Common Problems Useful Solutions Common Problems Useful Solutions Illustrations

Common Problems with Positioning in Long Term Care:

Severe Hand Contracture

Severe Hand Contracture

Patients with severe hand contractures experience intense pain when hand is pried open for routine hygiene or during corrective splint placement.

Useful Solution

Painful Shoulder Subluxation

Painful Shoulder Subluxation

Muscle weakness or imbalance caused by stroke or upper body injury leads to painful subluxation, contracture, or poor joint alignment.

Useful Solution

Fragile Skin Injuries

Fragile Skin Injuries

Patients with fragile skin are at a high risk of skin breakdown due to contact with hard surfaces, or from friction or shear incurred during repositioning.

Useful Solution

Heel Pressure and Footdrop Injuries

Heel Pressure and Footdrop Injuries

Immobile patients with lower extremity weakness are at an increased risk of developing secondary injuries due to pressure, cross-legged positioning, or footdrop.

Useful Solution

Bed Danger Zone Injuries

Bed Danger Zone Injuries

Restless or agitated patients are at risk of danger zone injuries such as bed gap entanglement/entrapment or trauma from contact with bed rails or head/footboards.

Useful Solution

Patient Transfers and Infection Control

Patient Transfers and Infection Control

Patient needs to be transferred but slings or gait belts are soiled, contaminated, or not readily available, prompting staff to either abandon their no-lift protocols or use contaminated equipment that poses an infection control risk.

Useful Solution

Wheelchair Falls

Wheelchair Falls

High-fall-risk patients with memory or cognitive issues inadvertently stand without securing their wheelchair brakes, allowing the chair to roll away and putting themselves at risk of serious injury.

Useful Solution

Sagging Wheelchair Sling Seats

Sagging Wheelchair Sling Seats

Sagging wheelchair seats make traditional flat-bottom cushions ineffective for pressure relief while causing instability, poor posture, and forward sliding.

Useful Solution

Poor Wheelchair Seating Support

Poor Wheelchair Seating Support

Traditional wheelchair cushions used on sagging seats can buckle or tilt, causing forward sliding or slouching that creates dangerous shear forces and pressure.

Useful Solution

Shear Injuries and Wheelchair Cushions

Shear Injuries and Wheelchair Cushions

The surface of a traditional wheelchair cushion remains static as the patient slides forward from fatigue or weakness, causing subcutaneous tissue damage, resulting in debilitating and costly pressure injuries.

Useful Solution

Poor Geri-Chair Positioning

Poor Geri-Chair Positioning

Patients with weakness or limited mobility tend to slump, side lean, or slide forward, leading to poor posture, increased health risks, and less functional independence.

Useful Solution

Lost Wheelchair Cushions

Lost Wheelchair Cushions

Wheelchair cushions are often lost or misplaced when wheelchairs are folded and stowed away, requiring staff to spend time searching for or purchasing replacement cushions.

Useful Solution