When pressure injury prevention fails as a result of non-adherence, various comorbidities, or gaps in care, it makes a major impact on the nation’s economy and has estimated costs of more than $100 billion in the United States.
By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC
It's November, and most people are thinking about turkey, stuffing, pumpkin spice, and the fall colors. But I think of Worldwide Pressure Ulcer Prevention and Awareness Day (November 19, 2015), National Caregivers Month, and how I can help. I have shared a holding sign video and personal photos on social media to share my story in hopes of educating others. My passion for wound care is driven by my mother dying in my arms at the young age of 47, due to complications of diabetes and stage IV pressure ulcers.
Beyond a "Bedsore": Wheelchair Cushions for Prevention of Pressure Ulcers
Family caregivers that are not in the health care profession use verbiage such as "bedsore" or "sores." A "bedsore" by definition owes its name to the observation of the patient who develops such a wound being bedridden and not properly repositioned. So naturally people automatically assume that pressure ulcers are solely due to lying in a bed. It makes me think of that non-compliant patient sitting in their wheelchair 14 hours a day who says, "I don't want to be in the bed, I will get a bedsore."
Another scenario I often see is family members carrying in a piece of bright blue egg crate foam, the inflatable invalid doughnut/hemorrhoid ring, or multicolored quilted pillow for use as their loved one's wheelchair cushion. I smile, take a deep breath and use these situations as educational opportunities. These family members are lacking the caregiver education piece. Educate these family caregivers about appropriate pressure redistribution or they will never understand the importance of pressure ulcer prevention. Use the "6 Key Question" approach every time: Who, What, Why, When, Where, and How?
Many researchers and clinicians who have studied pressure redistribution cushions have developed a common conclusion: No one cushion is best for all people. Routine durable medical equipment supplies are expected to be available and supplied by skilled nursing facilities, and long-term care facilities. We can take a more proactive approach to pressure ulcer prevention by making sure EVERY patient or resident in a wheelchair has the appropriate cushion for their needs. Pressure ulcer risk assessment tools are there for us to utilize, but I view EVERY patient or resident as being at risk for a pressure ulcer.
A Comparison of Pressure Redistribution Cushion Materials
"Prevention is better than cure." ~Desiderius Erasmus
Brienza D, Kelsey S, Karg P, et al. A Randomized Clinical Trial on Preventing Pressure Ulcers with Wheelchair Seat Cushions. J Am Geriatr Soc. 2010;58(12):2308-14.
2014 Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Available at: http://www.npuap.org/resources/educational-and-clinical-resources/preven...
Medicare.gov Supplier Directory - Common Supply Products
About the Author
Cheryl Carver is an independent wound educator and consultant. Carver's experience includes over a decade of hospital wound care and hyperbaric medicine. Carver single-handedly developed a comprehensive educational training manual for onboarding physicians and is the star of disease-specific educational video sessions accessible to employee providers and colleagues. Carver educates onboarding providers, in addition to bedside nurses in the numerous nursing homes across the country. Carver serves as a wound care certification committee member for the National Alliance of Wound Care and Ostomy, and is a board member of the Undersea Hyperbaric Medical Society Mid-West Chapter.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.