Head of Bed (HOB) Elevation Observation Tool Date: ______Observer Name: ______

1. Take protractor(s) with you – adult beds are the only ones with an inclinometer. 2. Guide for degrees of elevation:  Neonates (≤ 28 days) 15° Head of Bed (HOB) Elevation Observation Tool  All children (> 28 days)/ adults 30-45° 3. Measure at the bed frame angle that is visible under the mattress. Date: ______Observer Name: ______4. Record observation below & repeat for all mechanically ventilated PICU patients. 1. Take protractor(s) with you – adult beds are the only ones with an 5. If patient HOB is not elevated, confirm that there is no inclinometer. contraindication, such as spinal precautions. HOBs not elevated 2. Guide for degrees of elevation: due to contraindications are compliant.  Neonates (≤ 28 days) 15° 6. Review results of the audit with bedside RN.  All children (> 28 days)/ adults 30-45° 3. Measure at the bed frame angle that is visible under the mattress. For hand crank cribs, please make sure a protractor is in the room 4. Record observation below & repeat for all mechanically ventilated for the nurse. PICU patients. For click cribs, please make sure a pink click sign is present at the 5. If patient HOB is not elevated, confirm that there is no end of the bed for reference – 3 clicks is the correct height for 30- contraindication, such as spinal precautions. HOBs not elevated 45°. due to contraindications are compliant. Replacements are available at the PICU bulletin board. 6. Review results of the audit with bedside RN.

Use hash marks to tally the HOB elevation compliance for all For hand crank cribs, please make sure a protractor is in the room mechanically ventilated patients in the PICU. for the nurse. For click cribs, please make sure a pink click sign is present at the end of the bed for reference – 3 clicks is the correct height for 30- Practice Yes No 45°. Replacements are available at the PICU bulletin board. Proper HOB elevation? Use hash marks to tally the HOB elevation compliance for all mechanically ventilated patients in the PICU. Totals

Practice Yes No

Compliance = Proper HOB elevation? # of properly elevated HOBs X 100% Totals # of properly elevated HOBs + # of improperly elevated HOBs

Please use this tool to complete the HOB elevation compliance chart Compliance = on the PICU bulletin board. Thank you for being a part of this important effort! # of properly elevated HOBs X 100% # of properly elevated HOBs + # of improperly elevated HOBs Please use this tool to complete the HOB elevation compliance chart on the PICU bulletin board. Thank you for being a part of this important effort!