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

Background 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 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 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 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. Visual Changes Communication Safety Thinking Processes Emotions Behavioural Changes

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

Responses ”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 Multidisciplinary colleagues in stroke RQIA User Rep NICHS Departmental Standards and Guidelines Unit

Next Steps 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