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H - Skin Integrity

Figure 2.0 illustrates how typical interprofessional skin and wound management services should be delivered, Figure 3.0 describes the spectrum of interprofessional representation across organizations. Seven tertiary rehabilitation sites (58%) report a minimum skin integrity team comprised of a nurse, an OT and a physiatrist. The other disciplines are represented at one or two sites, except for PT, which is represented at five sites; and three sites report additional contributions from an enterostomy therapist, plastic surgeon, psychiatrist, hospitalist or an infectious disease specialist. Figure 3.0. A model Illustrating the Spectrum of Services Available to Prevent and Manage Pressure Ulcers Among Individuals with SCI. Figure 2.0 the Spectrum of Services Available to Prevent and Manage Presure Ulcers Among Individuals with SCI Figure 3.0 Distribution of Healthcare Profesionals Providing Skin Integrity Services in Tertiary SCI Rehabilitation Centres Acros Canada Infectious Disease Specialist Hospitalist Enterostomy Therapist Psychiatrist Plastic Surgeon Physiotherapist Physiatrist Occupational Therapist Nurse Practitioner/Advanced Practice Nurse Nurse (RNA/RPN) Nurse (RN) Family Practice Physician Dietitian/Nutritionist 0 2 4 6 8 10 12 Number of Sites Current Canadian SCI Pressure Ulcer Practice Profile Clinical Practice Guidelines 1. Houghton PE, Campbell KE, and BPG Panel members. Canadian Best Practice Guidelines for the Prevention, Assessment and Treatment of Pressure Ulcers in Individuals with Spinal Cord Injury; Rick Hansen Institute (RHI) and the Ontario Neurotrauma Foundation (ONF); 2012. (Contact phoughto@uwo.ca for more information) 2. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: quick reference guide. Washington, DC: National Pressure Ulcer Advisory Panel; 2009. http://www.epuap.org/guidelines/Final_Quick_ Prevention.pdf. Accessed May 29, 2012. 3. Paralyzed Veterans of America (PVA) Consortium for Spinal Cord Medicine Clinical Practice Guidelines. Pressure ulcer prevention and treatment following SCI: A clinical practice guideline for healthcare professionals. 2000;1-77. 4. Registered Nurses Association of Ontario (RNAO). Nursing Best Practice Guideline: Risk Assessment and Prevention of Pressure Ulcers; 2005. http://rnao.ca/bpg/guidelines/risk-assessment-andprevention pressure-ulcers. Accessed May 31, 2012. 5. Ovington LG. Dressings and adjunctive therapies: AHCPR guidelines revisited. Ostomy Wound Manage. 1999;45(Suppl 1A):94S-106S. Nursing skin assessment upon admission Interprofessional reassessment of risk Physical Interventions (e.g., dressings, seating) Education Medical Surgical 86 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


H - Skin Integrity
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