Contemporary Perspectives on Stroke Care Assignment Sample

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1. Introduction :The Role of Nursing in Stroke Care and Rehabilitation

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Stroke, described as a cardiovascular event that alters cerebral blood flow, ranks as one of the top causes of disability and death in the United States (Rc & St, 2021). Stroke may vary in intensity from mild attacks with no lasting consequences to severe ones that cause serious long-term impairment or death (Smith et al., 2018). The goal of this paper is to examine nursing's impact on the treatment of strokes, which are medical emergencies that may have lifelong effects. Stroke is a serious public health issue because of the ageing population and the widespread presence of risk factors such high blood pressure, obesity, and diabetes (Davis et al., 2021). Examining the pivotal role of person-centered care and self-management techniques in post-stroke rehabilitation, this study will investigate their impact on improving patient outcomes and alleviating the burden on healthcare systems. Delving into how nurses can be optimally engaged throughout the entire stroke care continuum, starting from initial response to rehabilitation and beyond, is crucial.

2. Background

According to Smith et al. (2018), around 795,000 individuals in the world wide have a stroke each year, making it the primary cause of significant disability that lasts for a long period. According to Johnson and Garcia (2019), ischemic strokes, which are the most common kind of stroke and are caused by a blockage in the blood arteries that supply blood to the brain, account for 87 percent of all strokes occurring. In particular, the incidence of occurrence has grown among those who are under the age of 45, which is suggestive of altering risk profiles and calls for exploration into the moderating effects of differences in lifestyle and environmental factors (Davis et al., 2021). The fact that there are people in the United States who have survived a stroke is indicative of a significant patient population that requires ongoing medical care. To put that into perspective, by the year 2020, millions of individuals will have suffered the aftereffects of a stroke and will need ongoing medical treatment (Davis et al., 2021). According to Davis et al. (2021), this prevalent occurrence highlights the need of having appropriate management approaches and the crucial requirement of having long-term healthcare support networks factors. It is estimated that the direct and indirect costs associated with the management of strokes amount to tens of billions of dollars annually in the United States alone (American Association of Neurological Surgeons, 2019). According to Williams et al. (2020) these figures also take into account the total expenditures incurred by society, which include lost productivity and informal care. As a result of the considerable financial impact that stroke has on both the public sector and on individuals, it is essential to develop treatments that are not only efficient but also cost-effective (Lee et al., 2022).

2.1 National or International Policy

A national and international policy overview highlighting the Million Hearts Initiative and Comprehensive Stroke Center Certification, emphasizing nurses' essential roles in stroke prevention, acute care, rehabilitation, advocacy, and patient education.

Policy 1: Million Hearts Initiative

Launched by the U.S. Department of Health and Human Services in 2015, the Million Hearts initiative is a national effort aimed at preventing 1 million heart attacks and strokes within five years (U.S. Department of Health and Human Services, 2015). Nurses play a crucial role in the Million Hearts Initiative, particularly in relation to individuals living with stroke (Warner et al., 2020). They are integral members of the healthcare team involved in various stages of stroke care, from prevention and early detection to rehabilitation and long-term management. In terms of prevention, nurses can educate individuals about modifiable risk factors for stroke, such as high blood pressure, high cholesterol, smoking, and lack of physical activity (McHutchion et al., 2021). They can provide counseling on lifestyle modifications, medication adherence, and regular health screenings. Additionally, nurses can advocate for policies and programs that promote cardiovascular health within communities. During the acute phase of stroke, nurses are often the first responders, administering emergency care and coordinating rapid transport to specialized stroke centers. They play a critical role in assessing and monitoring patients, implementing treatment protocols, and providing support to both patients and their families. In the rehabilitation phase, nurses collaborate with interdisciplinary teams to develop individualized care plans aimed at maximizing functional independence and improving quality of life for stroke survivors (Warner et al., 2020). They assist with activities of daily living, provide education on self-management strategies, and offer emotional support throughout the recovery process. Furthermore, nurses contribute to ongoing stroke research and quality improvement efforts, helping to identify best practices and implement evidence-based interventions to enhance patient outcomes (Green & Jones, 2016). Overall, nurses serve as advocates, educators, caregivers, and partners in the journey of individuals living with stroke, playing a vital role in the implementation and success of the Million Hearts Initiative's objectives.

Policy 2: The Comprehensive Stroke Center (CSC) Certification Program

The Comprehensive Stroke Center (CSC) Certification Program is a policy initiative designed to ensure that stroke care facilities meet rigorous standards for providing comprehensive, high-quality care to individuals experiencing stroke (Dusenbury et al., 2023). This certification program typically involves an accreditation process where stroke centers undergo evaluation based on specific criteria established by accrediting bodies or regulatory agencies.

The primary goal of the CSC Certification Program is to improve outcomes for individuals living with stroke by ensuring they receive timely and appropriate care that meets established clinical guidelines and best practices (Jauch et al., 2021). Comprehensive Stroke Centers are equipped to provide advanced levels of care, including specialized treatments such as thrombectomy and advanced neuroimaging, as well as comprehensive rehabilitation services. Nurses play a crucial role within Comprehensive Stroke Centers, serving as frontline caregivers and key members of the interdisciplinary stroke care team.

3. Rationale

This section emphasizes person-centered care (PCC) for stroke survivors, highlighting the importance of individualized care, nurse involvement, challenges like health literacy, and strategies to improve care through training and patient education.

3.1 Person-centred care

The patient's preferences, values, family status, social circumstances, and lifestyle choices are taken into account throughout the duration of the healthcare process, from the initial examination until discharge (Kris-Etherton et al., 2021). PCC is the term used to describe this kind of therapy (Forsgren, Åke and Saldert, 2022). Reeves et al. (2017) use stroke as an example of a chronic and challenging condition that requires not just immediate medical attention, but also ongoing care that is flexible and responsive to the patient's evolving demands.

First of all, to deliver the PCC to stroke survivors in the United States, a multidisciplinary team of healthcare professionals, which include doctors, should be involved (Liao et al., 2023). From the ER to rehabilitation establishments to the community following a stroke, a patient’s care requirements would be progressive (Liao et al., 2023). For example, the patient's own recovery objectives, such as going back to work, participating in social activities, or reaching a particular degree of independence, should impact the rehabilitation goals that are developed (Bernhardt et al., 2017). The patient should help develop these objectives. Nurses are essential in providing post-stroke care (PSC) to patients, serving as the primary point of contact and offering both physical and psychological support (Kjörk, 2022). Within healthcare teams, nurses play a crucial role by assessing patients' understanding of their condition, delivering personalized education, and advocating for patients' preferences (Kjörk, 2022). Registered Nurses (RNs) deliver direct care, administer medications, monitor vital signs, and educate patients on disease management. Nurse Practitioners (NPs) extend these responsibilities by diagnosing conditions, prescribing medications, developing treatment plans, and often serving as patients' primary healthcare providers. Clinical Nurse Specialists (CNSs) focus on specialized areas of healthcare such as pediatrics or oncology, offering patients specialized expertise and conducting research (Reed, Arbet, & Staubli, 2021). Nurses play a critical role in ensuring patients' care plans are cohesive and prioritize their needs (Kloppas et al., 2020).

Contemporary Perspectives on Stroke Care Assignment Sample

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Rehabilitation for stroke victims is complex and time-consuming because of the wide variety of symptoms they may experience, from cognitive difficulties to physical handicap (Mavaddat et al., 2021). A person's access to PCC may be impacted by inequalities in service provision. For instance, in rural locations, the quality and consistency of stroke treatment may suffer due to a lack of resources (Martín-Sanz et al., 2022). In American hospitals, it is not uncommon to see high nurse-to-patient ratios, which may reduce the amount of time available for nurses to conduct in-depth interactions with each patient. A nurse who is involved in the treatment of individuals with chronic ailments, like diabetes, provides an important function in educating them on their ailment suppositions, prescriptions, habits adjustments and so on. For instance, once the plan of monitoring blood glucose levels and insulin therapy is laid out, the nurse allocates enough time to voice the patient’s fears regarding self-injection and the implications of diabetes diagnosis for everyday life (Burt, 2023).

It's possible that not all nursing programmes devote enough time to developing this particular set of skills because of the emotional toll that strokes have on patients and their families. Stroke sufferers and the people who care for them usually have a difficult time emotionally recovering after the event (McAleese et al., 2019). According to Johnson and Garcia (2019), another obstacle is a lack of health literacy. Lack of health literacy is a major hindrance in Reaching the best health outcomes and patient-centred care (Murugesu et al., 2022). Individuals who have a low level of health literacy are sometimes unable to comprehend the medical instructions, the dosage schedule for administering the drugs or the follow-up appointments dating back to the visit; this is reflected in increased rates of medication errors, increased hospital readmissions and seriously poorer health prospects (Murugesu et al., 2022). Additionally, some stroke survivors may suffer from cognitive impairments that make it difficult for them to take part in the planning of their treatment, prompting the need for additional steps to ensure that their choices are followed (Johnson & Garcia, 2019). Stroke patients are also more likely to be older than the general population.

3.1.1 Mitigating PCC Challenges

To combat these issues, healthcare policy should push for increased nurse-to-patient ratios so that more patients may get person-centered care. In addition, nurses and other healthcare professionals need continuous education and training in PCC methods. An approach to the care provided to patients, PCC places an emphasize on the adaptation of care by the providers to the specific needs, wish, and ideology of individual patients (Pilnick, 2022). Improving healthcare outcomes and joy of patients is founded on this holistic approach. This is because the capacity of the nurses and other health workers to attain PCC is drastically limited by inadequate staffing of nurses that is very evidently linked to not only the quality of care that is provided to be individuals but also the quality of the health system that is capable of implementing PCC (Pilnick, 2022). Patient education programmes developed specifically for stroke survivors may improve health literacy by utilising plain language and culturally relevant resources variables (Davis et al., 2021).

3.2 Self-management

The term "self-management" is used to describe an individual's capacity to deal with the challenges of dealing with a chronic health condition, such as a stroke, including the symptoms, treatment, physical and psychological effects, and lifestyle adjustments that come along with it (Klockar et al., 2023). It includes everything a person has to do or change in order to manage their illness successfully (Klockar et al., 2023).

1. Self-Management Education

Stroke survivors need access to well-structured programmes that help them learn the skills they need to adhere to their condition-specific treatment plans, motivate them to make better lifestyle choices and provide them with emotional support in order to improve their quality of life. Stroke survivors can benefit from adapting existing programmes to their specific needs (Green and Jones, 2016). One such programme is the "Chronic Disease Self-Management Programme", which helps people learn to take charge of their health so they can continue to live fulfilling, productive lives despite the effects of a stroke. The nurse’s role in implementing programs such as CDSMP for stroke survivors is complex; this involves providing education, support and advocacy at the same time emphasising clinical skills to enable the patient to manage his or her condition (Fugazzaro et al., 2021). This is whereby nurses are essential in the implementation wing of stroke rehabilitation programs because they help nurses to adopt and implement interventions tailored to specific needs of stroke survivors (Fugazzaro et al., 2021). This enables nurses to develop effective and feasible stroke rehabilitation programs.

2. Shared Decision-Making

"Shared decision-making" is a procedure in which a patient and their healthcare provider jointly make decisions regarding the patient's treatment based on the patient's values and the most up-to-date medical evidence (Driever, Stiggelbout and Brand, 2020). This may force those who have survived a stroke to make decisions about their lifestyle, secondary preventive strategies, and therapy after the event. Shared decision-making protects patients' right to autonomy and promotes patients' active participation in their own treatment (Smith et al., 2018).

Roles within Nursing

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1. Role of the Nurse in Self-Management Education

Nurses is essential in facilitating and educating patients in self-management education. Patients are educated about the causes and effects of stroke as well as the need to take prescribed medications and participate in physical therapy (Johnson and Garcia, 2019). In the case of self-management education targeted at stroke survivors, nurses are in the centre of the implementation of specific content through programs such as the ‘Chronic Disease Self-Management Programme’ (CDSMP) (Halim et al., 2023). Nurses further concentrate on medication management informing about the working mechanisms of prescribed drugs, their side effects and the need to adhere to avoid further strokes. Physical therapy education is another important aspect, in which nurses perform the exercises, tell their advantages in promoting mobility and preventing complications, and encourage patients to pursue further exercise implementation in their daily lives (Doormaal et al., 2020). More importantly, nurses evaluate patients’ improvement and adjust their teaching style to fit the effectiveness and learning capacity of an individual, offering each acquirable, acceptable and helpful training.

Role of the Nurse in Shared Decision-Making

The role of nurses in promoting group decision-making is equally crucial. They may aid patients in making sense of data showing the range of possible outcomes from various treatments. The finest care for a patient may be provided when nurses create an atmosphere where patients feel safe expressing their opinions and wishes (Green and Jones, 2016). Furthermore, they may speak out about the patient's preferences to other members of the healthcare team to guarantee that the agreed-upon treatment is really given (Smith et al., 2018).

Challenges in Self-Management for Stroke Survivors

The complexity of stroke symptoms and the individual diversity in the healing process provide considerable hurdles in self-management. Patients' capacity to participate in self-management behaviours may be hindered by cognitive deficits and physical disability (Johnson and Garcia, 2019). Access to self-management resources, including as educational materials, rehabilitation programmes, and support groups, may also be influenced by a person's socioeconomic status (Blancafort Alias et al., 2021). Nurses and other medical staff may not always have the time or resources to give effective self-management assistance. Proper self-management depends much on the patient’s knowledge of his/her condition, treatment, necessary lifestyle changes, and strategies for dealing with the psychological consequences of the disease. The Open Door Education abbreviated as ODE is delivered by nurses and medical staff. Nevertheless, although patients need to have a thorough connection of their state that includes all the related information on how and when treatment should be applied, in the case of resource and time limitations (White and Lo, 2020). Such a level of education leaves patients poorly equipped to cope with their condition. Patients may have fewer chances to learn about their conditions and treatment options and participate in their care since the healthcare system prioritises emergency care over rehabilitation and ongoing assistance (Green and Jones, 2016).

2. Mitigating Challenges in Self-Management

Self-management support training for nurses and other healthcare workers is a must if healthcare systems are to overcome these obstacles (Johnson et al., 2022). Time for patient education and collaborative decision-making should be prioritised in policy. Moreover, in disadvantaged regions, continued care and resources for stroke survivors may be provided via the development and integration of technological solutions, such as telemedicine and mobile health apps (Verma et al., 2022). Post-stroke treatment must include self-management training and collaborative decision-making (Johnson and Garcia, 2019). Nurses play a crucial role in implementing these techniques by educating patients, supporting them, and advocating on their behalf throughout the care planning process. However, substantial difficulties persist and call for attention from healthcare policymakers and providers alike (Verma et al., 2022). Stroke survivors may have better outcomes and quality of life if nurses are able to help them cope with their condition (Smith et al., 2018).

Conclusion

In conclusion, self-management is an essential part of post-stroke treatment when it comes to rehabilitation. Integral to enabling stroke survivors to cope with the challenges of post-stroke living are the tactics of self-management education and shared decision-making. Stroke survivors who participate in individualised education programmes report considerable improvements in their functional independence, adherence to therapy regimens, and proactive health behaviour. Patient autonomy and cooperation are promoted via shared decision-making, which also guarantees treatment is in line with patients' beliefs and preferences. When it comes to these procedures, nurses are crucial.

The structure of stroke recovery shows the fundamental role of the nurses- a technique to organize the PCC and self-management training. Nurses lead in the fight against the complex challenges facing stroke survivors ranging from coping with physical and cognitive weaknesses to challenges presented by health literacy and care access. Programmes such as the Chronic Disease Self-Management Programme (CDSMP) use nurses as the instruments of delivering education, support and advocacy for survivors of strokes, who can now take charge of their health and steer the path of recovery with confidence.

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