B - EDUCATION AND SUPPORT OF INDIVIDUALS WITH SCI AND THEIR FAMILIES ACROSS THE CONTINUUM
B.1.1
The attending physician in acute care should communicate the patient’s diagnosis prior to acute care discharge and document clearly the discussion in the health record for consistent messaging across the continuum of care. The physician should ideally be accompanied by other members of the interprofessional team who can provide emotional support to the patient and family as needed. (Adapted from NICE 2016, p.17; Level C)
B.2.1
Individuals with SCI should have timely access to local peer support services and community-based programs to increase the quality of life and community participation after injury across their lifespan. (CAN-SCIP 2020; Level C)
B.2.2
Education for individuals with SCI, caregivers, and health care providers should be provided and comprehensive to all levels of learners. (PVA-NBD 2020, p.454; Level C)
B.3.1
After the individual with SCI has been stabilized, review the precipitating cause of the autonomic dysreflexia episode with the individual, family members, significant others, and caregivers to educate them regarding instigating factors, recognition, management, and prevention of future autonomic dysreflexia episodes.
- Adjust the treatment plan to ensure that future episodes are recognized and treated to prevent a medical crisis or, ideally, are avoided altogether.
- Discuss autonomic dysreflexia during the individual’s education program so that he or she will be able to minimize the risks known to precipitate autonomic dysreflexia, solve problems, recognize early onset, and obtain help as quickly as possible.
- Have an ongoing conversation and continue education at annual evaluations or clinic appointments.
- Give a written wallet card/guide or instruction sheet or consider a medical alert bracelet.
B.4.1
The components of the bowel program should be taught to individuals with an SCI as well as to caregivers. (PVA-NBD 2020, p.455; Level C)
B.4.2
Education on potential complications should be completed. (PVA-NBD 2020, p. 455; Level C)
B.4.3
Education and support for the caregiver should be considered and completed when appropriate. (PVA-NBD 2020, p.455; Level C)
B.4.4
Sexual intimacy and considerations related to bowel program management should be discussed. (PVA-NBD 2020, p.455; Level C)
B.5.1
An interprofessional team, consisting of members with professional knowledge and competency should provide support for vulnerable adults (physical, economic, social, or emotional vulnerability), particularly those who are socioeconomic disadvantaged, homeless, lacking social support, have pre-existing severe mental health issues or are victims of assault or violence. (Adapted from NICE 2016, p.16; Level C)
B.5.2
Clinicians should work with family members and caregivers of these vulnerable adults (physical, economic, social, or emotional vulnerability) to provide information and support while considering the individual's age, developmental stage, and cognitive function. (Adapted from NICE 2016, p.16, Level C)
B.5.3
Clinicians should contact the mental health team as soon as possible for patients who have a pre-existing psychological or psychiatric condition that might have contributed to their injury or a mental health problem that might affect their well-being or care in the hospital. Support and guidance should be given in accordance with activity and participation as described in the ICF model. (Adapted from NICE 2016, p.16; Level C)
B.5.4
For vulnerable individuals (physical, economic, social, or emotional vulnerability) with SCI, family members and caregivers should be allowed to remain within the hospital to provide appropriate support. (Adapted from NICE 2016, p.16; Level C)