Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. For patients, families and caregivers, this can be a difficult time of adjustment. The 2016 update of the Canadian Managing Transitions of Care following Stroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by clinicians who provide care to patients following stroke across a broad range of settings. The focus of these recommendations is on support, education and skills training for patients, families and caregivers; effective discharge planning; interprofessional communication; adaptation in resuming activities of daily living; and transition to long-term care for patients who are unable to return to or remain at home. Unlike other modules contained in the Canadian Stroke Best Practice Recommendations (such as acute inpatient care), many of these recommendations are based on consensus opinion, or evidence level C, highlighting the absence of conventional evidence (i.e. randomized controlled trials) in this area of stroke care. The quality of care transitions between stages and settings may have a direct impact on patient and family outcomes such as coping, readmissions and functional recovery. While many qualitative and non-controlled studies were reviewed, this gap in evidence combined with the fact that mortality from stoke is decreasing and more people are living with the effects of stroke, underscores the need to channel a portion of available research funds to recovery and adaptation following the acute phase of stroke.
In recent years, there has been an increased recognition of the potential cost of caring on the mental well-being of research animal facility personnel. While this issue is considered a normal consequence of caring for others, these stressors must be acknowledged and managed to ensure that the workplace culture remains positive and that employees are engaged. Factors that can contribute to these feelings in those working with animals in research include compassion and moral stress, issues related to staffing and scheduling of work, insufficient communication in the workplace, and public ambivalence toward the use of animals in science. The first step in developing a program is to survey facility personnel about their concerns, either formally (e.g., using a needs analysis) or informally. Two examples are provided to demonstrate different institutional approaches to assessing personnel needs and developing an internal compassion-resiliency program. The best programs are based on the needs and wants of personnel and these can be cost effective and geared at a grassroots level. Social support in the workplace, for example, through peer counseling, can be a highly effective means of helping personnel to build compassion-resiliency. Addressing mental well-being of research animal facility personnel is an important component of ensuring a positive culture of care in the workplace.
Although some threshold BBS scores could be determined, the accuracies of the scores render them of limited use for guiding gait-aid prescription in individual clients.
Purpose: The purpose of this study was to gain an understanding of the opportunities and challenges involved in providing clinical inter-professional education (IPE) to physical therapy (PT) students in the acute-care setting from the perspective of PT clinical instructors (CIs). Methods: Focus groups were conducted in four acute-care hospitals in Toronto. Participants were recruited using a purposive and convenience sampling approach in order to enhance our understanding of the perceptions of acute-care PT CIs. Eighteen full-time PT CIs with an average of 11 years in practice participated. A constant comparative process was employed to identify recurrent issues and themes within and between groups. Results: Three main themes emerged from the focus groups: (1) Clinical IPE happens when inter-professional collaboration (IPC) occurs; however, IPC differs according to setting, access to other professions, time, support, and structure. (2) IPE is a lifelong learning process that applies to both CIs and students. (3) Student preparedness is a prerequisite for clinical IPE. Conclusions: IPC is an integral part of clinical IPE that requires ongoing commitment and reflection by CIs to ensure that they are ready to instruct students who have some preparation in formal IPE. More knowledge about providing clinical IPE in a structured manner, through academic and health institutions, will allow CIs to become role models for future generations of PT students. Mé thodes : Des groupes de discussion ont é té mis sur pied dans quatre hô pitaux de soins de courte duré e de Toronto. Les participants ont é té recruté s selon une approche d'é chantillonnage au jugé et de commodité , afin que les chercheurs puissent mieux comprendre la perception des soins de courte duré e chez les ICP. Au total, 18 ICP comptant en moyenne 11 anné es de pratique ont participé à l'é tude. Un processus comparatif constant a é té utilisé pour identifier les questions et les thè mes qui revenaient parmi les divers groupes. Ré sultats : Trois grands thè mes se sont dé gagé s de ces groupes de discussion : (1) La FCI a lieu lorsqu'il y a collaboration interdisciplinaire. Toutefois, cette collaboration varie selon le cadre de pratique, l'accè s aux autres professions, le temps, le soutien apporté et la structure du cadre de pratique. (2) La FCI est un processus d'apprentissage permanent, qui s'applique aussi bien aux instructeurs qu'aux é tudiants. (3) Pour bé né ficier de la FCI, les é tudiants doivent ê tre pré paré s. Conclusions : La FCI constitue une partie inté grante de l'é ducation clinique interdisciplinaire. Elle exige des instructeurs un engagement continu et un travail de ré flexion afin qu'ils s'assurent d'ê tre bien prê ts à former les é tudiants qui possè dent dé jà une certaine forme de pré paration à la FCI. Une plus grande connaissance de la formation clinique interdisciplinaire, plus structuré e, dans le cadre des université s ou des institutions du secteur de la santé , permettra aux instructeurs de devenir des modè les pour les ...
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