ABSTRACT
In 1998 health care legislation in Ontario changed and allowed Primary Health Care Nurse Practitioners the possibility to expand their practice. At a rehabilitation centre, where spinal cord injured patients would seek primary health care services, a new amalgamated role was implemented to meet those needs. This article will described the advanced practice role that was developed, define the scope of practice, and demonstrate an innovative approach to service delivery. The role serves as a concrete link between primary health care services and tertiary care patients needs.
Subject(s)
Job Description , Nurse Practitioners/organization & administration , Primary Health Care/organization & administration , Rehabilitation Nursing/organization & administration , Spinal Cord Injuries/nursing , Spinal Cord Injuries/rehabilitation , Health Care Reform/legislation & jurisprudence , Humans , Nurse Practitioners/education , Ontario , Professional Autonomy , Rehabilitation Nursing/educationABSTRACT
Clean intermittent catheterization is a common method of urinary elimination for people with Spinal Cord Injuries. The methods of catheter cleaning for re-use, however, have not been validated with research studies. This study compared the effectiveness of Hydrogen Peroxide, vinegar, dishwashing detergent, and tap water alone to clean catheters contaminated with Pseudomonas aeruginosa and Escherichia coli. The effect of rinsing and drying before cleaning was also examined, as well as the effect of storage in paper or plastic bags after cleaning. Results indicated that rinsing and drying catheters immediately after use was the most effective at reducing bacteria to very near zero. Elements of a procedure are outlined, as well as plans for further development and testing of a rinse & dry procedure for catheter cleaning and re-use.
