One Person Can Make
A Difference
By
Wendy Simons
Recently I was
reflecting with a fellow elder care professional how one person can make
a difference. That one person was my sister, Dr. June Abbey, who was a
world class nursing research pioneer. She passed away in October, 2006,
but not without leaving a mark on an amazing number of individuals and
projects in physiological nursing. She was a visionary who’s areas of
study included fatigue (1971), hypothermia (1974), external pneumatic
intermittent compression leggings (1976), bladder alarms for
quadriplegics (1981) and maintenance of continence in nursing home
patients (1987) and was a nationally recognized for her expertise in
medical technology. While much of her research was brilliant, she also
sought the simplest solutions to the most complex problems.
The conversation
stemmed around the ever challenging situation of bedsores in the elderly
who are in hospital and medical settings such as skilled nursing
facilities. It is well known, as a person becomes less mobile,
malnourished and perhaps dehydrated, the skin may break down and
resulting sores or decubitus ulcers (localized breakdown and ulceration
of skin due to interference with its blood supply, usually occurring
over a bony prominence, such as the hip or heel that is subject to
continuous pressure, also called a bed sore or pressure sore) will
occur.
I shared with my
fellow professional the solution that June developed in her study in
1987. It’s amazingly simple, yet not implemented in today’s health care
settings, which amazes me. June, serving as Director of Nursing
Research at the University of Pittsburg, PA, and on the heels of
developing the bladder alarms for para-and quadriplegic patients,
developed a protocol in the skilled nursing care unit that all patients
subject to incontinence or bedsores utilize a color coded system to
assure they were being attended to or moved at regular intervals. How
did she do this? The simple procedure of covering the cushions they
rested on with colored slip covers. Basically, every two to four
hours, the slip covers on the cushions were to be changed. For example;
8am- blue cover, 10am-yellow cover, 12pm-pink cover, 2pm-green cover,
4pm-red cover, etc. This solution was so simple yet it guaranteed that
each person was moved (to change the cover) no less than every two
hours. Hence, no continuous pressure and voila….no bed sores! The
interesting side benefit of the study and protocol was that each
caregiving team began to watch to assure that the covers were changed,
as did the patients in the facility. Pretty soon everyone was watching
out for each other. Needless to say, easy compliance and team work
served to benefit those cared for by the facility, and everyone had
fun. Even family members participated! It brings to mind, how do we
really know how often someone who cannot move is moved? If bedsores
develop due to pressure and lack of movement, why do we not create a
system to assure pressure is relieved and the dependant person is moved
frequently? Sure….documentation often occurs that “someone” attended to
a resident, but does that really happen? Why not us a simple visual cue
to guarantee it happened and set staff, residents and others up for
success?
June made a
difference in so many lives. I firmly believe it only takes one person
to begin a change in health care protocols. I have shared this solution
with many of my health care professionals, but to no avail. So…… I
offer this to all who have a relative in a medical facility or anywhere
where you are not certain the care is being provided. Dye a pack of
different colored pillow covers, or find someone to sew some slipcovers
for those cushions your loved on sits or lies on….. then set up a
protocol to assure those covers are changed every 2-4 hours. I’d be
willing to bet your relative will not have sores!!! Simple solutions
are always best… I learned that from my genius sister.
