Visiting Expert in Pharmacy
by Suhaila Usuludin ~ March 18th, 2008. Filed under: General Medicine, Geriatrics, Latest News, Seminars, Work.For those who may ask the reason I am doing a locum instead of a permanent OT position, here it is. I will be going to La Trobe University, Australia to obtain my degree conversion in July. Hence, this explains the locum part.
Anyway, just after lunch, I attended a lecture by MOH Visiting Expert in Pharmacy, Prof. Geoff Sussman from Monash University, Australia. The topic of this lecture was regarding wounds and pressure sores management. What strikes me in this lecture was that he mentioned that wounds are mostly caused by trauma, and the most common reason for the occurence of trauma was due to hospital bed cots and wheelchair. This reminds me of the number of times a patient has to go in and out of the wheelchair for therapy session. Hence, it is essential to take note of possible cuts when positioning the footrests up and down while the patient is on the wheelchair. As for bed cots, I can’t visualise on how cuts can possibly occur except to get your limbs stuck in between the railings when positioning it up and down.
Well anyway, the lecture also includes on the nursing side on managing wounds. The evidence-based protocols and dressings to use. The creams, magnesium sulphide and such. I could not understand those.
As for pressure sores, he mentioned that the best way to prevent them is to remove the pressure by using pressure relief mattress or cushions. Then it comes to my question of “How about positionings?”. Changing the patients’ positions hourly. Does it work? Is it evidence-based?
However, after thinking it through, in positionings, the same amount of pressure still exists despite the reduction of time of the area of the body being ‘pressured’. Hence, I would think that after multiple times (although intermittent) of the area of the body being ‘pressured’, the risk of getting a pressure sore is higher than to remove the pressure by using those mattresses or cushions. Makes sense? What do you all think?
March 19th, 2008 at 6:52 pm
In singapore, I would think depends on the setting. ie Availability of manpower versus facilities. Whatever the case is , singapore aims to provide quality healthcare. Nursing Staff/aides would probably do both if possible. Most importantly, the nursing contingent are very conscientious about preventing pressure sores and even more so for dealing with pressure sores that are already occuring. From the occupational therapy perspective, we use bed positioning for more reasons other than relieving/preventing pressure sores. For instance, providing proprioceptive input into different joints, sensory stimulation, social interaction or even facilitation of patient-initiated activities! So, i suggest, as long no harm is done, we can either do it as a team or provide individual effort with regards to your qns.