ARJOHUNTLEIGH CARMINA & CARMINA BASIC Instructions for Use Jan 2012

© ARJO Hospital Equipment AB 2008 ARJO products are patented or patent pending. Patent information is available by contacting ARJO Hospital Equipment AB. Our policy is one of continous development, and we therefore reserve the right to make technical alterations without notice. The content of this publication may not be copied either whole or in part without the consent of ARJO Hospital Equipment AB.

Contents Foreword ...4 Safety Instructions ...5 Part designations ...6 Product description/function ...8 Push bar ...8 Commode container and holder (optional) ...8 Adjustable backrest ...8 Tiltable seat ...8 Push poles (optional) ...8 Arm rests ...10 Foot rest (optional) ...10 Castors ...10 Storage and product transportation ...10 Entering the chair ...12 Independent residents ...12 Independent residents (Carmina basic version) ...12 Dependent residents ...14 Dependent residents (Carmina basic version) ...16 Transport of resident ...18 Showering ...20 To the toilet ...22 Toiletting over a conventional toilet ...22 Toiletting by the bed side using a commode container (optional) 22 Cleaning instructions ...24 Care and Preventive Maintenance ...25 Trouble shooting ...26 Technical specifications ...28 Labels ...29 Accessories ...30

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Foreword Thank you for purchasing ARJO equipment. Your Carmina shower and commode chair for bariatrics is part of a series of quality products designed especially for hospitals, nursing homes and other health care use. We are dedicated to serving your needs and providing the best products available along with training that will bring your staff maximum benefit from every ARJO product. Please contact us if you have any questions about the operation or maintenance of your ARJO equipment.

Definitions in this manual: WARNING

Means: Safety warning. Failure to understand and obey this warning may result in injury to you or to others.

Please read this manual thoroughly! Please read this manual in its entirety before using your Carmina shower and commode chair for bariatrics. Information in the manual is crucial to the proper operation and maintenance of the equipment, and will help protect your product and ensure that equipment performs to your satisfaction. Some of the information in this manual is important for your safety and must be read and understood to help prevent possible injury. ARJO strongly advise and warn that only ARJO designed parts, which are designed for the purpose, should be used on equipment and other appliances supplied by ARJO, to avoid injuries attributable to the use of inadequate parts. Unauthorized modifications on any ARJO equipment may affect its safety. ARJO will not be held responsible for any accidents, incidents or lack of performance that occur as a result of any unauthorized modification to its products.

CAUTION

Means: Failure to follow these instructions may cause damage to all or parts of the system.

NOTE

Means: This is important information for the correct use of this system or equipment.

Service and Support Service must be performed regularly on your Carmina by ARJO authorized service personnel to ensure the safety and daily operation of your product. See chapter Care and Preventive Maintenance. If you require further information, please contact your local ARJO representative who can offer comprehensive support and service program to maximize the long-term safety, reliability and value of the product. Contact your local ARJO representative for replacement parts. Your service representative stocks the parts you will need.

Means: The name and address of the manufacturer

The directions right, left, front and rear in this manual are given as below rear

The telephone number appears on the last page of this manual. right left front

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Safety Instructions The equipment must be used in accordance with these safety instructions. Anyone using the equipment must also have read and understood the instructions in this manual. If there is anything you are not sure about, contact your ARJO representative.

Intended use Carmina The Carmina shower and commode chair is intended for hygiene care of hospital or nursing home adult bariatric residents. It shall be used during showering and toileting and to MOVE RESIDENTS to and from shower and toileting. Residents shall be supervised by trained nursing staff and use shall be in accordance with the instructions outlined in the Operating and Product Care Instructions. All other uses must be avoided.

Intended use Carmina basic The Carmina shower and commode chair is intended for hygiene care of hospital or nursing home adult bariatric residents. It is designed for STATIONARY USE only during showering and toileting of residents. Residents shall be supervised by trained nursing staff and use shall be in accordance with the instructions outlined in the Operating and Product Care Instructions. All other uses must be avoided.

To avoid the possibility of injury always ensure that: • • • •

• •

•

• •

Resident assessment

the castors and brakes work freely. the castors of the bed or other device are locked when transferring a resident to/from the Carmina. if there is a drain cover in the area where the chair is maneuvered, the drain cover must be smooth and set level with the floor. the slope of the floor does not exceed the ratio 1:50. transportation of residents is carried out only on hard floors.

WARNING

We recommend that facilities establish regular assessment routines. Caregivers should assess each resident according to the following criteria prior to use: The resident needs to be able to sit in an upright position, normally defined as active or semiactive. • The resident’s weight shall not exceed 320kg / 705 lbs. • The resident shall understand and respond to instructions. • The resident's length must be in the range of 148 and 190 cm (58 1/4” - 74 3/4”). If a resident does not meet these criteria, Carmina must not be used.

the equipment is used by appropriately trained staff. the resident's hands are resting in the lap during transportation. the Carmina is moved with care, especially in narrow passages and over un-even surfaces. the directions of driving during transportation is according to the illustration below.

Transport of residents is not allowed in Carmina basic because moving a chair without foot rest can cause that resident's feet may be pinched or wheels to roll over resident's feet and cause injury.

•

WARNING Do not overload the Carmina. If you do, the chair may break and the resident may be seriously injured. To safely lower a resident using a passive lift together with the Carmina the units must be placed according to the illustrations (top view) below. Front transfer Side transfer ex. Tenor

The expected lifetime of this equipment is ten (10) years, subject to preventative maintenance in accordance with the instructions for care and preventive maintenance.

100 mm(4”)

ex. Maxi Move

NOTE

100 mm (4”)

Modifications made to the equipment without expressed consent of ARJO will invalidate the supplier's product liability.

0 50 mm(2”) 0 50 mm (2”)

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Part designations 1

Push bar

2

Commode container with holder (optional)

3

Adjustable back rest

4

Tiltable seat

5

Push poles* 5a. Locking/release mechanism for push poles

6

Arm rests

7

Foot rest* 7a. Safety release mechanism for lowering of foot rest 7b. Pedals for foot rest manoeuvring

8

Castors

9

Anti-swiveling guide (only on Carmina basic version)

10 Strap to secure the foot rest during storage/transport of the chair*

* Parts of the product NOT included in the Carmina basic version.

6

Carmina 6

Carmina basic 1

3

7a 5 4 5a 7b

8

7

9

10

2

7

Product description/function Push bar

Tiltable seat

In order to get the correct position for the carer to push (manoeuvre) the chair. A full-length push bar is integrated (located) at the rear of the chair with enough room for multiple gripping positions from more than one caregiver. Illustration 1 and 2.

The seat has a comfortable design and can be folded up for cleaning/disinfection and access to the commode container. To fold up, grip the seat and pull up.The seat can then be kept in position by placing it in the support grooves. Illustration 6.

WARNING Do not put seat on frame without making sure it is properly placed on the frame. Resident may fall if seat is not properly placed.

Commode container with holder (optional) The container can be applied by raising the seat upwards and lowering the commode container into position. Alternatively, it can also be placed in position from the back under the seat. Illustration 3 and 4.

WARNING To ensure that the genitals of the resident not get pinched between the seat and container, ensure that: • the container is correctly placed (i.e. fully pushed in to the holder). • the resident sits centered over the opening in the seat. The holder is articulated to move freely over the toilet.

NOTE Place the commode container with the sockets of the handle vertical to the seat. Illustration 4

Push poles (optional) When placed at the front of the chair, the push poles enable easier maneuvering for nursing staff, especially through doorways and to/from toilet. In this position they can also be used by the resident for support when sitting down/standing up. The push poles can be swung away when not in use, ensuring complete access to the resident for general nursing procedures. The push poles can also be placed in the back position for easier side transfers.

Procedure for locking of the poles: a

Remove the pin. Illustration 7a.

b

Swing the push pole into its front position. Illustration 7a.

c

Put the pin in the hole until it is fully inserted Illustration 7b.

WARNING Never use push poles in front position without locking them. If not locked, they can move away unexpectedly when used for support and cause resident to fall.

Adjustable back rest Adjustable into four different positions to provide additional support for different size residents. Place in a suitable position before placing the resident. The larger the resident, the further back the back rest should be placed.The angle of the back rest adjusts itself for the resident. Illustration 5.

.

WARNING Avoid having the resident's hands anywhere else but on the arm rest when swiveling the push poles. If hands get between the frame and moving parts they may be pinched and injured.

WARNING Do not let the resident use the back rest for support during transfer to/from the chair. The back rest is movable and the resident may fall if using the back rest as a support.

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1

2

3

4

5a

5b

5c

6

7a

9

7b

Arm rests Provide support to the resident’s arms when sitting in the chair. Can be folded up to allow caregiver access for hygiene or for easier resident side transfers.

WARNING Never pull the arm rests. If the resident do so, the plastic cover can snap off and the resident may fall.

Anti-swiveling guides (only on Carmina basic version) Illustration 3a - apply guides , 3b - release guides. When smaller corrections have to be done in positioning of the chair, apply the guides to eliminate the risk of getting the resident’s feet jammed between the castor and the frame Apply the guides before the resident is in the chair.

WARNING Never move the chair with resident in it without applying the anti-swiveling guides. Moving the chair without guides engaged can cause wheels to roll over resident's feet and cause injury.

Removing and assembling of the plastic covers should only be done during cleaning and never when the resident is in the chair. Illustration 1.

Foot rest (optional) When flat to the floor: •

Possible for the resident to stand on when entering/exiting the chair. • Acts as a brake when resting on the floor. An elevated foot rest position provides a comfortable sitting position, lift access, and enables safe transportation to shower room/toilet.

Castors Carmina is equipped with four individual braked castors. Illustration 4a - apply brakes, 4b - release brakes.

Elevating the foot rest:

Storage and product transportation

•

(not Carmina basic version).

Press the pedal towards the floor. Illustration 2a The foot rest will lock into position.

To lower the foot rest : a

b

Press the pedal all the way to the floor. With the pedal in this position, pull the knob of the safety release mechanism (illustration 2b), which will release the locked position of the foot rest. Gently bring the pedal up to the starting position.

WARNING Never lower the foot rest with anyone's feet under it. Feet may be pinched between foot rest and floor.

In order to provide easier access through doorways when the resident is not in the chair, the foot rest can be folded away . a

Apply the castor brakes. Illustration 4a

b

Elevate the foot rest. Illustration 4c.

c

Lift the foot rest all the way up. Illustration 4d.

d

Fasten the safety strap. Illustration 4e.

e

Attach both pedals to the plastic hooks. Illustration 4f.

WARNING Never use the foot rest as a step when it is in the elevated position. If doing so, the chair and resident will fall over and seriously injure him/herself.

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1

3a

3b

2a

2b

4a

4b

4c

4d

4e

4f e

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Entering the chair User category: Independent residents:

Dependent residents:

• •

• •

mobile resident, walking pivot transfer, from bed/wheelchair

Independent residents

With mobile lifter (i.e. Tenor, MaxiMove) With ceiling lift

From a standing position:

Independent residents (Carmina basic)

a

Ensure that the foot rest is flush to the floor

From a standing position:

b

Apply brakes. Illustration 1.

a

Apply brakes and the anti-swiveling guides.

c

Ensure push poles are swung out and locked into the front position.

b

Ensure arm rests are in down position for support when seated.

d

Ensure that the arm rests are in down position for support when seated.

c

Let resident sit down and position him/herself comfortably.

e

Let the resident hold onto the push poles for support. Illustration 2.

f

Let resident sit down and position. Illustration 4.

WARNING Never use the foot rest as a step when it is in the elevated position. If doing so, the chair and resident will fall over and seriously injure him/herself. g

Raise the foot rest to the elevated position to enable transportation of the resident

h

Transport the resident to the shower or toilet. Illustration 6.

Side transfer from wheelchair/bed: For the resident to be able to move from a wheelchair/bed without lifting aids, the individual must be strong enough to move him/herself sideways and/or be able to stand up.

Pivot transfer: a

Lock the push pole (the one which is furthest away from the resident) into the front position. Illustration 3.

b

Raise the arm rests and swing back the push pole, located closest to the resident (if applicable) .

c

Apply the castor brakes. Illustration 1.

d

Ensure that the resident’s feet are on the floor or on the lowered foot rest. Illustration 4.

e

Stand the resident up.

f

Pivot and let the resident sit down with help of the push poles. Illustration 5.

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Dependent residents From the bed to Carmina using a ceiling lift. Illustration 1: Follow the separate operating instructions for the ceiling lift.

From a passive lift to Carmina (side transfer) Illustration 3: Follow the separate operating instructions regarding the passive lift (Maxi Move). a

Prepare the chair by lifting up the foot rest using the pedal.

Ensure that the push poles are placed to the back position (away from the resident area).

b

b

Place Carmina under the ceiling lift with the resident in the sling.

Ensure that the arm rests are in the raised position.

c

c

Apply the castor brakes.

Place the lift with the resident as close as possible to Carmina.

d

Lower the sling with the resident until he/she reaches the seat of the chair.

d

Raise the foot rest to the up position to enable the legs of the lift to go underneath. The legs should be in their most open position.

e

Unhook the sling.

e

f

Transfer the resident to the shower or toilet.

Move the chair over the legs of the lift, without moving the lift, through the side of the chair. Make sure the resident is directly over the seat of Carmina.

f

Apply the castor brakes.

g

Lower the lift until the resident is fully supported by the seat of the chair.

h

Unhook the sling.

i

Remove the passive lift.

k

Lower arm rests. Ensure that the resident can stabilize him/herself.

l

Place push poles to front position and ensure they are locked.

a

From a passive lift to Carmina (front transfer). Illustration 2: Follow the separate operating instructions regarding the passive lift (Tenor). a

Ensure that the push poles are placed in the back position (away from the resident area).

b

Ensure that the arm rests are in the raised position.

c

Raise the foot rest to the up position to enable the legs of the lift to go underneath. The legs should be in their most closed position.

d

Place the lift with the resident as close as possible to Carmina.

e

Move the chair, not the lift, when inserting the legs of the lift through the front of the chair under the foot rest. Make sure the resident is directly over the seat of Carmina.

f

Apply the brakes on Carmina.

g

Lower the lift until the resident reaches the seat.

h

Unhook the sling.

i

Remove the passive lift.

k

Lower arm rests. Ensure that the resident can stabilize him/herself.

l

Place push poles in the front position and ensure they are locked.

m Transport the resident to the shower or toilet.

m Transport the resident to the shower or toilet.

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Dependent residents (Carmina basic version) From the bed to Carmina using a ceiling lift: Follow the separate operating instructions regarding the ceiling lift.

Illustration 1. a

Place Carmina under the ceiling lift with the resident in the sling.

b

Apply castor brakes and the anti-swiveling guides.

c

Lower the sling with the resident until the resident is fully supported by the seat of the chair.

d

Unhook the sling.

From a passive lift to Carmina (front transfer): Follow the separate operating instructions regarding the actual lift (Tenor).

Illustration 2. a

Ensure that the arm rests are in the raised position.

b

Move the chair, not the lift, when inserting the legs of the lift through the front of the chair. Make sure the resident is direclty over the seat of Carmina.

c

Apply castor brakes and the anti-swiveling guides on Carmina.

d

Lower the lift until the resident is fully supported by the seat.

e

Unhook the sling.

f

Remove the passive lift.

g

Lower arm rests. Ensure that the resident can stabilize him/herself.

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Transport of resident

WARNING Transport of residents is not allowed in Carmina basic because moving a chair without foot rest can cause that resident's feet may be pinched or wheels to roll over resident's feet and cause injury.

The Carmina is pushed from the rear by multiple nursing staff members, using the full width push bar and with the residents feet on the raised foot rest.

WARNING Never leave the resident unattended. There is a risk of injury if the resident wants to leave the chair using the foot rest as a step as it is in elevated position.

WARNING When transporting the resident in Carmina, the resident's hands shall be resting in the lap. This is to avoid the resident's hands to get pinched against doorposts.

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Showering 1

Place the Carmina with the resident in the shower room.

2

Apply the castor brakes.

3

Place the push poles to the back position, away from the resident area (if applicable).

4

Raise the arm rests away from resident interface.

5

Undress the resident.

6

Lower arm rest for improved comfort and stability for the resident.

7

Wash and shower the resident in this position.

8

Dry and dress the resident.

WARNING If the assessment of the resident permits independent showering, ensure that the foot rest (if applicable) is lowered to the floor before the resident is left alone.

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To the toilet

WARNING Never leave the resident unattended with an elevated foot rest. If doing so the resident may use the foot rest as a step when he/she wants to leave the chair and the chair and resident will fall over and seriously injure him/ herself.

Toiletting over a conventional toilet a

Place Carmina with the resident close to the toilet.

b

Position Carmina directly over the toilet bowl using the push poles (if applicable) for leverage of small movements. Illustration 1.

WARNING Never position the resident over the toilet without first making sure the genitals of the resident will not get pinched between chair and toilet bowl. c

Apply castor brakes.

d

When the resident is ready, release the brakes and remove the chair from the toilet.

e

Apply the castor brakes again.

f

Clean and dry the resident.

g

Release the brakes.

h

Ready for transportation (if applicable).

Toileting by the bed side using a commode container (optional) 1

Lift the seat of the chair up and insert the commode container fully in the holder. Illustration 3a. Lower the seat back down.

2

Undress the lower part of the resident.

3

Position the resident as far back as possible on the seat.

Alternative: It is possible to insert the commode container when the resident already is sitting in the chair. Illustation 3b

WARNING Never insert the commode container in the holder from behind before ensuring that all parts of the resident's body are cleared. If doing so the resident genitals and skin may get pinched between the container and the holder.

WARNING Place the commode container with the sockets of the handle vertical to the seat. Illustration3c. By doing so you avoid the handle from getting caught around the holder and that the container gets hard to get out of the holder.

Carmina/Carmina basic: • can be used regardless of whether the toilet is attached to the wall or to the floor. • can be used as a seat extension for standard toilets that do not have the size or the weight capacity to support the bariatric resident.

NOTE Preferably remove the seat of the toilet before placing the Carmina over the bowl to get better matching. A toilet with an oblong long seat is recommended. See the measurements on matching toilet chairs. Illustration 2.

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Cleaning instructions For the best results, only use ARJO branded disinfectant cleansers. If you have any questions regarding disinfecting the equipment, or wish to order cleaning fluid, contact ARJO Customer Service. The following procedure should be carried out after every use and at the end of the day.

WARNING Always use protective gloves and protective glasses when handling concentrated cleaning agents. Avoid getting the cleaning agent on your skin or in your eyes. If this does occur, rinse thoroughly with plenty of water. Seek medical advice if irritation occurs. Always consult the material safety data sheet for the disinfectant cleanser. .

CAUTION Do not use phenol, citric acid or petroleumbased solvents, trichloroethylene or similar cleaning agents, as these may damage the plastic material. If a warm air drier is used, the temperature should not exceed 80 °C (176 °F). Steam or ethylene oxide sterilization can not be used because they may damage the product.. a

Use properly labeled spray bottle containing disinfection fluid mixed according to instructions on the container. Using the cleaning spray handle, spray cleaning fluid over the chair.

b

Scrub all parts of the chair. Use a nylon bristled brush, rag or disposable cloth. To get full access to all parts, fold up the foot rest to storage position, fold up the seat and loosen the plastic covers of the arm rests. Make sure you wash and disinfect all undersides of the chair and parts.

c

Allow an appropriate contact time for sanitization or disinfection according to the instructions for the disinfectant cleaner.

d

Rinse thoroughly with water.

e

Dry each part of Carmina with a clean cloth.

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Care and Preventive Maintenance The Carmina is subject to wear and tear, and the following actions must be performed when specified to ensure that the product remains within its original manufacturing specification.

WARNING The points on this checklist are the minimum the manufacturer recommends. In some cases due to heavy use of the product and exposure to aggressive enviroment, more frequent inspections should be carried out. Continuing to use this product without conducting regular inspections, or continuing to use this product when a fault is found will seriously compromise the user and resident’s safety. Local regulations and standards may be higher than the manufacturer’s. Preventive maintenance specified in this manual can prevent accidents. PREVENTIVE MAINTENANCE SCHEDULE- Carmina Every DAY

CAREGIVER OBLIGATIONS Action/Check

Every WEEK

Every YEAR

Every 2:nd YEAR

X

Cleaning/Disinfection Visually check all exposed parts

X

Check of mechanical attachments

X

Check and clean castors

X

Visually check the foot rest release mechanism

X

WARNING The following actions must be carried out by qualified personnel, using correct tools and knowledge of procedures. Failure to meet these requirements could result in personal injuries and/or unsafe product. QUALIFIED PERSONNEL Action/Check Check that the latest upgrades have been implemented

X

Check all vital parts for corrosion/damage

X

Check mechanical attachments

X

Perform a safe working load test (local requirements)

X

Perform full feature functionality test

X

Replace the rubber straps

X

Replace the cord for foot rest mechanism

X

Replace castors*

X*

* NOTE! Castors may require more or less frequent service/replacement, due to heavy use of the product and exposure to aggressive environment, but castors shall be replaced at least every third year regardless of wear and tear.

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Caregivers obligations shall be carried out by personnel with sufficient knowledge following the instructions in this manual.

Trouble shooting If the product does not work as intended, immediately contact your local ARJO representative for support.

Every day Carmina has to be cleaned immediately after usage. ARJO cleaning agents should be used in recommended concentrations. See further disinfecting/cleaning instructions on page 24.

Every week •

•

•

•

Visually check all exposed parts, especially where personal contact is made by either the resident or caregiver. Make sure no cracks or sharp edges have developed that could cause the resident or caregiver injury, or that have become unhygienic. Replace damaged parts (1). Check the mechanical attachments e.g bolts/screws, sockets for the holder of commode container, attachments of back rest, seat frame, pedals, foot rest and push poles. Check the hinge of the arm rests and that the locking pins of the push poles works freely. Check rubber straps for seat and foot rest (2). Only on Carmina basic: Check the attachments of the anti-swiveling device (2). Check that the castors are properly fixed and are rolling and swiveling freely. Clean with water (the function can be affected by soap, hair, dust and chemicals from floor cleaning). Check the brakes (3). Check the foot rest release mechanism - knob, cord and locking blocks (4).

Yearly Carmina must be serviced according to the Preventive Maintenance Schedule (ARJO Qualified Personnel action/ check).

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