The Relationship Between Pressure Ulcer Incidence and Buttock Seat Cushion Interface Pressure in At-Risk Elderly Wheelchair Users

Size: px
Start display at page:

Download "The Relationship Between Pressure Ulcer Incidence and Buttock Seat Cushion Interface Pressure in At-Risk Elderly Wheelchair Users"

Transcription

1 PROSTHETICS/ORTHOTICS/DEVICES The Relationship Between Pressure Ulcer Incidence and Buttock Seat Cushion Interface Pressure in At-Risk Elderly Wheelchair Users David M. Brienza, PhD, Patricia E. Karg, MS, Mary Jo Geyer, MS, Sheryl Kelsey, PhD, Elaine Trefler, MEd ABSTRACT. Brienza DM, Karg PE, Geyer MJ, Kelsey S, ALTHOUGH INTERFACE PRESSURE is the most common parameter used to compare support surface perfor- Trefler E. The relationship between pressure ulcer incidence and buttock seat cushion interface pressure in at-risk elderly mance, the relation between interface pressure and pressure wheelchair users. Arch Phys Med Rehabil 2001;82: ulcer incidence has not been adequately studied. Excessive pressure applied to skin over a bony prominence for prolonged periods is the most important extrinsic factor leading to pressure ulcers. Thus, measuring pressure on the skin skin interface pressure is a logical method for assessing this factor. However, the use and interpretation of interface pressure measurements to compare surfaces is confounded by several factors. Interface pressure measurements are highly dependent on the material properties of the pressure transducer, soft tissue, and support surface. Pressure measurements have a relatively high degree of variability. 1 In addition, the relation between interface pressure and the pressure in subcutaneous tissues depends on the composition and properties of the underlying tissue. 2 Despite these problems, many clinicians, researchers, and product developers assess support surface performance with interface pressure measurements. We developed and tested a protocol for a multisite, randomized clinical trial of the effectiveness of pressure-reducing seat cushions in preventing pressure ulcers. The analysis of pressure measurements was a secondary objective. We analyzed the pressure data to determine if there was a relation between buttock-cushion interface pressure and pressure ulcers. Results from other aspects of this study are published elsewhere. 3 Objective: To investigate the relation between pressure ulcer incidence and buttock wheelchair seat cushion interface pressure measurements. Design: Secondary analysis of data from a randomized clinical trial. Setting: Skilled nursing facility. Patients: Thirty-two elderly patients (age, 65yr), with Braden score 18 and Braden mobility and activity subscale score 5, who used wheelchairs 6hr/d, were free of existing sitting-induced pressure ulcers, and weighed 250lb. Interventions: Generic foam seat cushion or pressure-reducing seat cushion. Main Outcome Measures: The incidence of sitting-induced pressure ulcers over a 1- to 12-month period was compared with pressure measured between patients buttocks and wheelchair seat cushions. A flexible pad with a pressure sensor array was used to measure interface pressure. Results: Interface pressure measured on wheelchair seat cushions was higher (p.01 for both peak pressure and average of highest 4 pressures) for patients who developed sitting-acquired pressure ulcers compared with those patients who did not. Conclusions: Results indicated that higher interface pressure measurements are associated with a higher incidence of sitting-acquired pressure ulcers for high-risk elderly people who use wheelchairs. Key Words: Frail elderly; Pressure ulcer; Rehabilitation; Wheelchairs by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation From the Departments of Rehabilitation Science and Technology (Brienza, Karg, Geyer, Trefler), and Epidemiology (Kelsey), School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA. Accepted in revised form July 10, Supported by the National Institute on Disability and Rehabilitation Research (grant no. H133G70076) and with assistance from the following equipment manufacturers and suppliers: ROHO Inc., Sunrise Medical, and Etac. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. Reprints will not be available. Correspondence to David M. Brienza, PhD, Seating and Soft Tissue Biomechanics Laboratory, University of Pittsburgh, Dept of Rehabilitation Science and Technology, 5044 Forbes Tower, Ste 5040, Pittsburgh, PA 15260, DBrienza@pitt.edu /01/ $35.00/0 doi: /apmr A Similar Study Conine et al 4 studied the effectiveness of Jay cushions a in preventing pressure ulcers in a group of 163 elderly persons who use wheelchairs. They found that the incidence of pressure ulcers was significantly higher among those patients who experienced peak interface pressure recorded at 60 mmhg or higher... Forty percent of the subjects who developed pressure ulcers had higher peak pressure ( 60mmHg) than 19% of the subjects who did not develop pressure ulcers. The Scimedics Evaluator b was used to measure pressure under 5 bony prominences: the ischial tuberocities, the trochanters, and in the sacrococcygeal area. Confounding Factors Dodd and Gross 5 examined how pressure is transferred to subcutaneous tissue. In their study, they used weanling whitehaired pigs, which match human skin anatomy and physiology; the pigs were subjected to a near-uniaxial compression load over the wings of the ilia. Dodd and Gross found a variation by anatomic site of the amount of interface pressure that was transferred to the interstitial fluid. They measured a 28% and a 43% transfer to the interstitial fluid over the wing of the ilium and dorsal aspect of a spinous process, respectively. They believe that the specific underlying bony geometry is key to how much load is transferred. Reddy et al 6,7 concluded that nearly the entire external load is transferred to the interstitium. In their 1981 study, 6 they found that 65% to 75% of the interface pressure was transferred to the interstitial fluid. They

2 530 PRESSURE ULCERS AND INTERFACE PRESSURE, Brienza applied a uniform compressive load with a pressure cuff over the bone of a limb. In 1984, 7 they showed that 100% of the interface pressure transferred to the interstitial pressure measured in the posterior thigh of a seated person. Sangeorzan et al 2 studied the effect of interface pressure on subcutaneous pressure and tissue oxygenation via transcutaneous partial pressure of oxygen (TcPO 2 ). They used simultaneous measurement of TcPO 2, interface pressure, subcutaneous pressure, and skin deformation to investigate the relative effect of skin interface pressure over bone versus skin interface pressure over muscle on the lower leg. The results showed that less interface pressure was required to reduce TcPO 2 to 0 for the skin over bone compared with skin over muscle. In contrast, at the points of 0 TcPO 2, the subcutaneous pressures were not significantly different for skin over bone and skin over muscle. In other words, the subcutaneous pressure and TcPO 2 relationship was consistent for the over bone and over muscle sites, whereas the interface pressure and TcPO 2 relationship varied according to the site tested. The implication of this result is that the relation between skin interface pressure measurements and cutaneous perfusion, as measured by TcPO 2, depends on the mechanical properties of the underlying tissue. Hence, the interpretation of a skin interface pressure measurement must account for the properties of the underlying tissues; ie, high skin interface pressure over bone is likely more harmful than high interface pressure over softer tissues. Results of the studies by Dodd, Reddy, and Sangeorzan suggest that the relationships among skin interface pressure, subcutaneous pressure, and skin oxygenation vary from person to person and from measurement site to measurement site, based on the tissue thickness and composition and, thus, how it deforms. In our study, we recognized that these factors exist, but hypothesized that pressure ulcer incidence is associated with high skin interface pressure. Variability in Pressure Measurements A second problem in using skin interface pressure measurements to assess pressure ulcer risk concerns the relatively low accuracy of pressure mapping systems. The extent of this problem varies with the type of transducer, but is most severe with the pressure mapping arrays that are best suited for clinical use. Ferguson-Pell and Cardi 1 evaluated several interface pressure mapping systems and found that all the systems tested were linear and reproducible, but the mapping systems showed errors from hysteresis (approximately 20%), creep, and the potential for hammocking effects. The single measurement point-type sensors were more accurate. They concluded, Caution should be used when interpreting quantitative measurements from different mapping systems. It is common clinical practice to use pressure measurements when comparing seat support surfaces. In practice, when risk of pressure ulcers is the primary concern, support surfaces are chosen by minimizing peak pressures and pressure gradients, providing stability, accommodating orthopedic deformities, and providing comfort. Only relative pressure measurements are used to compare and optimize support surfaces. There is insufficient evidence to determine an absolute threshold on the magnitude of pressure below which any particular person is at decreased risk of developing pressure ulcers. METHODS Subjects were recruited from 2 skilled nursing facilities in the greater Pittsburgh area. All potential subjects were identified by the facilities charge nurse/supervisor, physical therapy supervisor, or occupational therapy supervisor. After obtaining the subject s consent, an initial screening was performed by using information from medical records. Screening criteria for inclusion comprised: (1) 65 years of age or older; (2) use of a wheelchair and tolerance for sitting for 6 or more hours a day; (3) absence of pressure ulcers on the sacrum, coccyx, and ischial tuberocities of the buttocks (ie, sitting-induced ulcers); (4) appropriate use of an Etac Twin wheelchair c (including weighing 250lb or less), and (5) a Braden score 8 of 18 or less, with a combined activity and mobility subscale score of 5 or less. Subjects who met the eligibility criteria were invited to participate in the study. After informed consent was obtained, a member of the research team performed a final eligibility screening, which involved a second risk assessment by using the Braden scale, skin inspection to confirm that there were no sitting-induced pressure ulcers, and another check that all criteria were met. The intervention began with a seating assessment by a physical therapist and included fitting the Etac Twin wheelchair to the subject. The wheelchairs were equipped with adjustable upholstered backs to permit changing the contour of the backrest to conform to orthopedic deformities and to provide an increased functional seat depth from 18 to 20 inches. Other than positioning belts, no additional optional equipment was used. Therefore, individuals who exceeded the 250-lb weight limit or who required optional equipment were excluded from the study. If the wheelchair could be adjusted to fit the subject, the subject was randomly assigned to a pressure-reducing cushion (PRC) or to a generic foam cushion (FOAM) group. The PRCs are intended to lower the risk of developing ulcers and to improve sitting tolerance by providing more surface area and/or by reducing peak pressure near the ischial tuberocities, sacrum, and coccyx regions of the sitting surface. We used the guidelines proposed by the Health Industry Manufacturers Association (HIMA) for classification of wheelchair seat cushions to select cushions for the PRC group. Cushions that met the functional characteristics of cushion groups 5, 6, or 7 were given to the PRC group (table 1). These groupings in the HIMA document define 3 levels of seat support that provide increasing skin protection through pressure reduction; the levels are based on minimal functional expectations of the cushion. The particular PRC given to each subject was dependent on individual needs as determined by the clinician who performed the seating evaluation. Solid seat inserts and/or incontinence Table 1: Minimal Functional Expectations of HIMA Groups 5, 6, and 7 Group 5 Skin protection and pressure reduction Minimum of 2-in thickness Supports or reduces deformities Group 6 Ability to immerse 2in A high level of skin protection by reducing loads on the tissues under the weight-bearing bony prominences, using any of the following: Reduced surface tension designs Active load distribution Isolation of bony prominences Group 7 Meet Group 6 description, plus Reduction or accommodation of deformity Capable of contouring to a minimum depth of 2in without bottoming out the seat support

3 PRESSURE ULCERS AND INTERFACE PRESSURE, Brienza 531 covers were provided as needed. The FOAM group received a generic, 3-inch convoluted foam cushion, d fitted incontinence cover, and solid seat insert. Interface pressures were measured and recorded during the seating assessments with a force sensing array (FSA) pressure-mapping device. e The device contains a15 15 array of cm, wafer thin, resistive sensors that are contained in a thin, flexible material and that measure pressure. The FSA device was calibrated according to the manufacturer s recommendations. Seating reassessments were made after 1 week ( 1d) and as needed after modification of the wheelchair, until a study endpoint was reached. Interface pressures were measured at the first reassessment and at some of the later sessions. Interface pressure measurements from either the initial assessment or the first reassessment were used for comparison, depending on the need for adjustments of the seating system at the 1-week reassessment. If no adjustments were made to the seating system, then the pressure measurements from the initial assessment were used. If adjustments were made, pressure was remeasured and those measurements were used in the data analysis. Thus, the measurements used for analysis included any final adjustments that were made to the wheelchair and seating system. Skin and risk assessments were performed weekly by 2 physical therapists; one of the 2 was the specialist who performed the seating assessments. Assessments were performed from the time of enrollment in the study until a study endpoint occurred. A study endpoint was defined as one of the following: first incidence of a pressure ulcer, transfer or discharge from the facility, voluntary withdrawal from the study, death, or the end of this study (July 1999). Skin reaction was classified by using the National Pressure Ulcer Advisory Panel staging method. 9 Non-pressure-induced ulcers, eg, from skin maceration from moisture, were delineated, but were still considered a pressure ulcer endpoint. Risk assessments were performed with the Braden scale for predicting pressure ulcer risk. 8 Pressure measurement data were analyzed by comparing the mean peak and mean of the average of the highest 4 pressures (not limited to adjacent sensors) for subjects who developed pressure ulcers with the same pressure values for subjects who did not. Independent t tests were used to compare group means, with statistical significance defined at an alpha level of.05. RESULTS Thirty-two subjects entered and completed the study. Their mean age was 85 8 years; mean Braden score was Subject No. Age (yr) Braden Score Table 2: Subject Characteristics and Outcomes Cushion Type Mean of Highest 4 Pressures Peak Pressure Endpoint FOAM Pressure ulcer PRC Voluntary withdrawal FOAM Deceased FOAM Completed with no pressure ulcer FOAM Pressure ulcer PRC Transfer/facility discharge PRC Pressure ulcer* PRC Completed with no pressure ulcer FOAM Pressure ulcer FOAM Pressure ulcer FOAM Completed with no pressure ulcer PRC Completed with no pressure ulcer PRC Pressure ulcer* PRC Pressure ulcer* FOAM Completed with no pressure ulcer PRC Completed with no pressure ulcer PRC Pressure Ulcer* FOAM Completed with no pressure ulcer PRC Completed with no pressure ulcer FOAM Pressure ulcer PRC Transfer/facility discharge PRC Deceased FOAM Pressure ulcer PRC Pressure ulcer FOAM Pressure ulcer FOAM Transfer/facility discharge FOAM Pressure ulcer PRC Completed with no pressure ulcer FOAM Pressure ulcer PRC Pressure ulcer FOAM Transfer/facility discharge FOAM Pressure ulcer Mean Standard Deviation * Cases in which protocol variances, improper use of equipment, or factors other than the seat cushion contributed to the development of a pressure ulcer.

4 532 PRESSURE ULCERS AND INTERFACE PRESSURE, Brienza Fig 1. Comparison of distribution for (A) peak pressure and (B) average of the highest 4 pressures between pressure ulcer (PU) and no pressure ulcer (No-PU) outcome groups. The difference in mean was significant (p <.01) in both cases. Box plots show the minimum, maximum, upper quartile, lower quartile, mean (grey line), and median (solid line) for each data set. Subject characteristics and summaries of outcomes are reported in table 2. Sixteen subjects developed pressure ulcers (6/15 in the PRC group, 10/17 in the FOAM group). The mean peak pressure 1 standard deviation (SD) was mmHg for subjects with pressure ulcers and 78 22mmHg for subjects without. The mean of the average of the highest 4 pressures was 89 22mmHg for subjects with pressure ulcers and 70 16mmHg for subjects without. These pressure data results are shown in figure 1 and table 3. Interface pressure measured on wheelchair seat cushions was higher (p.01 for both peak pressure and average of highest 4 pressures) for patients who developed sitting-surface pressure ulcers compared with those patients who did not. No significant group differences (p.05) were found for initial Braden scores, sitting time variances, or ratios of days-at-risk to total days (table 3). DISCUSSION The results of this study support the use of buttock-cushion interface pressure measurements to assist in determining pressure ulcer risk. Our results suggest an association between high buttock seat cushion interface pressure and the incidence of pressure ulcers. This study supports results from a similar study 4 and the popular belief that high interface pressure is a factor in pressure ulcer development. However, the absolute magnitudes of pressure from the Conine et al 4 study should not be compared with the values from this study because the nature of the Scimedics sensor b is significantly different from the FSA system that we used. The Scimedics sensor consists of an electropneumatic air bladder with a 10cm diameter. The interface pressure is determined by measuring the pressure required to collapse the bladder. The pressure measurement is representative of the average pressure over the sensor s 78.5cm 2 area. The individual sensors in the FSA pressure mapping system cover an area of 6.25cm 2. Because of the smaller size, the FSA peak pressure measurement is likely to be higher than the Scimedics sensor s pressure measurement. The study protocol called for subjects to use their wheelchairs and wheelchair seat cushions a minimum of 6 hours a day and to use the cushion without additional pads or sheets. Variances in the protocol discovered during the weekly reassessments were noted. Improper uses of the equipment were also noted. In several cases, variances in the protocol, improper use of the seat cushion, or factors other than sitting loads apparently led to the development of pressure ulcers. These cases are marked with an asterisk in table 2. There were 4 such cases in the PRC group and none in the FOAM group. In subjects who developed pressure ulcers, we found that the location of the ulcer coincided with the location of the peak interface pressure in the FOAM group, but not in the PRC group. In the FOAM group, 7 of the 10 pressure ulcers were predicted by the location of peak pressure. In the PRC group, only 1 of the 6 pressure ulcers coincided with the peak pressure location. This difference between the groups may be because some pressure ulcers in the PRC group were not induced by sitting. In fact, 3 of the 6 pressure ulcers that occurred in the PRC group were from shearing; however, according to the study s definitions, they were classified as a pressure ulcer endpoint. Caution is necessary in interpreting the results of this study. Although we found a significant difference in peak pressure between the pressure ulcer and nonpressure-ulcer groups, the absolute values of the pressure measurements are not necessarily comparable to other pressure measurement systems or to measurements taken in other situations. For the FSA system used in our study, the inaccuracies caused by hysteresis have been reduced by using a calibration procedure that accounts for the direction (increasing or decreasing) of pressure changes. The potential for hammocking effects has been reduced by using a more flexible mat substrate that conforms to curved surfaces. Despite these design improvements to the FSA system since the system was evaluated in 1993, 1 there is the possibility that the measurements are biased. We attempted to minimize this possibility by using a fixed protocol for making the pressure measurements that required the measurement to be recorded at a fixed time (approximately 2min) after the subject sat on the mat. Our study was also small (n 32) and was limited to elderly people with a relatively high risk of developing pressure ulcers. The mean Braden score of our sample was 13. Interestingly, there was little difference in the mean Braden score of those who developed pressure ulcers (12.9) compared with the mean score of those who did not (13.0). This was a pilot study to test for feasibility and to develop the protocol for a multisite clinical trial with sufficient statistical power. Therefore, there are limitations to the study and to Parameter Table 3: Group Means ( 1 SD) Pressure Ulcer Group No Pressure Ulcer Peak pressure mmHg 78 22mmHg Average highest 4 pressure 89 22mmHg 70 16mmHg Initial Braden score Sitting time compiled/total days Days at-risk/total days NOTE. Values presented as mean 1 SD.

5 PRESSURE ULCERS AND INTERFACE PRESSURE, Brienza 533 the interpretation of its results. The study was performed primarily at 1 clinical site. One person performed the seating evaluation and selection of the pressure-reducing cushions. That same person was involved in the skin assessments. Bias is, therefore, introduced that would not be acceptable in a fullscale trial. CONCLUSIONS We investigated the relation between buttock wheelchair seat cushion interface pressure measurements and pressure ulcer incidence. We found that peak pressure and the average of the highest 4 pressures were significant predictors of pressure ulcer incidence. The participants were elderly wheelchair users at high risk for pressure ulcers who used common, generic seat cushions or special pressure-reducing seat cushions. Our results suggest that interface pressure measurements are useful in assessing seat support surfaces for their potential to cause a pressure ulcer. However, further research is necessary to develop specific guidelines for predicting pressure ulcer risk based on interface pressure measurements. References 1. Ferguson-Pell M, Cardi MD. Prototype development and comparative evaluation of wheelchair pressure mapping system. Assist Technol 1993;5: Sangeorzan BJ, Harrington RM, Wyss CR, Czerniecki JM, Matsen FA III. Circulatory and mechanical response of skin to loading. J Orthop Res 1989;7: Geyer MJ, Brienza DM, Karg PE, Kelsey S, Trefler E. A randomized control trial to evaluate pressure reducing seat cushions for elderly wheelchair users. Adv Skin Wound Care 2001;14. In press. 4. Conine TA, Hershler C, Daeschsel D, Peel C, Pearson A. Pressure sore prophylaxis in elderly patients using polyurethane foam or Jay wheelchair cushions. Int J Rehabil Res 1994;17: Dodd KT, Gross DR. Three-dimensional tissue deformation in subcutaneous tissues overlying bony prominences may help to explain load transfer to the interstitium. J Biomech 1991;24: Reddy NP, Palmieri V, Cochran GV. Subcutaneous interstitial fluid pressure during external loading. Am J Physiol 1981;240: Reddy NP, Palmieri V, Cochran GV. Evaluation of transducer performance for buttock-cushion interface pressure measurements. J Rehabil Res Dev 1984;21: Braden B, Bergstrom N. Predictive validity of the Braden Scale for pressure sore risk in a nursing home population. Res Nurs Health 1994;17: Agency for Health Care Policy and Research. Pressure ulcers in adults: prediction and prevention. Clinical Practice Guideline No. 3. Washington (DC): Public Health Service, US Dept of Health and Human Services; 1992 May. AHCPR Publ. No Sponsored by the Agency for Health Care Policy and Research. Suppliers a. Sunrise Medical, PO Box 18626, Boulder, CO b. Scimedics/Next Generation Co, Enterprise Cir N #108, Temecula, CA c. Etac Sverige AB, Box 203, Anderstorp SE Sweden. d. Bioclinic Standard CE3408; Sunrise Medical, 5001 Joerns Dr, Stevens Point, WI e. Vista Medical, Ltd, 120 Maryland St, Winnipeg, Man R3G 1L1.

MULTIPLE SCLEROSIS (MS) is the most common cause

MULTIPLE SCLEROSIS (MS) is the most common cause ORIGINAL ARTICLE Impact of Sitting Time on Seat-Interface Pressure and on Pressure Mapping With Multiple Sclerosis Patients Shelley A. Crawford, BSc, May D. Stinson, PhD, Deirdre M. Walsh, DPhil, Alison

More information

DEFINITION OF PRESSURE. Pressure = Force / Area

DEFINITION OF PRESSURE. Pressure = Force / Area PRESSURE & POSTURE IN WHEELCHAIR SEATING DEFINITION OF PRESSURE Pressure = Force / Area ANATOMY OF THE SKIN Epidermis Dermis Subcutaneous Layer EFFECTS OF PRESSURE Occludes capillaries Restricts flow of

More information

S C I E N C E O F S E AT I N G

S C I E N C E O F S E AT I N G S C I E N C E O F S E AT I N G GLOSSARY OF TERMS Like the modern running shoe, today s wheelchair seat cushion is a complex mix of design terminology: firmness layering, pre-contouring, segmentation, tension

More information

The Seating Interface For The Individual With SCI: Minimizing Risk and Maximizing Function

The Seating Interface For The Individual With SCI: Minimizing Risk and Maximizing Function The Seating Interface For The Individual With SCI: Minimizing Risk and Maximizing Function Disclosure of PI- RRTC Grant James S. Krause, PhD, Holly Wise, PhD; PT, and Emily Johnson, MHA have disclosed

More information

PREVENTING PRESSURE ULCERS in users of seat cushions. Pressure Mapping in Seating: A Frequency Analysis Approach. Ingrid Eitzen, PT, MSc

PREVENTING PRESSURE ULCERS in users of seat cushions. Pressure Mapping in Seating: A Frequency Analysis Approach. Ingrid Eitzen, PT, MSc 1136 Pressure Mapping in Seating: A Frequency Analysis Approach Ingrid Eitzen, PT, MSc ABSTRACT. Eitzen I. Pressure mapping in seating: a frequency analysis approach. Arch Phys Med Rehabil 2004; 85:1136-40.

More information

Presentation Goals. Project Goals. ISS Presentation Final 1. Cushion Characterization ISS 2011

Presentation Goals. Project Goals. ISS Presentation Final 1. Cushion Characterization ISS 2011 Cushion Characterization ISS 2011 1 Presentation Goals Update on the cushion characterization project we introduced at last year s ISS Share our results, recommendations and proposed next steps Obtain

More information

JAY J3 Cushion: Design Improvements for Enhanced Clinical Benefit

JAY J3 Cushion: Design Improvements for Enhanced Clinical Benefit A Sunrise Medical White Paper 7477 E. Dry Creek Parkway Longmont, CO 80503 www.sunrisemedical.com JAY J3 Cushion: Design Improvements for Enhanced Clinical Benefit By: JAY Design Team 5/7/2009 Contents

More information

Intelligent Sensor Systems for Healthcare: A Case Study of Pressure Ulcer TITOLO. Prevention and Treatment TESI. Rui (April) Dai

Intelligent Sensor Systems for Healthcare: A Case Study of Pressure Ulcer TITOLO. Prevention and Treatment TESI. Rui (April) Dai Intelligent Sensor Systems for Healthcare: A Case Study of Pressure Ulcer TITOLO Prevention and Treatment TESI Rui (April) Dai Assistant Professor Department of Computer Science North Dakota State University

More information

Study of 3D buttocks tissue deformation to inform pressure ulcer risk and cushion test method development.

Study of 3D buttocks tissue deformation to inform pressure ulcer risk and cushion test method development. Study of 3D buttocks tissue deformation to inform pressure ulcer risk and cushion test method development. Sharon Sonenblum, PhD Stephen Sprigle, PhD, PT Questions Anatomical Variations What variations

More information

Do Not Live in Fear of Pressure and Shear

Do Not Live in Fear of Pressure and Shear Do Not Live in Fear of Pressure and Shear Thomas Hetzel, PT, ATP Ride Designs, Denver, Colorado 2016, Aspen Seating/Ride Designs Course Objectives 1. Discuss the difference between posture and postural

More information

S I G N AT U R E S E R I E S

S I G N AT U R E S E R I E S S I G N AT U R E S E R I E S Since 1983, JAY has engineered products that provide the optimal combination of support, comfort and protection through progressive design and advanced materials. As industry

More information

White Paper on Pressure Management by David M. Brienza, Mary Jo Geyer and Patricia Karg

White Paper on Pressure Management by David M. Brienza, Mary Jo Geyer and Patricia Karg White Paper on Pressure Management by David M. Brienza, Mary Jo Geyer and Patricia Karg Introduction Unrelieved pressure upon weight-bearing tissues can produce lesions, identified by their etiology as

More information

Background BLOOD FLOW AND PRESSURE CHANGES THAT OCCUR WITH TILT-IN-SPACE. Tilt-in-Space for Pressure Relief. Pressure Ulcer Development

Background BLOOD FLOW AND PRESSURE CHANGES THAT OCCUR WITH TILT-IN-SPACE. Tilt-in-Space for Pressure Relief. Pressure Ulcer Development d 9/2/2009 BLOOD FLOW AND PRESSURE CHANGES THAT OCCUR WITH TILT-IN-SPACE Sharon Eve Sonenblum, Ph.D. European Seating Symposium September 15 th, 2009 Pressure Ulcer Development Possible mechanisms for

More information

The Importance of Skin Examination. following Spinal Cord Injury

The Importance of Skin Examination. following Spinal Cord Injury The Importance of Skin Examination following Spinal Cord Injury An individual who sustains a spinal cord injury (SCI) has a lifetime of increased susceptibility to skin problems, including pressure ulcers

More information

Presented By: Jennifer Birt, OT Reg(MB) Specialized Seating & Mobility Clinical Specialist

Presented By: Jennifer Birt, OT Reg(MB) Specialized Seating & Mobility Clinical Specialist Presented By: Jennifer Birt, OT Reg(MB) Specialized Seating & Mobility Clinical Specialist 2013 1. Define and understand the concept of practical pressure management and categorizing individuals at different

More information

Cushion use and performance in everyday life. Stephen Sprigle

Cushion use and performance in everyday life. Stephen Sprigle Cushion use and performance in everyday life Stephen Sprigle Surveying used cushions Documenting degradation Temperature and humidity Controlled tests Within everyday use Surveying used cushions Survey

More information

Prevention and management of Pressure ulcers

Prevention and management of Pressure ulcers Prevention and management of Pressure ulcers A guide for patients, carers and relatives What is a pressure ulcer? Pressure ulcers are an injury to the skin and/or underlying tissues. They are also known

More information

A wheelchair is a body orthosis on wheels. Understanding basic principles of seating. Seating REQUIREMENTS OF SEATING

A wheelchair is a body orthosis on wheels. Understanding basic principles of seating. Seating REQUIREMENTS OF SEATING Understanding basic principles of seating A wheelchair is a body orthosis on wheels. Bengt Engström Orthosis = splint FUNCTIONS OF AN ORTHOSIS Maintaining alignment Protecting weak muscles Protecting joints

More information

The Seated Patient 15 th Biennial Conference New Orleans

The Seated Patient 15 th Biennial Conference New Orleans The Seated Patient 15 th Biennial Conference New Orleans Track 1 March 11, 2017 Christine Berke MSN APRN-NP CWOCN-AP Nebraska Medicine cberke@nebraskamed.com 2017 National Pressure Ulcer Advisory Panel

More information

Managemen. Pressure Ulcer Prevention and Treatment. Guidance. Posture. Posture. Posture. Posture. Posture

Managemen. Pressure Ulcer Prevention and Treatment. Guidance. Posture. Posture. Posture. Posture. Posture men menm Pressure Ulcer Prevention and Treatment Guidance Post ture Manag The reduction of the numbers of s is a high priority for Southern Health NHS Foundation Trust Purpose of this guidance is to help:

More information

SUPPORT SURFACES AND POSITIONING

SUPPORT SURFACES AND POSITIONING SUPPORT SURFACES AND POSITIONING American Medical Technologies Irvine, CA 1 Disclaimer The information presented herein is provided for educational and informational purposes only and to promote the safeand-effective

More information

9/6/2017. Cushion and Back Comparison: What s New? Disclaimers. Objectives

9/6/2017. Cushion and Back Comparison: What s New? Disclaimers. Objectives Cushion and Back Comparison: What s New? Presented by: Erin Michael, PT, DPT, ATP/SMS Manager, Patient Advocacy and Special Programs International Center for Spinal Cord Injury Kennedy Krieger Institute

More information

The effect of seat shape on the risk of pressure ulcers using discomfort and interface pressure measurements

The effect of seat shape on the risk of pressure ulcers using discomfort and interface pressure measurements 6918POI38110.1177/0309364613486918Prosthetics and Orthotics InternationalTasker et al. Original Research Report The effect of seat shape on the risk of pressure ulcers using discomfort and interface pressure

More information

Evaluation of the new flexible contour backrest for wheelchairs

Evaluation of the new flexible contour backrest for wheelchairs Department Veterans Affairs Journal of Rehabilitation Research and Development Vol. 37 No. 3, II/lay/June 2000 Pages 325 333 Evaluation of the new flexible contour backrest for wheelchairs Frederic Parent,

More information

TASK: S-2 DISTORTION MEASUREMENT AND BIOMECHANICAL ANALYSIS OF IN VIVO LOAD BEARING SOFT TISSUES

TASK: S-2 DISTORTION MEASUREMENT AND BIOMECHANICAL ANALYSIS OF IN VIVO LOAD BEARING SOFT TISSUES TASK: S-2 DISTORTION MEASUREMENT AND BIOMECHANICAL ANALYSIS OF IN VIVO LOAD BEARING SOFT TISSUES Investigators: David M. Brienza, Patricia Karg, Jue Wang, Chen-Tse Lin Collaborator: Ying-Wei Yuan, Qiang

More information

Based on the analysis of the National Spinal Cord

Based on the analysis of the National Spinal Cord Case Report Comparison of Three Wheelchair Cushions for Effectiveness of Pressure Relief Hon Keung Yuen, Donna Garrett Key Words: evaluation process, occupational therapy single subject research spinal

More information

Blood Flow and Pressure Changes that Occur with Tilt-in- Space

Blood Flow and Pressure Changes that Occur with Tilt-in- Space RESNA Blood Flow and Pressure Changes that Occur with Tilt-in- Space Journal: RESNA 2010 Annual Conference Manuscript ID: Draft Submission Type: Student Scientific Paper Topic Area: Seating (S) Note: The

More information

Effective Seating Assessments

Effective Seating Assessments Effective Seating Assessments Amy Barber @Yorkshire_Care #YORTRAINGOLD2017 www.yorkshirecareequipment.com Effective Seating Assessments A M Y B A R B E R O C C U PAT I O N A L T H E R A P I S T Y O RT

More information

FACTORS ASSOCIATED WITH CLINICAL DECISIONS AND PRESSURE ULCER DEVELOPMENT IN LONG TERM CARE RESIDENTS. Ana Luiza Caltabiano Allegretti

FACTORS ASSOCIATED WITH CLINICAL DECISIONS AND PRESSURE ULCER DEVELOPMENT IN LONG TERM CARE RESIDENTS. Ana Luiza Caltabiano Allegretti FACTORS ASSOCIATED WITH CLINICAL DECISIONS AND PRESSURE ULCER DEVELOPMENT IN LONG TERM CARE RESIDENTS by Ana Luiza Caltabiano Allegretti Occupational Therapy, Pontificia Universidade Catolica de Campinas,

More information

individual while providing excellent stability. A unique ventilation for long-term sitting comfort.

individual while providing excellent stability. A unique ventilation for long-term sitting comfort. cushioning products by supracor featuring Stimulite honeycomb Discover How Our Cells Work For Your Cells Sleek and modern, Supracor s revolutionary Stimulite honeycomb is fast replacing conventional cushioning

More information

A New Approach to Pressure, Friction, Shear and Microclimate Management in Wheelchair Seating Imagine the Possibilities

A New Approach to Pressure, Friction, Shear and Microclimate Management in Wheelchair Seating Imagine the Possibilities A New Approach to Pressure, Friction, Shear and Microclimate Management in Wheelchair Seating Imagine the Possibilities Marty Carlson, MS(Engr.), CPO, Mark Payette, CO, ATP, Wieland Kaphingst, Dipl.-Ing.,

More information

Advanced Clinical Solutions. Pressure Ulcer. Carilex Medical Group 1

Advanced Clinical Solutions. Pressure Ulcer. Carilex Medical Group 1 Advanced Clinical Solutions Pressure Ulcer Carilex Medical Group 1 Advanced Clinical Solutions Contents About Pressure Ulcer! 2 Stages of Pressure Ulcer! 5 Reference! 7 Carilex Medical Group 1 About Pressure

More information

Ottobock Custom Seating OBSS Tru-Shape, OBSS Ortho-Shape, NUTEC Seating. Reimbursement Reference Guide

Ottobock Custom Seating OBSS Tru-Shape, OBSS Ortho-Shape, NUTEC Seating. Reimbursement Reference Guide OBSS Tru-Shape, OBSS Ortho-Shape, NUTEC Seating Reimbursement Reference Guide Reimbursement Reference Guide (Effective 11/1/2015) s Custom Seating works continually to improve the independence and quality

More information

What s the Support, for Support?

What s the Support, for Support? What s the Support, for Support? Evan Call, MS, CSM 2017 National Pressure Ulcer Advisory Panel www.npuap.org A Note About Standards S3I Terms and Definitions were now 9 years old Should we find a different

More information

FUNDAMENTAL SEATING PRINCIPLES Power Point PDF Bengt Engström Physiotherapist. Concept ENGSTRÖM

FUNDAMENTAL SEATING PRINCIPLES Power Point PDF Bengt Engström Physiotherapist. Concept ENGSTRÖM FUNDAMENTAL SEATING PRINCIPLES Power Point PDF Bengt Engström Physiotherapist Starting with a few questions! How are your clients sitting? What kind of problems do you see? How long time are your clients

More information

Specialized Seating and Pressure Management Principles for the Bariatric Client

Specialized Seating and Pressure Management Principles for the Bariatric Client Specialized Seating and Pressure Management Principles for the Bariatric Client Jennifer Birt, OT Reg(MB) Specialized Seating and Mobility Clinical Specialist HSC (p) 787-4266 Email: jlbirt@hsc.mb.ca October

More information

A New Health Strategy to Prevent Pressure Ulcer Formation in Paraplegics using Computer and Sensory Substitution via the Tongue

A New Health Strategy to Prevent Pressure Ulcer Formation in Paraplegics using Computer and Sensory Substitution via the Tongue A New Health Strategy to Prevent Pressure Ulcer Formation in Paraplegics using Computer and Sensory Substitution via the Tongue Alexandre MOREAU-GAUDRY a,c,1, Anne PRINCE b, Jacques DEMONGEOT a,c and Yohan

More information

CLPNA Pressure Ulcers ecourse: Module 4 Quiz II page 1

CLPNA Pressure Ulcers ecourse: Module 4 Quiz II page 1 CLPNA Pressure Ulcers ecourse: Module 4 Quiz II 1. When are good times to do a skin inspection of a patient or resident? a. Bathing b. Meal times c. Dressing d. Assisting e. Sleeping 2. For patients who

More information

Creating stability. Stable seating starts from the bottom. Literally!

Creating stability. Stable seating starts from the bottom. Literally! Creating stability Stable seating starts from the bottom. Literally! A shape for every need. The StarLock cell locking technology shapes each air cell in the cushion individually to suit each user s needs.

More information

Pressure Injury Assessment Guide South West Regional Wound Care Program Last Updated October 31,

Pressure Injury Assessment Guide South West Regional Wound Care Program Last Updated October 31, Developed in collaboration with the Wound Care Champions, Wound Care Specialists, Enterostomal Nurses, and South West Regional Wound Care Program (SWRWCP) members from Long Term Care Homes, Hospitals,

More information

INTRODUCING THE FROM

INTRODUCING THE FROM INTRODUCING THE FROM ERGONOMICS; A MEDICAL DEFINITION HUMAN ENGINEERING OR HUMAN FACTORS ENGINEERING An applied science concerned with the characteristics of people that need to be considered in designing

More information

Pressure Ulcers ecourse

Pressure Ulcers ecourse Pressure Ulcers ecourse Module 4.1: Prevention of Pressure Ulcers Handout College of Licensed Practical Nurses of Alberta (Canada) CLPNA.com and StudywithCLPNA.com CLPNA Pressure Ulcers ecourse Module

More information

Presented by: Jennifer Birt, OT Reg(MB) Specialized Seating and Mobility Clinical Specialist Rehabilitation Day Program

Presented by: Jennifer Birt, OT Reg(MB) Specialized Seating and Mobility Clinical Specialist Rehabilitation Day Program Pressure Management Assessment Tool (PMAT): Development and Implementation of a Comprehensive Clinical Evaluation for Managing Pressure from a 24 Hour Perspective Presented by: Jennifer Birt, OT Reg(MB)

More information

Preventing Foot Ulcers in the Neuropathic Diabetic Foot. Glossary of Terms

Preventing Foot Ulcers in the Neuropathic Diabetic Foot. Glossary of Terms Preventing Foot Ulcers in the Neuropathic Diabetic Foot Warren Woods, Certified Orthotist, Health Sciences Centre, Rehabilitation Engineering Department What you need to know Glossary of Terms Neuropathic

More information

COMPLEX SEATING SPECIALISTS

COMPLEX SEATING SPECIALISTS COMPLEX SEATING SPECIALISTS Dedicated to improving your lifestyle At Specialised Wheelchair Company (SWCo) we are passionate about providing the best service for our clients. We have established a team

More information

Adult Manual Wheelchairs. Etac Prio. Time to shape up!

Adult Manual Wheelchairs. Etac Prio. Time to shape up! Adult Manual Wheelchairs Etac Prio Time to shape up! Etac Prio - shape and support It s a matter of individual ability. Our aim is to make the most of the users ability, using shaping and supportive features.

More information

What is Occupational Therapy?

What is Occupational Therapy? Introduction to Occupational Therapy Services What is Occupational Therapy? Alice Chan, OTI Tai Po Hospital a health profession that focuses on promoting health and well being through engagement in meaningful

More information

Ride Custom Systems Face Sheet :~)

Ride Custom Systems Face Sheet :~) Ride Designs a branch of Aspen Seating, LLC toll-free 866.781.1633 phone 303.781.1633 fax 303.781.1722 www.ridedesigns.com Ride Custom Systems Face Sheet :~) Please fill in one face sheet per client order.

More information

Comparison of wheelchair cushion calibration by users with spinal cord injury and by occupational therapists, using a pressure mapping system

Comparison of wheelchair cushion calibration by users with spinal cord injury and by occupational therapists, using a pressure mapping system Comparison of wheelchair cushion calibration by users with spinal cord injury and by occupational therapists, using a pressure mapping system Differences in cushion calibration by the user and occupational

More information

PRESSURE ULCERS SIMPLIFIED

PRESSURE ULCERS SIMPLIFIED 10 PRESSURE ULCERS SIMPLIFIED This leaflet is intended to give you information and answers to some question you may have around pressure ulcers PRESSURE ULCERS SIMPLIFIED Pressure ulcer development has

More information

Adult Manual Wheelchairs. Etac Prio. Time to shape up!

Adult Manual Wheelchairs. Etac Prio. Time to shape up! Adult Manual Wheelchairs Etac Prio Time to shape up! Etac Prio - shape and support It s a matter of individual ability. Our aim is to make the most of the users ability, using shaping and supportive features.

More information

Pressure Ulcer Staging. Staging of Wounds are based on the deepest level of tissue damage

Pressure Ulcer Staging. Staging of Wounds are based on the deepest level of tissue damage Pressure Ulcer Staging Staging of Wounds are based on the deepest level of tissue damage Pressure Ulcer Staging New Pressure Ulcer Staging Stage I Stage II Stage III Stage IV Unstageable Suspected Deep

More information

The Problem with Shear the Science

The Problem with Shear the Science The Problem with Shear the Science Dan Bader 1,2, Peter Worsley 1 and Cees Oomens 2 1 Faculty of Health Science, University of Southampton, UK and 2 Department of Biomedical Engineering, Eindhoven University

More information

11/15/2015. npuap.org. What s New in the 2014 Pressure Ulcer Prevention? It s All About Guidelines

11/15/2015. npuap.org. What s New in the 2014 Pressure Ulcer Prevention? It s All About Guidelines What s New in the 2014 Pressure Ulcer Prevention? It s All About Guidelines Joyce Black, PhD, RN CWCN, FAAN University of Nebraska npuap.org A = direct evidence from well designed controlled trials N =

More information

Adult Manual Wheelchairs. Etac Prio. Time to shape up!

Adult Manual Wheelchairs. Etac Prio. Time to shape up! Adult Manual Wheelchairs Etac Prio Time to shape up! Etac Prio - shape and support It s a matter of individual ability. Our aim is to make the most of the users ability, using shaping and supportive features.

More information

International Pressure Ulcer Guidelines Update Aamir Siddiqui, MD, FACS Division of Plastic Surgery Henry Ford Hospital Detroit MI

International Pressure Ulcer Guidelines Update Aamir Siddiqui, MD, FACS Division of Plastic Surgery Henry Ford Hospital Detroit MI International Pressure Ulcer Guidelines Update 2015 Aamir Siddiqui, MD, FACS Division of Plastic Surgery Henry Ford Hospital Detroit MI Disclosure Aamir Siddiqui has listed no financial interest/arrangement

More information

Bed Sores No More! Pressure Injuries Risk Factors and Updated Staging Methodology. Nicolle Samuels, MSPT, CLT-LANA, CWS, CKTP

Bed Sores No More! Pressure Injuries Risk Factors and Updated Staging Methodology. Nicolle Samuels, MSPT, CLT-LANA, CWS, CKTP Bed Sores No More! Pressure Injuries Risk Factors and Updated Staging Methodology Nicolle Samuels, MSPT, CLT-LANA, CWS, CKTP Objectives Understand updated definitions as well as staging and classification

More information

Multi Patient FSA Pressure Mapping

Multi Patient FSA Pressure Mapping Produced By Innovative Healthcare Services Ltd Copyright 2012 Multi Patient FSA Mapping Patient categories - 56kg Female : 106kg Male ATMOS AIR Initial Map Sequence Time: 0.00 Second Map Sequence Time:

More information

Pressure Ulcer Prevention for OR. Jeanne Knecht RN, CWON Wound/Ostomy Specialist

Pressure Ulcer Prevention for OR. Jeanne Knecht RN, CWON Wound/Ostomy Specialist Pressure Ulcer Prevention for OR Jeanne Knecht RN, CWON Wound/Ostomy Specialist Benefis Hospital Stats 2009 12 month incident rate 1.90 Benefis Benchmark 3 National Benchmark 5-8 How did we achieve Education

More information

Effects of Different Cyclic Pressurization and Relief Patterns on Heel Skin Blood Perfusion

Effects of Different Cyclic Pressurization and Relief Patterns on Heel Skin Blood Perfusion ORIGINAL INVESTIGATION Effects of Different Cyclic Pressurization and Relief Patterns on Heel Skin Blood Perfusion Harvey N. Mayrovitz, PhD, and Nancy Sims, RN ABSTRACT OBJECTIVE: It was hypothesized that

More information

Update on Pressure Ulcers: Utilizing an Interdisciplinary Approach to Pressure Ulcer Prevention. Charlene A. Demers GNP-BC, CWOCN

Update on Pressure Ulcers: Utilizing an Interdisciplinary Approach to Pressure Ulcer Prevention. Charlene A. Demers GNP-BC, CWOCN Update on Pressure Ulcers: Utilizing an Interdisciplinary Approach to Pressure Ulcer Prevention Charlene A. Demers GNP-BC, CWOCN Scope of the Issue Cost $9 billion to $11 billion $20,000-$150,000 per ulcer

More information

It s a fact... Your computer workstation should include a chair that s right for you.

It s a fact... Your computer workstation should include a chair that s right for you. MARCH 2002 DoD Ergonomics Working Group It s a fact... Your computer workstation should include a chair that s right for you. Most chairs are designed for people weighing no more than 275 pounds. If you

More information

The Effect of Surface Electric Stimulation of the Gluteal Muscles on the Interface Pressure in Seated People With Spinal Cord Injury

The Effect of Surface Electric Stimulation of the Gluteal Muscles on the Interface Pressure in Seated People With Spinal Cord Injury 1724 ORIGINAL ARTICLE The Effect of Surface Electric Stimulation of the Gluteal Muscles on the Interface Pressure in Seated People With Spinal Cord Injury Andrea van Londen, MSc, Mariska Herwegh, MSc,

More information

Blood Flow and Pressure Changes that Occur with Tilt-in-Space. Sharon Eve Sonenblum, PhD RESNA June 28 th, 2010

Blood Flow and Pressure Changes that Occur with Tilt-in-Space. Sharon Eve Sonenblum, PhD RESNA June 28 th, 2010 Blood Flow and Pressure Changes that Occur with Tilt-in-Space Sharon Eve Sonenblum, PhD RESNA June 28 th, 2010 Background Justification: lack of ability to independently reposition or do pressure reliefs

More information

11/2/2017. Individualized Seating and Wheeled Mobility for the Older Adult

11/2/2017. Individualized Seating and Wheeled Mobility for the Older Adult 1 2 3 4 for the Older Adult Course Objectives Upon completion of this course the participant will be able to: Recognize the need for individualized seating and wheeled mobility Understand seating as it

More information

P ressureulcersrepresentasignificanthealthcarecostaswellasasignificantrisk

P ressureulcersrepresentasignificanthealthcarecostaswellasasignificantrisk Evaluating the Pressure-Reducing Capabilities of the Gel Pad in Supine Sarah Thorne, Katrine Sauvé, Christine Yacoub, Paulette Guitard KEY WORDS gels pressure pressure ulcer supine position OBJECTIVE.

More information

Jay Cushions and Backs

Jay Cushions and Backs Jay Cushions and Backs Superior clinical seating Jay cushions and backs are a reliable support for my patients. The various range of Jay products is an important help for me to find the appropriate product

More information

IN THE UNITED STATES, nearly 50% of the 1.4 million

IN THE UNITED STATES, nearly 50% of the 1.4 million 862 ORIGINAL ARTICLE Periodically Relieving Ischial Sitting Load to Decrease the Risk of Pressure Ulcers Mohsen Makhsous, PhD, Diane M. Rowles, MS, ACNP, BC, William Z. Rymer, MD, PhD, James Bankard, BS,

More information

MOBILE AIR CHAIR. A new era in mobile pressure management. aspire for... Comfort Support Relief. S.W.L 180kg.

MOBILE AIR CHAIR. A new era in mobile pressure management. aspire for... Comfort Support Relief. S.W.L 180kg. MOBILE AIR CHAIR A new era in mobile pressure management aspire for... Comfort Support Relief S.W.L 180kg World s leading high stretch, durable and breathable healthcare fabric Integrated Postural Support

More information

PREVALENCE & INCIDENCE

PREVALENCE & INCIDENCE PREVALENCE & INCIDENCE Contents Prevalence.................................... 2 Point Prevalence...................................... 3 Period Prevalence..................................... 4 Incidence....................................

More information

Pressure Ulcer Prevention Laura E. Edsberg, PhD

Pressure Ulcer Prevention Laura E. Edsberg, PhD Pressure Ulcer Prevention Laura E. Edsberg, PhD Pressure Ulcer Localized injury to the skin and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure (including pressure

More information

Alberta Health. Alberta Aids to Daily Living Seating and Wheelchair Accessories Benefits Policy & Procedures Manual

Alberta Health. Alberta Aids to Daily Living Seating and Wheelchair Accessories Benefits Policy & Procedures Manual Alberta Health Alberta Aids to Daily Living Seating and Wheelchair Accessories Benefits Policy & Procedures Manual October 1, 2016 Alberta Health, Alberta Aids to Daily Living Revision History Description

More information

Durable Medical Equipment Providers

Durable Medical Equipment Providers August 2009 Provider Bulletin Number 974 Durable Medical Equipment Providers Vacuum Assisted Wound Closure Therapy Negative pressure wound therapy (NPWT) must be requested and supplied by an enrolled durable

More information

Zody s Ergonomic Features and Adjustments

Zody s Ergonomic Features and Adjustments Zody s Ergonomic Features and Adjustments by: Teresa A. Bellingar, Ph.D. Ergonomic standards and guidelines recommend several working postures sitting while reclining, upright, or in forward tilt; standing

More information

1. EXECUTIVE SUMMARY 2. PRODUCT SUMMARY

1. EXECUTIVE SUMMARY 2. PRODUCT SUMMARY 1. EXECUTIVE SUMMARY Success or failure in the medical industry begins with a diagnosis. This fact is well known and revered by clinicians, therapists, and health care providers. However, despite this

More information

The Basics of Wheelchair Seating and Positioning. Benefits of a Proper Seating Evaluation for Individuals with SCI

The Basics of Wheelchair Seating and Positioning. Benefits of a Proper Seating Evaluation for Individuals with SCI Objectives Allison Greenwood, OTR/L, ATP Senior Occupational Therapist Outpatient Neurologic Therapy The Basics of Wheelchair Seating and Positioning 1. Identify criteria for referral for a seating evaluation

More information

An Evaluation of an Obstacle Avoidance Force Feedback Joystick

An Evaluation of an Obstacle Avoidance Force Feedback Joystick An Evaluation of an Obstacle Avoidance Force Feedback Joystick James L. Protho, M.S. Edmund F. LoPresti, B.S. David M. Brienza, Ph.D. University of Pittsburgh Rehabilitation Science and Technology A Research

More information

1. Can self-propel, or use their foot to push (punt), a standard manual wheelchair 1 and be safe and able to do essential daily tasks.

1. Can self-propel, or use their foot to push (punt), a standard manual wheelchair 1 and be safe and able to do essential daily tasks. Disability Support Services Equipment and Modifications Competency Framework Wheeled Mobility and Postural Management Introduction The Wheeled Mobility and Postural Management Credential recognises that

More information

The Effect of Surface Curvature and a Gel Liner Interface on Performance Properties of the Tekscan F-Socket System. Lara Schrock 4.25.

The Effect of Surface Curvature and a Gel Liner Interface on Performance Properties of the Tekscan F-Socket System. Lara Schrock 4.25. The Effect of Surface Curvature and a Gel Liner Interface on Performance Properties of the Tekscan F-Socket System Lara Schrock 4.25.07 Background The presence of mechanical loads at the limb socket interface

More information

PATIENT CARE MANUAL POLICY

PATIENT CARE MANUAL POLICY PATIENT CARE MANUAL POLICY NUMBER #VII-F-20 PAGE 1 OF 2 APPROVED BY: CATEGORY: Senior Vice President, Medicine and Chief of Staff; Vice President and Senior Operating Officer, Covenant Health, Rural Health

More information

Supporting the Spine When Seated

Supporting the Spine When Seated Supporting the Spine When Seated THE SCIENCE AND RESEARCH BEHIND THE MIRRA CHAIR The human spine is dynamic and requires dynamic support during seated periods. The four regions of the spine have unique

More information

$15 BILLION the government spent on PU treatment in Objectives

$15 BILLION the government spent on PU treatment in Objectives Objectives Is It All About Pressure? Clinical Decision Making in Determining the Cause of Pressure Ulcers Presented by: W. Darren Hammond, MPT, CWS The ROHO Institute for Continuing Education and Research

More information

Palliative Care. EPUAP/NPUAP Publish New Pressure Ulcer Guidelines for. Treatment. Improving Quality of Care Based on CMS Guidelines 39

Palliative Care. EPUAP/NPUAP Publish New Pressure Ulcer Guidelines for. Treatment. Improving Quality of Care Based on CMS Guidelines 39 Treatment EPUAP/NPUAP Publish New Pressure Ulcer Guidelines for Palliative Care Dealing with the end of a loved one s life is difficult enough, but when wound and skin care issues are involved, the decisions

More information

THERAKAIR VISIO ADVANCED LOW AIR LOSS PRESSURE RELIEF WITH PULSATION THERAPY. with people in mind.

THERAKAIR VISIO ADVANCED LOW AIR LOSS PRESSURE RELIEF WITH PULSATION THERAPY. with people in mind. THERAKAIR VISIO ADVANCED LOW AIR LOSS PRESSURE RELIEF WITH PULSATION THERAPY with people in mind www.arjohuntleigh.com ADVANCED LOW AIR LOSS PRESSURE RELIEF WITH PULSATION THERAPY THE CLINICAL CHALLENGE:

More information

CARE OF THE NEONATE: ITS ALL ABOUT THE SKIN. Katherine Kunkel, MSN, RNC-NIC, WCC

CARE OF THE NEONATE: ITS ALL ABOUT THE SKIN. Katherine Kunkel, MSN, RNC-NIC, WCC CARE OF THE NEONATE: ITS ALL ABOUT THE SKIN Katherine Kunkel, MSN, RNC-NIC, WCC Learning Objectives Recognize what are risk factors for the neonate within the intensive care unit. Understand the physiology

More information

PRESSURE INJURIES WHAT S IN A NAME?

PRESSURE INJURIES WHAT S IN A NAME? PRESSURE INJURIES WHAT S IN A NAME? LINDA NORTON MScCH, PhD candidate, OT Reg.(ONT) Motion Specialties, University of Toronto and University of Western Ontario The term pressure ulcer has been replaced

More information

PRESSURE IQ EVOLVE NON-POWERED MATTRESS SOLUTION FOR THE PREVENTION AND TREATMENT OF STAGE I-IV PRESSURE ULCERS

PRESSURE IQ EVOLVE NON-POWERED MATTRESS SOLUTION FOR THE PREVENTION AND TREATMENT OF STAGE I-IV PRESSURE ULCERS PRESSURE IQ EVOLVE NON-POWERED MATTRESS SOLUTION FOR THE PREVENTION AND TREATMENT OF STAGE I-IV PRESSURE ULCERS... with people in mind 10542_Arjo_EVOLVE_Brochurer_USA_215.9x279.4.indd 1 RAISING THE STANDARD

More information

SHAPED TO SUPPORT YOUR EVERY MOVE

SHAPED TO SUPPORT YOUR EVERY MOVE SHAPED TO SUPPORT YOUR EVERY MOVE OPTIMA SERIES FEATURES & BENEFITS The nxt Back Support Series provides a range of back Support models, with Pelvic or thoracic shapes and posterior, posterior lateral

More information

DO NOT SIT WITHOUT PROPER FIT. Objectives. Recommendations 4/23/2014 CSMC Participants will be able to:

DO NOT SIT WITHOUT PROPER FIT. Objectives. Recommendations 4/23/2014 CSMC Participants will be able to: DO NOT SIT WITHOUT PROPER FIT CSMC 2014 Presented by: Elizabeth Cole, MSPT, ATP Director of Clinical Rehab Services Objectives Participants will be able to: Match each anatomical measurement to the corresponding

More information

Ann Leland, APRN, CNP, DNP Instructor, college of surgery

Ann Leland, APRN, CNP, DNP Instructor, college of surgery Ann Leland, APRN, CNP, DNP Instructor, college of surgery leland.ann@mayo.edu 2015 MFMER 3543652-1 Pressure ulcers Mayo School of Continuous Professional Development 2nd Annual Inpatient Medicine for NPs

More information

Draft of Recommendations for Training and Use of Power Tilt systems

Draft of Recommendations for Training and Use of Power Tilt systems Draft of Recommendations for Training and Use of Power Tilt systems Chris Maurer, MS PT, ATP Sharon Sonenblum, PhD Offered by Stephen Sprigle, PhD, PT WHY? NO ONE TILTS(for pressure reliefs)! Medically

More information

DON T JUST PROVIDE A BAND-AID ELIZABETH COLE, MSPT, ATP U.S. Rehab / VGM

DON T JUST PROVIDE A BAND-AID ELIZABETH COLE, MSPT, ATP U.S. Rehab / VGM DON T JUST PROVIDE A BAND-AID ELIZABETH COLE, MSPT, ATP U.S. Rehab / VGM Selecting the most appropriate product solutions for specific postural problems should be a thoughtful exercise in analyzing the

More information

Prevention and management of pressure ulcers

Prevention and management of pressure ulcers The Clatterbridge Cancer Centre NHS Foundation Trust Prevention and management of pressure ulcers Nursing A guide for patients and carers Contents What is a pressure ulcer?... 1 Who gets pressure ulcers?...

More information

Recognizing Pressure Injury

Recognizing Pressure Injury Recognizing Pressure Injury Karen Zulkowski, DNS, RN Hawaii Recorded on March 8, 2017 1 A Little About Myself Executive editor of the Journal of the World Council of Enterostomal Therapists (JWCET) and

More information

GREGORY Commercial Furniture

GREGORY Commercial Furniture 1 1 2 2 The tear drop shape represents internal foam cores and highlights were your Ischial Tuberosities should sit. Pommel at the front discourages user crossing legs. The unique waterfall front reduces

More information

Predictive value of transcutaneous oxygen pressure and amputation success by use of supine and elevation measurements

Predictive value of transcutaneous oxygen pressure and amputation success by use of supine and elevation measurements Predictive value of transcutaneous oxygen pressure and amputation success by use of supine and elevation measurements J. Michael Bacharach, MD, Thom W. Rooke, MD, Philip J. Osmundson, MD, and Peter Gloviczki,

More information

Promoting Skin Integrity in End of Life Care. Part 1. Tracey McKenzie Head of Tissue Viability Services TSDFT

Promoting Skin Integrity in End of Life Care. Part 1. Tracey McKenzie Head of Tissue Viability Services TSDFT Promoting Skin Integrity in End of Life Care Part 1 Tracey McKenzie Head of Tissue Viability Services TSDFT To Understand the Extrinsic Factors of Pressure Ulcer (PU) development To understand the Intrinsic

More information

new discoveries Pressure Ulcers: A New Perspective Deep Tissue Injury Research, Part I

new discoveries Pressure Ulcers: A New Perspective Deep Tissue Injury Research, Part I Deep Tissue Injury Research, Part I Pressure Ulcers: A New Perspective They re not a new medical condition, and healthcare professionals have been dealing with them for so long that multiple terms have

More information

Pressure Redistribution Clinical Training. August 2014

Pressure Redistribution Clinical Training. August 2014 Pressure Redistribution Clinical Training August 2014 Goal: To help clinicians better understand and execute proper patient pressure redistribution and positioning Contents (Click the link to move to that

More information

Growth Capable. Mike 6 tall in a Granstand III MSS. Nichole 42 tall in a Kidstand III MSS

Growth Capable. Mike 6 tall in a Granstand III MSS. Nichole 42 tall in a Kidstand III MSS Growth Capable Granstand III MSS / Kidstand III MSS is Growth Capable! Unprecedented growth capability in one product - the Granstand III Modular Standing System is just that - A System! Granstand III

More information