Models to Promote Best Practice in Interprofessional Care of Stroke Survivors and Their Caregivers #2834

INSTRUCTIONAL COURSE DETAIL

TUE, 26 OCT: 8:00 AM – 5:00 PM

FACULTY

Tamilyn Bakas, PhD, RN, FAHA, FAAN
Professor and Chair
Department of Science of Nursing Care
Indiana University School of Nursing

Barbara Lutz, PhD, RN, CRRN, APHN-BC, FAHA, FA
McNeill Distinguished Professor
School of Nursing / College of Health and Human Services
University of North Carolina-Wilmington

Elaine Tilka Miller, PhD, RN, CRRN, FAAN, FAHA
Professor of Nursing, University of Cincinnati
College of Nursing, Cincinnati, Ohio

Kristen Lee Mauk, PhD, DNP, CRRN, GCNS-BC, GNP-BC
Professor and Kreft Endowed Chair
Valparaiso University College of Nursing and Health Professions
Valparaiso, Indiana, USA

DIAGNOSIS

Stroke

FOCUS

Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)

Training/instruction in new knowledge/skills (attendees will develop new competencies that can be applied in practice or research)

BRIEF DESCRIPTION

Stroke survivors and their caregivers must learn to cope with many changes after stroke. Since most survivors are cared for at home, family caregiving must be addressed by the entire rehabilitation team. To provide interprofessional, evidence-based care for the family affected by stroke, an examination of models to guide interventions is essential. The purpose of this instructional course is to present models that can guide interventions in the care of stroke survivors and caregivers. Models for: 1) assessing stroke caregiver readiness post-discharge, 2) phases of stroke recovery, 3) the survivor-caregiver dyad, and 4) best evidence for reducing stroke and risk factors will be presented.

ABSTRACT BODY

Stroke is a leading cause of disability and death. In the US alone, stroke is the 4th leading cause of death, with nearly 800,000 people per year experiencing a stroke. Stroke reduces mobility in over half of those over age 65, and the costs of stroke treatment and lost productivity are over $36 billion annually (CDC, 2014). The sequelae and complications from stroke are numerous and include such issues as hemiplegia, gait disorders, bowel and bladder dysfunction, dysphagia, aphasias, visual changes, behavioral changes, and emotional lability. Survivors of stroke, their family members, and caregivers must learn to cope with many changes after stroke. Since most stroke survivors are cared for at home, family caregiving must be addressed by the entire rehabilitation team. Caregiver stress is one of the major factors leading to institutionalization of stroke survivors (AHA/ASA, 2014), which in turn results in increased costs to the healthcare system. To provide interprofessional, evidence-based care for the family affected by stroke, an examination of models to guide interventions is essential.

The purpose of this instructional course is to present some unique models that can guide interventions in the care of stroke survivors and caregivers. Models based on best existing evidence can help guide professionals who work with survivors and their families to provide better care. There are emerging evidence-based programs related to caregiver interventions that may be incorporated into practice, and this provides the initial focus for this instructional course. A model for assessing and facilitating stroke caregiver readiness post-discharge will be presented. The stroke care trajectory will be reviewed, and implications for family caregivers will be discussed using the domains of a model that encompasses the continuum of care. Best evidence related to reducing stroke and risk factors in survivors will also be presented. Family caregiver/stroke survivor dyad interventions will be discussed, with a review of the AHA scientific statement on stroke family caregivers, including an update on recently published interventions. Finally, a grounded theory-based interprofessional model for post-stroke recovery will be reviewed. The six phases of stroke rehabilitation and recovery in this model include: agonizing, fantasizing, realizing, blending, framing, and owning. This instructional course will assist participants to see how models can be used to suggest interventions to promote positive outcomes. During the last portion of the course, case studies and other experiential learning activities will be used to engage participants in application of these models in clinical practice scenarios.

Bakas, T., Clark, P. C. Kelly-Yayes, M., King, R. B., Lutz, B., & Miller, E. (2014). Evidence for Stroke Family Caregiver and Dyad Interventions: A Statement for Healthcare Professionals rom the American Heart Association and American Stroke Association. Stroke, 45, 2836-2852.

Campbell, M., Fitzpatrick, R., Haines, A., Kinmonth, A. L., Sandercock, P., Spiegelhalter, D. & Tyrer, P. (2000) Framework for design and evaluation of complex interventions to improve health. British Medical Journal, 321(7262), 694696.

Centers for Disease Control and Prevention. (2014). Stroke facts. Retrieved from http://www.cdc.gov/stroke/facts.htm

LEARNING OBJECTIVES

  1. Identify models to guide care for stroke survivors and family caregivers.
  2. Discuss how models can help guide care for improved outcomes after stroke.
  3. Apply new knowledge from various models to develop interprofessional, evidence-based interventions for stroke survivors and their caregivers.

INTENDED TARGET AUDIENCE

nurses, therapists (PT, OT, Speech), physiatrists, social workers

BIO SKETCHES

Barbara Lutz, PhD, RN, CRRN, APHN-BC, FAHA, FNAP, FAAN, is the McNeill Distinguished Professor in Nursing at the University of North Carolina-Wilmington. She has more than 30 years of experience and is certified as a rehabilitation and advanced public health nurse. She is devoted to advancing the study of health outcomes in vulnerable populations, such as stroke survivors and their caregivers. Her work in aging and stroke also has been recognized by numerous awards including Fellowship in the American Academy of Nursing; Distinguished Scholar and Fellow in the National Academies of Practice; the Association of Rehabilitation Nurses Doctorate Prepared Nurse Researcher Role Award; AHA Fellowship; the Institute for Learning and Retirement Junior Research Mentor in Aging Award, the University of Florida Foundation Research Professorship, and the Rehabilitation Nursing Editors’ Choice Award. She is active in national professional organizations including serving on several committees for the American Heart Association, as a member of the Board of Directors of the Association of Rehabilitation Nurses, and as past chair of the Rehabilitation Nursing Foundation. She has authored 5 book chapters and more than 30 peer-reviewed publications.

Tamilyn Bakas is currently a professor at Indiana University School of Nursing where she conducts research aimed at improving the quality of life of family caregivers of stroke survivors. Her descriptive work in this area has resulted in publications focusing on the needs and concerns of stroke caregivers, and on the development of clinical assessment tools and measurement instruments for family caregiving research. Her current research focus is to design and evaluate theory-based interventions to improve quality of life outcomes in family caregivers of stroke survivors. Dr. Bakas is a Fellow of the American Academy of Nursing. She is also a Fellow of the American Heart Association and has been an active participant on various committees in both the Council on Cardiovascular Nursing and the Stroke Council. She is a full member of the Indiana University Graduate School and currently teaches courses that focus on research design, instrumentation, and data analysis. She mentors both undergraduate and graduate students in conducting research. She also provides leadership as chair of the Department of Science of Nursing Care that supports faculty, staff, and students in creating innovative learning environments that support excellence in education and research to advance the health of the world's citizens.

Dr. Elaine Miller: For over 30 years, Dr. Miller has been actively engaged in building and in some cases synthesizing the level of the science that underpins the quality of care for primarily physically impaired children and adults who are most at risk for stroke and transient ischemic attacks.   In addition, she has always been interested in individuals of all age groups with severe physical disabilities and is certified in rehabilitation and gerontology nursing. Many of my funded research projects have focused on educational interventions to reduce modifiable stroke risk factors in primarily African Americans as well as interventions targeting healthcare providers to improve care for frail individuals.   Dr. Miller also has over 60 publications with many focusing on stroke related topics and educational interventions for those most at risk for stroke.

Dr. Mauk is a Professor of Nursing at Valparaiso University and holds the Kreft Endowed Chair for the Advancement of Nursing Science. She is certified as an advanced practice nurse in gerontological nursing (GCNS-BC and GNP-BC) and palliative care (ACHPN), as well as rehabilitation nursing (CRRN). Dr. Mauk has over 30 years of experience in rehabilitation and gerontological nursing, and teaches in these specialties at both the graduate and undergraduate levels. She has authored or edited eight books, including two that were recognized with an AJN Book of the Year Award. She has served on editorial boards for RNJ and Geriatric Nursing, and has authored numerous articles and book chapters. Her PhD dissertation was a grounded theory model for post stroke recovery. Dr. Mauk is a frequent presenter at conferences and maintains an active consulting practice. Some of her recognitions include: AJN Book of the Year Award (2010), CASE/Carnegie Indiana Professor of the Year (2007), VU Caterpillar Award for Excellence in Teaching (2007), ARN Educator Role Award (2007), and the ARN Distinguished Service Award (2005). Dr. Mauk is the immediate past President of the Association of Rehabilitation Nurses and a Fellow of the American Academy of Nursing.

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