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Pressure Injury Toolkit For Spinal Cord Injury and Spina Bifida

Beyond the wound - Bringing best practice to the bedside

Self management

How to support self management

Help people learn, apply and incorporate effective pressure management strategies into their daily life.20

  • Involve family and care givers
  • Consider technology based tools that will facilitate52
    • learning (Eg. E-learning packages, interface pressure mapping)
    • adoption of strategies (Eg. Audio reminders) and
    • individually tailored advice (Eg. Telemedicine programs).
  • To monitor their own skin and wound, the person may choose to take photos or video on their own phone or camera
  • Facilitate the person to develop a personal action plan:
    • List specific goals and behaviours needed to heal the wound
    • Identify and list barriers to achieving the goals and strategies to address these barriers
    • Specify a follow up plan
    • Share the plan with family, carers, health care team20

This can be implemented through various approaches such as motivational interviewing, The Five A’s, Health Coaching and The Flinder’s Model for example.

Children with SCI or SB

  1. Provide education and resources developed specifically for children that:
    • Explain that bumps and bruises may be PIs, for example, the bruise on the side of a child’s hips may be a deep tissue injury as a consequence of their wheelchair being too small.
    • Aimed at a child’s understanding of how the body works and to help them develop insight into the importance of looking after and respecting their body. For example, Life Education “All Systems Go!” App.
    • Provide biofeedback such as pressure mapping.
  2. Introduce the process of health management early to optimise opportunities to provide education:
    • When developing a care plan invite the child to participate or at least be in the room.
    • Use a skills developmental chart to understand the level of responsibility expected at different ages. It promotes the learning of skills such as dressing, transferring and bladder and bowel management at a developmentally appropriate time to ensure skills are learnt, if possible, at an appropriate age.
      Example Self Care Development Chart.

    Self-management  for children and adults with SB: A presentation from the SB World Conference by Kathy Sawin, 2017.

  3. Communicate:
    • Use one individualised plan for the child and ensure it ‘goes with’ the child from home to school and leisure activity settings.

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