Clinical Justification – Empowering Health & Social Care Professionals

At CareFlex we are dedicated to not only supporting Health & Social Care Professionals to enhance the lives of the individuals they work with but also empowering them to do so with confidence. A key part of achieving this is clinical justification to ensure both appropriateness and cost-effectiveness of specialist seating provision.

Clinical justification is the evidenced information that links the recommended prescription to the intended objectives following a comprehensive assessment. It is an opportunity for Health & Social Care Professionals to advocate for the best client outcomes. It ultimately aids in decision-making, prioritising and securing funding for equipment.

However, this process of autonomy and self-determination can be a challenging skill to master; especially with current professional constraints and economic pressures. I wonder how often a Health & Social Care Professional is queried on their equipment-recommendation? And I wonder how many are confident in their response and trust in their clinical justification?

Specialist seating is critical to an individual’s quality of life. When the ability to achieve good posture is affected, either through age, illness, disability or disease, it can have a significant impact on health and wellbeing. Specialist seating aims to allow individuals, who might otherwise have difficulty, to achieve their optimum sitting posture.

Lack of postural care in sitting can cause tension in the body and increase the risk of significant secondary complications, such as exacerbated pain and postural deterioration.1 Proper positioning has demonstrated that it can decrease fatigue whilst helping to alleviate chronic discomfort.2 As the body structure is supported, and the segments work together efficiently, the individual will experience improved comfort, energy conservation, and interaction with the environment. Being comfortable and feeling safe can also increase tolerance of a desired seated position and compliance with equipment.

Pelvic stability is imperative as it is the foundation for good seated posture, dictating what happens to the body segments above and below; it’s vital for not only protecting the body segments but also encouraging normal functional movement. As we know, this promotion of independence is crucial for an individual’s well-being and is an important factor in living a fulfilling life.

Another major goal is to promote good health and enhance autonomic nervous system function.3 The inability to sit upright can result in increased dependence and decline in overall health over time, primarily reflecting altered physiological function.4 Trunk asymmetry and poor head position can impair respiration, cardiac efficiency, swallow function, and digestion. Consequently, increasing the risk of aspiration, infection, and any related hospital admission. An appropriate seating system can provide the optimum position for respiratory and circulatory functions.An upright sitting position can also facilitate a normal swallowing pattern5 and improve components of eating and drinking behaviour by maintaining good head alignment.6

Finally, we cannot underestimate the importance of psychosocial factors on the overall quality of life. An inability to sit out comfortably can result in individuals becoming confined to their beds with limited interaction and engagement. Did you know that loneliness and social isolation are twice as harmful as obesity to physical and mental health?7 A stable posture can encourage much-needed participation in social activities at home, school or work, and as part of the community.8

Please join us for our live webinar on the 21st of July to understand more about the critical role of specialist seating and how CareFlex can support Health & Social Care Professionals from assessment through to prescription, review and beyond. We want to provide you with the knowledge you need to recommend equipment with confidence. We will also explore the cost-effectiveness of appropriate specialist seating provisions, including the fundamental human cost.
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References

1
  1. Royal College of Physicians (2016) National clinical guideline for stroke Available from: https://www.strokeaudit.org/Guideline/Full-Guideline.aspx
2
  1. Cook AM, Hussey SM (2002) Assistive Technologies Principles and Practice St Louis: Mosby
3
  1. Jones M, Gray S (2005) Assistive technology: positioning and mobility In SK Effgen (Ed) Meeting the Physical Therapy Needs of Children Philadelphia: FA
4
  1. Healy A, Ramsey C, Sexsmith E (1997) Postural support systems: their fabrication and functional use Developmental Medicine and Children Neurology 39:706-710
5
  1. Pountney TE, Mulcahy CM, Clarke SM, Green EM (2000) The Chailey Approach to Postural Management Birmingham: Active Design Ltd.
6
  1. Hulme JB, Shaver J, Acher S, Mullette L, Eggert C (1987) Effects of adaptive seating devices on the eating and drinking of children with multiple handicaps The American Journal of Occupational Therapy 41(2):81-89
7
  1. Holt-Lunstad J, Smith T, Baker M, Harris T, Stephenson D (2015) Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review Perspectives on Psychological Science 10(2):227-237
8
  1. Trefler E, Taylor SJ (1991) Prescription and positioning: evaluating the physically disabled individual for wheelchair seating Prosthetics and Orthotics International 15(3):217-224