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Medical Grade Sheepskin to be added to SWEP picklist

28 October 2019

Medical Grade Sheepskin to be added to SWEP picklist

The Statewide Equipment Program (SWEP) is committed to providing consumers with access to a range of assistive technology items that are evidence based and suitable for various environments and presenting scenarios.

In response to clinical evidence supporting the effectiveness of medical grade sheepskin for the prevention of pressure injury, we are adding this item to our quotable picklist. You will now be able to find this item available under Seating - T1.11 and Bedding - B2.7

AT Practitioners will need to ensure that items requested are in fact medical grade sheepskin, and this detail will need to be clearly indicated on quotes provided.  SWEP will only fund sheepskins that are dark green in colour and have the standards stamp or tag to indicate they are compliant with the high-temperature AS4480.1 medical grade sheepskin standard. AT Practitioners will need to ensure that items requested are in fact medical grade sheepskin, and this detail will need to be clearly indicated on quotes provided. SWEP will only fund sheepskins that are dark green in colour and have the standards stamp or tag to indicate they are compliant with the high-temperature AS4480.1 medical grade sheepskin standard.  

The pressure care subsidy can be utilised for this item.

Uses for medical grade sheepskin may include mattress overlays, cushion overlays, booties or padding to protect vulnerable skin.

Clinical reasoning and risk assessment

As with all pressure care strategies, medical grade sheepskin is not a one size fits all solution. There are multiple factors to be considered about the consumer and the environment where the sheepskin is to be used. SWEP would like to stress that it views medical grade sheepskin as most appropriate for use in situations where a low pressure injury risk has been identified. It is rarely, if ever, appropriate for open wounds or situations assessed as being moderate or high pressure injury risk.

Prior to requesting a medical grade sheepskin item, SWEP expects AT practitioners to complete a thorough pressure care risk assessment. This could involve using a scale such as the Braden or Waterlow assessment tool. You will also need to assess:

  •      the size and weight of the consumer
  •      mobility of the consumer and activities that need to be done while using the sheepskin,
  •       location, number and severity of existing pressure ulcers,
  •       anticipated progression or change to pressure injury risk,
  •      support available to position and/or maintain the sheepskin,
  •       how the sheepskin interacts with other items used by the consumer,
  •       what factors are contributing to the pressure care risk and whether sheepskin is appropriate for addressing them,and
  •      any other item/s that may be more suitable.

To reflect the higher level of clinical decision making that is required to ensure that medical grade sheepskin is being used appropriately, these items have been rated as Amber. As with all applications through SWEP, if consumer attributes are significant and complex the overall rating of the application may be increased to red.

Evidence supporting this addition

A Cochrane Systematic Review (2015) concluded that " medical grade sheepskins are associated with a decrease in pressure ulcer development "(reference 1). A number of randomised clinical trials have showed decreased rates of pressure ulcers through use of a medical grade sheepskin mattress overlay (references 2, 3 and 4).

The 2014 Clinical Practice Guidelines for Prevention and Treatment of Pressure Ulcers (reference 5) state that pressure, shear, heat, and moisture are significant contributing factors for tissue breakdown. A report by the Medicines and Healthcare Products Regulatory Agency (MHRA) showed medical grade sheepskin to perform favourably to address these factors (reference 6).

You can find further information about evidence and prompts for assessment in our Medical Grade Sheepskin practitioner resource guide found here.

 What happens next?

SWEP will be monitoring the funding of medical grade sheepskin as a solution for pressure related risks, including the situations in which it is requested.

SWEP welcomes your feedback on this change, as well as further evidence or concerns which you feel need to be considered as part of bringing these items onto the picklist.

For any queries or if you would like to provide feedback please email swepcaho@bhs.org.au

Regards


Donna Markham

Chief Allied Health Officer


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