THE PATIENT AND SOCIETY: IT’S IMPACT ON OUR DIAGNOSIS
MaryGrace P. Haydock
Utica College Abstract: OBJECTIVE: Review and the understanding of the make-up of the WHO ICF model. Application of WHO ICF model in stroke management (WHO, 2006). Case Presentation: This is a case of 60-year-old African American widowed female( 5years) presented with a medical diagnosis of cerebrovascular disease secondary to right intracerebral hemorrhage and found to have right arteriovenous malformation .No residual AVM post op. Onset date was April 11/2014.Past medical history of depression is otherwise patient without significant past medical history. Family History: Diabetes and hypertension. The previous level of function: the patient was independent w/ her …show more content…
The WHO ICF model is being used to provide a common framework to deliver and study the efficacy of rehabilitation outcomes across rehabilitation settings. The WHO ICF model can be used to facilitate for management of professional decision-making, communication, and collaborative efforts among nursing and other interdisciplinary team members and professional colleagues. The WHO ICF model as a framework for management of documentation relating to patient care and determining payment for services required. The WHO ICF is valuable in rehabilitation, research and education. It assists professionals to look beyond their own areas of practice, communicate across disciplines, and think from a functioning perspective rather than the perspective of a health condition of the …show more content…
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes Bleeding into one or both cerebral hemispheres including the basal ganglia and the cerebral cortex. The WHO ICF model can be used to assess the quality of rehabilitation care and the impact of loss of body functions and structures, activities limitations, and contextual factors include the unique personal and environmental variables of each stroke patient in a sub-acute setting. The WHO ICF model defines activity and participation dimensions separately, and applies these dimensions as a singular construct when clinically qualifying and quantifying the consequences of a health condition (WHO,
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Mr. Fix-it is a 59 year old man with a history of alcohol abuse and diabetic hypertension. Mr. Fix-it has been currently experiencing symptoms such as: rambling speech, poor short-term memory, weakness on the left side of his body, neglects both visual and auditory stimuli to his left side, difficulty with rapid visual scanning, difficulty with complex visual, perceptual and constructional tasks, unable to recall nonverbal materials, and mild articulatory problems. The diagnosis for Mr. Fix-it’s problem is most likely a right-hemisphere stroke. A right-hemisphere stroke is occurs when a blood clot blocks a vessel in the brain, or when there is a torn vessel bleeding into the brain. “A right-hemisphere stroke is common in adults who have diabetes and who are over the age of 55”, similar to Mr. Fix-it (Kluwer, 2012). In addition, Mr. Fix-it has a history of alcohol abuse in which it could have also increased his chances of experiencing a right-hemisphere stroke.
Lippincott, W. (2013). Management of Patients with Cerebrovascular Disorders. Brunner and suddarth's textbook of medical -surgical nursing 12th ed. + nursing diagnosis, (p. 1895). S.l.: Wolters Kluwer Health.
At the multidisciplinary meeting, the nurse will collect and assess the information provided by the other disciplines and family members stating that the patient is not at her prior level of functioning and then analyze the information to develop a diagnosis of deconditioning. Next, the nurse identifies outcomes for the patient to get stronger, achieve prior level of function, have activities of daily living (ADL’s) met in a safe environment by planning for home health, equipment, and 24/7 supervision through family or placement in a facility. This will be implemented by coordinating delivery of a walker and a 3 in 1 chair prior to discharge to daughter’s home with the home health agency nurse, physical therapist, and aide scheduled to start that day. In a week, the nurse evaluates that outcomes are being met by following up with patient, daughter, and home health agency evaluating that the patient is getting stronger, ADL’s are being met, and will soon be able to return to living independently. To achieve these standards of practice, every nurse should be aware of her own nurse practice act to ensure to be functioning with in the laws of the nurse’s state and to ensure the best outcomes and safety of the patients. In closing, it is every nurses duty to be the best nurse they are capable of being by looking at the scope of nursing practice which gives us the framework to achieve
Globally the leading reason for mortality and morbidity rate is stroke. Nearly twenty million individuals can suffer from stroke annually and around five million individuals won't survive . The developing countries account for a median of 85% of worldwide deaths from stroke . Stroke ends up in practical impairments with a median rate of two hundredth survivors who need institutional care once an amount of three months and 15%-30% are going to be disabled for good .
Nelson, A., Powell-Cope, G., Palacios, P., Luther, L. S., Black, T., Hillman, T., Christiansen, B., . . . . Nathenson, P., (2007). Web. Rehabilitation Nursing. Nurse Staffing and Patient Outcomes in Inpatient and Rehabilitation Settings. Rehabilitation Nursing, Vol. 32, 179-200.
Solis, P. (n.d.). Stroke as a core measure: American heart association: What’s coming down the
There are six set standards of the nursing practice; assessment, diagnosis, outcome identification, planning, implementation, and evaluation (ANA, 2010; pp. 9-10). Throughout a typical shift on the unit I work for, I have set tasks I am expected to complete in order to progress the patient’s care, and to keep the patient safe. I begin my shift by completing my initial assessment on my patient. During this time, I am getting to know my patient and assessing if there are any new issues that need my immediate intervention. From here, I am able to discuss appropriate goals for the day with my patient. This may come in the form of increasing mobility by walking around the unit, decreasing pain, or simply taking a bath. Next, I plan when and how these tasks will be able to be done, and coordinate care with the appropriate members of the team; such as, nursing assistants and physical therapists. Evaluating the patient after any intervention assists in discovering what works and what does not for the individual. “The nursing process in practice is not linear as often conceptualized, with a feedback loop from evaluation to assessment. Rather, it relies heavily on the bi-directional feedback loop...
The World Health Organisation (2013) explains that an Ischaemic stroke occurs as a result of a blood vessel becoming blocked by a clot, reducing the supply of oxygen to the brain and, therefore, damaging tissue. The rationale for selecting Mary for this discussion is; the author wishes to expand her evidenced based knowledge of stroke since it is the principal cause of disability and the third leading cause of mortality within the Scottish population (Scottish Intercollegiate Guidelines Network (SIGN), 2008) and, therefore, a national priority. In response to this priority, the Scottish Government (2009) produced their ‘Better Heart Disease and Stroke Care Action Plan’. Additionally, they have introduced a HEAT target to ensure 90% of stroke patients get transferred to a specialised stroke unit on the day of admission to hospital (Scottish Government, 2012).
The goal for nurses as a profession is not only to be “patient advocates” but also assist the patient to learn and gain the necessary skills to achieve the best level of functioning for the patient based on their current illness. In order to help a patient achieve their optimal level of functioning the nurse must work with the patient and the interdisciplinary team to create a collaborative plan that is logical for the patient. Through examining a musculoskeletal disorder case study #35 from Preusser (2008), one can create a critical pathway for the patient, S.P. a 75 year old female, with severe rheumatoid arthritis (RA) and admitted to the orthopedic ward for a hip fracture status post fall (p. 183). Since the patient’s needs is unique and complex the nurse must tailor a plan with the patient which will include “…assessments, consultations, treatments, lifestyle changes, disease education…” in order for the patient have the most appropriate evidence-based care and make informed decisions when it is necessary (Oliver, 2006, p. 28). The aim for the nurse caring for the S.P. is to help prepare the patient for an upcoming procedure and focus care to the patient by gathering necessary information about her while. Collaboration with the patient, family members, rehabilitation, medical and surgical team about the treatment plans can help us provide proper patient’s care by utilizing actions and interventions within the scope and standards of the nursing practice.
“Time is brain” is the repeated catch phrase when addressing the treatment and management of stroke (Saver, 2006). Access to prompt and appropriate medical care during the first few hours of stroke onset is critical to patient survival and outcomes. Recent changes in the guidelines for acute stroke care released by the American Heart Association (AHA) and the American Stroke Association (ASA) have improved patient access to treatment. Stroke treatment now follows the model of myocardial infarction treatment. Hospitals are categorized into four levels based on stroke treatment capability. The most specialized treatment is available in comprehensive stroke centers followed by primary stroke centers, acute stroke-ready hospitals, and community hospitals. The use of telemedicine now enables even community hospitals, with limited specialized capabilities, to care for stroke patients. Telemedicine puts emergency hospital personnel in contact with neurologists providing expertise in the evaluation of a stroke patient and determination of their eligibility for treatment with thrombolytic medication (Jefferey, 2013).
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...
Stroke has been classified as the most disabling chronic disease, with deleterious consequences for individuals, families, and society1. Stroke impacts on all domains in the ICF. The body dimension (body functions and structures), the individual dimension (activity), and the social dimension (participation). All domains influence each other2.
Stroke is a commonly known disease that is often fatal. This cellular disease occurs when blood flow to the brain is interrupted by either a blood clot halting the progress of blood cells in an artery, called an Ischemic stroke, or a blood vessel in the brain bursting or leaking causing internal bleeding in the brain, called a hemorrhagic stroke. When this happens, brain cells are deprived of oxygen and nutrients because the blood cells carrying these essential things are stopped, causing them to die. When the cells in the brain die, sensation or movement in a limb might be cut off and may limit an organism’s abilities. A person with stroke is affected depending on where in the brain the stroke occurs. In other words, symptoms of a stroke
Rehabilitation Nurses are a specialized group of healthcare providers within the sphere of the medical field that focus on rehabilitation, the process of helping people physically recover from, trauma, disability or illness (The Rehabilitation Staff Nurse, n.d.). The primary purpose of a Rehabilitation Nurse revolves around creating a therapeutic environment for a patient and assisting the impaired individual reach maximum function. Generally, their role involves developing a treatment plan that encourages physical activity and helping patients adapt to a new, altered lifestyle (The Rehabilitation Staff Nurse, n.d.). Since rehab treatment relies on trust, support and motivation, the nurse-patient relationship is pivotal to reach the highest