Perceptions of Practice Guidelines for People with Spinal Cord Injury

Authors

  • Gail Powell-Cope PhD, ARNP, FAAN,

    Corresponding author
    1. Center of Innovation on Disability and Rehabilitation Research VISN 8, Department of Veterans Affairs (VA), Veterans Health Administration, Tampa, FL, USA
    • Correspondence

      Gail Powell-Cope, Tampa Co-Director, Center of Innovation on Disability and Rehabilitation Research VISN 8, Department of Veterans Affairs, 8900 Grand Oak Circle, Tampa, FL.

      E-mail: Gail.Powell-Cope@va.gov

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  • D. Helen Moore PhD, BSW,

    1. Center of Innovation on Disability and Rehabilitation Research VISN 8, Department of Veterans Affairs (VA), Veterans Health Administration, Tampa, FL, USA
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  • Frances M. Weaver PhD,

    1. HSR&D Center of Innovation, Hines VA Hospital and Stritch School of Medicine, Loyola University, Chicago, IL, USA
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  • Susan Thomason MN, RN, ACNS-BC, CRRN, CWN

    1. Tampa VA Research and Education Foundation, Tampa, FL, USA
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Abstract

Purpose

The Consortium for Spinal Cord Medicine published clinical practice guidelines (CPG) related to upper limb (UL) preservation in people with spinal cord injury (SCI) in 2005. The purpose of this qualitative research was to identify stakeholder agreement with recommendations, performance gaps, and barriers and facilitators to CPG implementation.

Design

This 6-month study focused on the perspectives of healthcare providers, veterans, and key informants. The Promoting Action on Research Implementation in Health Services (PARiHS) was used to frame the interview questions, analyze data from focus groups and interviews, and develop conclusions and recommendations.

Method

SCI Centers at the Tampa, Seattle, and Hines Veterans' hospitals participated.

The purposeful sample for the focus groups included 32 healthcare providers, 21 veterans with SCI, and 3 key informants. Analysis of qualitative data netted the percent of agreement with recommendations, performance gaps, and strategies for CPG implementation.

Findings

Content analysis of focus group data revealed that healthcare providers agreed or partially agreed with 20 (57%) of the 35 CSCM CPG on UL preservation of function. Agreement ranged from 100% for assessment to 28% for equipment use. Barriers for implementation related to administrative and system issues.

Conclusion

Consideration of gaps, barriers, and facilitators to implementation will assist clinicians to target interventions to preserve UL function.

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