E14: Review

Those affected by stroke are offered a review of their health and social care status and secondary prevention needs from primary care services, typically within around six weeks and six months of leaving hospital. (Key: e = element | k = knowledge | s = skill)

Knowledge and understanding of…

e14k_1:
The assessment and management of problems: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical
e14k_2:
Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations
e14k_3:
The needs and aspirations of those affected by stroke, particularly those related to the problems listed above, and how these needs and aspirations can be met
e14k_4:
Support services, organisations and resources available (e.g. health, social, voluntary, independent sector; packages of care, finance and personal budgets, self-management, respite care, equipment, adaptations, rehabilitation, psychological, educational, employment, housing, transport)
e14k_5:
The impact of stroke on the individual, carer and family
e14k_6:
The implications of stroke for lifestyle, driving, work and family
e14k_7:
Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities)
e14k_8:
Pharmacological and non-pharmacological interventions for secondary prevention and how to help recovery after stroke
e14k_9:
Side effects of risk factor interventions and treatments to help with recovery after stroke
e14k_10:
Methods to help communication with those affected by stroke when conducting a review
e14k_11:
Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance

Skills and ability to...

e14s_1:
Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity
e14s_2:
Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support
e14s_3:
Monitor the individual’s progress and agree or change a maintenance or management plan
e14s_4:
Assess, discuss and review with those affected by stroke: goal-setting and outcomes
e14s_5:
Plan assessments and treatments; provide information, relevant to individual needs and aspirations (personalise information)
e14s_6:
Identify need and when to refer for more specialist or differing interventions/treatments where necessary
e14s_7:
Review process in your area and act on the review
e14s_8:
Assess and facilitate concordance