Demographic and stroke-related factors as predictors of quality of acute stroke care provided by allied health professionals

Bernhardt, Julie; Grimmer, Karen

doi:10.2147/jmdh.s22569

Cited by 17 publications

(27 citation statements)

References 41 publications

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“…Although this finding is promising, medical record audits of compliance with early mobilization process of care indicators from Australia and Europe have found compliance rates of between 11% and 49%. 30,31 We do not know whether the support for the practice of early first mobilization evident in this study would translate to high levels of compliance in the real practice setting. Interestingly, the present survey suggests that everyone agrees with the practice, whereas we found clinicians to be very mixed in their view of the early mobilization with many concerned about harm.…”

Section: Early Mobilizationmentioning

confidence: 89%

Physical Therapists' Guideline Adherence on Early Mobilization and Intensity of Practice at Dutch Acute Stroke Units

Otterman

Wees

Bernhardt

et al. 2012

Stroke

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Background and Purpose-Clinical practice guidelines for patients with stroke recommend early stroke rehabilitation at acute hospital stroke units. The present study aimed to (1) explore the organization of early stroke rehabilitation; (2) investigate current practice with respect to early mobilization and augmented exercise therapy time; and (3) identify the perceived barriers to and facilitators for guideline adherence as reported by physical therapists (PTs) working on acute hospital stroke units. Methods-All 96 Dutch acute hospital stroke units were requested to assign one PT for participation in the survey. Results-Of the 96 contacted PTs, 91 returned the questionnaire. Seventy-one percent of acute hospital stroke units reported that out-of-bed mobilization of patients was performed within 24 hours. PTs provided a mean of 22 minutes of physical therapy per weekday and weekend therapy was not standard practice. PTs reported having sufficient knowledge of and experience with the clinical practice guidelines for patients with stroke and reported that the clinical practice guidelines for patients with stroke left enough room for them to draw their own conclusions and to take patient preferences into account. PTs perceived insufficient time to comply with the clinical practice guidelines for patients with stroke and a need for financial compensation to realize human resources. Conclusions-Our national survey among PTs suggests that the organization of early stroke rehabilitation varies considerably and that early mobilization and intensity of practice in early stroke rehabilitation are not optimal. Addressing this problem requires agreement between hospital management boards and insurance companies about minimum services and resources required and the introduction of novel methods of increasing duration of exercise therapy with minimal use of resources.

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Section: Early Mobilizationmentioning

confidence: 89%

Physical Therapists' Guideline Adherence on Early Mobilization and Intensity of Practice at Dutch Acute Stroke Units

Otterman

Wees

Bernhardt

et al. 2012

Stroke

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“…Quality improvement activities have gained in popularity in conjunction with evidence-based practice initiatives, as audits of current practice provide a wealth of information on what could be improved 15,16. Luker et al highlighted a range of derived information on quality of stroke care that could be obtained from a simple audit of quality care indicators from 300 consecutive patients in three Australian hospitals 10,11…”

Section: Discussionmentioning

confidence: 99%

“…An audit to establish current rehabilitation practices for stroke patients in the Philippines would also have the potential to capture “gaps” in current practice patient records, as was found by Luker et al11 These gaps could be addressed as part of the education provided to Filipino health care practitioners as part of the guidelines implementation program. For instance, capture of information on stroke severity (National Institutes of Health Stroke Scale) is recommended as part of best practice stroke management 3,10,11.…”

Section: Introductionmentioning

confidence: 99%

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Protocol for audit of current Filipino practice in rehabilitation of stroke inpatients

Gonzalez‐Suarez¹,

Dizon²,

Grimmer³

et al. 2015

JMDH

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BackgroundStroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol.MethodsA clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine) are active members and are affiliated with various hospitals in the Philippines. Data collectors will be identified and trained in the audit process. A pilot audit will be conducted to test the feasibility of the audit protocol, and refinements to the protocol will be undertaken as necessary. The comprehensive audit process will take place for a period of 3 months. Data will be encoded using MS Excel®. Data will be reported as means and percentages as appropriate. Subgroup analysis will be undertaken to look into differences and variability of stroke patient descriptors and rehabilitation activities.ConclusionThis audit study is an ambitious project, but given the “need” to conduct the audit to identify “gaps” in current practice, and the value it can bring to serve as a platform for implementation of evidence-based stroke management in the Philippines to achieve best patient and health outcomes, the audit team is more than ready to take up the challenge.

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“…Poor compliance with mood and psychological distress screening has been reported in UK [16][17][18] , Australian [19] and Canadian [20] stroke settings. The reasons for poor compliance with psychological distress screening in stroke settings have been explored.…”

Section: Introductionmentioning

confidence: 99%

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

Gillespie

Cadden

2013

JNEP

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Aim: To develop a practical system to enable nurses to screen for psychological distress following stroke.Background: Mood disorders and psychological distress are prevalent following stroke, but often go undetected and therefore untreated. National guidelines recommend screening for distress, but the evidence suggests that there are significant barriers to the implementation of post-stroke mood and psychological distress screening programmes. One barrier relates to limitations of questionnaire methods for identifying distress. Specifically, existing mood questionnaires are often too lengthy; miss important emotional changes that result from stroke; and do not necessarily point nurses towards the most helpful intervention approaches. Methods:We sought to develop a brief, clinically valid screening system that could be used by nurses to identify the levels of psychological distress experienced by stroke survivors. As well as determining levels of distress, the system was intended to aid the identification of first-line interventions that nurses could offer to alleviate distress.Results: A screening system was identified from the oncology literature (the Distress Management System [DMS]) that appeared to meet the broad requirements for screening for stroke-related distress. To tailor the DMS for stroke settings, we obtained feedback on the components of the DMS from stroke survivors and stroke nurses, and also consulted the research literature. This led us to: (1) retain the distress screening component of the DMS, the 'Distress Thermometer'; (2) modify the DMS's 'Concerns Checklist' to reflect the main problems encountered after stroke; and (3) add a 'Resource Pack' to the screening system to enable nurses to offer first-line interventions targeted at individuals' distress. The result, the Distress Management System for Stroke (DMSS), is presented in full in this paper. Conclusion:The DMSS is a potentially useful tool for nurses working in stroke settings. It is brief, straightforward to administer, captures the main emotional concerns of stroke survivors, and the findings from the DMSS can be used to structure interventions for psychological distress. Future work is required, however, to establish the DMSS's reliability, validity and clinical effectiveness.

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Demographic and stroke-related factors as predictors of quality of acute stroke care provided by allied health professionals

Cited by 17 publications

References 41 publications

Physical Therapists' Guideline Adherence on Early Mobilization and Intensity of Practice at Dutch Acute Stroke Units

Physical Therapists' Guideline Adherence on Early Mobilization and Intensity of Practice at Dutch Acute Stroke Units

Protocol for audit of current Filipino practice in rehabilitation of stroke inpatients

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

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