1. Topic-
|
|
|
2. Content-
|
| Identifying signs and symptoms of pressure sores, steps to reduce
risk, and establishing support system to aid in risk reduction. |
| |
|
3. Goals: Aims/Outcomes-
|
1. Patient will verbalize 5 signs/risks of developing a pressure
sore in order to demonstrate understanding of potential for decubitis
ulcer.
2. Patient will consistently perform effective pressure reliefs every
30 minutes from chair or while in bed to reduce risk of pressure sore
development.
3 Patient will identify 3 friends and instruct each on signs/risks
of pressure sores and techniques to reduce risk. |
| |
|
|
4. Objectives-
|
1. Determine patient's understanding of the medical terms used and
the potential threat of pressure sores.
2. Increase strength and unsupported sitting balance, improve awareness
of time, and increase knowledge of techniques to engage in positional
changes.
3. Allow patient to identify and have control over who he feels is
responsible enough to assist with his needs, shows patient's teach-back
ability. |
| |
|
5. Materials and Aids-
|
| Visual aids including photos of wounds caused by pressure sores.
Access to previous patient who has experienced a pressure sore. Telephone
to allow patient to call friends who he chooses to be incorporated
into his care. Spinal Cord binder. Written agreement to initiate pressure
relief every 30 minutes. Pressure mapping system with computer to
allow patient to see exactly where increased pressure occurs. |
| |
|
6. Procedures/Methods-
|
|
A. Introduction-
1. Provide statistical research about pressure sores, incidence
rate for SCI and complications associated with pressure sores.
2. Review spinal cord binder and progress thus far.
3. Discuss goals and allow patient to provide input and identify possible
limitations of reaching goals.
|
| |
|
|
B. Development-
1. Demonstrate methods of pressure relief in wheelchair for paraplegia:
side lean, forward fold, push-up.
2. Set up pressure mapping system and allow patient to see on screen
where increased pressure occurs.
3. Facilitate identification of 3 reliable friends for patient to
recruit for treatment session. |
| |
|
|
C. Practice-
1. Observe patient performing pressure reliefs while seated while
supervised.
2. Allow patient to call 3 friends and invite them to a planned treatment
session.
3. Request patient identify high risk areas using long handled mirror,
and signs of pressure sore.
4. Sign written agreement where patient agrees to perform pressure
reliefs every 30 minutes while in chair. |
| |
|
|
D. Independent Practice-
1. Discuss all points at next session to determine carryover and
what information needs more attention.
2. Instruct patient to prepare written treatment plan for when friends
come, identifying information he feels most important to teach them
3. Instruct patient to continue pressure reliefs throughout day.
|
| |
|
|
E. Accommodations (Differentiated Instruction)-
1. Due to patient's age, he may determine that texting a friend
to set up an appointment is more appropriate
2. Patient may respond better to someone who has experienced a spinal
cord injury, therefore volunteer who is close to patient's age will
be present to provide input as needed.
3. Upper body strength may not be good enough yet to perform all forms
of pressure reliefs, therefore may need adjustment.
4. Pt may not be able to determine a 30 minute period, therefore alarm
can be set to provide auditory cue. |
| |
|
|
F. Checking for understanding-
1. Observe patient during physical and recreational therapy session
(discussing with therapists ahead of time) to assess whether pressure
reliefs are completed every 30 minutes.
2. Daily skin checks to be completed by nursing or OT to assessment
for skin breakdown.
3. Assess patient's ability to fully communicate information to friends. |
| |
|
|
G. Closure-
1. Identify questions or concerns that patient feels will limit
ability to perform pressure reliefs in order to address next session.
2. Discuss plan for next session. |
| |
|