Medical staff's perception of factors contributing to accelerated rehabilitation in patients with cervical spinal cord injury: A qualitative research.
Qiuxue Li, Qianghuizi Zhang, Weiwei Liu and 1 others
PMID 36879367WHAT IT FOUND
Staff cited inconsistent messaging and heavy workloads as barriers to Enhanced Recovery After Surgery in cervical spinal cord injury.
Nurses reported delaying catheter removal on night shifts due to staffing shortages. Patients' belief that rest aids healing reduced compliance with early mobilization.
Key findings
01Nurses reported delaying urinary catheter removal to day shifts because night staffing was insufficient to manage failed voiding trials, hindering Enhanced Recovery protocols.
02Inconsistent instructions between departments, such as anesthesiology nurses restricting water for six hours while ward staff taught two hours, undermined the rehabilitation pathway.
03Patients' traditional belief that bone injuries require 100 days of bed rest led to poor compliance with early mobilization exercises.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study only included views from medical staff, not patients, so patient-side barriers are inferred rather than reported directly. Participants were drawn from only two cities in China, which may limit the applicability of findings to other healthcare systems or cultural contexts. Face-to-face interviews were conducted with participants wearing masks due to the epidemic, preventing observation of facial expressions and non-verbal cues. Two interviews were conducted online, which may have affected the depth of data compared to in-person sessions.
Declared interests
The authors declared no conflicts of interest, and the study received no funding.
The easy way to misread this
Do not interpret the staff's reported barriers as evidence that ERAS protocols are ineffective or unsafe. The study describes implementation challenges in specific Chinese tertiary hospitals, such as staffing shortages and communication gaps, rather than clinical failures of the rehabilitation method itself.