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Patients will be cared for on the hospital stroke unit for as long as is needed.

This may be only for a few days or a couple of weeks, but the exact length of stay will depend on their condition. They will receive active therapy from the multi-disciplinary team during this period and be regularly reviewed.

Timely, good quality rehabilitation can help people who have had a stroke to regain their independence and to live in their own home. Early rehabilitation also reduces the risk of developing preventable secondary complications and reduces the length of stay in hospital.

Once patients have been assessed as being ready to leave hospital, the stroke team will discuss with the patient, and the patient's family and carers, the next steps towards being discharged from hospital.

 

Unfortunately, some patients are not able to recover after their stroke. The hospital will ensure that these patients receive special care that follows the Liverpool Care Pathway (LCP). The LCP is used at the bedside to make sure that patients who are dying receive the highest quality of care during the last hours and days of their life.

The LCP is an integrated care pathway. This means that health and care professionals from all the different organisations involved in the person's care work closely together to provide the best possible end-of-life care. The LCP can be followed in other care settings, including care homes, in their own home or in a hospice.

The LCP is recommended as best practice by the Department of Health in the UK.

 

What you can expect

These are the standards that you should expect:

 

National Institute for Health and Clinical Excellence (NICE) Quality Standard for Stroke

 

Patients with stroke are assessed and managed by stroke nursing staff and at least one member of the specialist rehabilitation team within 24 hours of admission to hospital and by all relevant members of the specialist rehabilitation team within 72 hours, with documented multidisciplinary goals agreed within 5 days.

What this means for you:

  • You should expect to spend all your time in hospital in a specialist stroke unit and the national Department of Health standard is that at least 80% of patients should spend at least 90% of their time in hospital on a specialist stroke unit.
  • You should be cared for by a team of healthcare professionals who are specially trained in working with people who have had a stroke. This team will be based around the specialist stroke unit in the hospital.
  • The team will include nurses and therapists as well as the medical staff.
  • At least one of the therapists should have assessed you within 24 hours of admission and all relevant members of the team within 72 hours.
  • You should have been able to discuss with the team the care plan which sets out your personal goals and the therapy you will receive within 5 days of admission to hospital.

 

Patients who need ongoing inpatient rehabilitation after completion of their acute diagnosis and treatment are treated in a specialist stroke rehabilitation unit.

What this means for you:

  • For some patients the immediate therapy support will meet their needs or they are well enough to continue therapy at home. Other patients will need on-going rehabilitation in hospital.
  • If you are transferred to a stroke rehabilitation unit, either in the acute or in a community hospital, you should also be cared for by a specialist team of nurses, doctors and therapists.
  • You should expect to spend all your time in hospital in a specialist stroke unit (both acute and rehabilitation) and the national Department of Health standard is that at least 80% of patients should spend at least 90% of their time in hospital on a specialist stroke unit.
  • In the South West, several counties have community hospital stroke rehabilitation units and the stroke teams have worked together to produce guidelines about how these units should operate.

 

Patients with stroke are offered a minimum of 45 minutes of each active therapy that is required for a minimum of 5 days a week at a level that enables the patient to meet their rehabilitation goals for as long as they are continuing to benefit from the therapy and are able to tolerate it.

What this means for you:

  • Your care plan will set out the therapy support that you need and the goals for your recovery and rehabilitation. For each of the various therapies (occupational therapy, physiotherapy, speech and language therapy) you should receive at least 45 minutes of active therapy for at least 5 days a week.
  • In the South West, the stroke teams have worked together to produce guidelines setting out that the therapy can be delivered through several different routes using qualified and suitably trained rehabilitation support workers and agreed forms of tele-therapy (assisted therapies using modern electronic and telecommunications). This therapy is in addition to every day activities undertaken by the patient with help.

 

Patients with stroke who have a continued loss of bladder control 2 weeks after diagnosis are reassessed to identify the cause of incontinence and have an ongoing treatment plan involving both patients and carers.

What this means for you:

  • Some patients have loss of bladder control two weeks after their diagnosis and it is important that they are reassessed by a member of staff with skills in this area who can produce a treatment plan to promote continence.