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…

the assessment and management of the physiological, neurological, and psychological effects of stroke at review
ways to assess and meet the needs and aspirations of those affected by stroke during review
the full range of local and national resources and services available to address the physiological, neurological, and psychological needs of those affected by stroke, including: health, social, voluntary, and independent; how to facilitate access and length of referral time
the range of potential impacts of stroke on the patient, carer, and family, the need to assess these, and assessment methods
the implications of stroke for lifestyle; driving; occupation, including voluntary work or education; and social participation
risk factors for further vascular events
pharmacological and non-pharmacological interventions for secondary prevention and to promote recovery after stroke, and their potential adverse effects
the range of methods, resources, and approaches available to facilitate communication with those affected by stroke when conducting a review
medication adherence: how to assess it; how it is affected by individual preference; how to motivate; and how to facilitate improved engagement

Skills and ability to...

take and interpret a thorough medical history, including information from carers, family and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate
recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support
monitor progress and agree or change a maintenance or management plan in conjunction with those affected by stroke, identifying resources to facilitate participation and inclusion
assess, discuss, and review goal-setting and outcomes with those affected by stroke
assess medication adherence and facilitate improved engagement
plan appropriate assessments and treatments based on outcome of review
identify need and when to refer for more specialist or differing interventions and treatments where necessary
evaluate the review process in your service and act on the results