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DTSTART;TZID=America/New_York:20190613T120000
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DTSTAMP:20260414T225344
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UID:1642-1560427200-1560430800@reltoronto.ca
SUMMARY:Laura Teague - Surgical Closure of Pelvic Pressure Ulcers in Spinal Cord Injured Adults: Case Identification\, Costs\, Health Care Utilization and Risk Factors for Surgical Complications
DESCRIPTION:Abstract\nPressure ulcers\, also known as pressure injuries (PI)\, are a common and serious complication of spinal cord injury (SCI). Impaired wound healing in SCI patients contributes to the progression of these ulcers to more severe stages\, which are increasingly more difficult to manage. Best practice guidelines suggest that surgical reconstruction with a flap is an option for chronic stage IV PIs that have failed to heal with more conservative measures. However\, little is known about the epidemiology of surgically reconstructed PIs in SCI patients. Despite efforts to select suitable patients for this procedure\, the rate of surgical wound complications remains high and the cost of management is extensive. Accordingly\, it is important to establish a systematic approach for identifying SCI patients with surgically reconstructed PIs to facilitate the study of predictors of sustained wound closure\, quantify the cost of surgical reconstruction\, and evaluate the efficiency of treatment and recovery options. \nTo address gaps in the literature\, this study aimed to achieve four objectives: (1) To estimate the hospital costs of surgical reconstruction of stage IV PIs in SCI patients and characterize the relationship of demographics\, socioeconomic status and lifestyle factors to cost at discharge from SMH\, (2) To determine a standardized method of identifying cases of surgically reconstructed PIs in SCI patients from large databases\,  (3) To identify and validate risk factors for complications of surgical reconstructed stage IV PIs in SCI patients at discharge from SMH wound care follow-up and (4) to identify long term cost and health care utilization of persons with SCI who have undergone surgical flap closure at SMH in the ICES database. \nAbout the Speaker\nLaura Teague is has started working in her new role as Nurse-Practitioner-Clinical and Academic Lead for wound care at the Sinai Health System in Toronto\, Ontario. \nFrom 1987 to 2016\, Laura worked in various clinical and leadership positions as a registered nurse\, clinical nurse specialist and nurse practitioner – wound care at a teaching hospital in downtown Toronto. She lead and grew an interdisciplinary team to address wound prevention and treatment at this hospital. In the role of clinical nurse specialist and nurse practitioner\, Laura lead annual hospital point prevalence studies for pressure injuries for 13 years. Results from these studies leveraged changes in practice\, education\, products\, supply chain and devices to mitigate avoidable and unavoidable injury. \nLaura’ passion for quality improvement and development of standards of practice has been driven through her experience in the wound prevention and treatment field. She has been directly involved with development of best practice guidelines through the RNAO. Laura has provided continuous leadership through development of the Ontario Woundcare Interest Group as the founding president and membership on the executive. Through this interest group\, she lead 3 health technology assessment applications and one Ontario Drug Benefit review application. Laura also successfully negotiated an educational clinical institute focused on best practices in wound prevention and treatment with the RNAO\, which is in its 11thyear. \nLaura is currently completing her thesis in the PhD program at McMaster University\, Faculty of Health Sciences\, School of Nursing. Her thesis work involves a cohort study of spinal cord injured persons who have undergone surgical closure for pressure ulcers. This study is funded by the Ontario Neuro-trauma Foundation.
URL:https://reltoronto.ca/index.php/lecture/laura-teague-surgical-closure-of-pelvic-pressure-ulcers/
LOCATION:Lyndhurst Center –  Lecture Rooms A & B\, 520 Sutherland Drive\, Toronto\, Ontario\, M4G3V9\, Canada
CATEGORIES:Dr. Jousse Lecture Series,SCRP Best Practice Forum,Season 11
ATTACH;FMTTYPE=image/png:https://reltoronto.ca/wp-content/uploads/Laura-Teague.png
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DTSTART;TZID=America/New_York:20180719T120000
DTEND;TZID=America/New_York:20180719T130000
DTSTAMP:20260414T225344
CREATED:20180705T170055Z
LAST-MODIFIED:20180705T180439Z
UID:1475-1532001600-1532005200@reltoronto.ca
SUMMARY:Anne Bryden - Advanced Assessment of the Upper Limb in Tetraplegia: A Three-Tiered Approach to Characterizing Paralysis
DESCRIPTION:Abstract\nBackground:  More than half of all individuals who sustain a spinal cord injury (SCI) experience some degree of impairment in the upper limb. Functional use of the arm and hand is of paramount importance to these individuals. Fortunately\, the number of clinical trials and advanced interventions targeting upper limb function are increasing\, generating optimism for improved recovery and restoration after SCI. New interventions for restoring function and improving recovery require more detailed examination of the motor capacities of the upper limb. Objectives: The purpose of this presentation is to introduce a three-tiered approach to evaluating motor function\, with specific attention to the characteristics of weak and fully paralyzed muscles during acute rehabilitation. The three tiers include (1) evaluation of voluntary strength via manual muscle testing\, (2) evaluation of lower motor neuron integrity in upper motor neuron–paralyzed muscles using surface electrical stimulation\, and (3) evaluation of latent motor responses in paralyzed muscles that exhibit a strong response to electrical stimulation\, using surface electromyographic recording electrodes. These characteristics contribute important information that can be utilized to mitigate potential secondary conditions such as contractures and identify effective interventions such as activity-based interventions or reconstructive procedures. The goal is to encourage frontline clinicians\, occupational and physical therapists who are experts in muscle assessment\, to consider a more in-depth analysis of paralysis after SCI. Conclusion: Given the rapid advancements in SCI research and clinical interventions\, it is critical that methods of evaluation and classification evolve. The success or failure of these interventions may depend on the specific characteristics identified in the three-tiered assessment. Without this assessment\, the physiological starting point for each individual is unknown\, adding significant variability in measuring the outcomes of these interventions. \nAbout the Speaker\nAnne Bryden\, MA\, OTR/L is the Director of Clinical Trials and Research for the Institute for Functional Restoration (IFR) at Case Western Reserve University.  The IFR is a non-profit organization with the mission of translating science and technological research interventions targeted toward spinal cord injury and other paralytic conditions into clinical programs to help people with these conditions.  The IFR is closely affiliated with The Cleveland FES Center. \nAnne received her Bachelor of Science in Occupational Therapy from Cleveland State University in 1991.  She has a Master’s degree in Sociology and is currently a doctoral candidate in Sociology at Case Western Reserve University. Anne has over twenty years of experience specializing in upper extremity care of people with cervical spinal cord injury. Anne leads the functional assessment program for upper extremity neuroprosthetics and reconstructive surgeries at The Cleveland FES Center.  Currently she is responsible for leading the multi-center pivotal clinical trial for the networked neuroprosthesis\, the latest innovation developed at the Cleveland FES Center. Her research interests include upper extremity assessment\, surgical interventions\, outcomes measurement\, and the social determinants of health and wellness in people with chronic physical disability.  Additionally\, she is exploring the experiences of navigating health and social resources following SCI through the lens of human rights\, by measuring barriers and facilitators to obtaining services necessary for quality of life.  She is also conducting research on the human rights knowledge base of health professionals and other stakeholders involved in the care of people with SCI. \nAnne has authored and co-authored several peer-reviewed publications on the topic of spinal cord injury. She is the recipient of the 2015 Neilsen Foundation Allied Health Professional Research Award of the American Spinal Injury Association (ASIA).  Currently Anne is the Chair of the Rehabilitation Standards Committee of ASIA.  Additional professional memberships include The American Occupational Therapy Association\, The American Sociological Association and the International Spinal Cord Society. \n 
URL:https://reltoronto.ca/index.php/lecture/anne-bryden-advanced-assessment-of-the-upper-limb-in-tetraplegia-a-three-tiered-approach-to-characterizing-paralysis/
LOCATION:Lyndhurst Center –  Lecture Rooms A & B\, 520 Sutherland Drive\, Toronto\, Ontario\, M4G3V9\, Canada
CATEGORIES:SCRP Best Practice Forum
ATTACH;FMTTYPE=image/jpeg:https://reltoronto.ca/wp-content/uploads/anne-bryden.jpg
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