dynamic role of the nurse in stroke rehabilitation nancy boaro, bscn, mn, cnn(c), crn(c) advanced...
TRANSCRIPT
Dynamic Role of the Nurse in Stroke Rehabilitation
Nancy Boaro, BScN, MN, CNN(C), CRN(C)Advanced Practice Leader, Neuro Rehab Program Toronto Rehabilitation Institute
Objectives
Define the goal of rehab nursing Outline the roles of the rehab nurse Outline the competencies of the stroke
rehab nurse Highlight areas for stroke rehab nursing
intervention and interprofessional collaboration via case study
Goal of Rehabilitation Nursing
“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)
Promote maximum functional abilityOptimal healthAdaptation to an altered lifestyle
The Multidimensional Role of The Stroke Rehabilitation Nurse
Leader and
Collaborator
Leader and
Collaborator
Provider of
Care
Provider of
Care
Coordinator Of
Care
Coordinator Of
Care
Client Advocate
Client Advocate
Educator and
Coach
Educator and
Coach Stroke RehabNurse
Stroke RehabNurse
Provider of Care
Provides quality evidence based nursing Focuses on restoring & maintaining
function and preventing complications Interacts therapeutically with clients and
their support systems (ARN,1998, OARN,
1998)
Educator and Coach
Wellness and prevention Self care
assesses their readiness to learn plans teaching times and strategies (uni-
profession or interprofessional)
Advocacy skills
Leader and Collaborator
Works with the team to establish goals to promote maximal patient independence.
Rehab Nurse as Advocate
Patient or unit / program based
Accessibility of rehabilitation services
Politically involved at all levels
Rehab Nurse as Coordinator Uses holistic,
interprofessional approach
Identifies and measures functional goals for patients
plan and guide care
CNA Rehabilitation Nursing Competencies
CNA established national standards of practice and competencies for rehabilitation nursing in 2005
Recognized as a specialty practice with certification exam
Rehabilitation Nursing CompetenciesFunctional Health Patterns
Discharge and Transition Mobility Sexuality Sleep and rest Sensory and Pain Nutrition, Elimination, Skin Integrity Cardiopulmonary Psychosocial adaptation
Role of the Nurse in Rehabilitation Assesses
Pre-existing and current status Physical, emotional, functional, social indicators Diagnostics
Selects nursing interventions to enhance and support physical, psychological, and social functioning
Collaborates Evaluates
Patient/family response to interventions/plan of care
Rehabilitation Nursing Competencies Psychosocial Health Patterns
Self-perception Family structure Health beliefs Caregiver burden Family resources
for coping Financial Emotional Physical environmental
Cultural Spiritual Motivation Stress response Coping Unresolved grief,
anger Emotional fatigue Denial
Stroke Specific Rehabilitation Nursing Competencies
Understands Risk factors for stroke Anatomy and pathophysiology of stroke Nursing interventions optimize function of client
with strokeRecognizes
Clinical manifestations of stroke Deficits of clients with stroke specific to stroke
locationInterprets laboratory values
Case Study
Final Thoughts
The scope of practice of a stroke rehab nurse is broad and dynamic
Significant impact on patient’s rehabilitation experience and recovery
Many opportunities for interprofessional collaboration to optimize patient outcomes
Contact Information
Nancy BoaroAdvanced Practice Leader
Neuro Rehab ProgramToronto Rehab
416-597-3422 ext [email protected]
QUESTIONS?