scholarly journals Possible Effectiveness of Collaboration between Occupational Therapists and Care Managers using the Management Tool for Daily Life Performance for Stroke Patients in Transitional Care

2017 ◽  
Vol 13 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Kazuaki Iokawa ◽  
Keiichi Hasegawa ◽  
Takashi Ishikawa
Keyword(s):  
Transitional Care ◽  
Daily Life ◽  
Occupational Therapists ◽  
Management Tool ◽  
Stroke Patients ◽  
Care Managers

scholarly journals Enhancing Our Understanding of Transitional Care Programs

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 136-137
Author(s):  
Katherine McGilton ◽  
Shirin Vellani ◽  
Alexandra Krassikova ◽  
Alexia Cumal ◽  
Sheryl Robertson ◽  
...  
Keyword(s):  
Older Adults ◽  
Transitional Care ◽  
Discharge Planning ◽  
Grey Literature ◽  
Occupational Therapists ◽  
Community Dwelling ◽  
Bibliographic Databases ◽  
Multidisciplinary Teams ◽  
Term Care ◽  
Hospitalized Older Adults

Abstract Many hospitalized older adults experience delayed discharge. Transitional care programs (TCPs) provide short-term care to these patients to prepare them for transfer to nursing homes or back to the community. There are knowledge gaps related to the processes and outcomes of TCPs. We conducted a scoping review following Arksey & O’Malley’s framework to identify the: 1) characteristics of older patients served by TCPs, 2) services provided within TCPs, and 3) outcomes used to evaluate TCPs. We searched bibliographic databases and grey literature. We included papers and reports involving community-dwelling older adults aged ≥ 65 years and examined the processes and/or outcomes of TCPs. The search retrieved 4828 references; 38 studies and 2 reports met the inclusion criteria. Most studies were conducted in Europe (n=19) and America (n=13). Patients admitted to TCPs were 59-86 years old, had 2-10 chronic conditions, 26-74% lived alone, the majority were functionally dependent and had mild cognitive impairment. Most TCPs were staffed by nurses, physiotherapists, occupational therapists, social workers and physicians, and support staff. The TCPs provided 5 major types of services: assessment, care planning, treatment, evaluation/care monitoring and discharge planning. The outcomes most frequently assessed were discharge destination, mortality, hospital readmission, length of stay, cost and functional status. TCPs that reported significant improvement in older adults’ functions (which was the main goal of the TCPs) included multiple services delivered by multidisciplinary teams. There is a wide variation in the operationalization of TCPs within and between countries.

RecoverNow: A patient perspective on the delivery of mobile tablet-based stroke rehabilitation in the acute care setting

2018 ◽  
Vol 14 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Karen Mallet ◽  
Rany Shamloul ◽  
Michael Pugliese ◽  
Emma Power ◽  
Dale Corbett ◽  
...  
Keyword(s):  
Acute Care ◽  
Stroke Rehabilitation ◽  
Care Setting ◽  
Hand Function ◽  
Occupational Therapists ◽  
Fine Motor ◽  
Stroke Patients ◽  
Acute Setting ◽  
Cognitive Therapies ◽  
Mobile Tablets

Background/aim We previously reported the feasibility of RecoverNow (a mobile tablet-based post-stroke communication therapy in acute care). RecoverNow has since expanded to include fine motor and cognitive therapies. Our objectives were to gain a better understanding of patient experiences and recovery goals using mobile tablets. Methods Speech-language pathologists or occupational therapists identified patients with stroke and communication, fine motor, or cognitive/perceptual deficits. Patients were provided with iPads individually programmed with applications based on assessment results, and instructed to use it at least 1 h/day. At discharge, patients completed a 19-question quantitative and open-ended engagement survey addressing intervention timing, mobile device/apps, recovery goals, and therapy duration. Results Over a six-month period, we enrolled 33 participants (three did not complete the survey). Median time from stroke to initiation of tablet-based therapy was six days. Patients engaged in therapy on average 59.6 min/day and preferred communication and hand function therapies. Most patients (63.3%) agreed that therapy was commenced at a reasonable time, although half expressed an interest in starting sooner, 66.7% reported that using the device 1 h/day was enough, 64.3% would use it after discharge, and 60.7% would use it for eight weeks. Sixty-seven percent of patients expressed a need for family/friend/caregiver to help them use it. Conclusion Our results suggest that stroke patients are interested in mobile tablet-based therapy in acute care. Patients in the acute setting prefer to focus on communication and hand therapies, are willing to begin within days of their stroke and may require assistance with the tablets.

Study on Nursing Effect of Individualized Health Education Combined with Cognitive Training in Elderly Stroke Patients

2021 ◽  
Vol 7 (5) ◽  
pp. 3168-3173
Author(s):  
NING Min ◽  
ZENG Hui
Keyword(s):  
Job Satisfaction ◽  
Health Education ◽  
Cognitive Training ◽  
Daily Life ◽  
Self Care ◽  
Control Group ◽  
Stroke Patients ◽  
Routine Treatment ◽  
Experimental Group

Objective To study the nursing effect of individualized health education combined with cognitive training in elderly stroke patients. Methods 112 elderly stroke patients treated in the Department of Neurology of our hospital from January to June 2017 were randomly divided into experimental group and control group. In the control group, routine treatment, nursing and rehabilitation exercises were carried out, and regular health education was carried out. The experimental group, on the basis of routine treatment, nursing and rehabilitation exercise, carried out individualized health education and cognitive training combining the content of individualized health education. The effect of intervention was evaluated by Montreal Cognitive Assessment Scale (MoCA), health education questionnaire, daily life self-care scale (ADL) and nurse job satisfaction questionnaire before intervention, at the end of intervention for 4 weeks and at the end of intervention for 12 weeks. Results At the end of 4th and 12th week after intervention, the scores o MoCA, the awareness rate of health education, ADL and job satisfaction of nurses were higher than those before intervention, and the observation group was higher than that of the control group (P<0.05), with statistical difference (P<0.05). Conclusion Individualized health education combined with cognitive training can effectively improve the patients’ cognitive function, improve the patients’ awareness of stroke disease and the compliance of health education, improve the patients’ self-care ability in daily life and the satisfaction of nursing work, so as to improve the patients’ quality of life and quality of living.

Abstract TP308: Transitional Care in Stroke Certified and Non-certified Hospitals: The Comprehensive Post-Acute Stroke Services (COMPASS) Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Janet Prvu Bettger ◽  
Sara Jones ◽  
Anna Kucharska-Newton ◽  
Janet Freburger ◽  
Walter Ambrosius ◽  
...  
Keyword(s):  
Transitional Care ◽  
Discharge Planning ◽  
Care Transitions ◽  
Cluster Randomized Trial ◽  
Stroke Patients ◽  
Care Needs ◽  
Post Discharge ◽  
Exact Test ◽  
Chi Squared

Background: Greater than 50% of stroke patients are discharged home from the hospital, most with continuing care needs. In the absence of evidence-based transitional care interventions for stroke patients, procedures likely vary by hospital even among stroke-certified hospitals with requirements for transitional care protocols. We examined the standard of transitional care among NC hospitals enrolled in the COMPASS study comparing stroke-certified and non-certified hospitals. Methods: Hospitals completed an online, self-administered, web-based questionnaire to assess usual care related to hospitals’ transitional care strategy, stroke program structural components, discharge planning processes, and post-discharge patient management and follow-up. Response frequencies were compared between stroke certified versus non-certified hospitals using chi-squared statistics and Fisher’s exact test. Results: As of July 2016, the first 27 hospitals enrolled (of 40 expected) completed the survey (67% certified as a primary or comprehensive stroke center). On average, 54% of stroke patients were discharged home. Processes supporting hospital-to-home care transitions, such as timely follow-up calls and follow-up with neurology, were infrequent and overall less common for non-certified hospitals (Table). Assessment of post-discharge outcomes was particularly infrequent among non-certified sites (11%) compared with certified sites (56%). Uptake of transitional care management billing codes and quality metrics was low for both certified and non-certified hospitals. Conclusion: Significant variation exists in the infrastructure and processes supporting care transitions for stroke patients among COMPASS hospitals in NC. COMPASS as a pragmatic cluster-randomized trial will compare outcomes among hospitals that implement a CMS-directed model of transitional care with those hospitals that provide highly variable transitional care services.

Abstract TP419: Shared Medical Appointments: Supporting Stroke Care Transitions Through Improved Knowledge and Peer Support

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kathleen Burns ◽  
Karen S Theodore
Keyword(s):  
Risk Factors ◽  
Transitional Care ◽  
Care Transitions ◽  
Individual Risk ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Shared Medical Appointments ◽  
Complex Needs ◽  
Improved Outcomes ◽  
Hospital To Home

Background: Stroke patients have complex needs and are at high risk for complications, making transitional care critical to achieving improved outcomes. Although shared medical appointments (SMAs) are known to improve outcomes for other patient populations, evidence supporting SMA benefit for stroke patient transition from hospital to home is lacking. This study’s purpose was to examine feasibility of participation, patient satisfaction and understanding of key stroke topics following a transitional stroke SMA. Methods: Inclusion criteria for this study included: age 18 years or older, hospitalized for stroke/TIA, and planned discharge to home. Individuals with deficits impairing group participation were excluded. Eligible patients were educated on and invited to attend a SMA occurring 1-2weeks after hospital discharge. The SMA included a private exam and interactive group session to address key stroke topics: 1) medication compliance 2) individual risk factors, 3) secondary prevention, 4) signs of stroke and 5) actions for signs of stroke. Following the SMA, participants completed a two-part survey seeking a) a yes/no response to assess increased understanding of stroke topics, and b) level of agreement on satisfaction with the SMA format. Responses were analyzed using descriptive statistics. Results: While 15 patients agreed to participate prior to discharge, only eight attended the SMA. Attendees were primarily male (75%) with an ischemic stroke diagnosis (63%). The majority who did not attend were female (71%) and without family present during in-hospital education and invitation (86%). Age, stroke severity and stroke risk factors for both groups were otherwise similar. All participants reported an increased understanding of all stroke topics and 95% were satisfied with the SMA. Conclusion: Findings support use of SMAs for stroke patients transitioning from hospital to home. Reinforcing key stroke topics in a peer supported environment may increase understanding and compliance, leading to improved outcomes. Additional research is warranted to explore barriers to SMA participation.

Development of an Assessment Scale for Commencing Home-Visit Nursing in Japan: Examining the Construct

2019 ◽  
Vol 31 (3) ◽  
pp. 186-192
Author(s):  
Naoko Shimohigoshi ◽  
Rika Yatsushiro
Keyword(s):  
Factor Analysis ◽  
Medical Treatment ◽  
Home Visit ◽  
Daily Life ◽  
Item Analysis ◽  
Postal Survey ◽  
Assessment Scale ◽  
Medical Support ◽  
Care Managers ◽  
Physical Changes

This study examined the assessment criteria based on which care managers (CMs) decide to commence home-visit nursing to develop a common assessment scale to guide CMs in making sound decisions about whether to commence home-visit nursing. For this purpose, we conducted a postal survey of 200 CMs. After removing 17 items from the questionnaire based on item analysis, we analyzed the remaining factors to confirm construct validity. This factor analysis identified 96 items comprising the following four factors: (1) the daily life condition of users and the support required by them, (2) strengthening medical support, (3) scheduling medical treatment/management or recuperation, and (4) preparing for users’ mental and physical changes and preventing the deterioration of the situation. The results of the study indicate the first step in the process of developing a common assessment scale; in this study, we clarified the general factors that underpin a decision to commence home-visit nursing and the relationships among the items for each factor.

scholarly journals Korean Model for Post-acute Comprehensive rehabilitation (KOMPACT): The Study Protocol for a Pragmatic Multicenter Randomized Controlled Study on Early Supported Discharge

2021 ◽  
Vol 12 ◽  
Author(s):  
Won Kee Chang ◽  
Won-Seok Kim ◽  
Min Kyun Sohn ◽  
Sungju Jee ◽  
Yong-Il Shin ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Acute Stroke ◽  
Study Protocol ◽  
Transitional Care ◽  
Controlled Trial ◽  
Controlled Study ◽  
Care Model ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Early Supported Discharge

Introduction: Early supported discharge (ESD) is a transitional care model aimed at facilitating post-acute stroke patients' discharge to home. Previous studies have demonstrated that ESD provides equivalent patient and caregiver outcomes with superior cost-effectiveness compared to conventional rehabilitation (CR). This study intends to examine the feasibility of ESD in Korea.Methods and Analysis: This study is designed as a multicenter assessor-blinded, randomized controlled trial. Ninety post-acute stroke patients with mild to moderate disability (modified Rankin Scale 1–3) will be recruited from three university hospitals (30 patients per hospital) in Korea and allocated to either the ESD group or the CR group in a 1:1 ratio. Patients in the ESD group will receive individualized discharge planning and goal setting, a 4-week home-based rehabilitation program, and liaison service to community-based resources by a multidisciplinary team. Patients in the CR group will receive rehabilitation practices according to their current hospital policy.Outcomes: The primary outcome is the Korean version of the modified Barthel Index, and the primary endpoint was post-onset 3 months. Clinical outcomes, patient/caregiver reported outcomes, and socioeconomic outcomes will be measured at baseline, 1 month after discharge, 2 months after discharge, and 3 months after onset.Discussion: The efficacy and cost-effectiveness of ESD can vary according to the healthcare system and sociocultural aspects. To establish ESD as an alternative transitional care model for post-acute stroke patients in Korea, its feasibility needs to be examined in prior. This study will add evidence on the applicability of ESD in Korea.Ethical Considerations: The study protocol was reviewed and approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB number B-2012/654-308). The study protocol was registered at ClinicalTrials.gov (Identifier NCT04720820). Disseminations will include submission to peer-reviewed journals and presentations at conferences.

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