Successfully reported this slideshow.
Moving beyond the bed –One woman’s journey outof her bed following femurfractureMargaret Goodall, Eleanor Barrett
2    This presentation is dedicated to      the memory of one lady who       exceeded all expectations
3    San Fillipo Syndrome• Mucopolysaccharidoses III• Genetic, autosomal recessive• Lack of enzyme to break down  glycosam...
4        Effects of San Fillipo        Syndrome for Jean•   Normal development to age 2- 6•   Learning delay and regressio...
5      Why was Jean in bed?• Series of chest infections and hospital  admissions• Spontaneous fracture of Right Neck of  F...
6    Jean’s Priorities    • 1 – to have some social interaction    • 2 – to have a shower    • 3 – to be comfortable and p...
7    Our objectives• Maintain lung health.• Maintain skin integrity.• Maintain available joint range of  movement.• Safe w...
8    Comfort in bed
9     Seating comfort and     mobility In conjunction with Wheelchair outreach   clinic• Comfort over postural support• Fl...
10     House design                                           Level                          Family   Bath                ...
11         Bed to wheelchair         transfers•    Pat slide with 3 staff•    Chair did not go completely flat•    Not com...
12      Lateral transfer difficulties     The Regency          Over reaching for     chair reclined to    lateral transfer...
13      Sling Options• Orthopaedic Consultant consent• Sling options – remain in semi-reclined  position, maintain hip pos...
14     Sling choice     Sling tried in     first instance
15     Jean’s sling
16     Hanger barsH- style hanger bar   X- style hanger bar
17     Choice of hoist     •   Minimise number of transfers     •   Staff numbers needed to transfer     •   Space to move...
18         Shower options•   Swap bedrooms•   Widen current doorway to bedroom•   Add new doorway from bedroom to lounge• ...
19     Jean’s shower trolley     Short shower trolley fits through     doorway into bedroom for transfers
20     Meeting Jean’s priorities     Jean was     • Able to get out of the bedroom and       join in with others in the lo...
21         Achieving our objectives• Maintained Jeans lung health.• Maintain her skin integrity.• Staff working safely• Ma...
Upcoming SlideShare
Loading in …5
×

Moving beyond the bed – One woman’s journey out of her bed following femur fracture

608 views

Published on

Margaret Goodall
Specialist Worker, Occupational Therapy, Explore
(P53, Wednesday, NZI 5 Room, 4.30-5)

Published in: Health & Medicine, Technology
  • Be the first to comment

  • Be the first to like this

Moving beyond the bed – One woman’s journey out of her bed following femur fracture

  1. 1. Moving beyond the bed –One woman’s journey outof her bed following femurfractureMargaret Goodall, Eleanor Barrett
  2. 2. 2 This presentation is dedicated to the memory of one lady who exceeded all expectations
  3. 3. 3 San Fillipo Syndrome• Mucopolysaccharidoses III• Genetic, autosomal recessive• Lack of enzyme to break down glycosaminoglocan heparin sulphate.• Build up of sugars in brain and other organs.• Management of symptoms
  4. 4. 4 Effects of San Fillipo Syndrome for Jean• Normal development to age 2- 6• Learning delay and regression• Speech delay and regression, decreased swallow• Stiff joints• Over production of mucus – respiratory infections• Urinary tract infections• Congestive Heart Failure,• Enlarged liver and spleen• Sleep disturbance• Behavioural challenges
  5. 5. 5 Why was Jean in bed?• Series of chest infections and hospital admissions• Spontaneous fracture of Right Neck of Femur• Changing body shape and contractures• Spontaneous fracture of Left Shaft of femur
  6. 6. 6 Jean’s Priorities • 1 – to have some social interaction • 2 – to have a shower • 3 – to be comfortable and pain free particularly in bed.
  7. 7. 7 Our objectives• Maintain lung health.• Maintain skin integrity.• Maintain available joint range of movement.• Safe working practice for staff• Comfortable seating and mobility• Maintain personal hygiene
  8. 8. 8 Comfort in bed
  9. 9. 9 Seating comfort and mobility In conjunction with Wheelchair outreach clinic• Comfort over postural support• Flat as possible for transfers• Able to be transported in van• Issued with Regency Care Chair
  10. 10. 10 House design Level Family Bath access room room shower Jeans roomKitchen/living area Patio and garden area
  11. 11. 11 Bed to wheelchair transfers• Pat slide with 3 staff• Chair did not go completely flat• Not comfortable for Jean• Staff levels• Staff safety• Technique to be used occasionally
  12. 12. 12 Lateral transfer difficulties The Regency Over reaching for chair reclined to lateral transfers. the full extent
  13. 13. 13 Sling Options• Orthopaedic Consultant consent• Sling options – remain in semi-reclined position, maintain hip position – flexion and abduction and external rotation at hips• Ease of positioning and removal
  14. 14. 14 Sling choice Sling tried in first instance
  15. 15. 15 Jean’s sling
  16. 16. 16 Hanger barsH- style hanger bar X- style hanger bar
  17. 17. 17 Choice of hoist • Minimise number of transfers • Staff numbers needed to transfer • Space to move • Mobile vs Gantry • Access to shower
  18. 18. 18 Shower options• Swap bedrooms• Widen current doorway to bedroom• Add new doorway from bedroom to lounge• Extra gantry track in bathroom• Different shower trolley
  19. 19. 19 Jean’s shower trolley Short shower trolley fits through doorway into bedroom for transfers
  20. 20. 20 Meeting Jean’s priorities Jean was • Able to get out of the bedroom and join in with others in the lounge, • Having regular showers • As comfortable as possible in her bed and wheelchair
  21. 21. 21 Achieving our objectives• Maintained Jeans lung health.• Maintain her skin integrity.• Staff working safely• Maintained available joint range of movement.• Comfortable seating and mobility.• Access to social interactions• Improved her personal hygiene

×