Neil

An interesting situation which raises a number of questions.

The first is why is anyone using an engineer to install a community alarm
and pendant? These devices are designed to be user installable and anyone
with a little bit of training or an instruction sheet can install a
community alarm unit and the associated pendant(s). This point is underlined
by the fact that there are companies in this country and elsewhere whose
entire business model is based on what the trade calls "postal
installations". However, there are a number of reputable public sector
alarms services operating within the Glasgow area and you may wish to
consider using one of these as their installation costs (using trained and
experienced staff) are likely to be lower than those associated with
engineer installation.

The second issue is more relevant to this discussion group. I understand
that you see the engineer as being a bit of a jobs worth in insisting that
the pendant is designed to be worn on the wrist. However, this may simply be
a matter of poor communications skills and he is stating the manufacturer's
design intentions and the resulting ergonomics of the product. A number of
manufacturer's have designed their pendants, or the assemblies used for
wrist mounting, to have a particular curvature and to have straps that are a
particular length and to utilise a particular buckle design and size. In
making these decisions, the designers have given consideration to the size
and shape of the average adult human wrist. You are proposing to take a
product that is possibly optimised to fit an adult wrist and place it on an
ankle. If you give some consideration to this, you will note that the
average adult ankle is larger than the wrist and has a distinctly different
shape, including the existence of flat bone surfaces. It is possible that
fitting a pendant around someone's ankle may be extremely uncomfortable and
may even result in bruising and sores. It could be that the engineer's
refusal to install a pendant designed to be wrist worn on an ankle is an
expression of concern for the intended user and also seeking to protect his
employer from complaints and a potential law action for personal damages.
(If you have any doubts about this, why don't you put your wrist watch or
the pendant on your ankle for a day and see how it feels?)

Of course, if you wish to affix a pendant to an ankle because it is the best
place for an individual to wear it and be able to operate it, then you
should do so. The issue is simply how you will attach the pendant and ensure
that it does not cause injury to the individual. That is a matter of
ergonomic design and, given that it is a low volume requirement, you should
expect to address this requirement through a one-off retaining solution
which takes account of the individual's ankle size, shape and level of
mobility. The key issues for me would be the size of the ankle band, its
softness and flexibility and the padding that may be required around the
pendant to prevent pressure points developing. This sounds like a project
for the clinical engineering service.

I hope that this response illuminates some of the issues that the risk
assessment should consider and points a way to an acceptable solution.

 
John Hennock
Director, HPS Consulting Ltd - Management and technical consultants
Specialists in the application of technology to housing and care
Tel  +44 (0)121 314 8066    (DD +44 (0)1427 677545)
Fax +44 (0)870 762 7696
Web: www.hpsconsulting.com
 

-----Original Message-----
From: A discussion list for Assistive Technology professionals.
[mailto:[log in to unmask]] On Behalf Of Gregory, Neil
Sent: 10 October 2008 13:34
To: [log in to unmask]
Subject: Ankle worn community alarm button

Dear All,

I've had an OT on the phone this morning saying that a certain community
alarm company will not install a pendant on someone's ankle. This patient
uses his feet for a variety of tasks including to a Touch Talker. The
engineer has said that the intended use of the equipment is wrist worn only.

This strikes me as someone reading only the stated use of the item and not
adapting to specific patient needs. I can't see a problem of having this on
an ankle. Even a simple risk assessment surely show the benefits of the
system compared to not having it at all.

Has anyone had this situation and also found a simple solution without going
to a full Environmental Control System?

Many thanks,

Neil Gregory
Bio-Engineer
WeSTMARC - West of Scotland Mobility and Rehabilitation Centre Southern
General Hospital, Glasgow
Email: [log in to unmask]

Web: www.nhsggc.org.uk/westmarc


Tel - 0844 8113001 (Lo-Call)

Fax - 0141-201 2649
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