This module provides information and strategies to manage pressure injuries within the context of a seating and wheeled mobility system prescribed for clients with a spinal cord injury (SCI).
A high percentage of clients with SCI experience skin breakdown. A priority goal of seating is to prevent the development of sitting acquired pressure injuries which frequently result in hospitalisation.
In a study of 253 people with SCI over a ten year period, pressure sores accounted for 6.6% of total readmissions, and 27.9% of re-hospitalisation bed days1.
Apart from the cost to health care, pressure injuries have significant negative impact on the client’s physical, psychosocial and financial status. During the conservative or surgical management phase, a client’s ability to conduct work and self-care activities is reduced while the level of isolation and dependency may increase. Furthermore, extensive periods of bed rest can result in a reduction of cardiac respiratory fitness, physical deconditioning, development of postural asymmetry and contractures.
At the conclusion of this module, you will be able to:
- Understand the terminology related to pressure and support surfaces
- Identify pressure related issues in seating and wheeled mobility
- Set seating goals to manage pressure
- List the key seating principles to address pressure issues, and
- Apply strategies to manage pressure in seating and wheeled mobility systems.
In this module
- Terms and definitions
- The importance of pressure management for SCI clients
- What to do if the client has pressure injury located on a seating surface
- Keep the big picture in mind
- Be systematic: Identifying pressure issues in seating
- Setting pressure management goals in the client’s context
- Recognizing key relationships between the client and wheelchair
- Four key considerations
- Keys to pressure management
- Skeletal anatomy and seating pressure risks
- Pressure management equipment: Pressure care cushions
- Pressure management equipment: Configuration of seating and wheelchair
- Weight-shift strategies
- Formulate trials
- Work as a team
- Key concepts in this module
- Case Study: Katherine
- Case study questions
- Case study answers
- Middleton J, Lim K, Taylor L, Soden R, Rutkowski S. Patterns of mordbidity and rehospitalisation following spinal cord injury. Spinal Cord [Internet]. June 2004 [cited October 2015]; 42(6):359-67. Available from https://www.researchgate.net/publication/7936357_Patterns_of_morbidity_and_rehospitalisation_following_spinal_cord_injury DOI: 10.1038/sj.sc.3101601