Archives of Physical Medicine and Rehabilitation, October 2018, Vol.99(10), pp.2118-2121
To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.apmr.2018.04.030 Byline: Denise May Goodwin, PhD [Denise.firstname.lastname@example.org] (a,*), James Brock, PhD (b), Sarah Dunlop, PhD (c), Louise Goodes, BSc (c), James Middleton, MBBS, PhD (d), Andrew Nunn, MBBS (e), Breanna Wright, PhD (a), Peter Bragge, PhD (a) Keywords Knowledge translation; Rehabilitation; Spinal cord injury; Urinary catheters; Urinary tract infections Abstract We examined spinal cord injury (SCI) catheterization practices in Australia to understand practice patterns and consistency with research evidence. A national facilitated discussion forum was held during the annual Australian and New Zealand Spinal Cord Society conference attended by 66 conference delegates. Initially, presentations were given on the latest laboratory research examining bladder changes following SCI; an overview of evidence-based recommendations indicating that intermittent catheterization is best practice; and results of a single-center practice audit that demonstrated substantial delay in transition between acute SCI and intermittent catheterization. The ensuing discussion covered current catheterization practices in both inpatient SCI units and the community and highlighted gaps between evidence and practice, with considerable variation in practice between centers and settings. Reported challenges to implementing best practice included social, economic, and resource factors. A disconnect between hospital and community practice was also identified as an important barrier to long-term uptake of intermittent catheterization following acute SCI. The discussion identified 3 proposed activities: (1) explore current practice and bladder health following SCI in greater depth across SCI units and in local communities through audits and standardized biochemical analysis; (2) determine the behavioral drivers of current practice; and (3) develop a knowledge translation strategy to better align practice with current clinical practice guidelines. List of abbreviations ANZSCoS, Australian and New Zealand Spinal Cord Society; CPG, clinical practice guideline; IC, intermittent catheterization; IDC, indwelling catheter; SCI, spinal cord injury; UTI, urinary tract infection Author Affiliation: (a) BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Clayton, Australia (b) Department of Anatomy and Neuroscience, University of Melbourne, Melbourne, Australia (c) School of Biological Sciences, The University of Western Australia, Perth, Australia (d) John Walsh Centre for Rehabilitation Research, Kolling Institute, University of Sydney, Sydney, Australia (e) Victorian Spinal Cord Service, Austin Health, Melbourne, Australia * Corresponding author Denise Goodwin, BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, VIC 3800. (footnote) Supported by the Transport Accident Commission, through the Institute for Safety, Compensation and Recovery Research. (footnote) Disclosures: P.B. is a member of the Spinal Cord Injury Network board, a not-for-profit organization with a mission to improve spinal cord injury research and care. P.B. receives reimbursement for costs associated with attending board meetings. The other authors have nothing to disclose.
Knowledge Translation ; Rehabilitation ; Spinal Cord Injury ; Urinary Catheters ; Urinary Tract Infections ; Medicine ; Physical Therapy
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