SCI-IEQCC Network and SCI-Ontario: Working together to develop and implement a skin check video resource for pressure injury prevention in spinal cord injury
DOI:
https://doi.org/10.63354/cjwoc.v1i1.13451Keywords:
pressure injury, skin, resourcesAbstract
Individuals with Spinal Cord Injury/Disease (SCI/D) face a high risk of developing pressure injuries (PI), which can significantly impact their health, well-being and the economic burden on the health care system. To help mitigate these risks, the Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI-IEQCC) identified gaps during the implementation of indicators in the tissue integrity domain, specifically in the area of patient education regarding daily skin checks.
A collaborative effort involving SCI-IEQCC, Spinal Cord Injury Ontario (SCIO), and individuals with lived experiences was undertaken to develop a skin check video resource. The process involved engaging a multidisciplinary team and other relevant stakeholders, creating storyboards, filming, and developing iterative feedback loops. Challenges included balancing clinician and user needs. Despite these challenges, an instructional video was successfully developed and integrated into SCI rehabilitation settings across Ontario.
The video demonstrates independent skin check and assisted skin check techniques and has been well-received, with 4,400 views to date. Implementation strategies varied across sites, reflecting local contexts and needs. Key findings include the importance of clear communication, stakeholder engagement, and iterative refinement. Future efforts will focus on sustaining and disseminating the video, including translating it into French and further integrating it into staff education.
References
Gunnewicht BR. Pressure Sores in patients with acute spinal cord injury. J Wound Care. 1995;4(10):452–454. doi:10.12968/jowc.1995.4.10.452 DOI: https://doi.org/10.12968/jowc.1995.4.10.452
Krause JS, Saunders LL. Health, secondary conditions, and life expectancy after spinal cord injury. Arch Phys Med Rehabil. 2011;92(11):1770–1775. doi:10.1016/j.apmr.2011.05.024 DOI: https://doi.org/10.1016/j.apmr.2011.05.024
Ash D. An Exploration of the occurrence of pressure ulcers in a British spinal injuries unit. J Clin Nurs. 2002;11(4):470–478. doi:10.1046/j.1365-2702.2002.00603.x DOI: https://doi.org/10.1046/j.1365-2702.2002.00603.x
New PW, Rawicki HB, Bailey MJ. Nontraumatic spinal cord injury rehabilitation: pressure ulcer patterns, prediction, and impact. Arch Phys Med Rehabil. 2004;85(1):87–93. doi:10.1016/s0003-9993(03)00378-2 DOI: https://doi.org/10.1016/S0003-9993(03)00378-2
Richard-Denis A, Thompson C, Bourassa-Moreau E, Parent S, Mac-Thiong JM. Does the acute care spinal cord injury setting predict the occurrence of pressure ulcers at arrival to intensive rehabilitation centres? Am J Phys Med Rehabil. 2016;95(4):300–308. doi:10.1097/PHM.0000000000000381 DOI: https://doi.org/10.1097/PHM.0000000000000381
Wang H, Niewczyk P, Divita M, et al. Impact of pressure ulcers on outcomes in inpatient rehabilitation facilities. Am J Phys Med Rehabil. 2014;93(3):207–216. doi:10.1097/PHM.0b013e3182a92b9c DOI: https://doi.org/10.1097/PHM.0b013e3182a92b9c
Salzberg C, Byrne D, Kabir R, Van Niewerburgh P, Cayten CG. Predicting pressure ulcers during initial hospitalization for acute spinal cord injury. Wounds. 1999;11(2):45–57.
Lala D, Dumont FS, Leblond J, Houghton PE, Noreau L. Impact of pressure ulcers on individuals living with spinal cord injury. Arch Phys Med Rehabil. 2014;95(12):2312–2319. doi:10.1016/j.apmr.2014.08.003 DOI: https://doi.org/10.1016/j.apmr.2014.08.003
Lourenco L, Blanes L, Salome GM, Ferrira LM. Quality of life and self-esteem in patients with paraplegia and pressure ulcers: a controlled cross-sectional study. J Wound Care. 2014;23(6):331–334, 336–337. doi:10.12968/jowc.2014.23.6.331 DOI: https://doi.org/10.12968/jowc.2014.23.6.331
Richards S, Waites K, Chen Y, Kogos S, Schmitt MM. The epidemiology of secondary conditions following spinal cord injury. Top Spinal Cord Inj Rehabil. 2004;10(1):15–29. doi:10.1310/YXM3-85YW-8VUG-NNUR DOI: https://doi.org/10.1310/YXM3-85YW-8VUG-NNUR
Chan BC, Nanwa N, Mittmann N, Bryant D, Coyte PC, Houghton PE. The average cost of pressure ulcer management in a community dwelling spinal cord injury population. Int Wound J. 2012;10(4):431–440. doi:10.1111/j.1742-481X.2012.01002.x DOI: https://doi.org/10.1111/j.1742-481X.2012.01002.x
Praxis Spinal Cord Institute, Rick Hansen Spinal Cord Injury Registry. A Look at Traumatic Spinal Cord Injury in Canada in 2018. Vancouver, BC: Praxis; 2020. https://praxisinstitute.org/wp-content/uploads/2020/03/RHSCIR-2018-Report_WEB.pdf
Craven BC, Alavinia S, Wiest MJ, et al. Methods for development of structure, process and outcome indicators for prioritized spinal cord injury rehabilitation domains: SCI-high project. J Spinal Cord Med. 2019;42(sup1):51–67. doi:10.1080/10790268.2019.1647386 DOI: https://doi.org/10.1080/10790268.2019.1647386
Wolfe DL, Walia S, Burns AS, et al. Development of an implementation-focused network to improve healthcare delivery as informed by the experiences of the sci knowledge mobilization network. J Spinal Cord Med. 2019 Oct;42(supl):34-42. doi:10.1080/10790268.2019.1649343. DOI: https://doi.org/10.1080/10790268.2019.1649343
Craven BC, Musselman K, Humphreys S, et al. Collaborative networks to achieve innovations in care. J Spinal Cord Med. 2021;44(supl):S5-S16. doi:10.1080/10790268.2021.1965449 DOI: https://doi.org/10.1080/10790268.2021.1965449
Batemen EA, Sreenivasan VA, Farahani F, et al. Improving practice through collaboration: early experiences from the multi-site spinal cord injury implementation and evaluation quality care consortium. J Spinal Cord Med. 2021;44(sup1):S147–S158. doi:10.1080/10790268.2021.1936946 DOI: https://doi.org/10.1080/10790268.2021.1936946
Flett H, Wiest MJ, Mushahwar V, et al. Development of tissue integrity indicators to advance the quality of spinal cord injury rehabilitation: SCI-high project. J Spinal Cord Med. 2019;42(sup1):196–204. doi:10.1080/10790268.2019.1621025 DOI: https://doi.org/10.1080/10790268.2019.1621025
Hakimzadeh Z, Adib-Hajbaghery M, Raygan F. The effect of a multimodal educational intervention on health literacy in patients with ischemic heart diseases. Journal of Health Literacy. 2022;7(4):71–83. doi:10.22038/JHL.2022.62772.1256
Fixsen DL, Ward C, Blase K, Naoom S, Metz A, Louison L. (2018) Assessing Drivers Best Practices. Chapel Hill, NC: Active Implementation Research, https://www.activeimplementation.org
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Canadian Journal of Wound, Ostomy and Continence

This work is licensed under a Creative Commons Attribution 4.0 International License.
