Authors (including presenting author) :
Mak SF(1), Law HY(1), Mak CK(1), Lam KK(1), Ho PY(1), Wong WL(1), To C(1), Yeung YMA(1)
Affiliation :
(1) Department of Rehabilitation & Extended Care, TWGHs Wong Tai Sin Hospital
Introduction :
Stroke is a critical medical condition characterized by the disruption of blood supply to the brain, leading to significant physical, cognitive, and emotional challenges for patients and their families. Early rehabilitation following a stroke is crucial for maximizing recovery and improving long-term outcomes. However, a recent review of inpatient admission records at a 71-bed convalescent ward in TWGHs Wong Tai Sin Hospital (WTSH) indicates that the average wait time for stroke patients to enter the neurological rehabilitation (NR) program is approximately 10 days. Identified service gaps include inconsistent stroke care practices stemming from insufficient nursing staff education, limited communication with patients and caregivers regarding stroke recovery, and inadequate early intervention. These gaps contribute to prolonged hospital stays, delayed community reintegration, and diminished functional recovery. This project aims to address these issues by enhancing nursing services and patient support, ultimately improving outcomes for stroke patients and their caregivers.
Objectives :
1. To enhance the confidence and satisfaction of stroke patients and their caregivers by improving their understanding of stroke management and recovery.
2. To improve nursing staff education and training on stroke care, thereby standardizing clinical practices and increasing staff confidence.
Methodology :
This prospective quasi-experimental study employs a pre-post intervention design within a 71-bed convalescent ward, WTSH. The study population consists of 22 ward nurses, with a target recruitment of 20 stroke patients and their caregivers who meet specific inclusion criteria (new stroke diagnosis, abbreviated mental test score greater than 8/10, presence of a capable caregiver).
Initially, a pre-test knowledge questionnaire will be administered to nursing staff to assess their baseline understanding of stroke care. Educational sessions, including talks and workshops, will be conducted, focusing on stroke pathology, management, and care strategies. A post-test questionnaire will measure improvements in staff knowledge and confidence.
Subsequently, 20 new stroke patients and their caregivers will be recruited based on defined inclusion and exclusion criteria. Pre-intervention assessments will utilize the General Self-Efficacy Scale to evaluate patients' and caregivers' confidence in managing stroke recovery. Tailored educational sessions will address stroke recovery, home care, and lifestyle modifications. Post-intervention assessments will measure changes in self-efficacy. Comprehensive evaluations will include feedback surveys from patients and caregivers to gauge satisfaction with care quality, communication, and competency in returning to the community.
Result & Outcome :
The project is ongoing, with nursing staff having completed pre-test assessments and participated in educational sessions. Initial results indicate improvements in staff knowledge following the educational interventions. Recruitment of the 20 patient-caregiver pairs is underway, with ongoing data collection. Preliminary assessments suggest positive changes in nursing staff knowledge and confidence levels post-intervention. However, data from patients and caregivers are still being collected, and a comprehensive analysis will be conducted upon project completion.
This project has the potential to significantly enhance the quality of stroke care in the convalescent wards of WTSH. By addressing gaps in nursing education and patient-caregiver communication, the initiative aims to improve discharge planning, reduce hospital stays, and support better functional recovery. While the project remains in progress, early indications suggest positive outcomes, which will be further evaluated upon completion. Lessons learned from this initiative will inform future efforts to optimize stroke care and rehabilitation services.
