Authors (including presenting author) :
Man YL (1), Chang KW (1), Lau FCA (1), Chan NH (2), Auyeung TW (2)
Affiliation :
(1)Department of Occupational Therapy, (2)Department of Medicine & Geriatrics, Pok Oi Hospital
Introduction :
Development of pressure injuries can prolong patient hospitalization and increase healthcare costs. One of the occupational therapy interventions is to assess and prescribe appropriate pressure relieving devices to patients with risks of pressure injury. Considering the limitations and effectiveness of current practice due to staffing constraints, pressure relieving abilities from multiple linen layers and generic design of commercially available device, a pilot project was conducted to explore the feasibility and applicability of using a newly designed positional devices adopting textiles with low friction coefficients as well as to enhance multi-disciplinary collaboration with ward staff.
Objectives :
To enhance overall effectiveness of pressure injury intervention
Methodology :
Geriatric in-patients with existing or at high risk of developing pressure injury were recruited from medical ward. Apart from the conventional care such as standardized dressing procedures and positional changes. In this pilot program, occupational therapists would assess and provide positional devices (a) small wedge cushion which was customized to Asian body size and/or (b) tailor-made foam mat with silk-like fabrics as overlay if indicated. Pressure distribution of lower trunk with the application of new positional devices were made by pressure mapping measurement. Besides, training workshops had arranged collaboratively with wound nurse to enhance ward staff’s knowledge and skills on proper positioning and use of devices. Educational poster and signage were developed which was posted in ward and bedhead signboard to improve communication with ward staff.
Result & Outcome :
Participants experienced a decrease on the impact of pressure after using the new devices as revealed by pressure mapping measurement. In prop up position, peak pressure was reduced by 37.3% to 61.6% while the average pressure was reduced by 5.5% to 7.2%. The peak pressure was reduced by around 24% in side-turning position. The low-friction fabrics also helped to reduce friction between bed linen and patient during nursing procedure.
A survey with 10 points scale was also conducted to collect ward staff’s feedback on the pilot program. A total of 12 nursing staff and 7 supporting staff had participated in the survey. The feedback was positive in general. The median score of the overall program effectiveness was 8, median score of the ease of cleaning were 8 and 5 for small wedge and foam mat respectively. Recommendations were received on the need in increasing the size of foam mat for easier use.
