You are here: Sister Kenny Rehabilitation Institute > Services & Programs > Spinal Cord Injury Program

Print

Send to a Friend

Rehab Nursing

The Rehab Nursing program helps individuals affected by chronic illness or physical disability achieve their greatest potential, adapt to their disabilities and work toward productive, independent lives.

At Sister Kenny Rehabilitation Institute, there are many components of the Rehab Nursing program for people with spinal cord injury:

• spinal cord injury education
• bladder management
• bowel management
• skin management
• autonomic dysreflexia management

Spinal cord injury education
A program is in place to ensure that all areas of spinal cord injury are covered. A series of videos are shown and a comprehensive manual is given to each patient.

Bladder management
The purpose of the program is to eliminate urine from the body with the eventual goal of restoring continence, which gives the patient control of his or her bladder.
Physicians in the Rehab Nursing program are skilled in the application of various medications used to regulate the bladder. A bladder management program is designed based on each patient’s needs and specific injury.

In addition to restoring continence, care team members will teach the patient about:

• the anatomy and physiology of the urinary system
• preventing complications like bladder infections, kidney stones and uretral reflux
• fluid guidelines in order to prevent overdistention (expansion) of the bladder.

Nurses, in collaboration with the physicians, will also establish a catheterization program to fit each patient’s individual bladder needs.

Bowel management
A custom bowel management program can be designed based on a patient’s individual needs. Various techniques used to achieve continence and regularity include:

• digital stimulation
• oral medications
• suppositories
• mini-enemas.

Program participants also learn about the importance of good nutrition and a high fiber diet in maintaining bowel continence and regularity.

Skin management
The best way to treat skin breakdown is to prevent it. We work with patients to establish good skin care to help them prevent hospital stays for pressure ulcer treatment and surgery. 

Guidelines established by our program require the patient to:

• do pressure relief at least every 20-30 minutes
• eat foods that feed the skin, including maintaining a good diet full of protein (necessary for when a patient is sick or losing weight as the skin becomes more sensitive), vitamins and minerals. Drink plenty of fluids within the limit of a bladder program.
• keep the skin clean and dry
• build up skin tolerance
• check your skin inch by inch twice a day: once before you get out of bed and again before you get back into bed
• be kind to your feet; circulation is slower and they take longer to heal 
• stop smoking

Care team members also work with each patient to:

• educate patients regarding their level of spinal cord injury and ways to maintain independence through promotion of self care.
• establish proper wheelchair positioning
• ensure that a proper mattress is used
• avoid extreme changes in temperature
• maintain ideal body weight
• wear clothing and shoes that are neither too loose nor too tight
• find ways to avoid stress

Autonomic dysreflexia
Autonomic dysreflexia is a life threatening emergency and must be treated immediately.
Autonomic dysreflexia is an overreaction of the nervous system caused by an irritation or other stimulus. The most common cause is a full bladder. Other causes are bowel fullness, irritation to the skin, sexual activity and infection. Physicians teach the patient and caregivers how to recognize signs and symptoms of autonomic dysreflexia and treatment options.

 

Sister Kenny Rehabilitation Institute
800 E. 28th St.
Minneapolis, MN 55407
612-863-4466

First published: 01/01/2004
Last updated: 07/14/2004

Reviewed by: Tama Almquist, nurse clinician, Sister Kenny Rehabilitation Institute, Allina Hospitals & Clinics