Human rights and litigation.

Sleep, like eating or drinking, is essential for living. Almost everyone has experienced the feeling of ‘falling to pieces’ after a night of poor sleep.

Sleep and Alzheimers

Gaur et al., (2022) described how inadequate sleep causes the aggregation of soluble amyloid beta protein and this may raise the likelihood of poor cognitive outcomes. One mech...

In 1944 Ludwig Guttmann went into the hospital at night to see how nurses were preventing pressure ulcers. After he explained the importance of repositioning to the nurses, the problem dissipated but still teams of three orderlies and a nurse repositioned patients 24 hours a day to prevent pressure ulcers. There was no mention of sleep deprivation caused by repositioning.

References

Frankel...

Large cell alternating pressure air mattresses will prevent pressure ulcers. Geriatrician Mary Bliss.

Ventilated patients.

Nothing has changed in 58 years. All healthcare facilities run on a lack of nursing staff.

Foreseeable and Preventable

This is the moment in nursing history to introduce informed consent to prevent pressure ulcers in hospitals...

Poorly fitting bed rails have caused deaths where a person's neck, chest or limbs become trapped in gaps between the bed rails or between the bed rail and the bed, headboard, or mattress. Other risks are: rolling over the top of the rail or climbing over the rail.

Floor sensor mats can be placed around the bed or room and that can alert staff the moment an elderly person is wandering and at risk of a fal...

Many people who acquired polio in their childhood experience new or increased impairments decades after their initial infection, so-called post-polio syndrome or late effects of polio (LEoP) [1]. Common impairments in persons with LEoP are muscle weakness, muscle fatigue, general fatigue and musculoskeletal pain during everyday activities and physical activities. The causes of LEoP are not clea...

Use the safe shoe checklist to assess footwear. This checklist is a reliable tool for evaluating specific shoe features that could potentially improve postural stability in patients. Discourage patients from walking in socks, because this is associated with a 10-fold increased risk of falling.¹⁶⁴

This is particularly relevant in the hospital setting: patients should no...

For older patients suffering from delirium or cognitive impairment, where it is unsafe for them to mobilise or transfer without help, individual observation and surveillance must be increased, and help with transfers must be provided as required. Ideally, one-on-one supervision should be applied for those patients with a mobility impairment for which they lack insight (eg cognitive impairment), and who impulsively att...

A bit about my training and going to Uni in my 40’s in Sydney

Pressure ulcer on a forearm

IV cannulation in the antecubital fossa and wrist causing extravasation of iron and chemotherapy drugs. Chemotherapy drugs destroyed the whole of the forearm.

Years and years ago we (nurses) had to stand and count the IV drops for a whole minute to ensure the correct amount of intravenous...

Alternating pressure air mattresses

Maggots “In the 21st century, eighty years after William Baer presented his ground-breaking work treating bone and soft tissue infections with live maggots, thousands of therapists around the globe have rediscovered the benefits of maggot therapy” (Sherman, 2009).

For many years now Lucilia sericata, and other, maggots have been used in pr...

Sleep deprivation resulting from repositioning and waking without consent is unacceptable, is a form of abuse, and may contribute to a cognitive decline in the elderly. If patients are allowed to sleep and only repositioned when awake, staff workload is reduced, manual handling injuries are minimized and consequently the risk of skin tears, an added problem in the elderly who have tissue-paper like skin, is decreased.

Patients are often repeatedly woken when being repositioned during that 24-hour period. This repositioning regime is often, if not always, carried out without informed consent.

One rare complication of eye surgery is sympathetic ophthalmia, where an operation performed on one eye can cause loss of vision in the other eye. The estimated chance of this occurring because of eye surgery was c...

Preventing pressure ulcers has traditionally involved repositioning patients every two hours to relieve pressure on any part of the body sandwiched between the bony skeleton and mattress, or chair.

Understanding that repositioning wakes patients resulting in sleep deprivation is my significant original contribution to knowledge. In addition, patients are not provided with information about repositioning ...

When I was researching the literature on two-hourly repositioning, studying the scientific papers, learning how pressure ulcers developed, searching for solutions to prevent pressure ulcers, I decided to find out what happens when we reposition patients; specifically, what transpires deep in the body tissues, unseen.

Knowing how to prevent pressure ulcers it became imperative to learn what happens when p...

For decades, aged care facility residents at risk of pressure ulcers have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week. Yet, pressure ulcers still develop.

We used a cross-sectional survey of eighty randomly selected medical records of residents aged ≥ 65 years from eight Australian Residential Aged Care Facilities to determine the number of residents at risk of PUs...

Caterpillars have spikes that they use as a defence mechanism to deter predators. The spikes are very painful if stood on. I talk about treating toddlers who have stood on caterpillars as well as treating children with gravel rash after falling off their bikes.

This podcast will teach you how to remove hundreds of spikes from the feet, and how to treat gravel rash with Duoderm, a favourite hydrocolloid d...

Sharp CA and White R.

Pressure Ulcer Risk Assessment: Do we need a ‘golden hour?’

Journal of wound care  vol 24, no 3, march 2015 

Letter to the Editor

Screening patients on 
admission using rapid clinical 
judgement, focusing on 
immobility, the only ...

I knew that pressure ulcers were caused by immobility and the survey showed that many nurses knew that too. They were not using official risk assessment tools but rather their own clinical judgement to screen for risk; and they were right. Nevertheless, it took writing this paper to prove that no risk screening tools could do a better job that nurses using their own knowledge and experie...

Tinea is a fungal skin infection that can be spread by skin to skin contact. It may be picked up in swimming baths, from floors and cubicles. Tinea is commonly seen on the feet but can affect the groin, scalp and beneath the breasts. Tinea is also known as ringworm but there are no worms.When dressing after a shower, put the patient’s socks on before...