Groundbreaking research in clinical seating by specialists Seating Matters reveals astounding 88.3% reduction in pressure ulcers.
Clinical Seating Specialists, Seating Matters partnered with world leading health science researchers at Ulster University to conduct a pioneering two year clinical trial. This research and its results have officially been launched to allow clinicians worldwide to translate and replicate the findings, helping improve outcomes for their patients requiring specialised seating.
As you read this, it is likely that you are sitting, perhaps at your work desk, or on your sofa. Now, imagine how you’d feel after sitting in that one position for 8 hours; the equivalent of a long haul flight. It would be no surprise to feel uncomfortable and agitated, not to mention the chance of developing pain. This is the discomfort that many people have to endure every day of their lives as they are seated in equipment which does not meet their individual needs. Educating clinicians worldwide with our research will help stop this being the norm and change the world of healthcare seating.
As an able bodied person, it is easy to take sitting comfortably for granted. It is an activity that is often engaged automatically, without thought. However, for our patients, particularly those with postural or pressure care needs, sitting should be accompanied by a thorough seating assessment to identify their individual needs and recommendations made regarding specialised seating to support these. As in many instances when this is not the case, patients are more vulnerable to the development of pressure ulcers, pain, discomfort, reduced quality of life and further postural/physiological complications. It is a staggering statistic that 60% of older people with a pressure ulcer die within one year, yet 95% are completely avoidable (Lyder 2002). 1 in 5 people are affected by pressure ulcers across the acute care, long term care and home care environments (Lyder 2002).
An astonishing amount of money is spent worldwide treating pressure ulcers. In the UK alone, the NHS spend over £2 billion each year (Bennett 2004). The majority of the money spent on treating pressure ulcers is accounted for by nursing time as the length of a hospital stay for a patient who gets a pressure ulcer is 6.4 days longer. This creates a huge financial burden and is a poor use of valuable resources that could be better invested in other areas of patient care or valuable staffing resources.
Martina Tierney, Clinical Director of Seating Matters, has practised Occupational Therapy for over 30 years and spent most of her career focused on the importance of specialised seating. She struggled to find chairs that suited the needs of her patients. Often Martina found that her patients had pressure ulcers, poor posture and spent long periods of time sitting in unsafe positions. It became clear that this was a worldwide problem, not just an issue in the UK and so the goal to ‘Change the World of Healthcare Seating’ became a mantra and with assistance from her family, they began to design and manufacture a solution to this growing problem.
Historically, clinical evidence and guidance to support the use of specialised seating for patients has been sparse and much of the work of occupational therapists and the multidisciplinary team has been based on anecdotal evidence or clinical experience. With pressures mounting on resources as well as budgets and staffing, intervention and treatment should be based on practice which has been evidenced based and proven clinically effective for our clients in order to optimise patient outcomes.
Seating Matters partnered with world leaders in clinical research at Ulster University to conduct a pioneering research trial; the results of which would help health professionals at all levels to improve the quality of life for their patients and change the world of healthcare seating. This comprehensive research trial was led by a team of experienced occupational therapists. It is one of the few in the world that has examined the relationship between the effectiveness of specialised seating in reducing the risk or incidence of pressure ulcers. Previous research has commonly focused solely on mattress or cushion provision for this purpose. The research team also hoped to examine the impact of specialised seating on posture, comfort, functional ability and quality of life for the user and also for the caregiver. The use of inappropriate seating can contribute significantly to patients sliding from the chair or falling to the side. It was hoped that by using appropriate seating the patients would not require such continuous postural correction and so reducing the burden on caregiver and nursing staff.
The results have shown that the correct use of specialised seating for those with postural and pressure care needs can significantly reduce the risk of sitting acquired pressure ulcers, discomfort and pain, whilst also contributing to improved physiological functioning such as respiration and improved socialisation/communication. One of the most significant results was the 88.3% reduction in the incidence of pressure ulcers for those research participants who benefited from the use of specialised seating. The seat was chosen to meet their individual needs, in comparison to those who sat in their original seating. Some of the other benefits among those using individualised specialised seating include:
- 95% increase in oxygen saturation levels
- Increased functional ability
- Improved posture and a reduction in the development of postural deformities or sliding/falling from the chair
- Improvement in respiration, elimination, digestion and other psychological functions
- Improved quality of life and psychological well-being
- Improved communication and interaction
- Improved comfort and reduction in pain levels
- A significant reduction in expenditure on staff labour and treatment of pressure ulcers
It was the goal of the research team at Seating Matters and Ulster University to create a research model which was replicable in clinical practice and in which findings can be achieved within everyday care. We recognise that a fundamental aspect of patient care is translating research into practise and for that reason the trial was conducted in a clinical setting using patients with significant postural and pressure needs as opposed to using able bodied participants in a controlled environment. Therapists across the world can replicate the model of thorough assessment, identification of need, provision of appropriate equipment and monitoring in order to achieve similar results for their patients. This is particularly well evidenced and relative to settings where seating needs are prevalent and often outweigh adequate equipment provision such as nursing homes, care facilities and hospitals.
As demonstrated, correct use of seating can go a long way to improve a person’s health as well as saving health services much needed money in the process. As well as the encouraging results for patients, there was also a very significant cost implication with the emergence of the above results. An economic study conducted by Ulster University economists based on UK pressure ulcer data indicated that introducing Seating Matters chairs in NHS hospitals and replicating the results of this study could yield a potential yearly saving of a staggering £319 million (Bailey & McGallion 2013).
It is hoped that sharing the results of this trial and the methods used to achieve them with therapists throughout the world, will have a significant impact on patient care. It will also help improve the role of the caregiver who is responsible for monitoring the seated patient. These results are disseminated at conferences and also shared as part of the ‘Why Seating Matters; the principles of seating, postural and pressure care management’ training programme. This training programme may be attended by all members of the multidisciplinary and care team and has been endorsed by the College of Occupational Therapists.
In sharing the results of this trial, we have recently have hosted our world exclusive research launch in Northern Ireland. Due to its success, we will be replicating the event globally in a location near you. If you would like to keep up to date or avail from our clinical educational material, please sign up on our website for your free copy of ‘The Clinician’s Seating Handbook’ and support us on our journey.
Bailey, M., McGallion, G. (2013) An economic cost benefit of using seating matters in NHS and nursing home environments, Ulster University.
Bennett, G., Dealey, C. & Posnett, J. (2004) The cost of pressure ulcers in the UK, Age and Ageing, Vol. 33 No.3, pp.230-235.
Lyder, CH. (2002) Pressure ulcer prevention. Annual Review of Nursing Research. 20: 35-61.