This is the first of two articles that summarise the proceedings of an Educational Workshop on the subject of Spinal Injuries. The second article will address equipment and solutions.

On Thursday 7th June 2001, Chiltern Invadex held an educational workshop on the subject of Spinal Injuries. The Workshop aimed to explore in depth the moving and handling issues faced by clinicians working in the area of Spinal Injuries and to examine the current range of Chiltern Invadex products in terms of their application within this clinical specialty. It was envisaged that information gathered from the workshop would be of educational value to both the attendees and the Company, by providing an insight to problems, needs and possible solutions.

Clinicians and others known to have an interest in the subject were invited to attend. Places were limited to 18 to ensure there was adequate opportunity for group discussion and information exchange. In total, 15 delegates attended from the following hospitals and treatment centres:

• Midland Centre for Spinal Injuries
• Leighton Hospital
• Pinderfields
• Sheffield Northern General
• Stoke Mandeveille Hospital
• There was also representation from the Spinal Injuries Association

The delegate group comprised a variety of practitioners, including Nurses, Occupational Therapists, and Physiotherapists. Unit Managers, Back Care and Moving and Handling advisors were also present, together with an individual who had experienced a spinal injury. Collectively, this diverse group of attendees offered perspectives from general and specialist hospital settings as well as outreach teams and the home environment.

The workshop opened with a welcome and introduction from the Chiltern Invadex team and a brief outline of the Company's history. The delegates then introduced themselves and outlined their individual expectations for the day.These included:

• Sharing ideas
• Identifying common problems
• Gaining an overview of current equipment
• Obtaining information on moving and handling techniques
• Addressing methods for ensuring staff safety whilst meeting client needs
• Networking

The main programme of the day commenced with a short presentation from the Company's Moving and Handling Specialist aimed at providing an overview of moving and handling issues for the Spinal Injured Client. This focussed on general areas of dysfunction and need within the client group, using an Occupational Therapy approach to emphasise the person, their daily occupations and the environments around them. This discussion was used as a basis for highlighting some of the moving and handling situations that arose in this clinical specialty, considering these from both a service perspective and that of individual clients.

Having been presented with an outline of general moving and handling issues delegates were invited to raise those which were of current concern to themselves, together with any problems they were experiencing in particular clinical settings. This instigated a lively discussion and wide ranging concerns were voiced by delegates.

Safety for clients and staff during moving and handling was considered paramount. The ability to transfer clients safely in a supported, flat position appeared to be a key issue as many clients require immobilisation for treatment and/or diagnostic purposes, but need to be moved from bed to trolley, trolley to bath and so on. The support offered by hoisting systems that aimed to facilitate flat transfers was also of concern, as was the compatibility of such equipment with clinical and diagnostic apparatus such as catheters, ventilators, scanners and x-ray tables.

The equipment compatibility issue also arose when considering a clients visit or discharge home. It was recognised that following the acute treatment phase, an assessment of the home environment is likely to occur and clients may spend time at home on a temporary or permanent basis. The question was raised as to whether equipment routinely used in a hospital setting could realistically be installed in a domestic setting. Some equipment may prove too cumbersome for a domestic environment and this could lead to a client being either unable to return home or to being less independent at home than they are in hospital. The capacity to transfer skills and techniques learnt in hospital to the home environment was a key feature in the successful rehabilitation and resettlement of clients.

The prevention of tissue damage during moving and handling was considered a priority, given the client groups susceptibility to pressure sores through immobility. Both the fitting and application of equipment could present difficulties and the need for clients to remain in position may cause pressure on skin and bony prominences. Some delegates expressed a desire for slings to be disposable as a method for minimising the spread of infection.

The issue of weighing clients accurately was also raised as important, both from the aspect of and moving and handling and the fact that it was a pre-requisite for some clinical interventions to be commenced. The facility to weigh a client in a flat position was required, as was the ability to identify whether a client's weight fell within the safe working load of available equipment.

Having identified a list of potential moving and handling problems, delegates were then shown the Company's current range of Moving and Handling and Showering and Bathing equipment. Evaluation forms were provided and delegates asked to review each product by first identifying any advantages and disadvantages and then commenting upon its suitability in relation to their service and clients. The outcome of this exercise will be discussed in the second article together with some ideas for solving moving and handling difficulties.

Debra Hall
Moving and Handling Specialist
August 2001

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