The second session of the 24 hour posture and pressure management programme looks at the anatomy in more detail concentrating on the pelvis – the keystone of posture, and the spine – the resulting position of which, dependent on the pelvic position. We start to look at how forces applied to the spine can compound postural deformities and increase risk of pressure damage. We then consider the position of the legs relative to the pelvis and how just looking at someone can be deceiving, identifying the need for a hands on assessment.

Learning objectives

• Know the anatomy of the pelvis, and how to identify important landmarks to aid your assessment
• Know how positions of the pelvis drive different presenting postures and spinal positions
• Know the different areas of the spine, and types of spinal positions which impact most on posture and the impact of these on pressure management
• Know indicators to show if spinal positions are correctable or need accommodation, and how to achieve this in seating
• Consider the position of the legs relative to the pelvis rather than the supporting surface (i.e chair).

In this 3^rd session we look at the elements required in a full postural assessment and factors which need to be taken into account in relation to pressure risk assessment, highlighting the SSKIN bundle and Purpose T assessment tool. There are short film clips to show how to find the anatomical landmarks to help carry out your assessment and look at range of movement of the lower limbs, relative to the pelvis. We consider the importance of understanding a situation in a holistic way and understanding the aims of our clients which can help us manage expectations.

Learning Objectives

• Be aware of what should be covered in a physical assessment of posture
• Be aware of what risk factors there are for pressure ulcers and how to assess for these
• Develop an understanding of how to carry out a physical assessment in a variety of settings
• Ensure assessment is holistic and expectations can be managed

In this session we look at how we collect the findings from our assessment and start to put pieces of the puzzle together to formulate recommendations and be able to clearly state the rationale for these. We consider the importance of assessing unsupported sitting positions to clearly identify the impact of accommodation and support of postural limitations.

Learning Objectives

• Be able to distinguish between fixed and correctable postural limitations and when to provide accommodation or correction
• Be aware of how to explore optimum positioning considering the accommodation and correction of identified postural limitations.
• Consider the impact on pressure management when considering optimum postural positioning

In the 5^th session of the programme we consider the tools we can use to accommodate, correct and support posture and manage pressure needs. We will consider the use of tilt in space and recline as features of a chair and also in bed positioning. We will look at how the choice of cushion (seat) and backrest can be used to maximise function and support posture and protect pressure areas. Head and foot supports need to be used effectively to support the limbs in the appropriate position which may not be central, midline or symmetrical.

Learning Objectives:

• Be confident in making recommendations based on your findings from an assessment
• Be confident in knowing the required product features to support, accommodate and correct postural limitations.
• Be confident in making recommendations for pressure relief products

This final session in the programme will pull together all the previous sessions into clinical case examples to illustrate the assessment process, analysis of findings and what solutions were used to manage posture and pressure requirements.

Learning Objectives

Be able to apply the principles of posture and pressure management to cases and work through:

• problem identification
• assessment
• recommendations
• clinical reasoning and justification for your recommendations