The role of seating in pressure management

Date: 22/03/2016 Host: @SeatingMatters

Many people, as a result of disabilities, diseases and conditions spend long periods of time sitting or confined to bedrest. The role of the occupational therapist is to correctly assess the needs of the patient, helping them to retain a level of occupation and independence, enabling them to complete functional tasks which are most important to them.

Pressure Management

Pressure Management is of paramount importance to consider for these patients with low mobility. A pressure ulcer is a localised injury to the skin and/or underlying tissue, usually
over a bony prominence caused by pressure or pressure in combination with shear, commonly formed in sitting or lying in one position for a period of time.

Pressure ulcers [or pressure injuries as they are being referred to more and more,] can be
debilitating and cause unnecessary pain and discomfort for the patient, as well as placing
extra burden onto care staff and expenses to care facilities. It is estimated that 1 in 5
patients across the continuum of care still suffer from pressure ulcers despite the amount of research and advanced clinical resources now available. For elderly patients, it has been
cited that 60% with a pressure ulcer die within one year, and in the UK alone £2-£3.1 billion is spent annually treating pressure ulcers – these are scary statistics.

Typically through the years the focus when thinking about relieving pressure ulcers and in
pressure management, has been on surfaces: i.e. beds, mattresses, and cushions. It’s often been the case that a patients pressure care needs are managed on a pressure relieving surface for much of the day, and then they are moved into an unsuitable chair with inadequate postural or pressure support which eliminates the benefits accrued by the
mattress, undoing all the good work. This traditional over reliance on mattresses and the lack of focus on seating is in part to blame for the increasing incidence of pressure ulcers across the world.

Seating Assessment

A seating assessment should be carried out by an occupational therapist or qualified seating specialist, to determine the extent of the postural and pressure management needs of the patient. The impact of specialist, individualised seating solutions positively affects the patients’ health and quality of life in many ways from supporting posture, reducing the risk of pressure ulcers, and most importantly, providing comfort. Best results are achieved for patients when proper therapeutic chairs are used in conjunction with pressure relieving beds and mattresses. This goes far beyond the typical idea that a pressure relieving cushion is enough.

Challenging Case Studies

If the patients’ primary medical condition creates secondary postural or medical complications, properly seating the patient can become more challenging. Incorrect seating can, for example, limit their social interaction, their physiological functions and the ability to carry out small tasks such as eating, drinking or reading a book.

Therefore, maximising the ability to interact and remain engaged with their surroundings as well as maintaining good overall skin care, respiration and so on, become important
considerations when selecting seating.

Evidence Based Practice

Seating Matters have recently unveiled their results of their 2 year research study with Ulster University, which clinically proves a reduction in pressure ulcers by 88.3% by using Seating Matters chairs. To find out more about the study please click here.

Martina Tierney/Seating Matters

Twitter: @Seatingmatters

Changing the world of healthcare Seating. Specialist seating for adults and children suffering from low mobility due to disability or disease. Worlds only tilt in space bariatric chair. Clinical evidence supporting the range which proves a reduction in pressure ulcers by 88.3%. Designed by Martina Tierney Occupational Therapist. Author of ‘The Clinician’s Seating Handbook’