Needs Assessment & Literature Review
Prior to the start of my doctoral capstone experience, I conducted a thorough literature review and multiple interviews with individuals with a spinal cord injury (SCI) and occupational therapists (OT) working within the SCI population to determine the need for my project.
An OTR with many years of experience working at Craig Hospital within the SCI population identified bowel and bladder education and training as a great need for individuals with a SCI
Individuals with a SCI identified bowel and bladder management as having a huge impact on their quality of life and revealed the need for more in-depth bowel and bladder education and training after SCI
Additional OTs requested further education and training for nursing staff and OT practitioners specific to bowel and bladder management after SCI
Various research studies have concluded that improving bowel and bladder function is a significant factor in enhancing quality of life by individuals with SCI (Korsten et al., 2004; Koyuncu et al., 2017; Inskip et al., 2018; Borsh et al., 2019)
Primary Project Site: Parkview Hospital Randallia - Inpatient Rehabilitation
Areas of Study: 1) Clinical Practice Skills and 2) Education
Project Mission: To positively impact the health and well-being of clients through the improvement of early, consistently available, and evidence-based resources that target improved ability to return to optimal occupational participation and management of one’s self-care, specifically bowel and bladder management after SCI.
Project Vision: Enhancing the quality of life for individuals with spinal cord injuries and other complex illnesses through education and evidence-based practices.
What I Accomplished
Collaborated with occupational therapists (OT), physical therapists (PT), nursing, clinical nurse specialist (CNS), nurse practitioners, and the rehab medical director of Parkview to create and implement a comprehensive and evidence-based bowel algorithm and catheter reference guide
Created and delivered a presentation pertaining to bowel and bladder management to current OTD students and inpatient and outpatient therapy departments
Completed over 125 observation hours with patients within the SCI population in both inpatient and outpatient settings
Created two case studies pertaining to patient’s bowel & bladder needs during their inpatient rehabilitation stay for educational purposes for future health care providers, patients, and caregiver training
Completed "SCI: Bowel, Bladder, and Sexual Dysfunction" continuing education course
Analyzed two patient experiences related to bowel & bladder management preparedness post-discharge from their rehab stay to develop a single case study report encompassing their bowel & bladder management strategies post-discharge from inpatient rehabilitation
Impact on Profession
Increasing interdisciplinary teamwork when addressing bowel and bladder management for patients within the SCI population
Advocating and educating on OT’s role in bowel and bladder management for individuals with a SCI
OTD students and hospital staff who attended my presentation learned how they can best educate and train their patients on bowel and bladder management post SCI to ultimately enhance their independence and quality of life
My plans for the future
I hope to work in an inpatient rehabilitation facility or within the SCI population. I plan to continue advocating for OT's role in bowel and bladder management within all settings.
I can be contacted at ainsworthr@huntington.edu
References
Borsh, S., Sikka, S., Callender, L., Bennett, M., Reynolds, M., & Driver, S. (2019). Implementation of a neurogenic bowel program for spinal cord injury in the acute care setting: Perceptions of patients and Staff. Occupational Therapy in Health Care, 33(3), 306–322. https://doi.org/10.1080/07380577.2019.1633586
Korsten, M. A., Fajardo, N. R., Rosman, A. S., Creasey, G. H., Spungen, A. M., & Bauman, W. A. (2004). Difficulty with evacuation after spinal cord injury: Colonic motility during sleep and effects of abdominal wall stimulation. Journal of Rehabilitation Research and Development, 41(1), 95–100. https://doi.org/10.1682/jrrd.2004.01.0095
Koyuncu, E., Nakipoğlu Yüzer, G. F., Taşoğlu, Ö., Kasap, Z., & Özgirgin, N. (2017). Neurogenic bowel dysfunction and its effect on quality of life in patients with spinal cord injury. Journal of Physical Medicine & Rehabilitation Sciences / Fiziksel Tup ve Rehabilitasyon Bilimleri Dergisi, 20(2), 77–82.
Inskip, J. A., Lucci, V. M., McGrath, M. S., Willms, R., & Claydon, V. E. (2018). A community perspective on bowel management and quality of life after spinal cord injury: The influence of autonomic dysreflexia. Journal of Neurotrauma, 35(1), 1091–1105. https://doi.org/10.1089/neu.2017.5343