How can we train stroke practitioners about patient self-management? Description and evaluation of a pathway wide training programme

Jones, Fiona; Bailey, Nicola

doi:10.5750/ejpch.v1i1.660

Cited by 13 publications

(22 citation statements)

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“…Questionnaires were administered to staff members immediately prior to the training, at an interim stage between the first and second training workshops, and following completion of training. The questionnaire items were designed to assess attitudes, beliefs, and knowledge about self-management support, and were modified to the acute stroke context from a questionnaire used within similar project across a stroke pathway [Jones and Bailey, 2013]. …”

Section: Baseline Measurementmentioning

confidence: 99%

“…Bridges stroke SMP has been introduced to stroke pathways that include some acute stroke unit staff [Jones and Bailey, 2013] but has not previously been introduced to an acute stroke unit as a whole.…”

Section: Introductionmentioning

confidence: 99%

“…Baseline data were captured on the washing and dressing practices on the acute stroke unit, to enable an assessment of the impact of Bridges training on everyday interdisciplinary rehabilitation processes that can encourage and promote self-management. See supplementary file: ds4061.pdf -"Figure 1: Overview of Bridges Stroke Self-Management Package"DesignTo date, Bridges stroke SMP has been developed, implemented, and assessed primarily within post-acute, rehabilitation stroke settings[Jones and Bailey, 2013]. As the focus within this project Page 2 of 7 was on implementation within a hyperacute and acute stroke service, the key features of the project design related to the challenges involved in its introduction to the multidisciplinary team's ways of working, within this new context.…”

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Starting early: integration of self-management support into an acute stroke service

Mäkelä

Gawned

Jones

2014

BMJ Qual Improv Report

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Self-management support following stroke is rare, despite emerging evidence for impact on patient outcomes. The promotion of a common approach to self-management support across a stroke pathway requires collaboration between professionals. To date, the feasibility of selfmanagement support in acute stroke settings has not been evaluated.The Bridges stroke self-management package (SMP) is based on self-efficacy principles. It is delivered by professionals and supported by a patient-held workbook. The aim of this project was to introduce the Bridges stroke SMP to the multidisciplinary staff of a London hyperacute and acute stroke unit.The 'Plan Do Study Act' (PDSA) cycle guided iterative stages of project development, with normalisation process theory helping to embed the intervention into existing ways of working. Questionnaires explored attitudes, beliefs and experiences of the staff who were integrating selfmanagement support into ways of working in the acute stroke setting.Self-management support training was delivered to a total of 46 multidisciplinary stroke staff. Of the staff who attended the follow-up training, 66% had implemented Bridges self-management support with patients since initial training, and 100% felt their practice had changed.Questionnaire findings demonstrated that staff attitudes and beliefs had changed following training, particularly regarding ownership and type of rehabilitation goals set, and prioritisation of self-management support within acute stroke care.Staff initiated an audit of washing and dressing practices pre-and post-training. This was designed to evaluate the number of occasions when techniques were used by staff to facilitate patients' independence and self-management. They found that the number of occasions featuring optimum practice went from 54% at baseline to 63% at three months post-training.This project demonstrated the feasibility of integrating self-management support into an acute stroke setting. Further work is required to evaluate sustainability of the Bridges stroke SMP, to understand the barriers and opportunities involved in engaging all professional groups in integrated self-management support in acute stroke settings, and to assess patient reported outcomes.

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Section: Baseline Measurementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Starting early: integration of self-management support into an acute stroke service

Mäkelä

Gawned

Jones

2014

BMJ Qual Improv Report

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“…Therefore, it is important to consider the attitudes, knowledge and beliefs of HCPs towards self-management when considering the implementation of this approach in stroke rehabilitation. A previous study that explored the attitudes of HCPs towards stroke self-management found that whilst stroke practitioners were positive about the Bridges SSMP and were willing to apply the principles of this approach to their practice, there were challenges and barriers to its implementation (Jones & Bailey, 2013). Identified barriers were lack of time, patients moving quickly between healthcare teams and the influence of the acute setting.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies on the attitudes of HCPs towards stroke selfmanagement have been conducted in the United Kingdom and the Netherlands (Jones & Bailey, 2013;Satink et al, 2015). However, in New Zealand, the attitudes of HCPs are unknown as the Bridges SSMP is still in the early stages of implementation and little research has been done in this area.…”

Section: Introductionmentioning

confidence: 99%

Attitudes of healthcare professionals towards self-management for patients with stroke

Taylor¹,

Monsanto²

2019

NZJP

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Self-management approaches towards stroke rehabilitation are gaining more attention due to emerging evidence of their impact on patient outcomes. This mixed methods study explored the attitudes of healthcare professionals (HCPs) towards stroke selfmanagement. The Bridges Stroke Self-Management Programme (Bridges SSMP) training was delivered to 51 HCPs in New Zealand. Questionnaires were completed by consenting participants (n=43) prior to administration of the Bridges SSMP training. In-depth, semi-structured interviews were conducted with three participants. The General Inductive Approach was used for thematic analysis of the qualitative data. The resulting overarching theme was "integrating the self-management concept into practice", which encompasses organisational, contextual and individual factors that HCPs feel are challenges when applying self-management. Two contributors to this theme -"education" and "facilitating empowerment" -emerged as barriers or enablers, respectively, to putting self-management into practice. Questionnaire data showed HCPs were confident in their capability of self-management concepts yet did not frequently use them in practice. Healthcare professionals were mostly positive about the concept of self-management but challenges and barriers were evident when applying this to practice. Hence, they may require a deeper understanding of the principles of self-management and become more familiar with the process by applying the principles of self-management in their own lives.Taylor, A., Monsanto, X., Kilgour, H., Smith, C., & Hale, L. (2019). Attitudes of healthcare professionals towards selfmanagement for patients with stroke.

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Implementation in rehabilitation: a roadmap for practitioners and researchers

Morris

Bernhardsson²,

Bird

et al. 2019

Disability and Rehabilitation

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PurposeDespite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners. MethodsRehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a "road map" analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings. Results and ConclusionsEffective implementation strategies for the complex world of rehabilitation are urgently required.The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasises the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation.

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How can we train stroke practitioners about patient self-management? Description and evaluation of a pathway wide training programme

Cited by 13 publications

References 15 publications

Starting early: integration of self-management support into an acute stroke service

Starting early: integration of self-management support into an acute stroke service

Attitudes of healthcare professionals towards self-management for patients with stroke

Implementation in rehabilitation: a roadmap for practitioners and researchers

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