Rebuilding Lives Through Teamwork - A stroke Patients Experience of CSSD

Summary

The video features Su Potter, the Matron for Stroke Services at Chester Royal Hospital, discussing the comprehensive stroke care provided by her team. They meet patients at admission, conduct early swallowing assessments, and involve various therapists for treatment. A new early supported discharge service will allow therapy teams to support patients at home post-discharge. Bob, a patient, shares his experience, highlighting the team's support and his progress in relearning daily activities with their help.

Takeaways

• 🏥 The Specialist Stroke Matron, Su Potter, oversees stroke services at Chester Royal Hospital, highlighting the integration of acute and rehab care since April 2011.
• 👩‍⚕️ The stroke team attends the Accident and Emergency (A&E) department to meet patients upon arrival, providing early assessments and family involvement.
• 🗣️ Swallowing assessments are conducted promptly to ensure patient safety in terms of nutrition and hydration.
• 👨‍⚕️ A multidisciplinary team including physiotherapists, occupational therapists, and speech and language therapists is involved in the patient's care from the outset.
• 🏠 An early supported discharge service is being introduced to assist patients transitioning from hospital to home, enhancing continuity of care.
• 👨‍🍳 Bob, a patient, recounts his experience of having a stroke and the challenges he faced, including mobility loss and the need to relearn basic tasks.
• 💊 The hospital's pharmacy services play a role in managing medication and conducting blood tests for stroke patients.
• 🧍‍♂️ Bob's rehabilitation involved learning to walk again with assistance, using a quad stick, and practicing transfers to improve mobility.
• 🍲 Occupational therapy included relearning daily activities such as cooking and making a cup of tea, which Bob found challenging but progress-enhancing.
• 👨‍⚕️ Bob praises the hospital's team for their support, professionalism, and the positive impact they've had on his recovery.
• 📈 Bob's experience illustrates the importance of a comprehensive rehabilitation program that includes both physical and occupational therapy.

Q & A

Who is Su Potter and what is her role at Chester Royal Hospital?

Su Potter is the Matron for stroke services at Chester Royal Hospital on the Eastwood Ward stroke unit. She has worked there for several years, including more recently with the new units that were combined in April 2011.

What is the benefit of the stroke team meeting patients at the point of admission?

Meeting patients at the point of admission allows the stroke team to hear firsthand about how patients have been managing at home, meet relatives early on, and start planning the care they will receive, which is seen as beneficial for providing a seamless service.

Why is the swallowing assessment crucial for stroke patients?

Swallowing assessments are crucial because they determine whether patients can swallow safely at an early stage, which is vital for their care and recovery.

What happens within the first 24 hours after a stroke patient is admitted?

Within 24 hours of admission, stroke patients are seen by physiotherapists, occupational therapists, and speech and language therapists if needed. They may also involve a dietician and the nursing team.

How does the stroke team at Chester Royal Hospital define a successful stroke team?

A successful stroke team at Chester Royal Hospital is defined by people working very closely together, with the strength of the team being dependent on these close working relationships.

What is the duration of rehabilitation for stroke patients at Chester Royal Hospital?

The duration of rehabilitation varies; some patients require a short period of time and minimal therapy input, while others may need prolonged rehabilitation that can extend into weeks or even months.

What is the new early supported discharge service starting in October?

The new early supported discharge service starting in October will involve therapy teams and nursing going out to patients' homes to support them post-discharge, aiming to enhance the care provided and make the transition home less daunting for patients.

What was Bob's experience when he first realized he had a stroke?

Bob's experience was frightening as he lost mobility, couldn't move, and had to crawl to reach a phone to call for help. He was conscious but unable to stand, and his limbs felt like jelly.

What kind of therapies did Bob undergo during his rehabilitation?

Bob underwent various therapies including physiotherapy, occupational therapy, and speech and language therapy if needed. He also had to relearn basic tasks like sitting, standing, and transferring from a wheelchair.

How did Bob find the support from the physiotherapy team at Chester Royal Hospital?

Bob found the support from the physiotherapy team to be excellent, noting that they helped him progress significantly and made a positive difference in his rehabilitation.

What simple tasks did Bob manage to do during his rehabilitation that he considers significant?

Bob managed to make cheese on toast and boil a kettle to make a cup of tea, which he considers significant progress as these are tasks he used to do easily before his stroke.

Outlines

00:00

🏥 Stroke Services at Chester Royal Hospital

Su Potter, the Matron for stroke services at Chester Royal Hospital, discusses the comprehensive care provided to stroke patients. The stroke unit, which combines acute and rehabilitation care, admits patients and conducts swallowing assessments immediately. The team, including medical professionals and therapists, works closely to provide a seamless service. The process begins in the Accident and Emergency department and continues on the ward. The multidisciplinary team includes dieticians and nursing staff, and they aim to support patients both during their hospital stay and after discharge with a new early supported discharge service starting in October.

05:01

🚑 Bob's Stroke Recovery Experience

Bob, a stroke patient, shares his experience of recovery. He recalls the sudden loss of mobility and the frightening realization of his condition. Bob discusses the various therapies he underwent, including physiotherapy, occupational therapy, and speech and language therapy. He mentions the importance of learning to perform daily tasks again, such as making a cup of tea, which he found challenging but ultimately rewarding. Bob praises the hospital's team, noting their support and the positive impact they've had on his recovery process.

Keywords

💡Stroke

A stroke is a serious medical condition that occurs when the blood supply to part of the brain is cut off. This can deprive brain tissue of oxygen and nutrients, leading to cell death. In the video, the theme revolves around the care and treatment of stroke patients, highlighting the importance of immediate and specialized care to manage and potentially reverse the effects of a stroke.

💡Clinical Specialist Services Division

This refers to a specialized department within a hospital that focuses on providing expert care for specific medical conditions. In the context of the video, the division is involved in the comprehensive care of stroke patients, indicating a multidisciplinary approach to treatment and rehabilitation.

💡Specialist Stroke Matron

A Specialist Stroke Matron is a nurse with advanced training and experience in stroke care. They oversee the care of stroke patients and coordinate the multidisciplinary team's efforts. Su Potter, introduced in the script, is an example of such a matron, emphasizing the leadership role in patient care.

💡Acute and Rehab

These terms refer to different stages of medical care. 'Acute' care is the immediate medical treatment given to a patient with a serious condition, while 'Rehab' (rehabilitation) is the process of helping patients recover and regain skills after an illness or injury. The video mentions a combined unit for acute and rehab, showing a continuum of care for stroke patients.

💡Swallowing Assessments

After a stroke, patients may have difficulty swallowing, which can lead to choking or malnutrition. 'Swallowing assessments' are evaluations done to determine the safety and effectiveness of a patient's swallowing function. The script mentions these assessments as a critical early step in stroke care.

💡Therapy Teams

Therapy teams in the context of stroke care include physiotherapists, occupational therapists, and speech and language therapists. They work together to help patients regain physical abilities, manage daily activities, and improve communication skills. The video underscores the importance of these teams in the recovery process.

💡Early Supported Discharge Service

This is a service designed to support patients at home after hospital discharge, typically involving therapy teams and nursing staff. The script mentions an upcoming service of this kind, indicating a shift towards community-based care to help patients transition smoothly back to their homes.

💡Physiotherapists

Physiotherapists are healthcare professionals who help patients improve movement and manage pain. In the video, they are part of the therapy team that assists stroke patients in regaining mobility and strength, which is crucial for recovery.

💡Occupational Therapists

Occupational therapists help patients regain the ability to perform daily activities after an illness or injury. The script mentions their involvement in stroke care, highlighting their role in helping patients adapt to new limitations and regain independence.

💡Speech and Language Therapists

These therapists specialize in helping individuals with communication and swallowing difficulties. After a stroke, such assistance is vital for patients who may have aphasia or dysphagia. The video script includes them as part of the comprehensive care team.

💡Dietician

A dietician is a professional who provides guidance on nutrition and dietary needs. In the context of stroke care, as mentioned in the script, a dietician may be involved to ensure patients can safely swallow and receive proper nutrition, which is essential for recovery.

Highlights

Introduction to the Specialist Stroke Matron role at Chester Royal Hospital

Combination of acute and rehab units in April 2011

Early involvement in patient care upon admission

Importance of meeting relatives early in the care process

Conducting swallowing assessments immediately upon patient arrival

Seamless service provision from admission to ward care

Involvement of multidisciplinary team within 24 hours of admission

Role of physiotherapists, occupational therapists, and speech and language therapists

Importance of dieticians in stroke care

Collaboration among team members for successful stroke care

Variability in therapy duration based on patient needs

Introduction of early supported discharge service in October

Pilot success of the early supported discharge service

Therapy teams and nursing support post-discharge at home

Patient's personal account of experiencing a stroke

Impact of stroke on mobility and the fear it instills

Patient's experience with the medical team and therapy sessions

Importance of relearning basic skills post-stroke

Progression from assisted walking to using a quad stick

Patient's experience with therapy and the support received

Patient's perspective on the importance of the therapy team

Patient's progress and the positive impact of the therapy

Transcripts

[Music]

you've had a chance to look at how the

clinical specialist services division is

involved in the care of the stroke

patient now let's hear from The

Specialist stroke matron and Bob a

patient who has recently used our stroke

Services my name is Su Potter I'm the M

for stroke services at Chester Royal

Hospital on the Eastwood Ward stroke

unit I worked here for a number of years

more recently with the new two units

were combined uh in April 2011 so we

have acute and Rehab on the same site

now the process here for when the

patient is admitted is that we uh will

attend AE and we will see all the

patients at the point of them arriving

which is very beneficial we get the

chance to hear firsthand of how of how

the patients been managing it home we

get to meet the relatives from an early

stage and it generally um feels that

that this is beneficial to the service

you know providing a seamless service we

also do the uh swallowing assessments as

soon as a patient comes in which is

absolutely vital for patients that you

know to be able to swallow at a very

early stage um and then once they come

onto the ward we can then we we already

know them we've already met them in A&A

and we've already started the um

planning of the care that they're going

to receive whilst they're with us and

have ched to the relatives at that time

as well to keep them informed of what

we're

doing when the patients first admitted

they are dealt with by the medical team

but then very quickly within 24 hours

they will be seen by the

physiotherapists and and very soon

afterwards also by the occupational

therapists and also the speech and

language um therapists if the patient

needs assessment with swallowing or

communication uh there at that point

then we very often have to involve the

dietician uh and the fotus obvious

involved because uh they routinely take

the Bloods um and any other disciplines

uh that work within the team uh

including the nursing team as well it's

a large team and the the strength of the

successful stroke team um are dependent

on people working very closely together

so whilst the medical model is the

initial part of a patient's care the

bulk of the patient's care is relating

to therapy and it requires very close

working relationships within that team

and we do have a very very strong team

here who work closely together um some

patients are here only for a short space

of time and require sometimes very

little therapy input uh whilst other

patients can require a prolonged period

of Rehabilitation that can go into weeks

and sometimes months and that obviously

involves us getting very close to the

patients and the families and everybody

that's involved uh with that level of

care uh what is due to start in the

beginning of October is the new early

supported discharge service and from our

perspective this will um enhance the

care that we already give and we

previously piloted it and it was very

successful and it will involve our

therapy teams nursing going out to the

patients at home and supporting them at

home on discharge and at the moment that

that's uh quite daunting for the patient

to go home with uh unfamiliar people and

we see this will be the gold standard

for the service that we now provide

[Music]

all I can remember getting up one Sunday

morning probably about what 8 week ago

and everything fine about half 7 in the

morning I got up out of bed walked along

the side of the the bed to to make him

my way to the toilet and I came back out

again and I felt all funny next thing I

know but I won't Flor I was still

conscious and I knew what were

happening but I I couldn't I couldn't

move i' lost my Mobility I couldn't

stand up and out my legs are just like

jelly my arms right I floor on carpet I

thought right back to the

bedroom we cordless telephone on a shelf

and I crawled along shuffled along I bet

it took me an hour to get to that phone

and I'm talking a distance of only a few

yards L and just I could just reach

phone it's C the phone and i r neighbor

of mine he he pick phone straight away

and out paramedics come and they come to

me well I to be honest I little bit this

is a bit I can't remember a lot of

really I know they were there in the

bedroom I don't know a lot about it

coming in here I can remember the

ambulance coming in and dropping me off

and taking me into accident emergency

place first thing I thought and I

thought B what's up with me I can't sh

my arm I was like if it were if it

didn't belong me my leg and that like

you know I'm in trouble here and then of

course had to tell me what Happ i' go

idea what would happened to me but um

it's a very frightening experience you

know well I've

had right from just know I've had the

nutrition people got some people out

understand when they have a stroke

sometimes they have difficulty in

swallowing but luckily that that's not

affect me at all and I've also had the

uh I'm from the

pharmacy and um that's what took the

blood had them and uh down to a doctor

come to see me you know and he got me

doing various things which touching you

in various places could you feel this

and you know and I can although not got

to use in me arm and me

hand everything sensitive little thing

like that where he touched saying are

you I'm am I touching your left or right

you know and all that I knew I knew

exactly what we were doing they do a lot

of things you know trying to get your

arm going moving it to where you would

like it up in there where you would be

able to normally learning how to get oh

I mean I know that might sound stupid

saying that

but it's like it's like relearn

everything again you've got to sitting

in this chair and go in right position

feed in right position to make it easier

for you to finally stand first of all it

started off with just AED walking where

you Vis either side of you and that and

then we progressed on to using a one of

these what they call a quad stick which

I've been using they do what they call a

lot of trans transfers that's like going

back with your stick and turning into

your wheelchair like a either left from

left or right to make sure you can

control your sitting and that like and

everything and that like it's been a

good experience to me really well it's

it's certainly moved me on a lot there's

no question about that I want to get

right together as soon as as possible as

far as I'm concerned but I mean this

this phys team they've got here the

excellent I've been in here this morning

and I've been using that cooker and we

sat at as breakfast here how and here

over there I just only a bit of cheese

on toast that s simple little thing like

that you know only the other things I've

done in here is just simply boiling it

Kettle to mash a cup a cup of tea I've

done that two or three times you know

but I mean it's something that you just

You' have done normally as a matter of

course is it that anybody would have

done like you know if you want to drink

you make a drink don't you but to when

you're like this it's not might laugh

but it's not it's like climbing the

mountain try to do trying to do

something but they tell me I've

progressed reasonably well I mean I'd

like to think that I could do

better but you know but they seem to

think I've all right they've been all

right with me and you know everything

been been fine really I suppose it

couldn't have been better really you

know they've tra me all right you know

and all that and everything you can have

a laugh and a joke with them and they

they have a good team here h

[Music]