Royal Rehab, Ryde, NSW, Australia.
Susan Wakil School of Nursing & Midwifery, The University of Sydney, Sydney, NSW, Australia.
J Clin Nurs. 2021 Jun;30(11-12):1633-1644. doi: 10.1111/jocn.15717. Epub 2021 Mar 8.
To examine the nature of problems experienced by people with spinal cord injury (SCI) when accessing help to maintain recommended bowel regimes while hospitalised outside a specialist spinal injury service.
Bowel dysfunction is one particularly undesirable aspect of life with a SCI, with constipation and incontinence common.
Descriptive qualitative.
Accounts of problems encountered in hospitals in New South Wales Australia collected during interviews with 11 people living with SCI and 12 responses provided by spinal clinicians via an online survey were subjected to thematic analysis. The COREQ guidelines were followed for reporting.
There were similarities across data collected from both sources. Individuals with SCI described instances where their bowel care needs did not fit with the pace and processes in acute hospitals. The clinician data pointed to a failure of healthcare professionals to assist people with SCI to maintain bowel care regimes recommended by specialist spinal services. Both groups described times when bowel care received was unreliable and fragmented, along with reports of staff who were unwilling and/or unable to provide the assistance required. Many and varied physical and psychosocial repercussions for individuals were associated with these system failures. In some instances, rather than restoring health, being admitted to hospital represented a significant health risk.
A failure of hospital systems to meet the bowel care needs of people with SCI when hospitalised outside a specialist spinal unit was identified. System and individual factors contributed to these problems, hence addressing them requires both system and individual responses.
If this problem is left unaddressed, the health and quality of life of people with SCI will continue to be compromised. Nursing scope of practice needs to be clarified and communicated to nurses outside specialist spinal injury units in relation to their role in maintaining bowel care regimes recommended for their patients by spinal specialists, and nurses need to ensure they possess the skills required. To allocate the time needed to provide this care, individual nurses need the support of the whole nursing team, including managers who are prepared to arrange additional staff when needed.
调查脊髓损伤（SCI）患者在非专科脊髓损伤服务机构住院期间，寻求帮助以维持推荐的肠道管理方案时所遇到的问题的性质。
肠道功能障碍是 SCI 患者生活中一个特别不理想的方面，便秘和失禁很常见。
描述性定性研究。
通过对 11 名脊髓损伤患者进行访谈，并通过在线调查收到 12 名脊髓临床医生的回复，收集了澳大利亚新南威尔士州医院遇到的问题的描述，然后对这些数据进行主题分析。按照 COREQ 指南报告。
从两个来源收集的数据有相似之处。脊髓损伤患者描述了他们的肠道护理需求与急性医院的节奏和流程不匹配的情况。临床医生的数据表明，医疗保健专业人员未能帮助脊髓损伤患者维持专科脊髓服务推荐的肠道护理方案。两组都描述了肠道护理不可靠和碎片化的情况，以及有不愿和/或无法提供所需帮助的工作人员的报告。许多和各种身体和心理社会后果与这些系统故障有关。在某些情况下，住院不仅没有恢复健康，反而给患者带来了重大的健康风险。
当脊髓损伤患者在非专科脊髓单位住院时，医院系统未能满足他们的肠道护理需求。系统和个人因素促成了这些问题，因此需要系统和个人共同做出回应。
如果这个问题得不到解决，脊髓损伤患者的健康和生活质量将继续受到影响。护理实践范围需要在专科脊髓损伤单位之外的护士中得到明确和传达，包括在维持脊髓专家为其患者推荐的肠道护理方案方面的作用，并且护士需要确保他们具备所需的技能。为了分配提供这种护理所需的时间，个别护士需要整个护理团队的支持，包括准备在需要时安排额外人员的管理人员。
