Abstract
Background: Aquatic therapy can be a safe and effective intervention for individuals with spinal cord injury (SCI). It harnesses the unique physical properties of water—such as temperature, density, viscosity, turbulence, hydrostatic pressure, buoyancy, and resistance—to enhance functional capacities. Despite its benefits, unplanned bowel evacuations during aquatic therapy can disrupt therapy sessions and cause embarrassment and anxiety for patients. Surveillance data from our center between 2018 and 2023 indicated yearly unplanned bowel evacuations rate ranging from 0.13% to 0.65%. Methods: A mission statement to reduce unplanned bowel evacuations during aquatic therapy by 50% within 6 months was established. Quality improvement methodologies, including project analysis, solution development, and evaluation were applied. Results: After implementing the Plan-Do-Study-Act cycle, the rate of unplanned bowel evacuation dropped to 0% over 6 months from a baseline median of 0.56%. Continuous monitoring is necessary to sustain these results. Conclusion: Quality improvement methods can effectively address unplanned bowel evacuations during aquatic therapy for individuals with SCI. While initial results are promising, further data collection is required for conclusive evidence.
Published Version
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