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Video & Booklet Review Don't get Sore. - Get Moving
Journal of Tissue Viability Vol5 No 2
Video & Booklet Review Don't get Sore- Get Moving The Department of Health Crown Business Communications, 1995 VHS PAL 18 mins.
Relieving the pressure. Your guide to pressure sores The Department of Health 1994 This video is aimed at patients/clients and carers and describes briefly the causes of pressure sores, who is at risk and how to prevent them. It is backed up by a leaflet 'Relieving the pressure: your guide to pressure sores'. The narrative of the video is reinforced by interviews with patients and clinical nursing staff rather than the usual 'experts'. This is a refreshing change and makes the video much more accessible to the lay person. Both the video and the pamphlet have a logical construction, attempting to describe what pressure sores are, how they are caused, who is at risk and how to avoid them. If criticisms are to be made, they are criticisms of emphasis rather than of content. The primary criticism of both video and leaflet is that they place unduly heavy emphasis on immobility as the cause of pressure sores. Immobility is very rarely the sole cause because even very small movements can relieve tissue distortion and consequent ischaemia- the actual physical cause of the sore. The direct cause of the vast majority of sores is the loss of sensation to ischaemic pain which stimulates healthy individuals to move and thus relieve tissue distortion. This is only mentioned in passing and a long way down the list of other factors (such as incontinence) most of whom cannot cause pressure sores in themselves but are merely aggravating factors when an individual is already susceptible due to loss of sensation. I would have liked to have seen a little more time devoted to pressure relieving equipment (PRE) as reliance on repositioning alone has not been particularly successful in the past, even in hospitals with nursing staff available 24 hours a day. The video in particular was a missed opportunity, as this medium is very useful for showing the essential skills necessary for running PRE (testing for 'bottoming out', not tucking tubes in, ensuring tubes are connected, etc). It could also have been used to reassure patients/carers who are worried that PRE will use a lot of electricity. These criticisms apart, there is much to recommend the video and the leaflet. The video draws heavily on disabled children
63
for examples, thus helping to tackle the common misconception that pressure sores are only a problem of the elderly. The message that prevention is better than cure is brought over well as well as the need for constant vigilance if someone is at risk. One can only commend the leaflet statement 'Don't be afraid to be a nuisance - always ask for help if you think you need it'. Pressure sores have serious consequences, a sore can so easily be "an illness in itself' as one speaker describes it. Healthcare professionals must be made to treat the risk of sore development seriously. There is also a lot of good practical advice on handling those at risk, and encouragement to mobilise for those who can. It is good to see the fact that 'you don't have to be stuck in bed to get a pressure sore' is recognised and exercise regimes recommended for those who spend a lot of time in chairs. Even the neurologically intact who are not really at risk are likely to benefit from the exercise. The same can be said for many other recommendations - such as that of improving nutrition. While in themselves unlikely to prevent pressure sores in the short term, they can improve the general condition of the individual and as such if he/she does become at risk of sores there will be less contributory factors to content with. Therefore the video and pamphlet can be recommended, with some reservations perhaps. The video can be purchased or rented from CFL vision, PO Box 35, Wetherby, Yorkshire, LS23 7EX (Tel: 01937 541083). The leaflet can be obtained by phoning the Health Literature Line on 0800 555 777.
Coming Event SCHOOLOFPROSTHETICSAND ORTHOTICS University of Salford/University College Salford
Forthcoming Study Days 1995
21 July
Wheelchairs and Seating - Experience Day
7/8 Sep
Orthotics for Clinicians, Nurses and Therapists
Co-ordinator: Dr S V S Rithalia, Scientific Officer, University of Salford Further details of both meetings can be obtained from: Mrs Norah Virtue, School of Prosthetics and Orthotics, Statham Street, Salford M6 6PU Tel 0161 736 1594 Fax 0161 736 1579
Video & Booklet Review Don't get Sore- Get Moving The Department of Health Crown Business Communications, 1995 VHS PAL 18 mins.
Relieving the pressure. Your guide to pressure sores The Department of Health 1994 This video is aimed at patients/clients and carers and describes briefly the causes of pressure sores, who is at risk and how to prevent them. It is backed up by a leaflet 'Relieving the pressure: your guide to pressure sores'. The narrative of the video is reinforced by interviews with patients and clinical nursing staff rather than the usual 'experts'. This is a refreshing change and makes the video much more accessible to the lay person. Both the video and the pamphlet have a logical construction, attempting to describe what pressure sores are, how they are caused, who is at risk and how to avoid them. If criticisms are to be made, they are criticisms of emphasis rather than of content. The primary criticism of both video and leaflet is that they place unduly heavy emphasis on immobility as the cause of pressure sores. Immobility is very rarely the sole cause because even very small movements can relieve tissue distortion and consequent ischaemia- the actual physical cause of the sore. The direct cause of the vast majority of sores is the loss of sensation to ischaemic pain which stimulates healthy individuals to move and thus relieve tissue distortion. This is only mentioned in passing and a long way down the list of other factors (such as incontinence) most of whom cannot cause pressure sores in themselves but are merely aggravating factors when an individual is already susceptible due to loss of sensation. I would have liked to have seen a little more time devoted to pressure relieving equipment (PRE) as reliance on repositioning alone has not been particularly successful in the past, even in hospitals with nursing staff available 24 hours a day. The video in particular was a missed opportunity, as this medium is very useful for showing the essential skills necessary for running PRE (testing for 'bottoming out', not tucking tubes in, ensuring tubes are connected, etc). It could also have been used to reassure patients/carers who are worried that PRE will use a lot of electricity. These criticisms apart, there is much to recommend the video and the leaflet. The video draws heavily on disabled children
63
for examples, thus helping to tackle the common misconception that pressure sores are only a problem of the elderly. The message that prevention is better than cure is brought over well as well as the need for constant vigilance if someone is at risk. One can only commend the leaflet statement 'Don't be afraid to be a nuisance - always ask for help if you think you need it'. Pressure sores have serious consequences, a sore can so easily be "an illness in itself' as one speaker describes it. Healthcare professionals must be made to treat the risk of sore development seriously. There is also a lot of good practical advice on handling those at risk, and encouragement to mobilise for those who can. It is good to see the fact that 'you don't have to be stuck in bed to get a pressure sore' is recognised and exercise regimes recommended for those who spend a lot of time in chairs. Even the neurologically intact who are not really at risk are likely to benefit from the exercise. The same can be said for many other recommendations - such as that of improving nutrition. While in themselves unlikely to prevent pressure sores in the short term, they can improve the general condition of the individual and as such if he/she does become at risk of sores there will be less contributory factors to content with. Therefore the video and pamphlet can be recommended, with some reservations perhaps. The video can be purchased or rented from CFL vision, PO Box 35, Wetherby, Yorkshire, LS23 7EX (Tel: 01937 541083). The leaflet can be obtained by phoning the Health Literature Line on 0800 555 777.
Coming Event SCHOOLOFPROSTHETICSAND ORTHOTICS University of Salford/University College Salford
Forthcoming Study Days 1995
21 July
Wheelchairs and Seating - Experience Day
7/8 Sep
Orthotics for Clinicians, Nurses and Therapists
Co-ordinator: Dr S V S Rithalia, Scientific Officer, University of Salford Further details of both meetings can be obtained from: Mrs Norah Virtue, School of Prosthetics and Orthotics, Statham Street, Salford M6 6PU Tel 0161 736 1594 Fax 0161 736 1579