Characteristics of neurogenic bowel in spinal cord injury and perceived quality of life.

PURPOSE: To investigate the association between characteristics of individuals with spinal cord injury and neurogenic bowel and their perceived quality of life. DESIGN/METHODS: The study design is an exploratory, descriptive correlational design. To measure the variables of the study the Quality of Life Survey developed by Randell et al. (2001) was used to measure perceived quality of life related to bowel management. Individual bowel management preferences and subjective costs and benefits of the preferences were gathered through the Neurogenic Bowel Characteristics Survey. PARTICIPANTS/METHOD: Data were collected from a random half of the individuals who met the inclusion criteria from the patient database (n=1193). Two hundred and forty one surveys were analyzed for this study. DISCUSSION: More than half of the sample (n=134) provided their own bowel management consisting of digital stimulation, suppositories, and other aids; 8% (n=19) had a colostomy. Regardless of the bowel management program 54% (n=127) were satisfied with current methods. Although time reported to complete bowel programs ranged from 1 to 120 minutes, there was no difference in rating of satisfaction with time. There was a statistically significant difference between those satisfied and dissatisfied with current bowel management and quality of life; those satisfied demonstrated a higher quality of life on three subscales, work function (p= .021), bowel problems (p< .001), and social function (p< .001). Those dissatisfied with their bowel program perceived a lower quality of life and indicated problems of time (p= .001), pain or discomfort (p= .033), and poor results (p< .001). CLINICAL RELEVANCE: Research data provide the patient's perspective on bowel management characteristics, complications, satisfaction, and their perceived quality of life. Results of this research will be incorporated into bowel management education and possible modification of the current inpatient bowel management program.

Nurse experts jump-start clinical simulation in rehabilitation nursing: supporting new graduate transition to competence.

This article outlines a high-fidelity simulation project developed and implemented by expert staff nurses at a specialty rehabilitation hospital. The project is designed to educate new graduate nurses on appropriate care for patients after a rare spinal cord surgical procedure. Due to the complicated nature of the surgery, patients are highly acute and may present with specific complications that need to be addressed for positive patient outcomes. Expert staff nurses imparted their knowledge in developing a scenario emphasizing common and unusual postsurgery patient presentations. The scenario was implemented as a teaching exercise for new graduate nurses, with experienced staff nurses as facilitators of learning in a safe, nonthreatening environment. New graduate nurses were overwhelmingly positive in the postsimulation debriefing, reporting increased confidence and knowledge necessary to care for these patients. Future endeavors include expanding involvement of staff nurses in simulation education and researching new graduate transition through simulation.