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Preventing Spinal Cord Injury Essay

1063 words - 5 pages

Pressure ulcers (PrUs) are a high-risk, high-volume, high-cost problem for persons with spinal cord injury (SCI). Approximately 273,000 persons are living with SCI in the United States today and approximately 12,000 new injuries occur per year [1]. Persons with SCI are at extreme risk for developing PrUs due to lack of sensation, immobility, moisture, and multiple other risk factors.2 Prevalence for PrUs in persons with SCI ranges from 14-32%, and recurrence rates have been reported to range from 31-79%.3 PrUs account for approximately one third of all VA SCI admissions and over half of all hospital days for veterans with SCI.3 The cost to manage one full-thickness ulcer can be as much as ...view middle of the document...

Experts advocate using engineering solutions such as mechanical or powered patient lifts (floor-based or ceiling) and friction-reducing devices to reduce the risk of injury associated with patient handling.11-20 The universal sling (i.e., a full-body, seated sling) is the most common lifting aid used to transfer and transport dependent patients, including: bed to wheelchair or dependency chair and vice versa, chair to commode, or between bed and stretcher. See Figure 1 for an example of an individual suspended in a universal sling. Although universal slings are the most common, many others have been designed to ambulate patients, to reposition them in bed, or to lift appendages. Furthermore, current nursing practice is to use universal slings and lifts for all transfers and transports involving dependent patients, as taught by practice algorithms in collaboration with the American Nursing Association.14
The impetus behind this research was the observation that patients are frequently left sitting on their slings while in their wheelchairs, for long periods of time, which may interfere with the pressure-reducing properties of the wheelchair cushion, placing the patient at risk for PrU development. This research aims to examine whether patient handling slings might contribute to pressure ulcer development in vulnerable populations, specifically persons with SCI. No evidence to date has been published that links the use of slings and lifts to pressure ulceration, and no literature exists which describes the interface pressures developed during suspension from patient handling slings. The main goals of this study were to describe and quantify risks associated with pressure ulceration due to normal forces and to identify the at-risk anatomical locations while lying supine on a hospital bed, seated in a wheelchair, or while suspended during typical patient transfers for various sling designs (e.g., universal, repositioning, hygiene, disposable).

METHODS

Study Design
A descriptive, observational study was conducted at a VA clinical research institution. Twenty-three patient handling slings (18 seated, 5 supine) were chosen to represent a wide variety of sling styles (e.g., slings with and without head support), materials, and...

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