Stoke Mandeville Hospital (National Spinal Injuries Centre)



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Stoke Mandeville Hospital (National Spinal Injuries Centre) Patient Education Department Patient Education Programme September 2008 (Review September 2009)

This booklet is for patients. The Patient Education Department runs a series of learning sessions that will equip you with the knowledge to be able to manage your spinal cord injury. The aim of this booklet is to give you details of the programme and learning objectives of each session.

Introduction (including Goal Planning and the Spinal Injuries Association) This session gives a general introduction to the Patient Education Room and the Patient Education programme. How knowledge and understanding of SCI complements the rehabilitation process The normality of the thoughts, feelings and stresses you might experience following your injury How gaining information from this programme can prepare you for your life after leaving hospital. How the Goal Planning process works Introduction to the Spinal Injuries Association By the end of the session you should: Understand the relevance of the programme Understand how Patient Education can support you and your family Have had a chance to meet the rest of the group Understand the Goal Planning process and your part in it how the Spinal Injuries Association can support you and your family

Introduction to the Spinal Cord: Basic Anatomy and Terminology Outline of common terms Anatomy of the spine and spinal cord Function of the spinal cord and nervous systems By the end of the session you should: Be able to define the term spinal cord Understand the basic anatomy and function of the spinal cord Understand the terminology relating to SCI which in turn allows for an understanding of your injury Understand what someone means when they talk about the central nervous system and autonomic nervous system. Understand the term Autonomic Dysreflexia and how to recognise the symptoms

Bladder Management Why do we need to manage the bladder? Bladder control prior to SCI Bladder control after SCI Methods of managing your bladder Deciding what method to use Complications and what to do about them: follow-up. By the end of the session you should: Know why and when your bladder needs to be managed Know what methods are available and why they are chosen Understand more about the type of catheters, sheaths etc available Know how to problem solve bladder problems

Pain Management What is pain and how it works Understanding the different types of pain that can be experienced after SCI How to mange pain after spinal cord injury By the end of the session you should: Understand more about how pain works Have a greater awareness of strategies to manage pain to Prevent it from interfering with your life Have an opportunity, if you wish, to discuss ways in which you can manage pain Know where to get help and advice

Care of the Skin What is a pressure ulcer? What causes pressure ulcers? Short & long term complications of pressure ulcers Discussion of specific problem areas time for questions. By the end of the session you should: What a pressure ulcer is How a pressure ulcer can be prevented What the early signs of pressure ulcer development are.

Understanding Legal Issues Group discussion to explore potential legal issues faced by patients to include but not limited to the following: a) Employment Issues b) Enforcing policies of insurance c) The use of Power of Attorney d) Claiming Compensation e) Complex welfare benefits f) Disability Discrimination Examine the relevant law applicable to these issues Discuss the role of the lawyer within the discharge process Have an opportunity to discuss legal issues with experienced lawyers By the end of this programme you should: Have had the opportunity to discuss relevant legal issues with an experienced lawyer Have a basic understanding of the relevant law Have explored ways of dealing with the legal issues and identified a plan of action where required

Bowel Management Implications of the spinal cord injury for bowel function What is Bowel Management? Why learn about Bowel Management? How to manage your bowels Possible problems of not managing bowels When and how to seek help? Alternative methods of bowel management By the end of the session you should: Understand the main functions of large bowel in health Understand major impacts of spinal cord injury on bowel function Know what the aims of bowel management are. Be aware of the interventions that can be used to manage the bowel Know how to avoid and manage constipation

Coping with Spinal Cord Injury consider sources of stress and how to manage them recognise the normality of individual reactions What influences stress? Breaking down stress Problem solving. By the end of the programme you should: Understand that there is variability in stress Understand how appraising a situation as a threat or challenge can alter your reaction to it Understand what helps someone cope Have had a chance to discuss stressful situations that may arise as a result of your SCI and develop solutions to these problems.

Mobility Group discussion to establish current knowledge level Procedure for seating provision Role of wheelchair service Renewal of equipment after discharge Will I get help with the cost of a wheelchair? Advice on travelling (car, rail, sea, air) & insurance. By the end of the programme you should: Understand wheelchair and cushion provision from admission to discharge and thereafter Know what type of cushion you have Know what wheelchairs are available and the cost of them Understand the grants/vouchers available that will help you pay for your wheelchair Appreciate the difficulties but possibilities of travel.

Talk with ex-patients A chance for you to talk to former patients about their life experiences of managing and living with a spinal cord injury. This is a discussion based group session and is your chance to ask questions about anything You may wish to ask questions such as: What is it like being at home? How did you set and achieve your goals? What are the issues relating to work? What changed most when you went home? What has stayed the same? This is also your chance to explore doubts, fears, wishes and hopes.

Problem Solving and Social Support Exploring possible difficulties that people with Spinal cord injury may face. Breaking down problems Generating possible solutions Discussing ideas in an open group setting, together with others living with spinal cord injury Choosing strategies to deal with problems Facilitating social support and coping By the end of the session you should: Have had the opportunity to discuss possible situations/ problems people with spinal cord injury may encounter in their everyday life. Explored possible ways of dealing with problems and possible solutions. Understand the various points of view and ways of dealing with situations. Understand the importance of social support and coping.

Sexuality & Personal Relationships Why is there sexual dysfunction following SCI? What is available to aid sexual function? What are the emotional issues surrounding sexuality? How can I deal with them? Will I be able to date again? Can I have children? By the end of the programme you should: Understand your body s sexual function following SCI and how it can be improved Understand the emotional side of sexuality and dating following SCI Understand what fertility treatment is available should you need it.

Fitness Implications of spinal cord injury on weight changes Secondary health problems associated with weight gain Impact of weight gain on function Benefits of exercise What sports are available following spinal cord injury Information on how to access sports and exercise post spinal cord injury Increase in knowledge why there are significant weight changes post spinal cord injury Understand the secondary health problems and the impact of weight gain on function post spinal cord injury Understand the benefits of exercise and the preparation and precautions that need to be undertaken prior to exercising Increased awareness of government initiatives and charities that assist in individuals participating in sports/ exercise post spinal cord injury Increase knowledge of sports/activities available to a large variety of individuals with spinal cord injury

Outpatient support after leaving hospital Introduction of the SPOP (Spinal Outpatients Team) multidisciplinary team Transport to SPOP The role of the peripatetic team, home visiting. community staff, GP and district nurse Supply of equipment Information on telephone help Question and answer session/troubleshooting the previous clinical talks. By the end of the programme you should: Be aware of the multidisciplinary team in SPOP Understand what the service provides Know how to access SPOP for information and advice.