1604. Integrated SCI Clinical Pathway: Initiative to Care in Medical Surgical Neuro ICU
Authors: Rosalie Magtoto; Karen Benett; Andrea Dyrkacz; Maureen Weaver, BA; Angela McGauley; Debra MacGarvie; Lisa Muc; Jennifer Morgan; Elizebel Rooplal, RN; Louise Pothier (Toronto, Canada)
Introduction: Spinal cord injury (SCI) is a traumatic or non -traumatic event that leads to motor, sensory and autonomic function loss. Patients sustaining SCI require highly specialized care from an inter-professional team to achieve the best possible outcomes and to prevent harm. It became clear in this study that patients were not always correctly identified as having an SCI. The objectives of this quality improvement project were to determine how staff members on the unit were identifying patients with SCI, to determine existing barriers and positive patient`s identification. Methods: Surveys were done to determine the extent of the problem of identification of SCI patients. Part one of the survey consisted of closed-ended questions about the demographics of health care providers. The second part of the survey included three open-ended questions to address how SCI patients get identified at the bedside. Results are reported in grouped themes for each of the major questions. In the second step of data collection, a bedside audit was performed using the Lean Method. Results: A total of 128 including nurses and allied health professionals responded to the survey. After examining all of the responses, 14 strategies were given to identify a SCI patient. In the second part of data collection, out of 50 nurses interviewed, 54% correctly identified a SCI patient, 36% incorrectly identified a SCI patients, and 10% were unsure. The top two barriers participants identified for SCI being difficult to identify were difficulty communicating with the patients and confusing diagnosis on chart. Conclusion: This study highlights that patients were not always correctly identified as having an SCI, leading to a lag in care deliver. Phase two of the project could provide guidelines to aid in the correct identification of SCI patients.