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					Nursing Standards for Adult Stroke Patients
Jane Greene Nurse Consultant for Older People Southern Health and Social Care Trust N. Ireland

Background
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NIMAST 1998 NIMAST Lead Nurses 2002 RCP Evidences Based Guidelines Scottish Stroke Competencies Skills for Health Stroke Units-evolved without planning Skilled AHPs/Medics

NSF Older People 2001 Standard 5 tasks Trusts to develop stroke services in line with best evidence. With the aim : “To reduce the incidence of stroke in the population and ensure that those who have had a stroke have prompt access to integrated stroke care services”.

Process
18 Lead Nurses 3 facilitated consensus workshops held during spring/summer 2006 to agree the following:
The format and layout of the standards

The different types and levels of evidence to be used The responsibilities of individual group members Consultation process Next steps

Standards

3 Key Areas
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Skills and knowledge required to provide skilled nursing care for patients following stroke Nursing care specific to stroke: meeting physical care needs Nursing care specific to stroke: meeting psychological, emotional and communication needs.

Section 1 Skills and Knowledge
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Common Effects of Stroke Specialist Care for Patients Following Stroke Immediate Effects of Stroke Nursing Management of the Adult Patient Following Stroke Reducing The Risk of Stroke Rehabilitation

Section 2 Meeting Physical Care Needs
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Moving and Handling the Patient Following Stroke Care of the Stroke Affected Side Loss of Consciousness Care of the Dying Promoting Urinary Continence Promoting Urinary Continence: the use of urinary catheters Promoting Faecal Continence Care of the Patient Wearing Anti Embolism Stockings Prevention of Pressure Ulcers Dysphagia Nutrition Oral Hygiene

Section 3
Psychological, emotional and communication needs.

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Visual Changes Communication Safety Thinking Processes Emotions Behavioural Changes

Consultation
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6 weeks Nursing in 5 countries Stroke nursing Education Commissioning at Board and Dept level Lobbying at Dept level

Responses
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”highly relevant to nurse clinicians” “this is a great piece of work” “could be used as an educational resource” “I think you all have to be congratulated”

Consultation Phase 2
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Multidisciplinary colleagues in stroke RQIA User Rep NICHS Departmental Standards and Guidelines Unit

Next Steps
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Amend following phase 2 consultation-July 2007 Publication Partnership with RCN re learning resource Implementation Plan-2007-2008 Performance Management

Nursing Standards for Adult Stroke Patients
Jane Greene Nurse Consultant for Older People Southern Health and Social Care Trust N.Ireland


				
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