From Evidence to Practice: A Systematic Approach to Implementing Electrical Stimulation Therapy for Treating Pressure Injuries in Community Dwelling Individuals with Spinal Cord Injury
Bibliographic record
Abstract
Pressure injuries are a common secondary health complication among individuals with a spinal cord injury (SCI) and can have a profound effect on quality of life. Unfortunately, pressure injury care in community dwelling individuals with SCI is often fragmented and inconsistent across Canada. Current best practice guidelines strongly recommend the use of electrical stimulation therapy (EST) to manage pressure injury in this population; however, there is little uptake of EST, and is not considered as a first-line treatment by many clinicians. Therefore, the objective of this dissertation is two-folds 1) to determine the impact of pressure injuries on individuals with SCI (Chapter 2), and 2) to utilize a systematic approach to implementing EST for managing pressure injuries in community dwelling individuals with SCI living in South West Local Health Integrated Network (LHIN) in Ontario (Chapters 3, 4, and 5). The first study highlighted the importance of implementing pressure injury prevention and management programs in this high-risk population by reporting the negative effect that pressure injuries has on the ability of individuals with SCI to participate in activities of daily living and recreational activities, and the significant impact on quality of life and health care utilization. In studies 2 and 3, a pressure injury model of care involving EST was developed based on the barriers and facilitators identified by local stakeholders. The model was later adapted to fit the local environment by a team of local experts and a SCI consumer in a two-day workshop. The final study used iterative plan, do, study, act (PDSA) cycles to implement the adapted model of care into current practices. Multiple issues associated with key implementation activities were identified to limit the sustainability of EST for treating pressure injuries in community dwelling individuals with SCI, despite the numerous strategies put in place to solve the issues. However, these studies not only provide a clear approach to implementing pressure injury best practices, but the findings provide important insight to future researchers or clinicians interested in implementing EST for managing pressure injuries in community dwelling individuals with SCI.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.325 | 0.491 |
| Meta-epidemiology (narrow) | 0.003 | 0.004 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.030 | 0.016 |
| Science and technology studies | 0.008 | 0.006 |
| Scholarly communication | 0.017 | 0.017 |
| Open science | 0.010 | 0.023 |
| Research integrity | 0.007 | 0.009 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".