Optimizing Stroke Care In The Sub-Stroke Case Study

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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 …show more content…

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

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