scholarly journals Stroke unities: the role of the occupational therapist and the perception of the multidisciplinary team

2021 ◽  
Vol 4 (6) ◽  
pp. 102-105
Author(s):  
António Arsénio Duarte ◽  
Ana Paula Martin ◽  
Diana Santos ◽  
Rafael Santos ◽  
Rita Viegas
Keyword(s):  
Acute Stroke ◽  
Multidisciplinary Team ◽  
Stroke Unit ◽  
Occupational Therapist ◽  
Medical Emergency ◽  
Structured Interviews ◽  
Stroke Patients ◽  
Stroke Units ◽  
The World

Every second a person in the world suffers from a stroke, not surprising, therefore, that stroke is the leading cause of death and morbidity in Portugal. Increasingly, acute stroke is considered a medical emergency. The evidence proves that the treatment of these patients in specialized units (stroke units) is effective in acute stroke. A stroke unit is a hospital area where professionals with specific, well-defined training work, who provide care to stroke patients who are already stabilized, but are still in an acute phase(DGS, 2001). The aim of this study is to understand the role of the occupational therapist in stroke units and to identify the perspective of the multidisciplinary team on their work, clarifying what are the advantages of this professional in the team. The study falls within the qualitative paradigm, exploratory and descriptive. Semi-structured interviews were performed to 39 health professionals. The technique used was the content analysis of interviews. Based on previously established categories, other categories emerged.

scholarly journals Five Years of Acute Stroke Unit Care: Comparing ASU and Non-ASU Admissions and Allied Health Involvement

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Isobel J. Hubbard ◽  
Malcolm Evans ◽  
Sarah McMullen-Roach ◽  
Jodie Marquez ◽  
Mark W. Parsons
Keyword(s):  
Length Of Stay ◽  
Acute Stroke ◽  
Stroke Unit ◽  
Allied Health ◽  
Stroke Patients ◽  
Stroke Units ◽  
John Hunter ◽  
Acute Stroke Unit ◽  
Allied Healthcare ◽  
Over Time

Background.Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU) provides specialised, hyperacute care and thrombolysis. John Hunter Hospital, Australia, admits 500 stroke patients each year and has a 4-bed ASU.Aims.This study investigated hospital admissions over a 5-year period of all strokes patients and of all patients admitted to the 4-bed ASU and the involvement of allied health professionals.Methods.The study retrospectively audited 5-year data from all stroke patients admitted to John Hunter Hospital(n=2525)and from nonstroke patients admitted to the ASU(n=826). The study’s primary outcomes were admission rates, length of stay (days), and allied health involvement.Results.Over 5 years, 47% of stroke patients were admitted to the ASU. More male stroke patients were admitted to the ASU (chi2=5.81;P=0.016). There was a trend over time towards parity between the number of stroke and nonstroke patients admitted to the ASU. When compared to those admitted elsewhere, ASU stroke patients had a longer length of stay (z=−8.233;P=0.0000) and were more likely to receive allied healthcare.Conclusion.This is the first study to report 5 years of ASU admissions. Acute Stroke Units may benefit from a review of the healthcare provided to all stroke patients. The trends over time with respect to the utilisation of the John Hunter Hospitall’s ASU have resulted in a review of the hospitall’s Stroke Unit and allied healthcare.

The role of nursing in the rehabilitation of acute stroke patients: Toward a unified theoretical perspective

Pflege ◽  
1999 ◽  
Vol 12 (1) ◽  
pp. 21-27
Author(s):  
Marit Kirkevold
Keyword(s):  
Acute Stroke ◽  
Theoretical Perspective ◽  
Stroke Patients ◽  
Role Of Nursing ◽  
Rolle Der Pflegenden

Eine Übersicht der bestehenden Literatur weist auf Unsicherheiten bezüglich der spezifischen Rolle der Pflegenden in der Rehabilitation von Hirnschlagpatientinnen und -patienten hin. Es existieren zwei unterschiedliche Begrifflichkeiten für die Rolle der Pflegenden, keine davon bezieht sich auf spezifische Rehabilitationsziele oder Patientenergebnisse. Ein anfänglicher theoretischer Beitrag der Rolle der Pflege in der Genesung vom Hirnschlag wird als Struktur unterbreitet, um die therapeutischen Aspekte der Pflege im Koordinieren, Erhalten und Üben zu vereinen. Bestehende Literatur untermauert diesen Beitrag. Weitere Forschung ist jedoch notwendig, um den spezifischen Inhalt und Fokus der Pflege in der Genesung bei Hirnschlag zu entwickeln.

Timing of Aspirin and Secondary Preventative Therapies in Acute Stroke: Support for Use of Stroke Units

2005 ◽  
Vol 50 (2) ◽  
pp. 69-72 ◽  
Author(s):  
J Reid ◽  
M-J MacLeod ◽  
D Williams
Keyword(s):  
Acute Stroke ◽  
Ct Scanning ◽  
Medical Ward ◽  
Stroke Patients ◽  
Stroke Units ◽  
General Medical Ward ◽  
Brain Scans ◽  
Angiotensin Ii Antagonist ◽  
Acute Stroke Unit ◽  
Ct Brain

Background: We aimed to study the timing of aspirin prescription in ischaemic stroke comparing patients admitted to an acute stroke unit (ASU) directly or via a general medical ward. We also analysed prescription of secondary preventive therapies in stroke patients in an ASU. Methods: Retrospective analysis was made of medical notes and prescription records of 69 patients admitted to an ASU over a three month period to establish timing of aspirin prescription with respect to onset of stroke symptoms, CT brain scan and route of admission to the ASU. Results: CT brain scans were obtained at a median of 2.1 days post stroke (IQ range 1.3–4.3). Patients directly admitted to the ASU received aspirin earlier post admission compared to those admitted via a medical ward (0.7 vs 2.2 days, p<0.01) and were also more likely to receive aspirin prior to CT scan being performed (57% vs 19%, p=0.02). 86% of stroke patients were discharged on an antiplatelet therapy, 79% on a statin, 37% on a thiazide diuretic and 32% on an ACE inhibitor or angiotensin II antagonist. Conclusion: Aspirin was given more promptly in acute stroke and more commonly prior to CT scanning in an ASU compared to a medical ward. Statin therapy is used extensively in stroke but there is a much lower rate of initiation of other secondary preventive therapies (e.g. anti-hypertensive therapy) in hospital. These findings demonstrate a hesitancy in early use of aspirin amongst general physicians and lends support for the use of stroke units.

Resource utilization and costs for treatment of stroke patients in an acute stroke unit in Greece

2016 ◽  
Vol 142 ◽  
pp. 8-14 ◽  
Author(s):  
Persefoni Kritikou ◽  
Konstantinos Spengos ◽  
Nikolaos Zakopoulos ◽  
Yannis Tountas ◽  
John Yfantopoulos ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Resource Utilization ◽  
Stroke Unit ◽  
Stroke Patients ◽  
Acute Stroke Unit

scholarly journals The central role of the occupational therapist in facilitating housing adaptations/home modifications for disabled children

2017 ◽  
Vol 80 (6) ◽  
pp. 375-383
Author(s):  
Gail Boniface ◽  
Deborah Morgan
Keyword(s):  
Positive Impact ◽  
Occupational Therapists ◽  
Occupational Therapist ◽  
Specific Information ◽  
Structured Interviews ◽  
Online Questionnaire ◽  
Negative Experience ◽  
Home Modifications ◽  
Information And Communication

Introduction Six reviews/inquiries into housing adaptations/home modifications processes occurred in Wales between 2004 and 2015. One resulted in the removal of the means test for children's Disabled Facilities Grants. This research investigated families' and professionals' experiences of the adaptations/home modification process to gain an understanding of their views and experiences. Method Mixed methods of an online questionnaire for professionals, and semi-structured interviews or an online questionnaire for families (depending on their preference), were employed. Forty-eight families participated and an additional 16 families responded to an online questionnaire. Analysis of qualitative data identified emergent themes, which are discussed in this article. Findings The themes were: poor information and communication mainly aimed at older adults; negative experience of the process; and the positive impact of the completed adaptation. Additionally, whilst undergoing the process, families felt that they needed a contact to guide them through the process. This contact was often by default the community occupational therapist. Conclusion A single contact person should be made available for families; occupational therapists should consider their part in that role; more specific information on children's needs should be provided; families need to recognize the part they can play in adding to delays in the delivery of adaptations.

scholarly journals Role of Renal Dysfunction as a Prognostic Factor in Acute Stroke Patients at a Tertiary Hospital in Northeastern Nigeria

2021 ◽  
Vol 32 (1) ◽  
pp. 199
Author(s):  
MohammadMaina Sulaiman ◽  
MusaMamman Watila ◽  
Jummai Shettima ◽  
Ibrahim Ummate ◽  
YakubuWilberforce Nyandaiti
Keyword(s):  
Prognostic Factor ◽  
Acute Stroke ◽  
Renal Dysfunction ◽  
Tertiary Hospital ◽  
Stroke Patients

Abstract TP372: Implementation of a New Intermittent Pneumatic Compression Protocol in a Stroke Unit

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Estela Sanjuan Menendez ◽  
Katherine E Santana Roman ◽  
Carlos A Molina ◽  
Pilar Giron Espot ◽  
Marc Ribo ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Unit ◽  
Intermittent Pneumatic Compression ◽  
Stroke Patients ◽  
Duration Of Treatment ◽  
Implementation Phase ◽  
Non Invasive ◽  
Dvt Prophylaxis ◽  
Hemodynamic Variables ◽  
Work Burden

Introduction: Intermittent pneumatic compression (IPC) has demonstrated to prevent deep venous thrombosis (DVT) and improve survival in acute stroke. Objective: We aimed to implement a new IPC protocol in our non-invasive stroke unit by applying IPC in the hyperacute stroke phase. Methods: All acute stroke patients with high DVT risk and contraindication for pharmacological DVT prophylaxis received IPC treatment. In ischemic stroke patients treated with reperfusion therapies, IPC protocol was planned for 24hours; intracraneal hemorrhage (ICH) patients were treated with IPC during 72hours. Clinical and hemodynamic variables were recorded. Nurses and patients were interviewed for satisfaction with the new protocol. Results: From March to August 2015, we enrolled 132 patients: 75 male (56.4%), mean age 71+/-15 y.o., ischemic strokes 103 (79.2%). Time from admission to IPC application 102+/-375min. Duration of treatment in ischemic patients was 37+/-21hours while in ICH was 44+/-26hours. No patient presented DVT in our series. We observed 6 deaths (4.5%) and 66 patients (56.4%) presented other complications, none of them related to IPC. Only at implementation phase nurses referred a relevant work burden with the new protocol compared to classical low-weighed-heparin DVT prophylaxis. After training it only takes a mean of 6±1.5 minutes to apply the treatment. Only 3 patients (2.3%) presented discomfort, 2 of them with early IPC drop off. Conclusion: IPC treatment is feasible, safe, and comfortable for stroke patients in the hyperacute phase. It increases work burden for nurses only at the implementation phase.

scholarly journals Mobile Stroke Unit in the UK Healthcare System: Avoidance of Unnecessary Accident and Emergency Admissions

2020 ◽  
Vol 49 (4) ◽  
pp. 388-395
Author(s):  
Iris Q. Grunwald ◽  
Daniel J. Phillips ◽  
David Sexby ◽  
Viola Wagner ◽  
Martin Lesmeister ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Acute Stroke ◽  
Stroke Unit ◽  
Hospital Admissions ◽  
Hospital Treatment ◽  
Stroke Patients ◽  
Transient Ischaemic Attacks ◽  
Accident And Emergency ◽  
Mobile Stroke Unit ◽  
The Uk

Background: Acute stroke patients are usually transported to the nearest hospital regardless of their required level of care. This can lead to increased pressure on emergency departments and treatment delay. Objective: The aim of the study was to explore the benefit of a mobile stroke unit (MSU) in the UK National Health Service (NHS) for reduction of hospital admissions. Methods: Prospective cohort audit observation with dispatch of the MSU in the East of England Ambulance Service area in Southend-on-Sea was conducted. Emergency patients categorized as code stroke and headache were included from June 5, 2018, to December 18, 2018. Rate of avoided admission to the accident and emergency (A&amp;E) department, rate of admission directly to target ward, and stroke management metrics were assessed. Results: In 116 MSU-treated patients, the following diagnoses were made: acute stroke, n = 33 (28.4%); transient ischaemic attacks, n = 13 (11.2%); stroke mimics, n = 32 (27.6%); and other conditions, n = 38 (32.8%). Pre-hospital thrombolysis was administered to 8 of 28 (28.6%) ischaemic stroke patients. Pre-hospital diagnosis avoided hospital admission for 29 (25.0%) patients. As hospital treatment was indicated, 35 (30.2%) patients were directly triaged to the stroke unit, 1 patient (0.9%) even directly to the catheter laboratory. Thus, only 50 (43.1%) patients required transfer to the A&amp;E department. Moreover, the MSU enabled thrombolysis with a median dispatch-to-needle time of 42 min (interquartile range, 40–60). Conclusion: This first deployment of an MSU in the UK NHS demonstrated improved triage decision-making for or against hospital admission and admission to the appropriate target ward, thereby reducing pressure on strained A&amp;E departments.

scholarly journals Evaluating the Role of Oxidative Stress in Acute Ischemic Stroke

2020 ◽  
Vol 11 (01) ◽  
pp. 156-159
Author(s):  
Bindu Menon ◽  
Krishnan Ramalingam ◽  
Rajeev Kumar
Keyword(s):  
Oxidative Stress ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Lipid Membranes ◽  
Demographic Data ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Antioxidant Power

Abstract Background The role of oxidative stress in neuronal injury due to ischemic stroke has been an interesting topic in stroke research. Malondialdehyde (MDA) has emerged as a sensitive oxidative stress biomarker owing to its ability to react with the lipid membranes. Total antioxidant power (TAP) is another biomarker to estimate the total oxidative stress in stroke patients. We aimed to determine the oxidative stress in acute stroke patients by measuring MDA and TAP. Materials and Methods MDA and TAP were determined in 100 patients with ischemic stroke and compared with that in 100 age- and sex-matched healthy adults. Demographic data, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), and disability measured by the Barthel index (BI) were recorded. The association of MDA and TAP with other variables was analyzed by paired t-test. Results Of the whole sample, 74% represented males. The mean NIHSS score was 13.11 and BI was 38.87. MDA was significantly higher in stroke patients (7.11 ± 1.67) than in controls (1.64 ± 0.82; p = 0.00). TAP was significantly lower in stroke patients (5.72 ± 1.41) than in controls (8.53 ± 2.4; p = 0.00). The lipid profile and blood sugar levels were also significantly higher in stroke patients. There was no association of MDA and TAP with other variables. Conclusion We found that oxidative stress was associated with acute ischemic stroke. However, we could not establish an association between oxidative stress and the severity of acute stroke.

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