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The Effectiveness of Specialised Seating Provision for Patients in Long Term Care

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THE EFFECTIVENESS OF SPECIALISED SEATING PROVISION FOR PATIENTS IN LONG TERM CARE

THE CRITICAL ISSUE Currently, 13 out of 100 patients die from a pressure injury. These painful and sometimes often fatal wounds are avoidable, yet are claiming the lives of those who are in long term care. The average length of stay for a patient who gets a pressure injury in hospital is 6.4 days. While guidance is available on most aspects of pressure injury prevention and management, there has been little discussion of how to specifically address these issues in seated patients. Clinical practice and decision making have generally depended on expert opinion combined with individual practitioner experience and preferences. Current expenditure in the UK is £2-3.1 billion per year.

 

PURPOSE OF STUDY The purpose of this study was to identify the importance of suitable seating provision in: • Reducing pressure injuries • Increasing functional ability • Improving posture • Reducing sliding or falling from chairs Through the provision of individually prescribed seating we aimed to reduce the incidence of pressure injuries for patients in long term care and facilitate increased functioning and quality of life for these patients.

 

METHODS This study was a controlled trial with two arms - control and interevention groups. Mixed methods using both qualitative and quantitative tools were employed. • Participants selected from 3 care facilities • 50% allocated to control group - they remained in existing seating system for 12 week trial period. • 50% allocated to intervention group –individually prescribed seating system from Seating Matters • Outcome measures were completed with all participants at baseline and again on completion of the 12 week trial period.

 

RESULTS There were a number of improvements evident in the intervention group which were not present in the control group. These results suggest that the prescription of individually tailored seating systems can: • Reduce the risk of pressure injuries by up to 88.3% • Increase saturated oxygen levels by 95% • Reduce the number of times patients need repositioned • Reduce the use high cost cushions by 93% • Reduce need for lap belts and pain medications • Improve quality of life Subsequently, patients experienced less health related problems and they were able to initiate and/or participate in more social activities. Further caregiver burden of moving and handling was greatly reduced which results in important time and cost savings which can be redirected into other aspects of caregiving for these patients. The needs of each patient are different and individualised evaluation and prescription of the most suitable seating system is warranted by appropriately trained occupational therapists.

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