OPTIMIZING STROKE CARE 2
Optimizing Stroke Care in the Sub-Acute Rehab Setting
Anita Jackson
Chamberlain College of Nursing
NR451 RN Capstone Course
Winter 2018
OPTIMIZING STROKE CARE 1
OPTIMIZING STROKE CARE 9
Optimizing Stroke Care in the Sub-Acute Rehab Setting
As a leading cause of disability in the adult population, strokes are a financial burden on the healthcare system and devastating to families. As a contributing factor, most stroke patients will require some form of lengthy rehabilitation to return to their optimal level of function. The sub-acute rehab (SAR) setting is one setting in which stroke patients are cared for and receive rehab. The majority of SAR programs concentrate on routine exercises performed by Occupational
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In the model, the star?s five points represent each step in the process of transformation. The first point is the discovery of new knowledge which represents the research of the topic. Next, the second point is the process of summarizing the evidence identified during the research process. The third point is analysis of the evidence followed by the fourth point, integrating the evidence into practice and the fifth point is evaluation. Each point is of equal value and builds on each other. Using this model will make the process easy for nursing because the nursing process is very …show more content…
al. (2016) concerning applying care-giver mediated exercise programs, there were several different outcomes measured for quality of evidence. These measures included activities of daily living (ADL), caregiver and patient mood, burden and quality of life (QoL), and length of stay in rehabilitation unit. One method to measure the quality of evidence for ADL was the Barthel Index. In comparison, the group receiving the CME interventions scored 5.09 points higher on Barthel Index than the control group with an evidence level of moderate. The SAR pilot unit currently uses a version of the Barthel Index for ADL measurements. Next, the caregiver mood, burden and QoL was scored on a caregiver strain index 0 to 13 and a caregiver burden scale 22 to 88. The results indicated the intervention group scores was 0.5 higher on the strain index and 1.3 lower on the burden scale with an evidence level of moderate. Correspondingly, the satisfaction with discharge process in the pilot unit is currently in the 56th percentile on Press Ganey scores. With a very low quality of evidence, length of stay (LOS) in rehab was 12 days lower. On the pilot unit, the stroke patients have the longest LOS at an average of 34 days and lowest rate of transition to home. With 25% of the patients being transitioned to long term care to include skilled nursing facilities and assisted living
Highly motivated to impact patient safety and quality of care. Experience with project management within Bellin’s refill pilot team, involving one-one training with orientation, competency assessment completions, evaluation of knowledge and understanding, in addition to implementation of evidenced-based practice involvement with protocol utilization. Achieved bachelor’s degree in nursing from Marian University May 2013. Part-time nursing master’s student at Marian University graduation anticipation December 2019. Licensure/Certification: WI Nursing License (File Number: 198659-30), CPR/AED Certified, NIH Stroke Scale Certification (2015), Pain Management Course Completion.
The fifth theme involved the loss of freedom. The cognitive capacity in this study refer to the caregiver’s information processing ability. Structure Providers: Institutional care quality was the single theme in this category. Appraisals were mostly negative and included feelings of resentment, a lack of support from family members, financial strain, and loss of freedom. Coping strategies included support groups, caring for one’s self, religion, and humor.
Lee, regarding about challenges in changes processes, as nurse leaders, we need to think outside our own silos, research how others are doing it and maybe change it and apply it to our needs. This is very similar to my topic of reverse innovation, which is getting ideas from the poor and applying it to the more developed economies (DePasse & Lee, 2013). Your question asked, how can you help your patients seek healthcare options that will meet their needs and stay cost effective? In my area of transplant, we have a separate department that handles insurance, Transplant Patient Access Services (TPAS) representatives.
A considerable strength is the extended period of time that this study lasted, the large sample of caregivers provided, and the continuous follow up that was conducted. Other strengths were that the counselors hold master’s or doctorate degrees in social work, psychology, and gerontology, and that the was a low attrition rate. SMART Goals Goal: To actively take care of Mary at home as long as possible. John will participate in a local support group for Alzheimer’s caregivers one time a week over the next 12 months. This is to emotionally decompress and receive knowledge of resources and skills that he can use in caring for Mary at home.
Interdisciplinary Team Paper Janet Borngesser University of Alabama at Birmingham Interdisciplinary Leadership Role Development NUR 737 Dr. Martha Lavender July 15, 2015 Interdisciplinary Team Paper The neurocritical care intensive care unit (NICU) team has certainly undergone much change and transformation since the first neurocritical care physician and nurse practitioner (NP) took over the team and seven bed unit in 1999. Prior to this initial ‘team’ the NICU was managed by the neurosurgery attending and residents in between surgeries. The NICU team’s purpose was to improve and provide better care to the variety of complex neuro critical ill patient population at a 605 bed academic center in Metro Atlanta.
Competencies gained from this course will be found in foundations of nursing informatics with benchmarking, outcome probabilities, and expert decision support. Healthcare Project Management (N527PE) Healthcare project management shows methods of managing healthcare projects, aiding the strategic goals of the institution. This course will add to competencies in each of the areas listed under systems life cycle in my previous paper. The skills necessary for performing needs assessments, gap analysis, and feasibility analysis will be acquired as well as creating clinical and data work flow diagrams.
Many veterans may over work themselves; work through high levels of pain and this can put them at risk for overuse injuries and other complications in addition to the chief compliant. The veterans I have had the opportunity to treat work hard and go above and beyond to get back to their previous level of function. To address this unique psychosocial challenge I educate veterans on the occupation of rest. I explain to the veterans that rest and recovery is just as important as active rehabilitation. For example, a CVA patient gained all of their function of extremities in the first two weeks post-
Using IT to reduce the number of descriptions are taking place during the same time implementation and other task occurring in the nursing unit. Challenges Experienced during an Informatics
Keck Medical Center of USC is a world-class health care facility because every staff member shares a commitment to achieving clinical excellence. I have made it my personal mission to provide compassionate care, alleviate suffering, and impart kindness in every interaction by living each day with integrity, passion, and dedication. In order to achieve just that, we as healthcare providers have an obligation to continually research the best, most effective interventions. I truly have a passion for the research process and served as a Research Assistant in the Social Psychology Laboratory at UCSB. In addition, I recently was able to conduct a quality improvement initiative during my Leadership clinical rotation, where I collected, analyzed, and synthesized hospital data in order to identify key areas in which cost-effective changes in the current stroke protocol would lead to improvements in patient
Occupational therapists use knowledge of sensory integration in planning and adapting activities for individuals with disabilities to achieve the desired outcomes. A routine of organized sequences of five stages reestablish the likelihood of an automatic, habitual response as well as restore environmental interaction for impaired individuals. Since the OBRA-87 requires nursing home to create individualized care plans for residents to focus on maintain and improving the ability to walk and complete ADLs, the five stages method is one of the treatment methods can be used by occupational therapy practitioners to focus on maintain and improving the ability to walk and complete ADLs, the five stages method is one of the treatment methods can be used by occupational therapy practitioners to facilitate balanced healthy routines in institutional care settings. It helps clients to achieve the greater ability in ADLs and decrease disruptive behaviors throughout the day. In addition, it helps clients to shift an attitude from “I can’t” to “I can” in order to improve quality of life, happiness, and
As assessment is integral to the nursing process it is also incorporated into nursing models. Assessment is necessary during all nursing activities e.g. assisting an individual with their hygiene needs, taking observations or during repositioning/manual handling techniques. Orem’s model is a particularly effective tool in carrying out assessment as it has a practical approach in identifying patients’ needs by encompassing their universal, developmental and health deviation self-care deficits. ‘’Having a conceptual nursing model to practice may enable nurses to gather a detailed database that identifies actual and potential healthcare problems’’ (Capers, 1986). The grid, checklist format is a simple, fast and straightforward assessment guide and can be very useful in practice.
Two weeks later, he was not coping well at home and was admitted to an acute hospital because of heart failure and poor mobility. He was recommended for rehabilitation due to his inability to become motivated and lack of interest in doing everyday tasks for himself. Communication Patterns Communication throughout the case study was sometimes clear and positive, and other times unclear and negative. In Part one (in the Acute Hospital), communication between the ward nurse and the junior nurse at the community hospital was unclear.
Healthcare professionals play a role in quality management process by taking accurate patient information using the electronic health record system. Technology with professional knowledge of nursing improves quality of patient care and general quality management process in the healthcare. The baccalaureate nurse involves an integration of nursing knowledge, skills, and attitudes that are fundamental to improving quality and safety of patients in the healthcare
In this case, the nurse has to pass through five particular stages of learning from novice to
In this course, I learned the different nursing theories and how it has been