national-clinical-guidelines-for-stroke-fourth-edition

Occupational therapy concise guide for
stroke 2012
These profession-specific concise guidelines contain recommendations extracted from the National
clinical guideline for stroke, 4th edition, which contains over 300 recommendations covering almost every
aspect of stroke management. The recommendations for each profession are given with their numbers,
so that they can be found in the main guideline.
The recommendations in this document have direct implications for occupational therapy and aim to
provide occupational therapists with ready access to the latest guidance.
This concise guide was compiled by Dr Judi Edmans and Professor Avril Drummond who represent the
College of Occupational Therapists (COT) and the COT Specialist Section Neurological Practice.
Transfers of care – discharge from hospital
(3.8.1)
A All patients discharged from hospital, including
those to care homes, who have residual strokerelated
problems should be followed up within
72 hours by specialist stroke rehabilitation
services for assessment and ongoing
management.
C Patients being discharged who remain
dependent in some personal activities (eg
dressing, toileting) should have access to, where
appropriate, a transition package of:
● pre-discharge visits (eg at weekends)
● individual training and education for their
carers
● telephone counselling support for 3
months.
D Before discharge of a patient who remains
dependent in some activities, the patient’s
home environment should be assessed and
optimised, usually by a home visit by an
occupational therapist.
E Provide early supported discharge to patients
who are able to transfer independently or with
the assistance of one person. Early supported
discharge should be considered a specialist
stroke service and consist of the same intensity
and skillmix as available in hospital, without
delay in delivery.
G Carers of patients unable to transfer
independently should receive training in
moving and handling and the use of any
equipment provided until they are
demonstrably able to transfer and position the
patient safely in the home environment.
Goal setting (3.12.1)
Every patient involved in the rehabilitation process
should:
A have their feelings, wishes and expectations
established and acknowledged
B participate in the process of setting goals unless
they choose not to or are unable to participate
because of the severity of their cognitive or
linguistic impairments
C be given help to understand the nature and
process of goal setting, and be given help (eg
using established tools) to define and articulate
their personal goals
D have goals that:
● are meaningful and relevant to the
patient
● are challenging but achievable
● include both short-term (days/weeks) and
long-term (weeks/months) targets
● include both single clinicians and also the
whole team
© Royal College of Physicians 2012 145
Occupational therapy concise guide for stroke 2012