unavailable, Nightingale beds can supply recommended solutions and data sheets.