Sexual Health and Fertility in SCI: An Interdisciplinary Approach
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Share PrintWe strive to be among the best practices of the rehabilitation medicine by addressing sexual health issues through patient and staff education to communicate to patients that living well with spinal cord injury/disease is possible and that physical limitation do not negate a fundamental and important aspect of being HUMAN.
Adoptions:
8 successful, 7 in-progress
Awards and Recognition:
iNET Spread Investee, Diffusion of Excellence Promising Practice
Partners:
Diffusion of Excellence, Spinal Cord Injuries and Disorders, VHA Innovators Network
Recent Updates
Overview
The problem
Sexual functioning is a top concern for people living with spinal cord injuries and dysfunction (SCI/D) yet, is often neglected in clinical care. Many health care providers are not trained to discuss sexuality with patients. Sexuality is often poorly incorporated into the rehab process. Staff have decreased confidence in this topic.
Files
- SCI, consumer priorities, quality of life, well-being The health and life priorities of individuals with spinal cord injury: A systemic review
The solution
Sexual functioning is addressed using the PLISSIT model and a template was developed to facilitate data collection on veterans needs for sexual health concerns in the inpatient and outpatient settings. Treatment plans incorporating medications, adaptive equipment, and referrals were developed, Sexual functioning is to be regularly assessed. Education for sta
...
Sexual functioning is addressed using the PLISSIT model and a template was developed to facilitate data collection on veterans needs for sexual health concerns in the inpatient and outpatient settings. Treatment plans incorporating medications, adaptive equipment, and referrals were developed, Sexual functioning is to be regularly assessed. Education for staff is provided through TMS, grand round presentations, and monthly virtual calls.
See
more
Images
Above:
PLISSIT MODEL
Above:
SCI SEXUAL HEALTH STL
Files
- template for documentation Sexual health education documentation
The results
Patient responses to these changes were very positive. Veterans expressed great interest in sexual health topics and were appreciative to have sexual health needs and fertility issues assessed and treated. They were excited to collaboratively develop individualized treatment plans. Some veterans living with SCI/D for decades expressed the wish that these top
...
Patient responses to these changes were very positive. Veterans expressed great interest in sexual health topics and were appreciative to have sexual health needs and fertility issues assessed and treated. They were excited to collaboratively develop individualized treatment plans. Some veterans living with SCI/D for decades expressed the wish that these topics would have been addressed long ago. Addressing sexual health issues through patient and staff education is a simple practice which yields enormous gains for persons with SCI/D. Providing educations and interventions communicates to the patient that living well with SCI/D is possible and that physical limitations do not negate a fundamental and important aspect of being human.
See
more
Files
- Power BI reports with multiple components including responses to screening, catchment area, registry diagnosis and identified sex of Veteran SCI/D Sexual Health Screening Health Factors.
Metrics
- Health factors
- Clinic utilization
- TMS completed
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
Above:
Pilot results
Implementation
Timeline
-
3 months
Site educated on sexual health in spinal cord injury assessment -
1 month
CACs copy template into CPRS system -
3 month
Implement template into SCI assessment
Departments
- Extended care and rehabilitation
- Spinal cord injuries and disorders
- Education and training
- Nursing services
- Telehealth
- Physical medicine and rehabilitation
- Primary care
- Urology
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
PROCESSES |
|
TOOLS |
|
Links
- VA St. Louis Health care system Spinal Cord Injury Interdisciplinary team
- Education for veeran. PPT with voice recording Sexual Health in SCI
- Original design prinicples Sexual Health in SCI Design Principles
Optional Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
TOOLS |
|
Links
- Topic on sexuality and spinal cord injury, ranging from basic sexuality to parenting with SCI When it comes to sex and spinal cord injury, we're all about kissing and telling.
- 4th edition Guide to self-care for persons with spinal cord injury Yes You Can
- a clinical preactice guidline for health care professionals Sexuality and Reproductive Health in Adults with Spinal cord injury
- Vibratory stimulation Ferticare
Support Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
PROCESSES |
|
Files
- Diffusion of Excellence specializes in scaling emergent, high-impact health care practices across the nation’s largest integrated health care system. Diffusion of Excellence
Risks and mitigations
| Risk | Mitigation |
|---|---|
| No risks as process is the assesment question | Yes or no answer. |
About
Origin story
One day the clinical nurse leader came to my office and said, "Come with me, you have to talk about your sex stuff." I was taken to the innovation specialist who helped format my pitch and was in front of the executive team within the week. From there, a performance improvement project was started but also a new process to address sexual health in SCI.
Original team
April Conway
Adult nurse practitioner
Comment
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