E9: Treatment (stroke)
People who have had a stroke have prompt access to an acute stroke unit and spend the majority of their time at hospital in a stroke unit with high-quality stroke specialist care.
Key: e = element | k = knowledge | s = skill
Knowledge and understanding of…
e9k_1:
the signs and symptoms of stroke
e9k_2:
how to manage strokes that occur as a complication of another primary pathology
e9k_3:
the physiological, neurological, and psychological effects of stroke, their timeframe during and after a stroke, and the need to monitor and act upon them
e9k_4:
assessment and management options for physiological, neurological, and psychological effects of stroke
e9k_5:
complications after stroke and how to prevent and manage them
e9k_6:
any complications of investigations, interventions, and treatments for stroke and how to prevent and manage them
e9k_7:
cognitive effects of stroke and their impact on the patient's ability to consent to treatment
e9k_8:
when to refer for other specialist care
e9k_9:
assessing swallowing and management of dysphagia
e9k_10:
alternative methods for hydration and feeding; the interactions between enteral fluids, feeds and drug treatments; and the symptoms and effects of dehydration and malnutrition
e9k_11:
alternative methods for drug administration and the effects of stopping ongoing drug treatment because of swallowing problems
e9k_12:
the importance and methods of oral hygiene
e9k_13:
the importance of avoiding catheters, as well as managing retention and promoting continence
e9k_14:
the need for early mobilisation and positioning
e9k_15:
the range of potential impacts of stroke on the patient, carer, and family
e9k_16:
the roles, level, and number of health and social service professionals who should contribute to the care and support of individuals with stroke and those affected by stroke
e9k_17:
when to explore palliative care options, the availability and appropriateness of these options, and how to sensitively engage in discussions with the patient, carer, and family
Skills and ability to...
e9s_1:
determine, plan, and initiate the appropriate screening, assessments and investigations, and interventions and treatments, and their level of urgency
e9s_2:
perform a physiological assessment and assess vital signs
e9s_3:
perform a standardised neurological assessment using a recognised stroke scale or tool
e9s_4:
obtain and interpret the results of investigations to: diagnose and distinguish between stroke and transient ischaemic attack; classify stroke and identify atypical strokes; and to identify and exclude stroke mimics
e9s_5:
formulate and implement an immediate and ongoing management plan accordingly and initiate treatments within the relevant timescales
e9s_6:
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
e9s_7:
identify the need for more specialist or differing treatments when necessary and refer to those services
e9s_8:
monitor progress, identify complications or deteriorations, and deliver additional treatments as required
e9s_9:
identify and use safe methods of moving, handling, and positioning depending on the individual patient or staff needs
e9s_10:
assess and manage physiological, neurological, and psychological effects of stroke in collaboration with the multidisciplinary team
e9s_11:
deliver relevant methods of nutrition, hydration, and medication in patients identified as requiring alternative administration
e9s_12:
assess and discuss realistic goals with those affected by stroke, plan discharge, and link to follow-up services for patients and carers
e9s_13:
recognise impending death, begin sensitive discussions with the patient, carer, and family, and initiate palliative care where necessary
