Acute Stroke Nursing

Stroke is a medical emergency that requires immediate medical attention. With active and efficient nursing management in the initial hours after stroke onset and throughout subsequent care, effective recovery and rehabilitation is increased. Acute Stroke Nursing provides an evidence-based, practical text facilitating the provision of optimal stroke care during the primary prevention, acute and continuing care phases. This timely and comprehensive text is structured to follow the acute stroke pathway experienced by patients. It explores the causes, symptoms and effects of stroke, and provides guidance on issues such as nutrition, continence, positioning, mobility and carer support. The text also considers rehabilitation, discharge planning, palliative care and the role of the nurse within the multi-professional team. Acute Stroke Nursing is the definitive reference on acute stroke for all nurses and healthcare professionals wishing to extend their knowledge of stroke nursing. Evidence-based and practical in style, with case studies and practice examples throughout Edited and authored by recognised stroke nursing experts, clinicians and leaders in the field of nursing practice, research and education The first text to explore stroke management from UK and international perspectives, and with a nursing focus

Table of Contents:
Foreword vii Editors and Contributors xiii 1 Setting the scene 1 Caroline Watkins and Michael Leathley Introduction 1 Stroke epidemiology 2 Stroke policy 3 Stroke management strategies 8 Research and education 11 Conclusion 13 References 13 2 Developing stroke services: a key role for nursing and nurses 17 Christopher R. Burton Introduction 17 Service development 17 The nursing contribution to stroke services 19 The political agenda shaping stroke service development 25 Conclusion 30 References 30 3 What is a stroke? 33 Anne W. Alexandrov Introduction 33 Stroke development processes 34 Risk factors for stroke 37 Anatomy, physiology and related stroke clinical fi ndings 37 Standardised instruments for acute neurological assessment 57 Conclusion 60 References 64 4 Acute stroke nursing management 66 Anne W. Alexandrov Introduction 67 Priorities in acute stroke management 67 Hyperacute stroke management 68 Acute stroke management 80 Conclusion 85 References 85 5 Nutritional aspects of stroke care 91 Lin Perry and Elizabeth Boaden Introduction 92 Do stroke patients experience nutritional problems pre-stroke? 92 How does stroke affect dietary intake? 95 How can stroke patients be helped to maintain adequate dietary intake? 104 Conclusion 115 References 117 6 Promoting continence 123 Kathryn Getliffe and Wendy Brooks Introduction 124 Bladder problems and urinary incontinence 127 Bowel problems and bowel care 144 Conclusion 148 References 149 7 Management of physical impairments post-stroke 152 Cherry Kilbride and Rosie Kneafsey Introduction 153 Movement 153 Moving and handling people with stroke 155 Therapeutic positioning and seating in the acute phase 157 Promoting early mobilisation 159 Falls prevention 163 Restoration and re-education of movement 164 Management of the upper limb 168 Further rehabilitation strategies and novel developments 171 Patients’ perspective on mobility rehabilitation 174 Conclusion 175 References 176 8 Communication 184 Jane Marshall, Katerina Hilari and Madeline Cruice Introduction 185 Communication impairments caused by stroke 186 Language minorities 196 The role of the speech and language therapist in acute stroke care 197 Psychosocial issues and quality of life 199 Conclusion 201 References 201 9 Mood and behavioural changes 205 Peter Knapp Introduction 205 Psychological reactions to the onset of stroke 206 Conclusion 218 References 219 10 Minimally responsive stroke patients 222 Elaine Pierce and Aeron Ginnelly Introduction 222 Definitions and identification 223 Minimally responsive state 224 ‘Locked-in’ syndrome 232 Conclusion 237 References 238 11 Rehabilitation and recovery processes 241 Jane Williams and Julie Pryor Introduction 241 Initiation of rehabilitation 244 Outcomes of rehabilitation 246 Recovery processes 249 Transfer to rehabilitation 250 Rehabilitation provision 252 Conclusion 256 References 256 12 Stroke and palliative care: a diffi cult combination? 263 Christopher R. Burton and Sheila Payne Introduction 264 Palliative care 264 Relevance of palliative care to stroke 266 Organisational challenges 271 Conclusion 271 References 272 13 Reducing the risk of stroke 275 Peter Humphrey, Jo Gibson and Stephanie Jones Introduction 275 Primary prevention 276 Secondary prevention: identifying those at risk of stroke 279 Public awareness and access to services 296 Secondary prevention of stroke in less common aetiologies and patient groups 297 Conclusion 299 References 299 14 Longer-term support for survivors and supporters 309 Louise Brereton and Jill Manthorpe Introduction 309 Leaving hospital 310 What is required longer term? 313 What do carers want? 316 Conclusion 322 References 323 15 Stroke resources for professionals, patients and carers 331 Graham Williamson National associations 331 Resources for patients and carers 332 Other resources and organisations 333 Specialist international journals 336 Non-specialist journals’ stroke collections 336 Clinical practice guidelines 337 Finding current stroke research 338 Evidence-based practice resources 338 Chapter links 339 Index 343

About the Author :
Jane Williams is Consultant Nurse in Stroke Care, based in Portsmouth Hospitals NHS Trust, UK. She has been involved in many national working parties, including the National Stroke Strategy, UK Forum for Stroke Training, and UK Stroke Forum. Jane is member of The Stroke Association research awards committee. A founder member of the National Stroke Nursing Forum, Jane undertook a term of office as chair. Lin Perry is Professor of Nursing Research and Practice Development, University of Technology, Sydney and the Northern Hospitals Network, South Eastern Sydney and Illawarra Area Health Service. A member of the Intercollegiate Stroke Working Party in the UK, the National Stroke Foundation Guidelines Working Party and Stroke Services New South Wales in Australia, she has extensive experience with national guideline development, benchmarking, service review and evaluation. Caroline Watkins is Professor of Stroke and Older People's Care at the University of Central Lancashire, UK. As a member of the Vascular Team at the Department of Health, she is working to implement the National Stroke Strategy, and leads the development of the new UK Forum for Stroke Training. Caroline is the president of the Society for Research in Rehabilitation and on the Steering Group of the National Stroke Nursing Forum.

Review :
"Although aimed at acute stroke services, this book provides a good basis for members of the multidisciplinary team, especially all medical and neuroscience nurses . . . This book will be applicable to healthcare professionals for many years." (Primary Health Care, 1 July 2011) "This will certainly be the first place I turn for future stroke-related technique." (Nursing Older People, 1 November 2010)