Presentation on theme: "Dynamic Role of the Nurse in Stroke Rehabilitation"— Presentation transcript:
1 Dynamic Role of the Nurse in Stroke Rehabilitation Nancy Boaro, BScN, MN, CNN(C), CRN(C) Advanced Practice Leader, Neuro Rehab Program Toronto Rehabilitation InstituteHello all. It’s a pleasure to be here to speak to you on the topic of Stroke rehabilitation Nursing.Before we begin, by a show of hands how many of you are nurses, PT etc.
2 Objectives Define the goal of rehab nursing Outline the roles of the rehab nurseOutline the competencies of the stroke rehab nurseHighlight areas for stroke rehab nursing intervention and interprofessional collaboration via case studyDefine the goal of rehab nursingOutline the roles of the rehab nurseOutline the competencies of the stroke rehab nurseHighlight areas for stroke rehab nursing intervention and interprofessional collaboration via case study
3 Goal of Rehabilitation Nursing Promote maximum functional abilityOptimal healthAdaptation to an altered lifestyle“Goal of rehabilitation nursing is to assist the patient to attain and to maintain optimum health as it is defined by the patient.”(Hoeman, 2002)“Goal of rehabilitation nursing is to assist the patient to attain and to maintain optimum health as it is defined by the patient.”Where the client is viewed as a whole person and yet different from the sum of physical, psychological, spiritual, and socio-economic parts.Unique, autonomous, responsible for their own state of health, ability to solve his/her problems.
4 The Multidimensional Role of The Stroke Rehabilitation Nurse Provider of Care (e.g., caregiver, direct and indirect delivery of care);Leader and collaborator (e.g., clients, families, community providers, interdisciplinary team, support staff);Educator and coach (e.g., wellness and prevention, self-care and advocacy skills);Client advocate (e.g., promoting the accessibility of rehabilitation services to all clients; community education; awareness of advocating rehabilitation services at local, provincial and national levels);Coordinator of Care (e.g., delegation, integration of knowledge of team information into comprehensive continuum of care)
5 Provider of Care Provides quality evidence based nursing Focuses on restoring & maintaining function and preventing complicationsInteracts therapeutically with clients and their support systems(ARN,1998, OARN, 1998)Provides quality evidence based nursing 24/7Focuses on restoring & maintaining function and preventing complicationsInteracts therapeutically with clients and their support systemsHead to toe assessment , Monitor VSCare provider:Focuses on restoring and maintaining function, preventing complications, and avoiding further functional loss.Interacts therapeutically with clients and their support systems.
6 Educator and Coach Wellness and prevention Self care Advocacy skills assesses their readiness to learnplans teaching times and strategies (uni-profession or interprofessional)Advocacy skillsConsults with patients and/or families, to help them adapt to lifestyle changes. Modify stroke risk factors, chronic disease management, activity, weight loss etc. relaxation therapy stress reduction etcTeach self-care techniques and help them adapt to limitations and progress towards functional goalsDocuments the teaching-learning process, evaluates and validates it.CDM and risk modification
7 Leader and Collaborator Works with the team to establish goals to promote maximal patient independence.CollaboratorWorks with physicians, therapists, and other healthcare team members to solve problems and establish goals to promote maximal independence for clients with disabilities or chronic disabling conditions.Assertively communicates information and provides insight to others about the rehabilitation process and clients’ responses, reactions, needs and progress.
8 Rehab Nurse as Advocate Patient or unit / program basedAccessibility of rehabilitation servicesPolitically involved at all levelsPatient / family level with clients re: patient centered needs, discharge etc Advocate for the patient, sensitive to their diverse needs.Promoting Accessibility of rehabilitation services to all clients i.e. accessibility issues that arise on unit or within programs or organizationCommunity educationBroader advocacy through OARN and CARNCommitted to affordable, accessible, universal, accountable delivery of care. Accessibility advocacy within institutionOARN and CARN
9 Rehab Nurse as Coordinator Uses holistic, interprofessional approachIdentifies and measures functional goals for patientsplan and guide careBrings together the expertise of health professionals and integrates that knowledge into a comprehensive plan of care.Taking a holistic approach, facilitates the design and implementation of the family’s individual plan of careUses measurable functional goals to plan, coordinate, and evaluate ongoing client careFollows Rehabilitation Nursing Standards
10 CNA Rehabilitation Nursing Competencies CNA established national standards of practice and competencies for rehabilitation nursing in 2005Recognized as a specialty practice with certification examThe Canadian Nurses Association (CNA) has established national standards of practice for rehabilitation nursing as a means for ensuring high quality nursing care.Specialty practice in which nurses focus on:Restoration/maintenance of health & well beingPromotion of optimal functioningMaintenance of abilitiesPrevention of injuries
11 Rehabilitation Nursing Competencies Functional Health Patterns Discharge and TransitionMobilitySexualitySleep and restSensory and PainNutrition, Elimination, Skin IntegrityCardiopulmonaryPsychosocial adaptationDischarge and TransitionMobilitySexualitySleep and restSensory and PainNutrition, Elimination, Skin IntegrityCardiopulmonaryPsychosocial adaptationHow does this look in the stroke rehab population?
12 Role of the Nurse in Rehabilitation AssessesPre-existing and current statusPhysical, emotional, functional, social indicatorsDiagnosticsSelects nursing interventions to enhance and support physical, psychological, and social functioningCollaboratesEvaluatesPatient/family response to interventions/plan of care
13 Rehabilitation Nursing Competencies Psychosocial Health Patterns CulturalSpiritualMotivationStress responseCopingUnresolved grief, angerEmotional fatigueDenialSelf-perceptionFamily structureHealth beliefsCaregiver burdenFamily resources for copingFinancialEmotionalPhysicalenvironmental
14 Stroke Specific Rehabilitation Nursing Competencies UnderstandsRisk factors for strokeAnatomy and pathophysiology of strokeNursing interventions optimize function of client with strokeRecognizesClinical manifestations of strokeDeficits of clients with stroke specific to stroke locationInterprets laboratory valuesUnderstandsRisk factors for stroke (HTN, diabetes, smoking etc)Anatomy and pathophysiology of strokeNursing interventions optimize function of client with strokeRecognizesClinical manifestations of stroke (dysphagia, aphasia, hemiplegia, etc)Deficits of clients with stroke specific to stroke locationInterprets laboratory values (cholesterol, INR)
16 Final ThoughtsThe scope of practice of a stroke rehab nurse is broad and dynamicSignificant impact on patient’s rehabilitation experience and recoveryMany opportunities for interprofessional collaboration to optimize patient outcomesThe scope of practice of a stroke rehab nurse is broad and dynamicSignificant impact on patient’s rehabilitation experience and recoveryMany opportunities for interprofessional collaboration to optimize patient outcomes
17 Advanced Practice Leader Contact InformationNancy BoaroAdvanced Practice LeaderNeuro Rehab ProgramToronto Rehabext 3772