S - SKIN INTEGRITY
Reassess gross motor skills, abilities, and current pressure management strategies if gross motor function declines or a pressure injury develops. (PU-ONF 2013, p.136; Level C)
Select and train transfer techniques for all surfaces necessary for daily activities to ensure safe repositioning and minimize skin and tissue damage during movement. (PU-ONF 2013, p.138; Level C)
Teach transfers to all surfaces necessary for daily activities, as risks and abilities are context-dependent. (PU-ONF 2013, p.138; Level B)
Individualize pressure-redistributing strategies using a variety of weight-shifting approaches, including automatic pressure redistribution with functional movement, active lifting or shifting, dynamic weight shifts (tilt and recline), with and without power-assist and use of gel/air cushions. Encourage leaning forward or to the side, as this produces more complete and prolonged pressure reductions than lifting vertically. (PU-ONF 2013, p.141; Level B)
Use manual palpation, observation, and pressure mapping, as appropriate, to evaluate the effectiveness of weight-shifting strategies. (PU-ONF 2013, p.141; Level C)
Provide information about the effective use of weight-shifting strategies, including demonstrations, into the individual's pressure management plan. Work with the individual to select a technique (lifting or leaning) and frequency that best meets the individual's needs. (Adapted from PU-ONF 2013, p.141; Level C)
Ensure that an individual who does not use active or dynamic intentional weight shifts to redistribute pressure performs more frequent skin checks if activities or daily routines change. Educate the primary caregiver or attendant on conducting frequest skin checks. (Adapted from PU-ONF 2013, p.141; Level C)