2. The hospital team

The hospital team

1) Who they are and what they do?

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Medical:

  • Medical history
  • Neurological examination
  • Blood tests
  • Referral for CT or MRI scans
  • Medication – aspirin, warfarin, thrombolysis, statins
  • Detection and treatment of complications- infections,deep vein thrombosis, epileptic seizures
  • Monitoring and reducing risk of further stroke. (secondary prevention)
  • Communication with other hospitals, departments and with GP and primary care team

Nursing:

  • General observations, alertness, effects of stroke
  • Monitoring blood pressure, temperature, pulse, breathing, oxygen levels in the blood,weight
  • Swallowing assessment
  • Nutrition and hydration- eating and drinking
  • Mouth care keeping the mouth moist and clear of food, clean teeth
  • Help with feeding if needed
  • Safe/therapeutic positioning in bed or chair
  • Help to sit up in bed or chair, help with walking if safe to do so
  • Skin care preventing pressure sores
  • Help to maintain continence and going to toilet, manage catheters 
  • Discharge planning, liaison with community nurses, GP
  • Liaison with carers and relatives

Physiotherapy:

  • Assessment and treatment of muscle tone, strength and movement
  • Body positioning, posture and awareness
  • Balance in sitting, standing and walking
  • Assessment of sensation
  • Assessment and treatment of pain in arms and legs
  • Care of the affected arm and leg to prevent deformity or further damage
  • Provide walking aids and equipment
  • Specific treatments FES (functional electrical stimulation) TENS (transcutaneous electrical nerve stimulation)
  • Exercise and activity to do at home
  • Referral for community physiotherapy
  • Referral to Orthotist for special adapted items such as shoe raise, ankle /foot orthosis.
  • Discharge planning

Occupational Therapy:

  • Assessment and treatment of activities of daily living, washing, dressing, bathing, feeding, toileting
  • Assessment and treatment of memory, cognition and thinking problems
  • Assessment of perceptual problems, planning and sequencing
  • Dexterity and hand activities
  • Kitchen activities
  • Scanning and visual retraining
  • Home visits
  • Assessment and referral for equipment and adaptations at home.
  • Work related activity
  • Discharge planning

Speech and Language Therapy:

  • Assessment of swallowing including arranging x ray of swallow (videofluoroscopy) if required
  • Assessment and treatment of speech problems
  • Assessment and treatment of language problems
  • Assisting carers and relatives to learn communication strategies
  • Assessment and referral for equipment to aid communication
  • Referral for community speech and language therapy if required

Clinical Psychology:

  • Assessment and treatment of intellectual/cognitive and behavioural problems
  • Advice on personal and emotional issues
  • Therapy to manage change, tackle mood changes and mental health issues such as depression and anxiety
  • Coping strategies to manage daily tasks and stress
  • Advice to stroke team and carers for management of emotional and cognitive problems

Pharmacy:

  • Advice and dispensing medicine
  • Alternative medicines in liquid form for patients with swallowing difficulties.
  • Supply of dispensing packs such as Dosette boxes
  • Alternative caps for medicine bottles, large print labels
  • Checking controlled drugs (which can only be given following strict guidelines)
  • Checking and dispensing discharge prescriptions

Dietetics:

  • Advice for special diets, diabetics, weight loss, weight gain, low sodium, coeliacs
  • Advice for patients who require supplement or build up drinks
  • Monitoring patients on alternative feeding such as PEG (feeding tube into stomach through abdomen) or Nasogastric feeds (feeding tube into stomach through nose)
  • Advice on consistency of food and drinks for swallowing problems

Social Work:

  • Advice and information on social or care issues
  • Care needs assessments to meet the needs of the person at home
  • Advice on benefits, financial assessments
  • Advice on alternative care, alternative housing, supported accommodation, sheltered housing, care homes
  • Advice on private home care providers
  • Advice on carers needs assessment to meet the needs of carers at home
  • Advocacy for patients without next of kin
  • Referral for social work day care

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Medical:

  • Medical history
  • Neurological examination
  • Blood tests
  • Referral for CT or MRI scans
  • Medication. aspirin, warfarin, thrombolysis, statins
  • Detection and treatment of complications- infections,deep vein thrombosis, epileptic seizures
  • Monitoring and reducing risk of further stroke. (secondary prevention)
  • Communication with other hospitals, departments and with GP and primary care team

Nursing:

  • General observations, alertness, effects of stroke
  • Monitoring blood pressure, temperature, pulse, breathing, oxygen levels in the blood,weight
  • Swallowing assessment
  • Nutrition and hydration- eating and drinking
  • Mouth care keeping the mouth moist and clear of food, clean teeth
  • Help with feeding if needed
  • Safe/therapeutic positioning in bed or chair
  • Help to sit up in bed or chair, help with walking if safe to do so
  • Skin care preventing pressure sores
  • Help to maintain continence and going to toilet, manage catheters 
  • Discharge planning, liaison with community nurses, GP
  • Liaison with carers and relatives

Physiotherapy:

  • Assessment and treatment of muscle tone, strength and movement
  • Body positioning, posture and awareness
  • Balance in sitting, standing and walking
  • Assessment of sensation
  • Assessment and treatment of pain in arms and legs
  • Care of the affected arm and leg to prevent deformity or further damage
  • Provide walking aids and equipment
  • Specific treatments FES (functional electrical stimulation) TENS (transcutaneous electrical nerve stimulation)
  • Exercise and activity to do at home
  • Referral for community physiotherapy
  • Referral to Orthotist for special adapted items such as shoe raise, ankle /foot orthosis.
  • Discharge planning

Occupational Therapy:

  • Assessment and treatment of activities of daily living, washing, dressing, bathing, feeding, toileting
  • Assessment and treatment of memory and cognition
  • Assessment of perceptual problems, planning and sequencing
  • Dexterity and hand activities
  • Kitchen activities
  • Scanning and visual retraining
  • Home visits
  • Assessment and referral for equipment and adaptations at home.
  • Work related activity
  • Discharge planning

Speech and Language Therapy:

  • Assessment of swallowing including arranging x ray of swallow (videofluoroscopy) if required
  • Assessment and treatment of speech problems
  • Assessment and treatment of language problems
  • Assisting carers and relatives to learn communication strategies
  • Assessment and referral for equipment to aid communication
  • Referral for community speech and language therapy if required

Clinical Psychology:

  • Assessment and treatment of intellectual/cognitive and behavioural problems
  • Advice on personal and emotional issues
  • Therapy to manage change, tackle mood changes and mental health issues such as depression and anxiety
  • Coping strategies to manage daily tasks and stress
  • Advice to stroke team and carers for management of emotional and cognitive problems

Pharmacy:

  • Advice and dispensing medicine
  • Alternative medicines in liquid form for patients with swallowing difficulties.
  • Supply of dispensing packs such as Dosette boxes
  • Alternative caps for medicine bottles, large print labels
  • Checking controlled drugs (which can only be given following strict guidelines)
  • Checking and dispensing discharge prescriptions

Dietetics:

  • Advice for special diets, diabetics, weight loss, weight gain, low sodium, coeliacs
  • Advice for patients who require supplement or build up drinks
  • Monitoring patients on alternative feeding such as PEG (feeding tube into stomach through abdomen) or Nasogastric feeds (feeding tube into stomach through nose)
  • Advice on consistency of food and drinks for swallowing problems

Social Work:

  • Advice and information on social or care issues
  • Care needs assessments to meet the needs of the person at home
  • Advice on benefits, financial assessments
  • Advice on alternative care, alternative housing, supported accommodation, sheltered housing, care homes
  • Advice on private home care providers
  • Advice on carers needs assessment to meet the needs of carers at home
  • Advocacy for patients without next of kin
  • Referral for social work day care

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