The Effectiveness of Specialist Seating Provision for Nursing Home Residents
Condition: Physical Disability
Study type: Interventional

Summary: 
      A randomized control study aimed to investigate if suitable individualized seating provision
      is effective for adult nursing home residents in reducing the incidence of pressure ulcers,
      and increasing their quality of life and functioning.
    

Detailed description: 
      The United Kingdom (UK) population demographics confirm that older people are considered to
      be the fastest-growing group in the population (Dunnell, 2008). In 2007, 9.8 million people
      were aged over 65; however, by 2032 this figure is projected to rise to 16.1 million
      (Dunnell, 2008). Many of these older adults will have complex health and social care needs
      sometimes requiring nursing home care. A high standard and quality of care within our nursing
      homes is essential, to be able to deal with this growing population safely and to the highest
      standard possible, including the provision of individualised seating assessment, prescription
      and provision. An individually prescribed seating system should be based upon the assessment
      of the person's abilities and needs, and should best position and support them for comfort
      and function.

      When seating is not clinically suitable for the user there are many physiological and
      psychological implications for the user. For example, often pressure ulcers may develop.
      Pressure ulcers are currently a major concern for the NHS due to their prevalence, the cost
      of treatments and the impact on the person. Pressure ulcers can often be related to poor
      seating and indeed good seating can contribute to prevention and contribute to healing
      (Anton, 2005). Current expenditure by the NHS in the UK on pressure sores is £2.1bn annually.
      This equates to approximately £10,500 per sore (Bennett et al, 2004). Anecdotal evidence
      suggests that correct seating provision could be instrumental in depleting this cost by
      preventing pressure ulcers through investment in chairs before ulcers develop. This project
      set out to explore this topic via empirical research methods.

      Research Question To identify the importance of individualised seating in reducing postural
      difficulties for adult residents in nursing homes.

      Methods A pragmatic RCT design with qualitative and quantitative tools was used. These
      included: pulse oximeter readings of oxygen saturation levels and pulse rate; Braden scale of
      pressure risk; caregiver questionnaire; digital photographs of seated posture; and
      demographic information.

      Participants Forty residents were recruited from three nursing homes in N.Ireland, and were
      randomly assigned to either the control group (continue to use existing chair) or the
      intervention group (use an individually configured seating system) for the 12- week trial
      period. At the end of the 12- week trial period there were 18 participants in each group.
    

Intervention name(s): Individualized Seating provision
Intervention type(s): Other
Intervention description(s): Seating system selected and adjusted to meet individual needs.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: RCT; Specialized seating; Pressure ulcers