Developing a Model of Care for Healing Pressure Ulcers With Electrical Stimulation Therapy for Persons With Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2016 · DOI: 10.1310/sci2204-277 · Published: December 1, 2016

Spinal Cord Injury Neurology Dermatology

Simple Explanation

Electrical stimulation therapy (EST) is known to help heal pressure ulcers in people with spinal cord injuries (SCI), but it's not used as much as it could be, especially outside of hospitals. This research created a plan to use EST more in local communities. It looked at what makes it hard or easy to use EST and made a care plan that fits the community's needs. The study involved local people and used research methods to make sure the plan could work well and last. The plan considered things like teamwork among healthcare providers, training, and resources.

Study Duration

April to October 2014

Participants

29 stakeholders

Evidence Level

Not specified

Key Findings

1
The study identified key barriers to implementing EST, including a lack of collaboration and communication among healthcare providers across different settings.
2
Inadequate training and education among providers regarding the use of EST was a significant barrier.
3
A lack of funding, time, and staff were also identified as barriers to implementing EST in the community.

Research Summary

This article outlines a structured plan and collaborative approach between researchers and community members in developing a pressure ulcer model of care while taking into account perceived facilitators and barriers to implementing EST for managing pressure ulcers in the community-dwelling individuals with SCI. Using a similar stakeholder engagement approach, the next phase of the implementation planning will include further adapting the recommended practice in a 2-day ADAPTE workshop, where frontline providers will operationalize the model of care by taking into account the barriers to create process maps detailing steps needed to initiate EST in the local community. This will be followed by a field test using iterative Plan, Do, Study, Act (PDSA) cycles on a sample of community-dwelling individuals with SCI and pressure ulcers.

Practical Implications

Improved Interdisciplinary Collaboration

The model emphasizes the need for better communication and teamwork among healthcare providers to ensure holistic care for individuals with SCI and pressure ulcers.

Enhanced Training and Education Programs

The study highlights the importance of providing adequate training and education on EST for healthcare providers to increase its uptake and effectiveness.

Resource Allocation and Support

Addressing the lack of funding, time, and staff is crucial for the successful implementation of EST in community settings.

Study Limitations

1
The conversations were not audio recorded. Therefore, the meetings were not transcribed word for word, and appropriate coding could not be performed to complete a qualitative analysis.
2
Another limitation was that there was poor representation from personal support workers, community dietitians, and occupational therapists in the stakeholders group who were interviewed.
3
Any differences of opinion about aligning the facilitators or barriers with the implementation drivers were openly discussed and edits were made.

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