Stroke Rehabilitation Patient Education and Documentation
Kristie Barnette
Introduction
Inpatient stroke rehabilitation requires a multidisciplinary
team approach including the patient and family. Patients
and their families should be educated about their specific
type of stroke and comorbidities that increase the risks
for future strokes. Education beginning with the first
encounter upon admission should be a goal facilities are
striving for to increase the overall knowledge base for
patients and families. Knowledge is powerful tool to
combat future strokes and once you have had a stroke
the likelihood of recurrent stroke is 40% in the next five
years (National Stroke Association). Patients and families
need to know the risks and how to manage these risk
factors moving forward.
Education/Documentation Goals
Nurses should be on the forefront to begin teaching with
the first interaction with the stroke patient. Education can
begin with the admission assessment. It should not be
time consuming or lengthy but informative to the
patients specific diagnosis and comorbidities.
Primary Goal of this QI project is to begin stroke
education and subsequently the documentation of this
education in the electronic medical record (EMR) upon
admission.
Bon Secours Memorial College of Nursing
Materials and Methods
Checklist for admission nurses participating in the QI project
for each stroke admission they admitted. This checklist was a
quick reminder of the patients comorbidities and topics that
could be discussed on admission. Two nurses on the unit
agreed to assist with this QI. The other nurses on the unit were
not aware of any QI project and performed admissions for
stroke patients as usual.
Results
• The nurses involved included in the QI project admitted 7
patients. Documentation of stroke education in the EMR
was completed on 5 of the patients between them. See
table and graph labeled QI admits.
• The other nurses that were not part of the QI project
admitted a total of 4 stroke patients and there was no
stroke education documented on admission. And
subsequently, stroke documentation was not noted until 3
days later for each of the non QI stroke patients admitted.
See table and graph labeled out of QI admits.
.
Conclusion
Although the sample size of the nurses included and the
patients evaluated are small, the results are clear that the
education piece of nursing is being put on the back
burner. The nurses in the QI study stated the education
they incorporated into their admission process based on
the checklist for stroke did not make the admission
process any longer than usual and hopefully in the future
this can be a task type reminder added to the admission
process not only for stroke patients but for all patients.
References
1. Association of Rehabilitation Nursing ARN. (n.d.).
8
Retrieved July 22,2018 from
6 Admits
https://rehabnurse.org/about/roles/rehabilitation-staff-
4 Documented
nurse
2
0
QI Admits Out of QI Admits
2. Duncan, P. W., PhD, FAPTA, Zorowitz, R., MD, Bates, B.,
MD, Choi, J. Y., MD, Glasberg, J. J., MA, PT, Graham, G.
D., MD, PhD, et al. (2005). Management of Adult Stroke
Rehabilitation Care: A Clinical Practice Guideline.
doi:10.1161/01.STR.0000180861.54180.FF
3. NINDS. (n.d.). Retrieved July 20, 2018, from
https://stroke.nih.gov/materials/rehabilitation.htm
4. Preventing Another Stroke. (2016, August 12). Retrieved
July 12, 2018, from http://www.stroke.org/we-can-
help/survivors/stroke-recovery/first-steps-
recovery/preventing-another-stroke
Acknowledgements
Thank to Samantha and Jackie who so graciously helped
me with this QI project. And thanks to my mentor Karen,
who always encourages us to work together and
welcomes new ideas and ways of doing things better.