Specialist Seating in the Hospital Setting
Specialist seating is an important medical device in a patient’s journey through secondary care. Not only can specialist seating encourage comfort and feelings of safety, but can also aid in recovery and improve patient outcomes.
Specialist seating can help individuals who have experienced a stroke, are rehabilitating following a brain injury, have undergone orthopaedic surgery, or are recovering from illness including COVID-19.
What Are The Risks Associated With Hospital Admission?
- Pressure injuries
Patients in hospital can be at risk of developing pressure injuries, also known as pressure ulcers, due to the increased likelihood of prolonged rest and immobility, either due to illness, injury or surgery.
When pressure injuries occur they can have a profound impact on the overall wellbeing of patients, and can be both painful and debilitating1.
Pressure injuries can also result in longer lengths of stay in hospitals; adult patients who developed pressure injuries had an extended stay of over 4 days, which can have a major impact on their health outcomes2.
Some patients in hospitals are at an increased risk of falls, either due to specific postural challenges or general weakness from deconditioning. Reduced postural control and stability can result in individuals sliding out of their chair or falling during transfers.
Between 2015 and 2016, falls were the most commonly reported incident in acute and community hospitals and the third most common in mental health hospitals, with around 250,000 reported across these three hospital settings3.
A fall in hospital can be devastating; the human cost includes distress, injury, loss of confidence, and increased morbidity and mortality.
Patients in hospital are at risk of contracting healthcare-associated infections, also known as hospital-acquired infections.
Healthcare-associated infections are a serious risk to patients, staff and visitors. Over 4 million people in Europe get a healthcare-associated infection every year, and around 37,000 die as a direct result of the infection4.
Patients who present with postural challenges or general weakness can also be at risk of other means of infection, such as respiratory complications due to poor head positioning and altered swallow function.
What Are The Main Specialist Seating Considerations?
- The main objective should be for the patient to be comfortable; regardless of the clinical benefits, a chair may not be utilised if the user is not comfortable5.
- The chair must offer appropriate postural support to encourage pelvic stability, trunk alignment and head control, which are essential for function and independence.
- An integrated pressure redistributing system for those at risk of pressure injury is critical to encourage equal weight distribution over the maximum surface area possible. The opportunity to sit out can offer a much needed change of position to encourage blood flow and redistribute pressure.
- Tilt-in-space can further help encourage pressure redistribution, along with a range of postural management accessories for the more complex user.
- The feet must be adequately supported to promote postural stability and help keep the user from sliding or falling from the chair.
- The mobile user must be able to achieve good foot placement to enable safe transfers; a negative angle leg rest and flip-up footplate can help.
- The tilt-in-space function can further help keep the patient from sliding or falling from their chair, providing them with the necessary stability to enhance feelings of safety.
- It is essential that any chair prescribed within the hospital environment takes in to consideration infection prevention and control. Chairs should be configured with appropriate materials and fabrics that reduce the risk of cross-contamination and cleaned as per manufacturer’s instructions.
- It is vital that the chairs used in hospitals are highly adjustable to suit multi-user environments; one chair should be able to meet the majority of patients’ needs, which ensures the chair can be flexible to changing needs but also be recycled for a new user.
- Finally, chairs must also be easy to set-up and simple to use to ensure appropriate and safe operation of chair functions and accessories.
How Can Specialist Seating Impact Service Provision?
Specialist seating also plays a vital role in cost effectiveness and responsible use of resources, consequently securing high quality services for future generations. Specialist seating can promote optimum recovery and rehabilitation, resulting in a timely discharge from hospital. This is beneficial, not only for the patient but for the health service as a whole.
- Pressure injuries
Daily cost to the NHS of treating pressure ulcers is more than £1.4 million every day6. Posture and pressure are inextricably linked, and without adequate pressure care and prevention of injuries vital resources are being wasted.
Falls represent a significant cost to the wider healthcare system; annual cost to the NHS from falls among older people is estimated at £2.3 billion7. As explained above, falls can be better managed with appropriate postural support and stability.
Healthcare-associated infections can not only cause significant morbidity to those infected but also significant costs for the NHS8. Healthcare providers have a responsibility to safeguard patients through effective protocols and appropriate equipment.
Specialist seating can also improve staff outcomes as well as patient outcomes. The right chair can reduce dependence on staff by increasing patient independence with activities such as drinking, self feeding or reaching for personal possessions. This can reduce staff pressures and free up time for other tasks. Moving and handling can also be facilitated with easier positioning, improved access for equipment and more independent patients reducing carer effort. Chairs must be easy to manoeuvre so staff can complete safe moving & handling and porter patients around the environment when required.
How Can CareFlex Help?
Over the last 25 years we have built up many long lasting relationships; we take pride in our partnerships with the health and social care sector. CareFlex invests in these relationships and our commitment goes beyond the provision of specialist seating to conducting assessments and facilitating training events.
We have promised that we will continue to support the NHS and will prioritise their specialist seating provisions in order to help in their fight against COVID-19.
We offer an express chair service, designed for customers who urgently need a specialist seating system, including those who need a suitable solution for their home before they can be safely discharged. We are able to get a chair dispatched within 5 working days*. The HydroCare, the HydroTilt, the HydroFlex and the SmartSeatPro are all available on the express chair service with various configurations and options.
*Express chairs are subject to availability.
It is also worth mentioning that delays in clinical assessments and the lack of availability of correct equipment can cause ‘bed blocking’. Between 2016 and 2017 almost one million hospital bed days were lost due to delayed discharges; 12,656 lost days were solely due to problems securing equipment9. CareFlex have a team of experienced specialist assessors who can competently and confidently work with prescribing clinicians to help alleviate this issue along with our express chair service.
Please do get in touch to discuss your seating requirements and book a free specialist seating assessment.
- Moore ZE, Webster J, Samuriwo R (2015) Wound-care teams for preventing and treating pressure ulcers Cochrane Database Syst Rev 16(9)
- Graves N, Birrell F, Whitby M (2005) Effect of pressure ulcers on length of hospital stay Infect Control Hosp Epidemiol 26(3):293-7
- NHS Improvement (2017) The incidence and costs of inpatient falls in hospitals Available from: https://improvement.nhs.uk/resources/incidence-and-costs-inpatient-falls-hospitals/
- Public Health England (2016) Healthcare associated infections (HAI): point prevalence survey, EnglandAvailable from: https://www.gov.uk/government/publications/healthcare-associated-infections-hcai-point-prevalence-survey-england
- Bartley C, Stephens M (2017) Evaluating the impact of WaterCell® Technology on pressure redistribution and comfort/discomfort of adults with limited mobility Journal of Tissue Viability 26(2):144-149
- Guest JF (2017) The health economic burden that acute and chronic wounds impose on an average clinical commissioning group/health board in the UK Journal of Wound Care 26(6)
- National Institute for Health and Care Excellence (2018) NICE impact falls and fragility fractures Available from: https://www.nice.org.uk/media/default/about/what-we-do/into-practice/measuring-uptake/nice-impact-falls-and-fragility-fractures.pdf
- National Institute for Health and Care Excellence (2016) Healthcare-associated infections (QS113) Available from: https://www.nice.org.uk/guidance/qs113/resources/healthcareassociated-infections-pdf-75545296430533
- Age UK (2017) Four million hospital bed days lost since 2011 due to problems securing social care Available from: https://www.ageuk.org.uk/latest-press/articles/2017/october/four-million-hospital-beddays-lost-since-2011-due