K is for 'Keep moving'
ARTICLE WRITTEN BY SIOBHAN MCCOULOUGH
In this weeks clinical blog, we are looking at the 'K' of the SSKIN bundle which stands for 'keep moving'.
I am frequently told by retiring nurses that 'repositioning' was a lot more uniformed in their ward days than it is now, with routine turns 2 hourly. This is not always possible now, for instance in peoples own homes, or in a situation where pain or poor range of movement means it is difficult to reposition.
This for me is one of the most important aspects of the SSKIN model.
You can provide the best mattress or cushion in the world but your patient still needs repositioning!
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Do we need the full 30° angle to gain adequate tissue perfusion?
Watch this space as there is more research taking place here to see if a 12-18% angle is adequate in certain patients. My view is that offloading any area at risk is better than nothing.
Although we follow the guidelines of 30° (currently optional), if your patient is unable to manage this, look at other positioning aids such as the decubitus cushion to help a % level offloading the affected area and document.
Equally for those seated for long periods of time in chairs, encourage them to stand where possible or if unable they can rock from side to side or push up with their hands to give their bottom a break and encourage some circulation to the area. This can be incorporated into your repositioning plan and, if they have capacity, tell your patient or resident why and get them involved in the self care of their skin and keep them moving.
Do you have any advice about how to keep your patients moving? If so then let me know, or share here as it may give others some ideas too.
If you need clinical advice feel free to contact me here at OSKA™.