Cross-disciplinary relationships are known to be central to the effectiveness of rehabilitation service delivery. The purpose of this article is to: 1) share the findings of a facilitated reflection upon practice into the nature of cross-disciplinary care co‑ordination involving three clinicians – one registered nurse working in the role of clinical care co‑ordinator (CCC) and two social workers – who worked together in one inpatient rehabilitation unit; and 2) explain the facilitated reflection process so others may consider its relevance for their setting. The reflection involved 11 audio-recorded face-to-face sessions using a skilled facilitator and four writing activities related to the discussions. These data were subjected to thematic analysis. This analysis found that a synergy of effort between nursing and social work – the key ingredients of which were close collaboration, authentic professional support and purposeful shared patient care – enabled cross-disciplinary inpatient rehabilitation care co‑ordination. The professional and personal commitment of the three clinicians was a notable factor in their successful collaboration. This example of how individuals can shape cross-disciplinary working was made visible through facilitated reflection upon practice; others may find this technique useful for gaining a deeper understanding of various aspects of their practice.
Critical realism is increasingly gaining recognition as a philosophical approach beneficial to understanding complex real-world contexts such as those seen in nursing research. It enables a researcher to move beyond description to explaining what is occurring and to theorise as to why a phenomenon occurs in the way that it does and in what context. This article introduces and explains the core tenets of critical realism and specifically argues its relevance to rehabilitation nursing research. We also present an example of its use in a rehabilitation nursing project which illustrates how critical realism was infused through every stage of the research project and demonstrates the utility of the approach in identifying avenues for practice change.
Background Nutrition screening is paramount for the detection of malnutrition, allowing for improved patient care and timely nutrition management. Despite the well-documented prevalence of malnutrition in patients with traumatic brain injury (TBI) and spinal cord injury (SCI), no studies have assessed the validity of the malnutrition screening tool (MST) in these patient populations.
Objective The primary aim of this study was to explore health professionals’ perspectives on nutrition screening in patients with TBI and SCI in specialist inpatient rehabilitation. Furthermore, this study aimed to elucidate health professionals’ views on the barriers and enablers of nutrition management as directed by the MST score.
Methods Seven health professionals who used the MST in patients with TBI and SCI at a specialist rehabilitation centre participated in semi-structured, face-to-face interviews. Resultant transcripts were analysed thematically using the six-phase technique in QSR NVivo software.
Results Thematic analysis identified four main themes highlighting the barriers and enablers of the MST in patients with TBI and SCI: population-specific influencers (e.g., patient cognition and enteral feeding); the impact of the MST on staff resources; participant identification that additional resources were required to effectively administer the MST; and the importance of MST score-directed patient care.
Conclusions This study highlights challenges associated with the reliability of MST to direct nutrition care in patients with TBI and SCI, while recognising opportunities for improvement. This new knowledge underscores the importance of individualised patient care whilst identifying the need for sensitive, population-specific nutrition screening tools (NSTs).
The purpose of this article is to start a conversation about the nature of nursing’s contribution to return to work using spinal cord injury (SCI) as the particular focus. It discusses the significance of return to work following SCI, post‑SCI return to work rates, factors affecting post‑SCI return to work and vocational rehabilitation post‑SCI. There are many and varied benefits of work post‑SCI beyond financial security but, internationally, return to work rates remain low. There is a multitude of factors affecting return to work and many of these are modifiable. There is growing evidence supporting early intervention vocational rehabilitation that starts in the inpatient setting. In this discussion, specialist vocational rehabilitation is positioned as only part of what is needed. In their day-to-day work nurses have many opportunities to engage in conversations with their patients about returning to work and to positively influence patient thinking about the future. Consideration of this aspect of nursing work is every nurse’s responsibility as they strive to positively influence rehabilitation outcomes for their patients.