ischemic stroke clinical pathway acute - · pdf fileischemic stroke grey bruce health network...

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Discharge CriteriaMAR SheetAnticoagulant RecordTeaching ChecklistCaregiver Checklist

ISCHEMIC STROKE

GREY BRUCE HEALTH NETWORK

Place the Clinical Pathway in the nurses clinical area of the chart. All health care professionals should fill in the master signature sheet at the front of the Pathway. Addressograph/sticker each page of the Pathway.

PHYSICIANS: Add or delete tasks according to individual patient complexity, and initial all changes.

HEALTH CARE PROFESSIONALS: Initial tasks as completed. Place N/A and initial any box where the task is not applicable to the patient. Additional tasks due to patient individuality can be added to the pathway in “OTHER” boxes and/or Progress Notes.

TRANSFER PATIENTS: If patient is transferred to another hospital in Grey-Bruce or to CCAC, send a copy of the following:

- original to stay on patient chart - original to stay on patient chart

- original to stay on patient chart


CLINICAL PATHWAY

PATIENT ID

INCLUSION CRITERIA:


ACUTE - MEDICAL

Hanover and District Hospital

All Ischemic Stroke patients over 18 years of age admitted to hospital.EXCLUSION CRITERIA:

Hemorrhagic Stroke patients.

HOW TO USE THE CLINICAL PATHWAY

This is a proactive tool to avoid delays in treatment and discharge. These are not orders, only a guide to usual orders.

Updated August 2009© 2004-2009 Grey Bruce Health Network 1

Review August 2011

All rights reserved. No part of this document may be reproduced or transmitted, in any formor by any means, without the prior permission of the copyright owner.


Review August 2011

COMORBID CONDITIONS:

CONSULTS

NUTRITIONMOBILITY/ACTIVITY

DISCHARGEPLANNING

ISCHEMIC STROKE


CLINICAL PATHWAY

BED REST

NPO UNTIL DYSPHAGIA SCREENING TOOL COMPLETED

OTHER:

OTHER:

ASSESSMENT (OBSERVATIONS/ MEASUREMENTS/

ELIMINATION)

VITAL SIGNS, INCLUDING O2 SATS:

NON-THROMBOLYTIC PATIENT - Q4H THROMBOLYTIC PATIENT - Q15 MIN x 2H;

Q30 MIN x 2H; Q1H x 16H

SEE MAR SHEET AND/OR MEDICATION DOCUMENTATION

IV NORMAL SALINE AND INTERMITTENT SET

PSYCHOSOCIALSUPPORT/

EDUCATION

OTHER:

INFORM PATIENT AND FAMILY OF DIAGNOSIS

ADDRESS IMMEDIATE CONCERNS

OTHER:

CANADIAN NEUROLOGIC SCALE - STROKE ASSESSMENT SYSTEMQ4H & PRN (Q2H IF THROMBOLYTICS GIVEN)SCORE SHOULD NOT DECREASE MORE THAN ONE (1)

TEMP Q4H, TREAT TEMPS >37.5

TREATMENTS/ INTERVENTIONS

O2 IF NEEDED

DIAGNOSTICS/ LABORATORY

BLOOD WORK AS ORDERED

CT SCAN

MEDICATIONS

ECG

MODIFIED RANKIN SCALE

CHEST ASSESSMENT

PAIN ASSESSMENT

BLOOD PRESSURE WITHIN STATED RANGE THROMBOLYTIC THERAPY - <185/110 NON-THROMBOLYTIC THERAPY - <220/120

ACUTE - MEDICAL

Hanover and District Hospital PATIENT ID

PROCESSEMERGENCY PHASE

0-3 HOURS

DATE _______________


Review August 2011


Review August 2011

INITIAL

PERFORMANCE INDICATORS 1

ISCHEMIC STROKE

CONSULTS

DYSPHAGIA SCREENING TOOL COMPLETED

TEMP Q4H, TREAT TEMPS >37.5

CCAC

NON-THROMBOLYTIC PATIENT - Q4H THROMBOLYTIC PATIENT - Q15 MIN x 2H;

Q30 MIN x 2H; Q1H x 16H

OTHER:

DYSPHAGIA SCREENING TOOL


ELIMINATION)

MONITOR INTAKE/OUTPUT Q SHIFT

BRADEN RISK ASSESSMENT

Met Not Met N/A

MONITOR BOWEL AND BLADDER ROUTINE


CLINICAL PATHWAYACUTE - MEDICAL

VITAL SIGNS, INCLUDING O2 SATS:


PROCESSCRITICAL CARE

3-24 HOURS

DATE _______________

CHEST ASSESSMENT

PAIN ASSESSMENT

ASSESS FOR DVT

CANADIAN NEUROLOGIC SCALE - STROKE ASSESSMENT SYSTEMQ4H & PRN (Q2H IF THROMBOLYTICS GIVEN) SCORE SHOULD NOT DECREASE BY MORE THAN ONE (1)


CAROTID DOPPLER

PHARMACIST

FALLS RISK ASSESSMENT IF INDICATED

PHYSIOTHERAPY

OCCUPATIONAL THERAPY

SPEECH/LANGUAGE PATHOLOGIST IF REQUIRED

CLINICAL NUTRITION

SOCIAL WORKER

DISCHARGE PLANNING

OTHER:


ECHOCARDIOGRAM IF ORDERED

CHEST X-RAY IF ORDERED


Review August 2011

NUTRITION

MOBILITY/ACTIVITY

PSYCHOSOCIAL SUPPORT/

EDUCATION

ASSESS DISCHARGE CRITERIA DAILY

THROMBOLYTIC - BED REST IF THROMBOLYTIC GIVEN NON-THROMBOLYTIC - ACTIVITY AS TOLERATED

ORIENTATION TO UNIT AND PROCEDURES

RAISE HEAD OF BED TO 30-60 DEGREES

REVIEW VISITING GUIDELINES

ENCOURAGE PATIENT AND FAMILY TO ASK QUESTIONS

BEGIN TEACHING CHECKLIST IF APPROPRIATE

DISCHARGE PLANNING

DIET AS PER DYSPHAGIA SCREENING TOOL

USE POSITIONING TO MAINTAIN PROPER BODY ALIGNMENT (SEE "TIPS ANDTOOLS" BINDER FOR REFERENCE PURPOSES)

IF NON-AMBULATORY, ANTI AMBOLI STOCKINGS/SEQUENTIAL COMPRESSION DEVICES

ASSESS READINESS FOR REHAB USING REFERRAL FORM

INTRODUCE PATIENT PATHWAY

GIVE PATIENT EDUCATION MATERIALS, INCLUDING "LET'S TALK ABOUTSTROKE" BINDER


O2 IF NEEDED

IV NORMAL SALINE AND INTERMITTENT SET

MEDICATIONSSEE MAR SHEET

OTHER:

CRITICAL CARE PHASE3-24 HOURS

OTHER:

PROCESS

DATE _______________


Review August 2011

DATE_______

DATE_______

DATE_______

RISK FACTOR 1 2 3 4

Sensory Perception: Ability to respond meaningfully to pressure—related discomfort

Completely Limited Very Limited Slightly

LimitedNo Impairment

Moisture: Degree to which skin is exposed to moisture

Constantly Moist Often Moist Occasionally

MoistRarely Moist

Activity: Degree of Physical Activity Bedfast Chair Fast Walks

OccasionallyWalks Frequently

Mobility: Ability to change and control body position

Completely Immobile Very Limited Slightly

LimitedNo Limitations

Nutrition: Usual food intake pattern Very Poor Probably

Inadequate Adequate Excellent

Friction and Sheer Problem Potential Problem

No Apparent Problem

LOW RISK(SCORE > 15)

Ongoing assessment for change in status related to any of the six risk areas

-Patient education re: prevention

Braden Risk Assessment

-Monitor nutritional status-Skin care tools used: prevention mattresses or treatment (i.e. air mattresses), creams, bed hoop, trapeze, dressings

Initiate and document plan of care on Kardex and Unit specific Progress Notes including:

Includes “Moderate Risk Intervention” plus requested referral to:

Document reassessment weekly on Kardex

-Monitoring of pressure point areas -Dietitian

NURSE’S INITIALS

Nursing Intervention: Once you have assessed the patient and identified a risk category (high, moderate or low), carry out the following interventions for the patient's risk category.

MODERATE RISK (SCORE 13-14)

HIGH RISK (SCORE < 12)

-Activity level (i.e. turning, positioning) -Physiotherapy-Continence management -Occupational Therapy

PATIENT ID

SCORING (Key on Reverse)

SCORE

TOTAL SCORE




ISCHEMIC STROKE


Review August 2011

RISK FACTOR

Moisture

Degree to which skin is exposed to moisture

1. Constantly MoistSkin is kept moist almost constantly by perspiration, urine, etc. Dampness is detected every time patient is moved or turned.

2. Often MoistSkin is often, but not always moist. Linen must be changed at least once a shift.

3. Occasionally MoistSkin is occasionally moist, requiring an extra linen change approximately once a day.

4. Rarely MoistSkin is usually dry, linen only requires changing at routine intervals.

Activity

Degree of physical activity

1. BedfastConfined to a bed.

2. Chair FastAbility to walk severelylimited or nonexistent. Cannot bear own weight and/or must be assisted into chair or wheelchair.

3. Walks OccasionallyWalks occasionally during day, but for very short distances, with or without assistance. Spends majority of each shift in bed or chair.

4. Walks FrequentlyWalks outside the room at least twice a day and inside room at least once every two hours during waking hours.

Mobility

Ability to change and control body position

1. Completely ImmobileDoes not make even slight changes in body or extremity position without assistance.

2. Very LimitedMakes occasional slight changes in body or extremity position, but unable to make frequent or significant changesindependently.

3. Slightly LimitedMakes frequent, though slight changes in body or extremity position independently.

4. No LimitationsMakes major and frequent changes in position without assistance.

Nutrition 1. Very PoorNever eats a complete meal. Rarely eats more than 1/3 of any food offered. Eats 2 servings or less of protein (meat or dairy products) per day. Takes fluids poorly. Does not take a liquid dietary supplement.ORIs on NPO and/or maintained on clear fluids or IV for more than 5 days.

2. Probably InadequateRarely eats a complete meal and generally eats only about 1/2 of any food offered. Protein intake includes only 3 servings of meat or dairy products per day. Occasionally will take a dietary supplement.ORReceives less than optimum amount of liquid diet or tube feeding.

3. AdequateEats over half of most meals. Eats a total of 4 servings of protein (meat, dairy products) each day. Occasionally, will refuse a meal, but will usually take a supplement if offered.ORIs on a tube feeding or TPN (Total Parenteral Nutrition) regimen, which probably meets most of nutritional needs.

4. ExcellentEats most of every meal. Never refuses a meal. Usually eats a total of 4 or more servings of meat and dairy products. Occasionally eatsbetween meals. Does not require supplementation.

Friction and Shear

1. ProblemRequires moderate to maximum assistance in moving. Complete lifting without sliding against sheets is impossible. Frequently slides down in bed or chair, requiring frequent repositioning with maximum assistance. Spasticity, contractures or agitation leads to almost constant friction.

2. Potential ProblemMoves feebly or requires minimum assistance. During a move, skin probably slides to some extent against sheets, chair, restraints or other devices. Maintains relatively good position in chair or bed most of the time, but occasionally slides down.

3. No Apparent ProblemMoves in bed and in chair independently and has sufficient muscle strength to lift up completely during move. Maintains good position in bed or chair at all times.

SCORE/DESCRIPTION Sensory Perception

Ability to respond meaningfullyto pressure related discomfort

1. Completely LimitedUnresponsive (does not moan, flinch, or grasp) to painful stimuli, due to diminished level or consciousness or sedation.OR Limited ability to feel pain over most of body surface.

2. Very LimitedResponds only to painful stimuli. Cannot communicate discomfort except by moaning or restlessness.ORHas a sensory impairment, which limits the ability to feel pain or discomfort over 1/2 of body.

3. Slightly LimitedResponds to verbal commands but cannot always communicate discomfort or need to be turned.ORHas some sensory Impairment, which limits ability to feel pain or discomfort in 1 or 2 extremities.

4. No ImpairmentResponds to verbal commands. Has no sensory deficit, which would limit ability to feel or voice pain or discomfort.


Review August 2011

CONSULTS

NUTRITION


ELIMINATION)

BRADEN RISK ASSESSMENT IF INDICATED

MOBILITY/ACTIVITY

ESTABLISH METHOD OF PATIENT TRANSFER

AAT HOB 30-60 DEGREES WITH TED STOCKINGS OR SEQUENTIAL

COMPRESSION DEVICE (SCD) BRP WITH TED STOCKINGS OR SCD UP IN CHAIR WITH TED STOCKINGS OR SCD

USING POSITIONING TO MAINTAIN PROPER BODY ALIGNMENT (SEE "TIPS AND TOOLS" BINDER FOR REFERENCE PURPOSES)

CANADIAN NEUROLOGIC SCALE - STROKE ASSESSMENT SYSTEM Q6H& PRN

MEDICATIONS

OTHER:


CLINICAL PATHWAY


ACUTE - MEDICAL

ISCHEMIC STROKE

REASSESS DYSPHAGIA SCREENING TOOL IF INDICATED

VITAL SIGNS INCLUDING O2 SATS AS PER UNIT PROTOCOL

CHEST ASSESSMENT

PATIENT ID

DATE _______________ACUTE CARE

DAY 2

OTHER:



PROCESS

RANKIN SCALE IF PATIENT BEING DISCHARGED FROM ACUTE CARE

OTHER:

PAIN ASSESSMENT




OTHER:

O2 IF NEEDED

DISCONTINUE IV WHEN ORAL INTAKE >1500 ML IN 24 HOURS

IF NON-AMBULATORY, ANTI AMBOLI STOCKINGS/SEQUENTIAL COMPRESSION DEVICE

SEE MAR SHEET

BOWEL/BLADDER RETRAINING

DIET AS PER DYSPHAGIA SCREENING TOOL REGULAR TEXTURE - HEALTHY HEART DIET SPECIAL DIET: ________________________________________________


Review August 2011

DATE _______________


DISCHARGE PLANNING

PROCESSACUTE CARE

DAY 2


EDUCATION

REVIEW PATIENT PATHWAY

ADDRESS ANY QUESTIONS THE PATIENT/FAMILY MAY HAVE

DISCHARGE GOALS DISCUSSED WITH PATIENT AND FAMILY

FAMILY SUPPORT DETERMINED

ASSESS NEEDS FOR DISCHARGE

CONTINUE TEACHING CHECKLIST IF APPROPRIATE

ASSESS READINESS FOR REHAB USING REFERRAL FORM


Review August 2011


ELIMINATION)

CONSULTS

SEE MAR SHEET

OTHER:



CANADIAN NEUROLOGIC SCALE - STROKE ASSESSMENT SYSTEM Q SHIFT& PRN - SCORE SHOULD NOT DECREASE BY MORE THAN ONE (1)


O2 IF NEEDED


NUTRITION

DIET AS PER DYSPHAGIA SCREENING TOOL REGULAR TEXTURE - HEALTHY HEART DIET SPECIAL DIET: _________________________________________________

IF NON-AMBULATORY, ANTI AMBOLI STOCKINGS/SEQUENTIAL COMPRESSION DEVICE

OTHER:


IF STILL NPO RELATED TO DYSPHAGIA >48 HOURS THEN REINITIATE CLINICAL NUTRITION CONSULT

MOBILITY/ACTIVITY

PROCESS


CHEST ASSESSMENT



OTHER:


OTHER:




ISCHEMIC STROKE

PATIENT ID

DATE _______________ACUTE CARE

DAY 3

PAIN ASSESSMENT

SKIN INTEGRITY Q SHIFT


MEDICATIONS

ESTABLISH METHOD OF PATIENT TRANSFER

USING POSITIONING TO MAINTAIN PROPER BODY ALIGNMENT (SEE "TIPS AND TOOLS" BINDER FOR REFERENCE PURPOSES)

AAT HOB 30-60 DEGREES WITH TED STOCKINGS OR SEQUENTIAL

COMPRESSION DEVICE (SCD) BRP WITH TED STOCKINGS OR SCD UP IN CHAIR WITH TED STOCKINGS OR SCD

TOLERATES 30 MIN IN CHAIR BID


Review August 2011

DATE _______________

PROCESSACUTE CARE

DAY 3


EDUCATION

DISCHARGE PLANNING


ASSESS NEEDS FOR DISCHARGE


COMPLETE TEACHING CHECKLIST IF APPROPRIATE

ADDRESS ANY QUESTIONS THE PATIENT/FAMILY MAY HAVE

DISCUSS DISCHARGE PLANS WITH PATIENT/FAMILY


Review August 2011

INITIAL DATE

2

3

CONSULTS

NUTRITION

PERFORMANCE INDICATORS

INTERDISCIPLINARY CONSULTS COMPLETED

TRIAGE (TRANSITION PLAN) COMPLETED

CANADIAN NEUROLOGIC SCALE - STROKEASSESSMENT SYSTEM DAILY FOR 6 DAYS



SEE MAR SHEET

PATIENT ID

PROCESS DAY 4 - 6 DATE

___________DATE

___________DATE

___________

REASSESS DYSPHAGIA SCREENING TOOL IFINDICATED

OTHER:

OTHER:


ELIMINATION)

VITAL SIGNS INCLUDING O2 SATS AS PERUNIT PROTOCOL

CHEST ASSESSMENT

PAIN ASSESSMENT


BRADEN RISK ASSESSMENT UPDATED



OXYGEN TO KEEP O2 SATS >90 OR AS ORDERED

DISCONTINUE IV WHEN ORAL INTAKE >1500ML IN 24 HOURSIF NON-AMBULATORY, ANTI AMBOLI STOCKINGS/SEQUENTIAL COMPRESSION DEVICES




OTHER:

MEDICATIONS



ISCHEMIC STROKE

Met Not Met N/A

Met Not Met N/A

OTHER:

DIET AS PER DYSPHAGIA SCREENING TOOL REGULAR TEXTURE - HEALTHY HEART DIET SPECIAL DIET: ________________________


Review August 2011

PROCESS DAY 4 - 6 DATE

___________DATE

___________

MOBILITY/ACTIVITY

USING POSITIONING TO MAINTAIN PROPERBODY ALIGNMENT (SEE "TIP AND TOOLS" BINDER FOR REFERENCE PURPOSES)

ACTIVITY AS TOLERATED REVIEWED DAILY

TRANSFERS INDICATED ON KARDEX(SEE "HEALTHY MOVES" BOOKLET FOR REFERENCE PURPOSES)

AMBULATION INDICATED ON KARDEX

DOCUMENT TOLERATED SITTING TIME DAILY

RANGE OF MOTION AS PRESCRIBED BY PHYSIOTHERAPIST


COMPLETE TEACHING CHECKLIST IFAPPROPRIATE

ADDRESS ANY QUESTIONS, FEARS AND ANXIETIES THE PATIENT/FAMILY MAY HAVE

DATE ___________


EDUCATION

DISCHARGE PLANNING

UPDATE AND REVIEW PLAN FOR DISCHARGE WITH PATIENT/CAREGIVER

CAREGIVER TRAINING/EDUCATION CHECKLIST COMPLETED AND UNDERSTOOD BY CAREGIVER

CCAC DISCHARGE PLAN COMPLETED

ASSISTIVE DEVICES ARRANGED

HOME PROGRAM DEVELOPED AND DISCUSSED


REVIEW PATIENT-SPECIFIC RISK FACTORS FORSECONDARY PREVENTION


Review August 2011

INITIAL DATE

CONSULTS

NUTRITION


CLINICAL PATHWAY

Hanover and District HospitalACUTE - MEDICAL

ISCHEMIC STROKE

PATIENT OUTCOMES Once all outcomes are

achieved, move to discharge criteria

~If outcomes are not achieved

within one week, move to Transition Management/

Maintenance Phase

PATIENT USING APPROPRIATE ASSISTIVE DEVICE FOR MOBILITY

CAREGIVER IN RECEIPT OF INFORMATION AND DEMONSTRATVES UNDERSTANDING OF CARE MANAGEMENT OF STROKE PATIENT AT HOME AS PER TEACHING/EDUCATION CHECKLIST

SKIN INTEGRITY INTACT

PATIENT ID

PROCESSACUTE PROGRESSIVE PHASE

(BEYOND DAY 6)DATE

__________DATE

__________DATE

__________

BOWEL AND BLADDER ROUTINE ESTABLISHED


ELIMINATION)


CHEST ASSESSMENT

PAIN ASSESSMENT






OTHER:



OTHER:


OTHER:



DISCONTINUE IV WHEN ORAL INTAKE >1500ML IN 24 HOURS



OTHER:



Review August 2011

PROCESS BEYOND DAY 6DATE

__________DATE

__________DATE

__________

MOBILITY/ACTIVITY








EDUCATION


REVIEW PATIENT PATHWAY IF APPROPRIATE



DISCHARGE PLANNING








Review August 2011

INITIAL DATE

CONSULTS

NUTRITION

ISCHEMIC STROKE

ACUTE - MEDICAL


CLINICAL PATHWAY

PATIENT ID

PROCESSACUTE PROGRESSIVE PHASE

(BEYOND DAY 6)DATE

__________DATE

__________DATE

__________


PATIENT OUTCOMES Once all outcomes are

achieved, move to discharge criteria

~If outcomes are not achieved

within one week, move to Transition Management/

Maintenance Phase

PATIENT USING APPROPRIATE ASSISTIVE DEVICE FOR MOBILITY

CAREGIVER IN RECEIPT OF INFORMATION AND DEMONSTRATVES UNDERSTANDING OF CARE MANAGEMENT OF STROKE PATIENT AT HOME AS PER TEACHING/EDUCATION CHECKLIST




ELIMINATION)


CHEST ASSESSMENT

PAIN ASSESSMENT






OTHER:




OTHER:


OTHER:



DISCONTINUE IV WHEN ORAL INTAKE >1500ML IN 24 HOURS


OTHER:



Review August 2011

PROCESS BEYOND DAY 6DATE

__________DATE

__________DATE

__________

MOBILITY/ACTIVITY








EDUCATION





DISCHARGE PLANNING








Review August 2011

CONSULTS

NUTRITION


CLINICAL PATHWAY PATIENT ID ISCHEMIC STROKE

ACUTE - MEDICAL START DATE: ____________________________

Hanover and District Hospital END DATE: _______________________________

PROCESSTRANSITION MANAGEMENT /

MAINTENANCE PHASE (1 Week) DATE MET INITIAL

PATIENT OUTCOMESOnce all Outcomes are

achieved, move toDischarge Criteria

CAREGIVER IN RECEIPT OF INFORMATION AND DEMONSTRATES UNDERSTANDING OF CARE MANAGEMENT OF STROKE PATIENT AT HOME AS PER TEACHING/EDUCATION CHECKLIST




ELIMINATION)


CHEST ASSESSMENT ONLY IF DYSPHAGIC

PAIN ASSESSMENT






OTHER:



OTHER:


OTHER:






OTHER:



Review August 2011

PROCESS TRANSITION MANAGEMENT / MAINTENANCE PHASE (1 Week)

MOBILITY/ACTIVITY

USING POSITIONING TO MAINTAIN PROPER BODY ALIGNMENT (SEE "TIP AND TOOLS" BINDER FOR REFERENCE PURPOSES)


TRANSFERS INDICATED ON KARDEX (SEE "HEALTHY MOVES" BOOKLET FOR REFERENCE PURPOSES)





EDUCATION

REVIEW PATIENT-SPECIFIC RISK FACTORS FOR SECONDARY PREVENTION AS APPROPRIATE


REVIEW TEACHING CHECKLIST IF APPROPRIATE

ADDRESS ANY QUESTIONS, FEARS AND ANXIETIES THEPATIENT/FAMILY MAY HAVE

DISCHARGE PLANNING

UPDATE AND REVIEW PLAN FOR DISCHARGE WITHPATIENT/CAREGIVER







Review August 2011

4 DRIVING STATUS REVIEWED

5 SECONDARY PREVENTION RISK FACTORS ADDRESSED

CONSULTSDIAGNOSTICS/ LABORATORY


INITIALDISCHARGE CRITERIA


PROCESS DATE MET




ELIMINATION)

SPEECH/LANGUAGE AND/OR SWALLOWING FOLLOW UPARRANGED IF NEEDED

PERFORMANCE INDICATORS

Met Not Met N/A

Met Not Met N/A

ISCHEMIC STROKE

SKIN INTEGRITY PLAN

OUTPATIENT BLOOD WORK ARRANGED

ALL CONSULTS COMPLETED


MEDICATIONSMEDS EXPLAINED TO PATIENT AND FAMILY

CONSULTATION WITH PHARMACIST

NUTRITION

DIET EDUCATION COMPLETED

CONSULTED BY DIETITIAN

PATIENT RECEIVES ADEQUATE NUTRITION AND APPROPRIATE HYDRATION

TRANSFER INFORMATION CHECKLIST COMPLETED

MOBILITY/ACTIVITY

PATIENT IS SAFE IN MOBILITY AND ACTIVITIES OF DAILY LIVING WITHIN FUNCTIONAL ABILITY AND DISCHARGE DESTINATION

SAFETY EDUCATION FOR PATIENT AND FAMILY

FUNCTIONAL RECOVERY AND SELF-MANAGEMENT GOALS ARE ACHIEVABLE WITHIN THE COMMUNITY SETTING (HOME OR LTC)

APPROPRIATE AIDS IF REQUIRED

PATIENT AND FAMILY CAN DESCRIBE SECONDARY PREVENTIONTHERAPY

CAREGIVER TRAINING/EDUCATION COMPLETED

PATIENT AND FAMILY AWARE OF MANAGEMENT PLAN

PATIENT AND FAMILY HAVE UNDERSTANDING OF STROKEEDUCATION


EDUCATION

PATIENT AWARE OF RISK FACTORS AND MANAGEMENT

DISCHARGE PLANNING

PATIENT AND FAMILY AWARE OF FOLLOW UP APPOINTMENT

FOLLOW UP OUTPATIENT THERAPY AS APPROPRIATE

FAMILY PHYSICIAN AWARE OF MANAGEMENT PLAN



Review August 2011


Review August 2011

ischemic stroke clinical pathway acute - · pdf fileischemic stroke grey bruce health network...

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