Bedside cabinets, overbed tables, IV stands, medicine and emergency trolleys and steel storage. Which items earn their place at the bedside, which get pushed into a corner, and which finishes survive chlorine cleaning in a humid climate.
Ward furniture is the last thing bought and the first thing to look shabby. Two years after a fit-out you can usually tell which items were specified by someone who had worked a night shift. The overbed tables are in use, the bedside cabinets still lock and still shut, and the medicine trolley is at the nursing station rather than abandoned in a side room with a jammed drawer. The items that fail are rarely the cheapest ones on the list. They are the ones specified without reference to how the ward actually works.
A patient in a Bangladeshi ward normally arrives with an attendant, a bag, food, a water flask, medicines and a folder of documents. If the cabinet does not hold those things, they end up on the floor and under the bed, which is a cleaning problem and an infection control problem before it is a tidiness problem.
An overbed table is used by a patient who is sitting up in bed, often one handed, often weak. If height adjustment needs two hands and a knob, the table stays at whatever height the last person set and becomes a shelf. Gas spring adjustment on a single lever is the feature that makes the item work as intended, and it is worth refusing a substitution on.
The rest is unglamorous and easy to check. The base has to be low and narrow enough to pass under the bed frame, including under the castors and the lifting column, which on a modern electric bed is a real constraint. The top has to be large enough for a meal tray. The castors have to lock. Check the base against the bed you are actually buying, not against a generic bed, because an overbed table that will not go under the bed is a table on the far side of the room.
IV stands get pushed, leant on, hung with too many bags, wheeled over thresholds and used as walking aids by patients who should not be walking. They fail in three ways, and each has a specification answer.
| Failure | Cause | What to specify |
|---|---|---|
| It tips over | Base too small or too light, bags hung high, patient leaning on it while walking | Five leg base with a wide footprint and mass low down. Test stability with the pole at full extension and bags hung |
| The height lock slips | Plastic collar, or a thumbscrew that has worn its thread | Metal collar clamp with a positive lock. Check it still holds under load after repeated adjustment, not once in a showroom |
| Corrosion at the base | Chlorine mopping and standing water, often around a mild steel fastener in a stainless base | Stainless steel throughout including the fasteners, and a base shape that does not trap water |
Height range matters more than it sounds. A stand adjusting from around 1500 to 2500 mm lets gravity infusion run properly at the top of the range and lets the stand travel with a patient without the bag dropping below the cannula. Anti sway hooks stop bags swinging into walls and door frames when the stand is pushed, which is the usual cause of a cracked hook.
These two are frequently merged into one tender line, and they should not be. They are used at different frequencies, by different people, under different pressure.
A drug round trolley is used standing, several times a shift, moving between beds. What decides whether it works: enough drawers with adjustable dividers so stock is organised by the ward's own system rather than the manufacturer's; a central lock so the whole trolley secures with one key rather than six; an integrated sharps container so a used needle is disposed of at the point of use instead of being carried back; a foot operated waste bin; and a work surface at a height where a nurse can read a chart and draw up without stooping. Handrails at both ends, because it is pushed in both directions.
A crash cart is opened once a month and has to be right every time. Lockable drawers with a tamper evident seal, so anyone walking past can see whether it has been opened since the last check. A defibrillator platform on top. An oxygen cylinder holder that fits the cylinder your hospital actually uses rather than the one in the catalogue photograph. An IV pole and a CPR board carried on the trolley, not kept somewhere else. The property that matters most is that the layout is identical on every trolley in the hospital, because during an arrest nobody has time to work out which drawer this particular trolley keeps the adrenaline in.
Storage cabinets are the part of a fit-out most likely to be cut for budget and then improvised with whatever furniture is to hand, which is how wards end up storing sterile stock in a wooden almirah.
This is where a Bangladeshi ward parts company with the catalogue photograph, and it is worth being explicit in the tender rather than trusting that the supplier has thought about it.
| Finish | How it behaves in a ward here | Use it for |
|---|---|---|
| Stainless steel | Best resistance to chlorine and moisture, costs the most, and grade matters because a low grade will still show tea coloured staining | Wet areas, IV stands, basins, trolley frames near sluices |
| Powder coated steel | Good while the coating is unbroken. A chip at an edge becomes a rust spot, then a rust line | Cabinets, bed frames, general ward furniture |
| ABS and moulded plastic | Wipeable, no edges to fail, does not corrode. Can crack under impact and discolour with repeated strong chlorine | Bedside cabinets, bed heads and foot boards, panels |
| Chrome plated mild steel | Looks like stainless in a photograph and pits within a season anywhere it stays damp | Avoid in wards, sluices and labour rooms |
| Melamine faced board | Swells irreversibly once water reaches the core through a cut edge or a screw hole | Avoid anywhere that is wet cleaned, which in a ward means everywhere |
Two further questions are always worth asking and rarely are. First, are the cut edges of the coating covered, or is there bare metal under a shelf lip and inside the drawer runners where nobody looks until it stains. Second, are the fasteners the same metal as the item, because a mild steel screw in a stainless panel will rust and bleed a stain down the panel around it within a year.
Ward furniture bought as separate lowest bid lines produces a predictable ward: the overbed table will not go under the bed, the bedside cabinet is a different height from the bed platform, the IV stand does not fit the socket on the bed, and nothing matches when replacements are bought two years later. Bought as a fit-out from one supply, the dimensions are checked against each other once, the finish is consistent across the ward, and the spares come from one place with one phone number.
Whichever route you take, do three things before the order goes out. Check the overbed table base against the actual bed frame. Check that the IV stand fits the bed's pole socket if the bed has one. And order castors, drawer runners, locks and mattress covers as spares in the same purchase, because these are the parts that fail first and the ones that take longest to obtain separately once the project is closed.