Work as a team
Pressure issues have direct medical implications for a client, but they frequently also have social, psychological and financial implications. Refer the client to all the relevant professionals who are needed to address issues that arise such as wound management, nutrition, exercise regime during bed rest, care hours and equipment. The Agency for Clinical Innovation (ACI) has published a Model of Care for clients with a spinal cord injury in NSW. This document can be used as a reference covering a holistic health response to clients who are at risk of, or have a current, pressure injury. Intervention plans are presented in Section 7 of the Model of Care, which can be downloaded from the link below.
Referral to Spinal Seating Services
In New South Wales, the specialised Spinal Seating Services offers expert clinical and technical advice from skilled clinicians, engineering and technicians to prescribing clinicians and eligible clients. These services are equipped with pressure assessment tools, seating components for short term equipment trials, and fabrication capacity for custom designed cushions and custom seating equipment modifications.
In some instances there may be complicating factors, and local therapists may require support. In these cases, the client can be referred to a Spinal Seating Service.
Referrals to a Spinal Seating Service are indicated for clients with:
- Significant postural deformities
- An inability to maintain a good seating posture throughout the day
- Complex postural and functional needs where commercial products are not able to meet the desired outcome
- Custom-fabricated products that require replacement, such as: cushions, custom-made backrests, armrests and foot supports
- Unmanageable discomfort or skin marking
- Non-healing, sitting-acquired pressure injuries
- A history of recurrent pressure injuries
- Previous surgical interventions relating to pressure injuries
- Dependence on a respiratory ventilator, or
- Difficulty in resolving safety concerns with seating and mobility equipment.