Nurse
As a Nurse you play a crucial role in assessing, monitoring and making day-to-day decisions about stroke survivor care and how these are communicated to patients, their family members/carers and other professionals. To provide the best possible care for stroke survivors your job role and band has been analysed and broken down into 16 key elements. These 16 elements have then been further analysed and broken down into two categories: knowledge and skills. A score from 1 to 5 has been allocated to each knowledge and skills element with 1 = a minimum level of knowledge and skill (light shade of pink) up to 5 = a critical level of knowledge and skill (dark shade of pink). Some elements may not be applicable (n/a) to your job role profile and will be marked as zero (0). Take a look at the table below to see what level of stroke care knowledge and skills are expected of someone in your job role and level of responsibility.
Band 5 (new)
Profile AverageKnowledgeSkillsE1E2E3E4E5E6E7E8E9E10E11E12E13E14E15E16
Elements covered | Knowledge | Skills |
---|---|---|
E1: Awareness raising | 1.8 | 1.7 |
E2: Managing risk | 1.9 | 2.0 |
E3: Information | 2.0 | 2.0 |
E4: User involvement | 1.3 | 1.6 |
E5: Assessment (TIA) | 1.9 | 1.6 |
E6: Treatment (TIA) | 1.8 | 1.9 |
E7: Urgent response | 2.0 | 2.0 |
E8: Assessment (stroke) | 2.0 | 1.6 |
E9: Treatment (stroke) | 2.0 | 1.8 |
E10: Specialist rehabilitation | 2.0 | 1.8 |
E11: End-of-life care | 2.0 | 1.8 |
E12: Seamless transfer of care | 2.0 | 1.7 |
E13: Long-term care | 2.0 | 2.0 |
E14: Review | 1.9 | 2.0 |
E15: Participation in community | 2.0 | 1.8 |
E16: Return to work | 1.1 | 1.0 |
E1 | Awareness raising | Level |
---|---|---|
Knowledge and understanding of… | ||
e1k_1 | Signs and symptoms of stroke | 2 |
e1k_2 | Features of less common (atypical) presentation of stroke | 2 |
e1k_3 | Stroke mimics and likely presentation | 2 |
e1k_4 | Stroke and TIA as medical emergencies | 2 |
e1k_5 | Emergency response, investigations, interventions and treatments for stroke and TIA | 2 |
e1k_6 | Timeframe for emergency investigations, interventions and treatments for stroke and TIA | 2 |
e1k_7 | Anatomy and physiology of the central nervous system | 2 |
e1k_8 | Timeframe of physiological and neurological changes during a stroke | 2 |
e1k_9 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
Skills and ability to… | ||
e1s_1 | Initiate emergency protocol (Stroke Improvement Programme) | 2 |
e1s_2 | Communicate current event and need for emergency treatment | 2 |
e1s_3 | Know when to apply screening tests for stroke (FAST) and how to act on the results | 2 |
e1s_4 | Know when to apply vascular risk assessment tools for TIA (ABCD2) and how to act on the results | 2 |
e1s_5 | Identify emergency interventions and treatments for stroke and TIA available locally and know how to refer patients efficiently | 2 |
e1s_6 | Take and interpret thorough history, taking third party information where possible, and assess mental capacity | 2 |
e1s_7 | Identify and appropriately treat stroke mimics, e.g. hypoglycaemia, epileptic seizure | 2 |
E2 | Managing risk | Level |
---|---|---|
Knowledge and understanding of… | ||
e2k_1 | Risk factors for stroke and TIA (e.g. lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) | 2 |
e2k_2 | Stroke types and their aetiologies | 2 |
e2k_3 | Risk of stroke depending on type and aetiology | 1 |
e2k_4 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e2k_5 | Who provides interventions for primary and secondary prevention of stroke | 2 |
e2k_6 | Pharmacological and non-pharmacological interventions for primary and secondary prevention of stroke, and side effects of treatment | 2 |
e2k_7 | Methods of changing behaviour | 2 |
Skills and ability to… | ||
e2s_1 | Take and interpret thorough history, taking third party information where possible, and assess mental capacity | 2 |
e2s_2 | Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e2s_3 | Elicit needs and aspirations of those at risk of stroke and those affected by stroke | 2 |
e2s_4 | Identify risk factors and apply vascular risk assessment tools | 2 |
e2s_5 | 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 | 2 |
e2s_6 | Assess services (health, social, voluntary and independent) available locally for those affected by stroke: identify the full range available; establish relevance; communicate and liaise with services; signpost service | 2 |
e2s_7 | Assess motivation and take steps to augment management | 2 |
e2s_8 | Monitor progress and agree or change a maintenance or management plan | 2 |
e2s_9 | Assess and facilitate concordance | 2 |
E3 | Information | Level |
---|---|---|
Knowledge and understanding of… | ||
e3k_1 | Stroke types and their aetiologies | 2 |
e3k_2 | Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) | 2 |
e3k_3 | Pharmacological and non-pharmacological interventions for primary and secondary prevention of stroke, and side effects of treatment | 2 |
e3k_4 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e3k_5 | Who provides interventions for primary and secondary prevention of stroke | 2 |
e3k_6 | Full range of services (health, social, community, voluntary and independent) available locally for those affected by stroke | 2 |
e3k_7 | How to assess and overcome barriers to problems: psychological and emotional; social and relationship; cognitive and communication; physical and functional; visual and sensory impairments and pain; medical | 2 |
e3k_8 | The impact of stroke on the individual, carer and family | 2 |
e3k_9 | The implications of stroke for lifestyle, driving, work and family | 2 |
e3k_10 | Methods of changing behaviour | 2 |
Skills and ability to… | ||
e3s_1 | Take and interpret thorough history, taking third party information where possible, and assess mental capacity | 2 |
e3s_2 | Elicit needs and aspirations of those affected by stroke | 2 |
e3s_3 | 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 | 2 |
e3s_4 | Identify full range of services (health, social, community, voluntary and independent) available locally for those affected by stroke | 2 |
e3s_5 | Assess relevance and suitability of available services for those affected by stroke; communicate and liaise with services; share information; work across agencies; signpost services for those affected by stroke | 2 |
e3s_6 | Implement information sharing methods and reflect on effectiveness of information sharing | 2 |
e3s_7 | Assess motivation and take steps to augment management | 2 |
e3s_8 | 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 | 2 |
E4 | User involvement | Level |
---|---|---|
Knowledge and understanding of… | ||
e4k_1 | The services relevant for stroke patients and carers | 2 |
e4k_2 | How to assess and overcome barriers to problems: psychological and emotional; social and relationship; cognitive and communication; physical and functional; visual and sensory impairments and pain; medical | 2 |
e4k_3 | Methods to empower patients; patient advocacy | 2 |
e4k_4 | Methods that can be used to involve stroke patients and carers in service planning | 1 |
e4k_5 | Methods that can be used to capture stroke patient and carer views | 1 |
e4k_6 | Methods for using views to influence services | 1 |
e4k_7 | Factors that influence people’s ability to be involved in care and service planning | 1 |
e4k_8 | Methods of feeding back to stroke patients and carers how their contributions have influenced services | 1 |
e4k_9 | How service planning and decision making processes work and how they can be influenced | 1 |
Skills and ability to… | ||
e4s_1 | Assess services (health, social, voluntary and independent) available locally for those affected by stroke: identify the full range available; establish relevance; communicate and liaise with services; signpost service | 2 |
e4s_2 | Create an open and honest environment that is not intimidating and offers stroke patients and their carers the opportunity to freely give their views | 2 |
e4s_3 | Interact with people who have one or more of the following problems: communication; physical/functional; psychological; social; medical | 2 |
e4s_4 | Translate the views of those affected by stroke into service planning, development, delivery and monitoring | 2 |
e4s_5 | Identify hard-to-reach groups and ensure that their views are included | 1 |
e4s_6 | Overcome the factors that prevent those affected by stroke from being involved in care and service planning | 1 |
e4s_7 | Identify local opportunities and appropriate formats for formal and informal feedback (e.g. PALS, PPI) | 1 |
e4s_8 | Handle complaints to the satisfaction of all parties | 2 |
E5 | Assessment (TIA) | Level |
---|---|---|
Knowledge and understanding of… | ||
e5k_1 | Anatomy and physiology of the central nervous system | 2 |
e5k_2 | Risk factors for stroke and TIA (e.g. lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) | 2 |
e5k_3 | The signs and symptoms of TIA | 2 |
e5k_4 | How to distinguish between stroke and TIA | 2 |
e5k_5 | The future risk of stroke and TIA (e.g. ABCD2 and other risk scoring methods) | 2 |
e5k_6 | The features of atypical presentation of TIA/stroke and mimics and how to act when they are identified | 2 |
e5k_7 | Investigations, interventions and treatments for TIA (e.g. imaging, vascular, medical, cardiac, surgical) | 2 |
e5k_8 | Implications of the Mental Capacity Act and how it applies to TIA | 2 |
e5k_9 | Advocates for stroke and TIA patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e5k_10 | The timeframe for emergency and follow-on investigations, interventions and treatments for TIA | 2 |
e5k_11 | How to initiate emergency and ongoing treatment for TIA and vascular prevention | 2 |
e5k_12 | The indications, contraindications and limitations for imaging, investigations and interventions | 2 |
e5k_13 | Local protocols for imaging and reporting | 2 |
e5k_14 | Any complications of surgical procedures (e.g. stenting, carotid endarterectomy, closure of atrial septal defect (ASD) and patent foramen ovale (PFO)) | 1 |
e5k_15 | The results of investigations | 2 |
e5k_16 | The implications of TIA for lifestyle, driving, work and family | 2 |
e5k_17 | Management options for TIA/stroke and mimics, and other conditions | 2 |
Skills and ability to… | ||
e5s_1 | Take and interpret thorough history, record third party information where possible, and assess mental capacity | 2 |
e5s_2 | Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e5s_3 | Identify risk factors and apply vascular risk assessment tools for TIA (ABCD2) and screening tests for stroke (FAST) | 2 |
e5s_4 | Identify stroke, high risk TIA, lower risk TIA, atypical stroke and stroke mimics | 2 |
e5s_5 | Establish the cause of TIA | 2 |
e5s_6 | Recognise patients who have had a stroke rather than a TIA and to refer on for appropriate investigation and management | 2 |
e5s_7 | 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 | 2 |
e5s_8 | Identify emergency interventions and treatments for TIA available locally and know how to refer patients efficiently | 2 |
e5s_9 | Identify the service(s) to which the individual should be referred and to liaise effectively with those services | 2 |
e5s_10 | Perform a physiological assessment and assess vital signs | 2 |
e5s_11 | Decide on a relevant investigation and its level of urgency | 1 |
e5s_12 | Apply radiological knowledge for recognised investigations | n/a |
e5s_13 | Apply technical knowledge for recognised investigations and interventions | 1 |
e5s_14 | Apply surgical knowledge for recognised vascular interventions | 1 |
e5s_15 | Recognise and manage postoperative complications after stenting, endarterectomy, PFO and ASD closure | 1 |
e5s_16 | Obtain and interpret the results of investigations: this includes formulating an immediate and ongoing management plan, and initiating treatments within the relevant timelines | 1 |
e5s_17 | Confirm and communicate diagnosis, lifestyle advice and methods of secondary prevention to patients and carers | 1 |
e5s_18 | Communicate and discuss with the patient, carer, and health and social care professionals a diagnosis, results of investigations and subsequent needs and aspirations and a management plan, as well as the actions to be taken if a further vascular event occurs | 1 |
e5s_19 | Advise on lifestyle, driving, work and family | 2 |
e5s_20 | Identify local management and referral routes for TIA/stroke and mimics, and other conditions | 2 |
E6 | Treatment (TIA) | Level |
---|---|---|
Knowledge and understanding of… | ||
e6k_1 | The signs and symptoms of TIA | 2 |
e6k_2 | Atypical presentation of TIA and TIA mimics and how to act when they are identified | 2 |
e6k_3 | How to distinguish between stroke and TIA | 2 |
e6k_4 | Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) | 2 |
e6k_5 | Pharmacological and non-pharmacological interventions, and the level of urgency for risk factor management | 2 |
e6k_6 | Side effects of pharmacological and non-pharmacological interventions as well as the prevention and management of vascular events | 2 |
e6k_7 | Late complications of surgical procedures (e.g. stenting, carotid endarterectomy, closure of ASD and PFO) and the implications of the procedures on lifestyle | 1 |
e6k_8 | Implications of TIA for lifestyle, driving, work and family | 2 |
e6k_9 | Potential interventions for immediate and ongoing risk factor management | 2 |
e6k_10 | Methods of changing behaviour | 2 |
e6k_11 | How QOF and community targets for risk factor management affect prevention strategies | 1 |
e6k_12 | Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance | 1 |
e6k_13 | Likely persistent deficits or other ongoing problems | 2 |
e6k_14 | Why TIA/stroke review is important | 2 |
Skills and ability to… | ||
e6s_1 | Recognise recurrent vascular events | 2 |
e6s_2 | Perform a holistic overview, including assessment of pharmacological and non-pharmacological interventions | 2 |
e6s_3 | Perform and interpret blood pressure measurement and ECG | 2 |
e6s_4 | Assess and facilitate concordance | 2 |
e6s_5 | Assess motivation and take steps to augment management | 2 |
e6s_6 | Monitor progress and agree on or change to a maintenance or management plan | 2 |
e6s_7 | Use results of history and investigations to confirm a diagnosis and make an individual management plan for the patient, taking into account personal preferences | 2 |
e6s_8 | Identify interventions and treatments for stroke and TIA available locally and know how to refer patients efficiently | 2 |
e6s_9 | Communicate and discuss with the patient, carer, and health and social care professionals a diagnosis, results of investigations and subsequent needs and aspirations and a management plan, as well as the actions to be taken if a further vascular event occurs | 1 |
e6s_10 | Identify who provides interventions for immediate and ongoing risk factor management locally and refer | 2 |
e6s_11 | Identify where QOF and community targets for risk factor management may affect prevention strategies and take steps to overcome this | 1 |
e6s_12 | Recognise individuals with persistent deficits or other ongoing problems and arrange rehabilitation, support and management | 2 |
e6s_13 | Encourage people to come for review | 2 |
E7 | Urgent response | Level |
---|---|---|
Knowledge and understanding of… | ||
e7k_1 | Signs and symptoms of stroke | 2 |
e7k_2 | Features of less common (atypical) presentation of stroke | 2 |
e7k_3 | Stroke mimics and likely presentation | 2 |
e7k_4 | Stroke and TIA as medical emergencies | 2 |
e7k_5 | Emergency response, investigations, interventions and treatments for stroke and TIA | 2 |
e7k_6 | The timeframe for emergency investigations, interventions and treatments for stroke and TIA | 2 |
e7k_7 | The anatomy and physiology of the central nervous system | 2 |
e7k_8 | The physiological and neurological effects of stroke and their timeframe during and after a stroke | 2 |
e7k_9 | Monitoring and acting upon physiological and neurological changes during and after a stroke | 2 |
e7k_10 | How stroke can affect communication | 2 |
e7k_11 | Implications of the Mental Capacity Act and how it applies to TIA | 2 |
e7k_12 | Advocates for stroke and TIA patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e7k_13 | Complications after stroke (e.g. aspiration, airway obstruction, hypoxia, hypotension, hypertension, hyperglycaemia, bedsores), and preventing and managing them | 2 |
Skills and ability to… | ||
e7s_1 | Take and interpret thorough history, record third party information where possible, and assess mental capacity | 2 |
e7s_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 | 2 |
e7s_3 | Identify suspected stroke, perform screening tests (e.g. FAST) and act on results | 2 |
e7s_4 | Perform basic neurological and physiological assessment (vital signs) | 2 |
e7s_5 | Perform ABCDs (airways, breathing, circulation, disability), pulse oximetry and blood glucose assessment and to act on abnormal findings | 2 |
e7s_6 | Identify and use methods of moving and handling the patient that are safe, depending on the individual patient or staff needs | 2 |
e7s_7 | Recognise stroke-related communication problems and to adapt methods of communication | 2 |
e7s_8 | Identify emergency investigations, and interventions for stroke and TIA patients available locally (Stroke Networks) and know where to take them | 2 |
e7s_9 | Identify and appropriately treat stroke mimics, e.g. hypoglycaemia, epileptic seizure | 2 |
E8 | Assessment (stroke) | Level |
---|---|---|
Knowledge and understanding of… | ||
e8k_1 | The signs and symptoms of stroke | 2 |
e8k_2 | The neurological and physiological effects of stroke and the timeframe of changes during and after a stroke | 2 |
e8k_3 | How to monitor, and act upon, neurological and physiological changes during and after a stroke | 2 |
e8k_4 | Implications of the Mental Capacity Act and how it applies to stroke and TIA | 2 |
e8k_5 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e8k_6 | Features of atypical presentation of stroke and stroke mimics | 2 |
e8k_7 | Stroke types and their aetiologies | 2 |
e8k_8 | Different modalities to facilitate diagnosis and treatment of stroke (e.g. telemedicine) | 2 |
e8k_9 | Emergency investigations (e.g. imaging of brain, heart and cerebral arteries, blood tests) and interventions for stroke (e.g. intravenous and intra-arterial thrombolysis, vascular surgery, stenting, hemicraniotomy, evacuation of haematoma) and the timeframe within which they should be given | 2 |
e8k_10 | The indications and contraindications for investigations, interventions and treatments for stroke | 2 |
e8k_11 | Any complications of investigations, interventions and treatments for stroke and how to prevent and manage them | 2 |
Skills and ability to… | ||
e8s_1 | Take and interpret thorough history, record third party information where possible, and assess mental capacity | 2 |
e8s_2 | Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e8s_3 | Perform neurological and physiological assessment and assess vital signs | 2 |
e8s_4 | Perform a standardised neurological assessment using a recognised stroke scale (e.g. NIHSS, SNSS) | 2 |
e8s_5 | Interpret the results of investigations (e.g. imaging, vascular, blood tests) and the actions to be taken as a result | 1 |
e8s_6 | Diagnose stroke using clinical information and investigations: distinguish between a stroke and a TIA; identify atypical strokes and stroke mimics; formulate and implement a management plan accordingly | 1 |
e8s_7 | 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 | 2 |
e8s_8 | Identify the need for more specialist or differing treatments when necessary | 2 |
e8s_9 | Monitor progress, identify complications or deteriorations and deliver treatments for complications or deteriorations | 2 |
e8s_10 | Identify the level of urgency for any relevant medical, surgical and radiological investigations, interventions and treatments | 1 |
e8s_11 | Obtain and interpret the results of investigations and formulate an immediate and ongoing management plan; initiate treatments within the relevant timescales | 1 |
E9 | Treatment (stroke) | Level |
---|---|---|
Knowledge and understanding of… | ||
e9k_1 | Signs and symptoms of stroke | 2 |
e9k_2 | Neurological and physiological effects of stroke, monitoring, and the timeframe of changes, during and after a stroke | 2 |
e9k_3 | The need for early mobilisation and positioning | 2 |
e9k_4 | Assessing swallowing and managing of dysphagia | 2 |
e9k_5 | Alternative methods of feeding, hydration and drug administration for patients with dysphagia | 2 |
e9k_6 | The interactions between enteral feeds, fluids and drug treatment | 2 |
e9k_7 | The effects of stopping ongoing drug treatment because of swallowing problems | 2 |
e9k_8 | Symptoms and effects of malnourishment | 2 |
e9k_9 | The importance and methods of oral hygiene | 2 |
e9k_10 | The importance of avoiding catheters, as well as managing retention and promoting continence | 2 |
e9k_11 | Assessing and managing problems: psychological and emotional; social and relationship; cognitive and communication; physical and functional; sensory impairment and pain; medical | 2 |
e9k_12 | Cognitive effects of the stroke and their impact on the patient’s ability to consent to treatment | 2 |
e9k_13 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e9k_14 | The impact of the stroke on family, friends and carers | 2 |
e9k_15 | Assessment and management options for neurological, physiological, functional and psychological problems after stroke | 2 |
e9k_16 | Complications after stroke and how to prevent and manage them | 2 |
e9k_17 | When to refer for other specialist care (e.g. intensive care unit, hemicraniotomy, haematoma evacuation, interventional radiology, vascular surgery) | 2 |
e9k_18 | Any complications of investigations, interventions and treatments for stroke and how to prevent and manage them | 2 |
e9k_19 | 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 | 2 |
e9k_20 | How to manage strokes that occur as a complication of another primary pathology | 2 |
Skills and ability to… | ||
e9s_1 | Take and interpret thorough history, record third party information where possible, and assess mental capacity | 2 |
e9s_2 | Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e9s_3 | Perform neurological and physiological assessment and assess vital signs | 2 |
e9s_4 | Perform a standardised neurological assessment using a recognised stroke scale (e.g. NIHSS, SNSS) | 2 |
e9s_5 | Identify the need and level of urgency for the relevant medical, surgical and radiological investigations, interventions and treatments; obtain and interpret the results of investigations: formulate an immediate and ongoing management plan; initiate treatments within the relevant timescales | 1 |
e9s_6 | Diagnose stroke using clinical information and investigations: distinguish between a stroke and a TIA; identify atypical strokes and stroke mimics; formulate and implement a management plan accordingly | 1 |
e9s_7 | 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 | 2 |
e9s_8 | Identify the need for more specialist or differing treatments when necessary and be able to refer to those services | 2 |
e9s_9 | Monitor progress, identify neurological and non-neurological complications or deterioration and to deliver treatments | 2 |
e9s_10 | Obtain and interpret the results of investigations and formulate a management plan accordingly | 1 |
e9s_11 | Identify and use therapeutic methods of moving and handling the patient that are safe, depending on the individual patient or staff needs and aspirations | 2 |
e9s_12 | Assess and manage: oral problems including dysphagia, nutrition and hydration; cognition; psychological and emotional problems; continence; pressure areas; mobility problems etc in collaboration with members of the multidisciplinary team | 2 |
e9s_13 | Deliver relevant methods of nutrition, hydration and medication in patients with dysphagia | 2 |
e9s_14 | Assess and discuss realistic goals with those affected by stroke, plan discharge and link to follow-up services for patients and carers | 2 |
e9s_15 | Recognise impending death and initiate palliative care where necessary | 2 |
E10 | Specialist rehabilitation | Level |
---|---|---|
Knowledge and understanding of… | ||
e10k_1 | The impact of stroke on the individual, carer and family | 2 |
e10k_2 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e10k_3 | The implications of stroke for lifestyle, driving, work, family and acceptance in the community | 2 |
e10k_4 | MDT assessment: the principles of stroke rehabilitation and rehabilitation referral; therapy techniques and their application | 2 |
E10k_5 | A range of neurological treatment approaches and their applications | 2 |
e10k_6 | Psychological and emotional problems after stroke (e.g. depression, emotionalism, anxiety, self esteem, confidence, well-being, challenging behaviour) | 2 |
e10k_7 | Social and relationship problems after stroke (e.g. sex, lifestyle, work, housing, driving, transport, leisure, financial/ income, work/employment, children, family, support network, carers, respite, pets) | 2 |
e10K_8 | Cognitive and communication problems after stroke (e.g. spatial awareness (neglect/inattention); visual field deficits; hemianopia; memory; attention; praxis; executive function; aphasia, dysarthria, articulatory dyspraxia) | 2 |
e10k_9 | Physiological, physical and functional problems after stroke (e.g. rest and sleep; respiratory, mobility; balance; senses; incontinence; bladder and bowel management; swallowing; feeding, nutrition and hydration; skin integrity; sexual; motor control; ADL) | 2 |
e10k_10 | Neurological, visual and sensory impairments and pain problems (e.g. shoulder pain, central post-stroke pain, spasticity, seizures) | 2 |
e10k_11 | Medical problems (e.g. medication, comorbidities, complications) | 2 |
e10k_12 | The process of transfer to the community (e.g. discharge planning, long-term management, further rehabilitation, social function) | 2 |
e10k_13 | The causes of, and how to assess, manage and treat, problems after stroke: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical | 2 |
e10k_14 | The impact of problems after stroke on day-to-day and outdoor functioning: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical | 2 |
e10k_15 | Methods that will support those affected by stroke with their recovery and help them to cope with problems after stroke: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical | 2 |
e10k_16 | Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) | 2 |
e10k_17 | Pharmacological and non-pharmacological interventions for secondary prevention that will also help recovery after stroke, and their side effects | 2 |
e10k_18 | Any 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) | 2 |
e10k_19 | Methods to facilitate communication with those affected by stroke | 2 |
e10k_20 | Therapeutic moving and handling | 2 |
e10k_21 | Methods of changing behaviour | 2 |
e10k_22 | The use of assessments and measures | 2 |
e10k_23 | The principles of goal setting | 2 |
e10k_24 | Assistive technology and other therapy interventions (e.g. functional electrical stimulation, orthotics) | 2 |
e10k_25 | Equipment and adaptations | 2 |
e10k_26 | Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance | 2 |
Skills and ability to… | ||
e10s_1 | Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity | 2 |
e10s_2 | Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e10s_3 | Provide a range of neurological intervention processes and to be able to clinically reason the selection and administration of an approach | 1 |
e10s_4 | 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 | 2 |
e10s_5 | Assess, discuss and review with those affected by stroke, including client-centred goal-setting and outcomes | 2 |
e10s_6 | Identify rehabilitation and support services in hospital and after discharge: inform the individual about services and how to access them; check availability and agree referral | 2 |
e10s_7 | Identify need and when to refer for more specialist or differing treatments where necessary: also agree referral (e.g. assistive technology, major adaptations to the home, disability employment adviser) | 1 |
e10s_8 | Provide advice and support on driving and refer to specialist centres as required | 1 |
e10s_9 | Identify local services and resources (e.g. health, social, voluntary, independent sector; equipment and adaptations, rehabilitation, psychological, educational, employment, housing, transport) to overcome barriers, facilitate participation and inclusion: also identify waiting times and implications for those affected by stroke | 1 |
e10s_10 | Monitor progress and agree or change a maintenance or management plan | 2 |
e10s_11 | Identify resources to help with participation and inclusion | 1 |
e10s_12 | Assess motivation and take steps to augment management | 2 |
e10s_13 | Assess and help with concordance | 2 |
e10s_14 | Identify and use therapeutic methods of moving and handling the patient that are safe, depending on the individual patient or staff needs and aspirations, and that will help with the optimum return of functional abilities | 2 |
e10s_15 | Assist, encourage and facilitate post-stroke physical, social and cultural reintegration | 2 |
e10s_16 | Recognise the signs, symptoms and impact of psychological and emotional problems after stroke (e.g. depression, emotionalism, anxiety, self esteem, confidence, well-being, challenging behaviour) and to help patients and their families to cope and manage; build self-esteem and confidence, encourage recovery and maximise potential | 2 |
e10s_17 | Recognise the signs, symptoms and impact of social and relationship problems after stroke (e.g. lifestyle, work, housing, driving, transport, leisure, financial/income, work/employment, children, family, support network, carers, relating, respite, pets) and to help patients and their families to cope and manage; encourage recovery and maximise potential | 2 |
e10s_18 | Recognise the signs, symptoms and impact of cognitive and communication problems after stroke (e.g. spatial awareness (neglect/inattention); visual field deficits; memory; attention; praxis; executive function; aphasia, dysarthria, articulatory dyspraxia) and to help patients and their families to cope and manage; encourage recovery and maximise potential | 2 |
e10s_19 | Recognise the signs, symptoms and impact of physiological, physical and functional problems after stroke (e.g. rest and sleep; respiratory, mobility; balance; senses; incontinence: bladder and bowel management; swallowing; feeding, nutrition and hydration; skin integrity; sexual; motor control; ADL) and to help patients and their families to cope and manage; encourage recovery and maximise potential | 2 |
e10s_20 | Recognise the signs, symptoms and impact of neurological, visual and sensory impairments and pain problems (e.g. shoulder pain; central post-stroke pain; spasticity, seizures) and to help patients and their families to cope and manage; encourage recovery and maximise potential | 2 |
e10s_21 | Recognise the signs, symptoms and impact of medical problems (e.g. medication, comorbidities, complications) and to help patients and their families to cope and manage; encourage recovery and maximise potential | 2 |
e10s_22 | Use a range of communication resources and approaches to ensure that patients and their carers are fully involved in the decision making process and their care | 2 |
e10s_23 | Provide a client-centred approach to care and manage any challenging behaviour | 2 |
E11 | End-of-life care | Level |
---|---|---|
Knowledge and understanding of… | ||
e11k_1 | End-of-life care strategies, advanced directives, and palliative care tools in relation to stroke | 2 |
e11k_2 | The implications of the Mental Capacity Act for stroke patients | 2 |
e11k_3 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e11k_4 | The range of support groups and services for those affected by stroke with palliative care needs | 2 |
e11k_5 | The needs and aspirations of those affected by stroke (i.e. patient, carer and family) | 2 |
e11k_6 | The assessment and management of problems, how they can be controlled and the implications for prognosis: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical | 2 |
e11k_7 | Pharmacological and non-pharmacological interventions for end-of-life care after stroke | 2 |
e11k_8 | The side effects of pharmacological and non-pharmacological interventions for end-of-life care after stroke | 2 |
Skills and ability to… | ||
E11s_1 | Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity | 2 |
E11s_2 | Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
E11s_3 | Communicate and discuss: current event; interventions/treatments and their timeframes; rationale for treatment; possible side effects of treatment; and provide advice and prognosis | 2 |
E11s_4 | Assess capacity and “best interests” according to the statutory principles | 2 |
E11s_5 | Provide sufficient information to enable informed choice and decision making by those affected by stroke | 2 |
E11s_6 | Identify need and when to refer for more specialist or differing treatments where necessary: agree referral | 1 |
E11s_7 | Recognise and manage symptoms taking account of individual needs and aspirations | 2 |
E11s_8 | Use palliative care, or other relevant tools, and care pathways | 2 |
E11s_9 | Identify local services and resources, including waiting times and implications for those affected by stroke | 1 |
E11s_10 | Use strategies to help with breaking bad news, managing emotions and obtaining information on advanced directives | 2 |
E11s_11 | Develop mechanisms to support the palliative care team and provide opportunities for debriefing sessions | 2 |
E12 | Seamless transfer of care | Level |
---|---|---|
Knowledge and understanding of… | ||
e12k_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; and how to involve users and carers | 2 |
e12k_2 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e12k_3 | The implications of stroke for lifestyle, driving, work and family | 2 |
e12k_4 | Methods to facilitate communication with those affected by stroke | 2 |
e12k_5 | 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) including exit strategies | 2 |
e12k_6 | The principles of good planning for transition between services or cessation of services and for transfer of care to the community, including the education of those affected by stroke | 2 |
e12k_7 | All agencies that are potentially involved along the whole of the Stroke Pathway | 2 |
e12k_8 | The principles of multi-agency working | 2 |
Skills and ability to… | ||
e12s_1 | Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity | 2 |
e12s_2 | Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e12s_3 | Assess, discuss and review with those affected by stroke: goal-setting, outcomes and exit strategies | 2 |
e12s_4 | Monitor progress and agree or change a maintenance or management plan | 2 |
e12s_5 | Identify need and when to refer for more specialist or differing treatments where necessary | 1 |
e12s_6 | Identify local services and resources (e.g. health, social, voluntary, independent sector; equipment and adaptations, rehabilitation, psychological, educational, employment, housing, transport) to facilitate participation and inclusion: check availability and waiting times; inform individual about services, identify how to access, or re-access, them and agree referral | 1 |
e12s_7 | Liaise with and work across agencies | 2 |
e12s_8 | Identify and utilise resources available locally and nationally to support those affected by stroke | 2 |
e12s_9 | Reflect on processes and pathways of care including mechanisms for review and exit strategies | 2 |
e12s_10 | Reflect on methods and effectiveness of information sharing | 1 |
E13 | Long-term care | Level |
---|---|---|
Knowledge and understanding of… | ||
e13k_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 | 2 |
e13k_2 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e13k_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 | 2 |
e13k_4 | The impact of stroke on the individual, carer and family | 2 |
e13k_5 | The implications of stroke for lifestyle, driving, work and family | 2 |
e13k_6 | Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) | 2 |
e13k_7 | Pharmacological and non-pharmacological interventions for secondary prevention and to facilitate recovery after stroke and their side effects | 2 |
e13k_8 | 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) | 2 |
e13k_9 | Assistive technology and other therapy interventions (e.g. functional electrical stimulation, orthotics) | 2 |
e13k_10 | Methods to facilitate communication with those affected by stroke | 2 |
e13k_11 | Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance | 2 |
Skills and ability to… | ||
e13s_1 | Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity | 2 |
e13s_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 | 2 |
e13s_3 | Monitor the individual’s progress and agree on or change a maintenance or management plan | 2 |
e13s_4 | Assess, discuss and review with those affected by stroke: goal-setting and outcomes | 2 |
e13s_5 | Identify need and when to refer for more specialist or differing treatments when necessary | 2 |
e13s_6 | Identify relevant rehabilitation and social support services after discharge: inform the individual about services and how to access them and agree referral | 2 |
e13s_7 | Identify the individual’s motivation and take steps to modify behaviour | 2 |
e13s_8 | Know of local services, their waiting times and implications for those affected by stroke and ensure that the individual is aware | 2 |
e13s_9 | Understand how those affected by stroke can be empowered (e.g. through self-management programmes) | 2 |
e13s_10 | Assess and facilitate concordance | 2 |
E14 | Review | Level |
---|---|---|
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 | 2 |
e14k_2 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
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 | 2 |
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) | 2 |
e14k_5 | The impact of stroke on the individual, carer and family | 2 |
e14k_6 | The implications of stroke for lifestyle, driving, work and family | 2 |
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) | 2 |
e14k_8 | Pharmacological and non-pharmacological interventions for secondary prevention and how to help recovery after stroke | 2 |
e14k_9 | Side effects of risk factor interventions and treatments to help with recovery after stroke | 2 |
e14k_10 | Methods to help communication with those affected by stroke when conducting a review | 2 |
e14k_11 | Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance | 1 |
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 | 2 |
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 | 2 |
e14s_3 | Monitor the individual’s progress and agree or change a maintenance or management plan | 2 |
e14s_4 | Assess, discuss and review with those affected by stroke: goal-setting and outcomes | 2 |
e14s_5 | Plan assessments and treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e14s_6 | Identify need and when to refer for more specialist or differing interventions/treatments where necessary | 2 |
e14s_7 | Review process in your area and act on the review | 2 |
e14s_8 | Assess and facilitate concordance | 2 |
E15 | Participation in community | Level |
---|---|---|
Knowledge and understanding of… | ||
e15k_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 | 2 |
e15k_2 | Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations | 2 |
e15k_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 | 2 |
e15k_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) | 2 |
e15k_5 | The impact of stroke on the individual, carer and family | 2 |
e15k_6 | The implications of stroke for lifestyle; driving; work, including voluntary and family | 2 |
e15k_7 | Methods to help communication with those affected by stroke, including when conducting a review | 2 |
Skills and ability to… | ||
e15s_1 | Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity | 2 |
e15s_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 | 2 |
e15s_3 | Assess, discuss and review with those affected by stroke: goal-setting and outcomes | 2 |
e15s_4 | Monitor the individual’s progress and agree on or change a maintenance or management plan | 2 |
e15s_5 | Plan assessments and treatments; provide information, relevant to individual needs and aspirations (personalise information) | 2 |
e15s_6 | Identify need and when to refer for more specialist or differing treatments where necessary | 2 |
e15s_7 | Know of local services, their waiting times and implications for those affected by stroke | 2 |
E15s_8 | Use individual commissioning | n/a |
E16 | Return to work | Level |
---|---|---|
Knowledge and understanding of… | ||
e16k_1 | The effects of stroke (cognitive, physical, sensory, visual, emotional, confidence) and how it may affect a return to work and/or education | 2 |
e16k_2 | Assessing the effects of stroke (cognitive, physical, sensory, visual, emotional, confidence) | 2 |
e16k_3 | Employment law, the Disability Discrimination Act, health and safety at work | 1 |
e16k_4 | The roles of healthcare and other professionals in employment-related services (occupational health, occupational psychologist, disability employment adviser) | 1 |
e16k_5 | The occupational therapist’s role in vocational rehabilitation | 1 |
e16k_6 | Jobcentre Plus, its services and its effectiveness for stroke | 1 |
e16k_7 | What is meant by “reasonable adjustment” in the workplace, how to adapt or instigate adaptation to the work environment and the employer’s responsibility | 1 |
e16k_8 | Available helpful technology for overcoming functional and activity limitations in the workplace | 1 |
e16k_9 | Ergonomic principles and how to overcome access issues | 1 |
e16k_10 | Return to work education | 1 |
e16k_11 | Health, work and well-being – the role of purposeful occupation and the detrimental effects of worklessness | 1 |
e16k_12 | The benefits system in relation to work | 1 |
e16k_13 | Workplace assessment including risk, job analysis, work hardening, return to work planning and job retention | 1 |
e16k_14 | Models of vocational rehabilitation for stroke and vocational case management | 1 |
e16k_15 | Vocational rehabilitation guidelines and standards for people with stroke (British Society of Rehabilitation Medicine; Vocational Rehabilitation Association; UK Rehabilitation Council) | 1 |
Skills and ability to… | ||
e16s_1 | Refer to a vocational rehabilitation service | 2 |
e16s_2 | Assess or refer for the assessment of visual, cognitive, functional and physical deficits following stroke | 2 |
e16s_3 | Identify local and national services for return to work, their availability and how they can be accessed | 1 |
e16s_4 | Know which professionals people should be referred to for employment-related services | 1 |
e16s_5 | Assess for, advise on and review the need for workplace adaptation | n/a |
e16s_6 | Assess for, advise on and review the need for assistive technology and environmental adaptations to overcome work-related activity limitations | n/a |
e16s_7 | With a stroke survivor, advise, prepare and plan a return to work or education and how they can be supported on the return to work pathway | n/a |
e16s_8 | Advise employers/educators about stroke and its effects and negotiate a return to work of the stroke survivor | n/a |
e16s_9 | Communicate stroke-related deficits to employers, colleagues, educators, family members and friends | 1 |
e16s_10 | Give benefits advice or refer | 1 |
e16s_11 | Carry out a workplace assessment and risk assessment, or refer | 1 |
e16s_12 | Carry out job analysis, or refer | 1 |
e16s_13 | Set goals for work return/retention | 1 |
e16s_14 | Case manage and refer to a case management service for a return to work after stroke | 2 |
e16s_15 | Implement guidelines in practice | 2 |
e16s_16 | Help the stroke survivor to remain in work, review the stroke survivor at work/in education and advise on workplace accommodations | 1 |