Jayne Warren

Category: Specialist Cushions

CNS Infection Control, Nevill Hall Hospital.

Mr. T. is a 25 year old gentleman, who was admitted to Nevill Hall Hospital in June, with a history of a cerebral bleed. He had no previous medical history and had been fit and well. Following confirmation of diagnosis at a regional neurological centre he was transferred back to Nevill Hall Hospital for rehabilitation.

The cerebral haemorrhage had left the patient with a dense left sided paralysis, speech was not affected. However, complications of blindness in both eyes had been diagnosed. It was not sure whether this would gradually be corrected, or if this was a permanent state.

The author first had contact with the patient when a nurse complained that the patient was unhappy and uncomfortable with the cushion used on his wheelchair. Particularly as he sat out in his chair for more than 12 hours a day.

Following initial assessment by the author on 28 August, it was noted that the patient was at low risk of developing a pressure sore. His general well being was good, he was cheerful and in no pain. His nutritional status was good and he had no pressure damage. At night he was nursed on a basic hospital mattress, with a fibre overlay to provide comfort and was able to reposition himself in bed.

In order to aid posture, comfort and confidence, it was decided to trial the Invacare Flo-tech Lite cushion. The patient was fully aware of the trial and that the cushion was not a pressure reducing aid, but purely an aid to comfort and posture. It was explained that if the cushion was unacceptable, an alternative cushion would be found.

On the 29 August the patient was re-assessed. He responded that he found the trial cushion to be more comfortable than the previous one used. His belief was that he felt the pommel to the front and middle of the cushion, helped to keep his legs slightly apart, stopping them from rubbing together, a problem he had experienced since his stroke.

At this time the patient was going home on a daily basis and returning to the hospital at night. On the 1 September the patient was re-interviewed and had experienced no problems with the cushion.

Prior to discharge, the ward staff interviewed the patient regarding the comfort of the cushion. He commented that it was comfortable enough to take it home. Although the cushion was only used for 1 week, it was felt that the patient’s comfort had improved at this difficult time.

Pressure sore risk, throughout these case studies was measured using the Waterlow score or PSPS.

References

Waterlow J (1985) A Risk Assessment Card Nursing Times (27) Nov 26, 51-55

Lowthian P. The practical assessment of pressure sore risk. Care – Science and practice 1987, 5. 3 – 7