The role of the nurse within the multi-professional rehabilitation team.

UNLABELLED: AIM OF THE STUDY/PAPER: To identify the contribution of the nurse within the multi-professional rehabilitation team. BACKGROUND: The requirement for nurses to work effectively within the multi-professional rehabilitation team is increasingly important with the higher incidence of chronic disease, growing numbers of older people and enhanced survival from major trauma. METHODS: A 2-year qualitative investigation was undertaken centred on three contrasting condition case studies (fractured neck of femur, rheumatoid arthritis and stroke). Clients were theoretically sampled, with their 'rehabilitation pathway' through different services providing the window through which the nurse's contribution was explored. Multiple methods and points of data collection were used, including observation, face to face interviews (clients, carers and staff) and record review. To enhance generalisability, a series of national expert workshops were undertaken with four groups: users, carers and carers' organizations; nurses; members of the multi-professional team; and educationalists. FINDINGS: Six interlinked roles for the nurse were identified: assessment, co-ordination and communication, technical and physical care, therapy integration and therapy carry-on, emotional support, and involving the family. Of particular significance is the creation of a supportive environment for rehabilitation to occur. Some nurses undertook aspects of all of these roles at any one time while others were only involved in one or two areas. While nurses expressed a desire to integrate therapy into their care delivery, the actual achievement of this goal was variable. CONCLUSIONS: Key elements of the nurse's contribution within rehabilitation should aim to maximize client choice to enhance independent living in the client's future environment. At a nursing educational policy level the nurse needs to have a full understanding of the principles and models of rehabilitation. At a practice level, the nurse's role must be valued and recognized, by nurses themselves and other team members.

O uso do sistema oclusor e o método de irrigação em clientes colostomizados: suas implicações para o cuidar em enfermagem / Nursery cares oclusor system uses and irrigation methodology in colostomy clients

Este estudo abordou o cuidar em enfermagem, o uso do Sistema Oclusor e o Método de Irrigação em clientes colostomizados. A investigação foi desenvolvida com vinte e cinco clientes portadores de colostomias definitivas, situadas em cólon esquerdo, cadastrados no Programa de Atenção à Pessoa Portadora de Ostomia do Indstituto Municipal de Medicina Física e Reabilitação Oscar Clark. As Hipóteses apresentadas foram a obtenção de um período maior de continência intestinal; o controle de eliminação de fezes, gases, ruídos e odores; o retorno de atividades cotidianas e a interligação do cuidar em enfermagem com o uso do Sistema Oclusor associado ao Método de Irrigação em colostomizados. A construção deste caminhar se fez através de abordagem metodológicas do tipo quantitativo, segundo modelo quase-experimental...

Teaching the use of walkers and canes.

Home care and hospice nurses frequently encounter patients who use assistive devices to safely remain mobile in their homes. Incorrectly used, these devices may contribute to falls. This article provides a review on the use and teaching of these devices to patients and caregivers. A physical therapist, occupational therapist, or rehabilitation nurse should be consulted for any questions about applying the guidelines in this article to patients.

[The nurse's role in the rehabilitation of the elderly]. / O papel da enfermeira na reabilitação do idoso.

As the elderly people in our country are increasing it becomes more and more frequent the elderly's presence in the services of health and especially of rehabilitation. We bring in this descriptive text the main aspects involved in the elderly's rehabilitation: the referring peculiarities to the rehabilitation in this age group, the functional evaluation as an important indicative of the life quality, the phases of the elderly's rehabilitation and the systematized nursing care through the nurse, inserted in the multidisciplinary team acts with the elderly patient and his family, in an individualized way.

Neurological rehabilitation nursing: a review of the research.

Neurological rehabilitation is increasingly seen as a specialist form of rehabilitation requiring specialist nursing knowledge. However, as in many areas of nursing, nurses in this field recognize that there is a need to increase their knowledge base to ensure that they provide the best and most up-to-date quality care for their patients and their families. To achieve high levels of competence, neurological rehabilitation nurses need to be aware of the existing body of research in this field so that they can make sound decisions regarding their practice and future research endeavours. This review aims to validate the existing knowledge base in this area by identifying and critically analysing research conducted in the area of neurological rehabilitation nursing during the decade 1988-1998 and by identifying any gaps and weaknesses that may be addressed by future research. Studies were included in the review if they examined an aspect of rehabilitation nursing, were concerned predominately with the neurological patient and were conducted in an in-patient setting. Research with a medical focus was not included and only research published in English was reviewed. Relevant research located examined the following areas: (1) the role of the rehabilitation nurse; (2) specific problems concerning the neurological rehabilitation patient; (3) specific nursing interventions; (4) rehabilitation nursing practice; (5) the delivery of rehabilitation programmes and team working; and (6) the family of the rehabilitation patient. The review concludes that research in this speciality remains limited both in quantity and quality. Most of the studies lack rigour and, because they were conducted at a single site, their generalizability to other clinical sites may be limited.

Rehabilitation, chronic illness and disability: the missing elements in nurse education.

Chronic illnesses represent one of the most significant health challenges in all developed countries and currently there is considerable debate about how to meet the rehabilitative needs of chronically ill and disabled people. The literature suggests that nursing has a potentially significant, but largely unrealized, role to play in addressing areas of current deficit. However, to fulfil this potential it is vital that the educational preparation of nurses at both qualifying and post-qualifying levels equips them with the necessary knowledge and skills. This paper describes a study which analysed curriculum documents from an extensive range of courses in the United Kingdom (UK) in order to determine the emphasis placed on rehabilitation, chronic illness and disability. The results reveal the overall lack of attention given to these important areas and the superficial manner in which key concepts are addressed. The need to identify more clearly the nursing contribution to rehabilitation is highlighted and indicative areas of knowledge and skill required to develop an expanded role are presented.

Características biológicas, sociales y de autovalencia de los pacientes hospitalizados en el Centro de Rehabilitación Sargento 2§ Irene Morales Capredena / Biological, social and self-care characteristics of hospitalizaed patients at Centro de Rehabilitación Sargento 2§ Irene Morales Capredena

La rehabilitación es un proceso complejo que resulta de la aplicación integrada de muchos procedimientos para lograr que un individuo recupere su estado funcional óptimo, tanto en el hogar como dentro de la comunidad, en la medida en que lo permita la utilización apropiada de todas sus posibilidades residuales. Para lograr esto, se requiere un trabajo multidisciplinario donde todos los integrantes del equipo de salud deben trabajar por la rehabilitación integral de la persona. El objetivo de esta tesis es conocer las características biológicas, sociales y de autovalencia de las personas hospitalizadas en Capredena. Este estudio es descriptivo y transversal con una muestra de 110 personas. Para la obtención de los datos se utilizó un cuestionario de preguntas cerradas, obteniéndose la información de las fichas clínicas y valoración física de los pacientes. En relación a los resultados, 83 por ciento de los pacientes son adultos mayores, un 22 por ciento permanece en la institución para cuidados de enfermería, un 38 por ciento es dependiente en todas las actividades de la vida diaria, un 25 por ciento esta con Sonda Folley, un 46 por ciento utiliza pañal y un 49 por ciento se moviliza en silla de ruedas. Cabe destacar el alto porcentaje de usuarios que permanecen en la institución por necesidad de cuidados de enfermería. Esta tesis pertenece a la línea del adulto en el área de rehabilitación, en ella se pretende describir al usuario e identificar problemas de enfermería, con el propósito de mejorar los cuidados

El desafío de la prevención primaria en la atención de enfermería / The challenge of the primary prevention in the infirmary attention

La autora destaca la importancia de la participación de la enfermera en la prevención primaria y aporta una experiencia de enfermería en medicina familiar (AU)

El desafío de la prevención primaria en la atención de enfermería / The challenge of the primary prevention in the infirmary attention

La autora destaca la importancia de la participación de la enfermera en la prevención primaria y aporta una experiencia de enfermería en medicina familiar

Ethical implications of caring in rehabilitation.

The establishment of special caring relationships between spinal cord injured individuals (SCI) and nurses or therapists during rehabilitation creates unique ethical dilemmas. This paper will explore the practical and ethical implications for health care professionals who feel a moral imperative, compelled by their special relationship with a particular SCI individual, to "break the rules" within a rehabilitation bureaucracy in order to provide individualized health care. From the staff perspective two issues will be examined: the status of special relationships in a health care organization and the ability to maintain one's personal and professional standards in a managed care environment. From the administrative perspective two ethical issues will be explored: the challenge of pursuing the good of the patient and the organization while navigating between the public and private spheres of health care in a health care system that values standardization.

Using critical incident technique to inform aged and extended care nursing.

Flanagan's critical incident technique was used to explore the beliefs of a cross-section of careers (both nursing and others) and consumers about the value of nursing and the nature of nursing's contribution in aged and extended care. The exploratory study found that nurses' being there, with and for residents, their families, and other health professionals, was influenced by two major themes that emerged from the data: personal and structural considerations. In this article, the potential of critical incident technique as a research method in nursing and for generating information about critical aspects of nursing work in aged and extended care is demonstrated.

A study of the psychosocial characteristics of patients in a geriatric rehabilitation unit in Israel.

This study characterizes the demographic backgrounds of patients in an Israeli geriatric rehabilitation unit, determines the factors associated with their family relationships and the instrumental support they received, and emphasizes the importance of social roles as a personal resource. The study population consisted of 336 low-income Jews, all of whom were immigrants. Virtually all of the subjects had a small, close support network composed mainly of their children and spouses. Their children were the most important source of instrumental support during their hospitalization. The subjects' sources of instrumental support prior to hospitalization varied, depending upon their age, gender, marital status, and social roles. Social exchange theory provided a framework for explaining their social roles. Factors found to be predictors of good family relationships were marital status, living arrangements, instrumental support, social roles, and educational level.

The opportunities and challenges of geriatric rehabilitation--a success story.

The rehabilitation philosophy of promoting function and independence should be the backbone of gerontological nursing practice. The attitudes and skills of nurses determine the rehabilitation climate for geriatric patients. Nurses need to be aware of the principles of geriatric rehabilitation nursing. The Geriatric Rehabilitation Program at Joseph Brant Memorial Hospital has not only acknowledged and enhanced the knowledge and skills of nursing staff, but has also raised awareness that geriatric rehabilitation is possible. It has also provided a structure in which nurses can practise geriatric rehabilitation nursing. Mrs. C. is a wonderful example of what this kind of program can do for patients. The face of rehabilitation nursing is changing, and it is time to turn the challenges of geriatric rehabilitation into opportunities for our patients, their families, and ourselves.