Catangui Elmer Javier, Slark Julia
Imperial College Healthcare NHS Trust, London, UK.
Br J Nurs. 2012;21(13):801-5. doi: 10.12968/bjon.2012.21.13.801.
Stroke is a devastating condition. The Royal College of Physicians (2008) highlights that integrated stroke care can improve patient care. Nurses are an integral part of the multidisciplinary team, providing 24/7 stroke care from planning and implementing care to the evaluation of the patient's condition. To improve the way nurses manage stroke patients in an acute setting, a nurse-led ward round was initiated to look at essential nursing care. The Imperial College Healthcare Trust stroke senior nursing team, consisting of a clinical nurse specialist, a ward manager, and a charge nurse, have organised a weekly stroke nurse-led ward round. The team takes rounds to each stroke patient in the ward to examine and evaluate the essentials of nursing care (e.g. oral care, skin integrity, continence, bowel and bladder management), and current stroke outcome measures. During the rounds, the team address nursing issues, make appropriate nursing goals, and discuss their plans with the nurses and other members of the team. A nurse-led ward round has addressed nursing issues in a timely proactive fashion. The initiative has been successful in improving clinical communication between nurses and patient involvement in their care planning. It has also empowered nurses to make decisions within their professional arena, and its contribution has had an impact on patient care and safety through early detection and prevention of stroke complications.
中风是一种极具破坏性的疾病。英国皇家内科医师学院(2008年)强调,综合中风护理可以改善患者护理。护士是多学科团队不可或缺的一部分,提供全天候的中风护理,从护理计划的制定与实施到患者病情评估。为了改善护士在急性病环境中管理中风患者的方式,发起了一次由护士主导的病房巡查,以审视基本护理工作。帝国理工学院医疗保健信托基金中风高级护理团队由一名临床护士专家、一名病房经理和一名护士长组成,他们组织了每周一次由护士主导的中风病房巡查。该团队巡查病房里的每一位中风患者,检查并评估护理要点(如口腔护理、皮肤完整性、大小便失禁、肠道和膀胱管理)以及当前的中风预后指标。巡查期间,团队处理护理问题,制定适当的护理目标,并与护士及团队其他成员讨论他们的计划。由护士主导的病房巡查及时、主动地解决了护理问题。该举措成功改善了护士之间的临床沟通以及患者在护理计划中的参与度。它还赋予护士在其专业领域内做出决策的权力,并且其贡献通过早期发现和预防中风并发症对患者护理和安全产生了影响。