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State Spinal Cord Injury Service

Spinal Seating Modules

Formulate trials

Some practical considerations to bear in mind when formulating trials:

  1. Ensure correct set up of trial equipment so that it closely approximates the system proposed for scripting.
  2. Fine tune the set up when the client is seated in the system by assessing and adjusting the configuration to meet pressure care goals.
  3. Discuss and communicate with the client and carer about the trial equipment process in order to reach the identified goals.
  4. Where possible relevant pressures should be measured before and after a change in seating configuration or equipment. Where it is not possible to accurately measure these pressures clinicians should trial new seating configurations conservatively.
  5. Skin checks are required to detect any pressure injury risks. Within reason and available resources, checks should be conducted after 20 – 30 minutes of the trial set up. If there are signs of skin damage (localised redness or non-blanching) suspend the trial until a seating review is undertaken. In the event of a suspended trial, clients should revert to known safe equipment and configurations. Otherwise repeat the skin check in 2 hourly increments for the first day (See Module 3 for a review of skin checks).
  6. Provide instructions for equipment use and maintenance during the trial.
  7. Encourage clients to provide feedback on aspects such as skin status, comfort, transfers, changed postural support, functional capacity etc. If several items are being trialled at the same time, the therapist should consider listing them and ask for feedback in a systematic way. This is particularly useful when documenting clinical rationale and funding applications. Establishing clear goals will make feedback easier.
  8. Consult with a Spinal Seating Service for assistance as required.

References

  1. “Preventing and treating pressure sores: a guide for people with spinal cord injuries” Bowman, T. Spinal Cord Injury Ontario, 2015 http://onf.org/system/attachments/312/original/Pressure_Ulcer_Guide_medium-res_single_pages.pdf
  2. Pressure Ulcers: What You Should Know. A Guide for People with Spinal