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Q&A with SCI Clinician Anna Kras-Dupuis

 

With a special interest and experience in best practice implementation and chronic disease self-management, she is now on the frontline team of the Knowledge Mobilization Network, an innovative, science-based national (multi-site) initiative to implement best practices in spinal cord injury care and treatments.

Where are you from originally? I emigrated over 30 years ago from Soviet Union (Belarus).

KrasDupuis_AnnaAnna Kras-Dupuis, RN MScN, CNN(C), CRN(C)
Transformation Specialist, Knowledge Mobilization Network
Clinical Nurse Specialist, Rehabilitation Program, St. Joseph’s Health Care London Parkwood Hospital (Photo courtesy of St. Joseph's Health Care London
For over 26 years, Anna has specialized in acute neurosciences, education and neurological rehabilitation, and has been recognized for her outstanding contributions to clinical practice, research and teaching with Sisters of St. Joseph’s Award for Excellence (2002); the Codman Award from the Canadian Association of Neurosciences Nurses (2003), and the USC Teaching Honour Roll Award of Excellence, University of Western Ontario (2008-2009).

 

Where did you receive your training? My parents, both in the medical profession, inspired me with their stories, and I wanted to do something to help people. There wasn’t the freedom to do that, where I was living at the time, so when we moved to Canada, I was able to pursue my nursing education at the University of Western Ontario, in London. I was excited about my future nursing career.

 

What inspired you to specialize in Neurosciences? When I was in school, my consolidation placement was in the acute neurosciences area of the hospital. I worked with a wonderful team and appreciated the complexity of the neuroscience patient…there was always so much to learn, and it was never predictable. This is a very complex patient population. You need your intuition and your knowledge… you’re always learning and problem solving. I knew then that this was my “cup of tea”.

 

You taught for a while and then returned to nursing. Yes, after five years, the opportunity came up to teach, at Fanshawe College. For me, it was about learning more, expanding and sharing my knowledge with others…I loved it! When I returned to the clinical setting at Parkwood Hospital in their newly-opened rehabilitation program for stroke patients with significant impairments, I could combine my experience in teaching with my clinical expertise. My role was to assess patients for admission to the program, provide a link to our rehabilitation team, and be a resource person. That role has evolved, so now I support the entire rehabilitation program, by providing leadership with best practice implementation, with education needs for staff, with facilitating practice change and accessibility to resource as required.

Why are ‘best practices’ important? Since I started nursing, we’ve always talked about the importance of knowing the evidence and staying on top of the latest information. However, it’s very challenging to stay current. In the last five to seven years or so, we have seen a shift from just gathering knowledge to learning how to transfer this knowledge to the bedside. Initial efforts have been mostly trial and error and not always successful. There is now an Implementation Science– that helps to frame knowledge translation or best practice implementation. It used to be up to the busy clinician to figure things out, now, we can work as a team to tackle it in a more systematic and rigorous way. So I guess, “Best Practices” only become “alive” when our patients get to experience them and there is tangible impact.

 

How does that work? Specializing and developing expertise for spinal cord injury, for example, happens in larger centres where there is a critical mass of patients who need this care. Staff work cohesively and collaboratively to share this expertise and leadership amongst themselves, and also with other professionals across the continuum of care. This is about building partnerships, mentorships and support. Sharing of the best practice implementation expertise will ultimately help to facilitate better outcomes for our patients, no matter where they receive this care.

 

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Joanna x, Dalton Wolfe and Jane Hsieh with Craig Somerville, a patient in the SCI Program.
 
CREDIT: Photo courtesy of St. Joseph's Health Care London
Kras-Dupuis (left) and team with Craig Sommerville, a patient in the SCI Program.
(Photo courtesy of St. Joseph's Health Care London)

Tell me about the Knowledge Mobilization Network team. Our multi-site team consists of many clinicians, researchers, administrators and consumers. It is really an amazing opportunity to learn from each other and create something that is built on collective wisdom.

About a year ago, we started with considering pressure ulcer prevention and management for spinal cord injury patients and embarked on the process of selecting which best practices we would implement first. This is when we began to build relationships with the teams at five other sites in Edmonton, Calgary, Toronto, Montreal and Quebec. We have come a long way since then so now we are working on two selected practices: how to conduct a comprehensive pressure ulcer risk assessment, and how to best provide structured and individualized education regarding the management and prevention of pressure ulcers. Site Implementation Teams have been formed and we have a well developed project teaming structure.

 

So what happens next? This initiative has given us an opportunity to learn how to implement and sustain best practices, so that when we look at other areas of practice, we will know the systematic way to approach them. It is about building capacity, learning the necessary skills of implementation and becoming good at it. We won’t be reinventing the wheel every time. The overall plan for the project includes sharing what we have learned outside spinal cord injury to other conditions and settings. We have started with the Pressure Ulcer Prevention, but will also be tackling Pain assessment and management, in parallel, later this year.

How has your work influenced your personal life? I believe in this work. It keeps me passionate and motivated – and it’s exciting, stimulating and challenging. I am blessed and fortunate to work with such a great team here and at other sites. And I have learned that life balance is so important – so I do enjoy my time off with my family and friends!

 

Do you have any advice for people thinking about entering this field? Get excited! There are so many opportunities to learn, advance knowledge, and to partner with your patients…to make a difference in their lives. The body of knowledge and research has grown exponentially in the rehabilitation field, in general, and in spinal cord injury, in particular. This gives us hope for recovery and potential for improvement that we never thought were possible.

 

Where do you see breakthroughs happening in SCI patient care? With the advances in research and technology, our patients can be armed with knowledge and access to a variety of resources and tools that will empower them to manage their own health. As well, consumers can start to connect with each other and health care professionals can reach people in their own homes to either provide advice or support, or to deliver an intervention.

 

You have a quote in your email signature by Elbert Hubbard: "The greatest mistake you can make in life is to continually be afraid you will make one". What does that mean to you? I am a strong believer that unless we take on a challenge or take a risk, we would never have opportunities to learn and get better at what we do! So I am all for pushing the envelope and embarking on unknown territories. I love the challenge!

 

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