Pressure Ulcer Prevention and Management in Spinal Cord-Injured Adults

Abstract

The authors assessed the educational needs of adults with spinal cord injury (SCI) in the prevention and early detection of pressure ulcers (PrUs). Specific recommendations are provided for the top needs identified, along with key issues to consider in implementing solutions. The authors used a needs assessment methodology using a purposeful, maximum variation sampling strategy that was based on age, injury level and completeness, time since injury, and PrU history to select cases that would identify the diverse influences on PrU education. The authors interviewed 16 adults with SCI concerning perception of PrU risk, education, environmental considerations, and access to care. Also interviewed were 8 SCI professionals, including a physician specializing in rehabilitation medicine, physical and occupational therapists, a nurse case manager, and a wound care nurse practitioner. The outcome of this research is the identification of educational needs for adults with SCI in PrU prevention and early detection. The needs identified are rank-ordered, and possible educational objectives are considered for each. Education needs identified include the following: *Awareness of lifelong risk for developing PrUs, including the ability to assess own risk factors and how risk changes over time. *Ability to take charge of own skin care regimen and to partner with health care providers. *Perform prevention strategies consistently that fit level of functioning and activity, and update practices as risk changes. *Ability to coordinate social supports. The need for effective education among adults with SCI in the prevention and early detection of PrUs is critical.