ABSTRACT
In June, the University of Central Lancashire opened its clinical trials unit, where staff will run complex intervention trials in a range of care areas, including stroke, musculoskeletal health, public health and mental health. One of the first trials looks at how hospital nursing policies in the first 24 hours after patients have had stroke affect their subsequent survival and disabilities. Known as HeadPoST, the study will recruit 20,000 patients globally, with the 6,000 UK research participants managed by Lancashire. This article explores the role of emergency nurses in supporting the research.
ABSTRACT
In acute stroke care, urgent specialist assessment and treatment are essential to reduce the risk of death and disability. However, many patients do not receive them due to a lack of specialist services. One solution is to use telemedicine. This can give all patients with acute stroke symptoms access to immediate expert assessment and advice, regardless of when and where they present to hospital. This article describes a telemedicine system developed and implemented in Lancashire and Cumbria. In its first year of operation, 319 patients received a telestroke video assessment with a consultant stroke physician; 131 of these patients were given thrombolysis. We discuss how the service was designed, staff training and development, and the implications for nursing practice. The development of a standardised telemedicine toolkit that may facilitate future telemedicine projects is also discussed.
Subject(s)
Emergency Medical Services/methods , Stroke/diagnosis , Stroke/nursing , Telemedicine/methods , Acute Disease , Female , Humans , Middle Aged , Stroke/drug therapy , Thrombolytic Therapy , United KingdomABSTRACT
BACKGROUND: Teamwork is regarded as the cornerstone of rehabilitation. It is recognized that the skills of a multiprofessional team are required to provide the care and interventions necessary to maximize the patient's potential to recover from his/her stroke. LITERATURE REVIEW: Critical evaluation of team working is lacking in the literature. Indeed, there is no consensus on a precise definition of teamwork or on the best way of implementing it, beyond a general exhortation to members to work to the same therapeutic plan in a cohesive manner. The literature has highlighted many problems in team working, including petty jealousies, ignorance and a perceived loss of autonomy and threat to professional status. AIM: To determine if the use of team co-ordinated approaches to stroke care and rehabilitation would improve staff attitudes to team working. METHOD: A pre-post design was adopted using 'The Team Climate Inventory' to explore attitudes to team working before and after introducing the interventions. Local Research Ethics Committee approval was obtained. RESULTS: Improvements in attitudes towards team working suggest that the introduction of team co-ordinated approaches (integrated care pathways and team notes) did not result in greater team working. LIMITATIONS: The introduction of an integrated care pathway and team notes is based on an assumption that they would enhance team working. CONCLUSIONS: The results suggest that the introduction of team co-ordinated approaches (team notes and care pathways) do not improve attitudes to team working, teams appear to take a long time to establish cohesion and develop shared values.
