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One Person Can Make A Difference


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.



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