Posture Support Chair and Wheelchair for the Severely Mentally and Physically Disabled Person whose Spine inclines to the Right : A Case Study Approach

在宅生活を続けてきた重度の重複障害を伴った在宅障害者で右側偏倚の著明な症例に対し,車いす及び座位保持椅子の作製を行った.実際に,家庭訪問し,実生活上での問題解決法として作製した車いすでの体幹サポートバー,車いす・座位保持椅子での背当て張り調整及び座位保持椅子での幅広肘当ては食事動作の改善に効果があり,肘当てのトライウォールを利用した仮合わせや既成品である高齢者用モジュール型木製椅子の試行期間の設定は有効であった.今後継続的なフォローアップにより,障害の変化に対応した生活上の取り組みが重要であると考えた.We made a wheelchair and posture support chair for a severely mentally and physically disabled person who had severe inclination of the spine to the right while sitting in a wheelchair at home. The trunk support bar of the wheelchair, the adjustable back and wide armrests of the posture support chair prevent the spine from inclining to the right and improve the user\u27s position for eating. A combination of the trial modular wooden chair for elderly persons and the "Tri-wall" arm support was effective in adjusting the wheelchair to the required position. The progress made in developing this wheelchair highlighted the importance of cooperation between general hospitals and rehabilitation facilities

トウニョウビョウ ケア ノ リスク マネージメント

The number of diabetics has been increasing in recent years. The diabetics are under varioustreatments, including the improvement of life habit and the medication for diabetes with insulin.Our hospital set a team of diabetic care, which is composed of a diabetic specialist, certified diabeteseducators（CDEs）, nurses, dietricians and pharmacists. This team takes great care of the diabetics.For medical safety measures, the department of risk management was organized in our hospital.The department investigated the cases of Hiyari-Hatto within 1 year and 3 months, from 2005to 2006, and found that 3% of them was the diabetic case, which was caused by the nurses exceptCDEs. Therefore the department made the manual of diabetic therapy in cooperation with theCDEs. All the staffs in our hospital were educated by the seminars according to the manual. Theknowledge about the diabetic therapy proved to be mostly accurate one year after the last seminar.For the improvement of medical safety, the department of risk management helps the CDEswith holding the educational seminars by giving the informations after analyzing the cases of Hiyari-Hatto and the questionnaires following the seminars