The nurses in the Neurology Ward of the Second Hospital of Zhejiang University customized an “early rehabilitation menu” for each stroke patient
Not long ago, 64-year-old Aunt Wu was rushed to the Second Affiliated Hospital of Zhejiang University School of Medicine for thrombectomy due to acute cerebral infarction. On the second day after the operation, she started rehabilitation exercises in the ward. In just one week, she was discharged from the hospital. “I thought I might be disabled, but I didn’t expect that my recovery is almost the same as before!” Aunt Wu couldn’t help but be overjoyed.
Had thrombectomy surgery after a sudden stroke
Aunt Wu lives in Xiaoshan. She has a history of hypertension for many years. On the morning of October 20th, she woke up at 7 o’clock in the morning as usual, but suddenly fell to the ground while going to the toilet. At that time, her left limb could not move, she could not speak, and her mouth could only make a whining sound. When the daughter found out, she dialed 120 in time to take her to the emergency department of a hospital near her home.
Aunt Wu arrived at the emergency room at 8 o’clock in the morning. After it was clear that it was an ischemic stroke, the doctor urgently gave her thrombolytic treatment. The tricky thing is that she is a very thick blood vessel blocked, thrombolysis can not solve the problem, she needs surgery to remove the thrombus. But the local hospital was unable to carry out the thrombus removal operation, so the family decided to urgently transfer to the Second Hospital of Zhejiang University for treatment.
At around 10 in the morning, Aunt Wu arrived at the emergency department of the Second Hospital of Zhejiang University under the escort of 120. At this time, she was unconscious. The hospital opened a green channel to evaluate and remove the thrombus for Aunt Wu at the first time. From entering the door to completing the evaluation for the imaging examination, the whole process was completed in only 5 minutes. There was no delay in every step of the preoperative preparation until the thrombus removal operation was successfully completed. The whole process can be said to be seamless.
At around 12 noon, the operation was successfully completed, and Aunt Wu was sent to the intensive care unit to closely observe the postoperative situation. Everything went well the next morning, and returned to the neurology general ward after evaluation.
After returning to the ward, Aunt Wu thought to herself that she was lucky to survive the operation and save her life. As for the extent to which it can recover in the future, it can only be resigned to fate.
When she thinks that there may be some sequelae after a stroke, such as hemiplegia, slurred speech, severe or even bedridden, and no quality of life in the future, she can’t help feeling frustrated.
Customized “Early Rehabilitation Menu”
Let stroke patients start rehabilitation in the ward
However, in the past few days in the ward, Aunt Wu gradually gained confidence in the future. Such a change started with an “early rehabilitation menu”.
Lan Meijuan, the first chairperson of the Nursing Branch of Zhejiang Stroke Society and director of the Nursing Department of the Second Hospital of Zhejiang University, introduced that the “early rehabilitation menu” is actually the “Clinical Path Table for Early Rehabilitation of Acute Stroke”, which is the neurology ward of the Second Hospital of Zhejiang University. A set of standardized rehabilitation procedures customized by the nursing staff for each acute stroke patient. According to the different conditions of each patient, a rehabilitation plan is designed for the patient like a nutritious meal, so that they can start postoperative rehabilitation as soon as possible during the hospitalization, restore their physical functions as much as possible, and improve the quality of life after discharge.
From the time she was admitted to the ward, the nurse customized a “rehabilitation menu” for Aunt Wu based on her condition, and designed a daily rehabilitation plan. For example, let her move her hands and feet on the first day, try to sit up on the second day, and walk a few steps along the side of the bed on the third day… After a few days, Aunt Wu’s hands and feet became more and more sharp and her speech became more and more clear. Clearly, she personally felt that she was improving every day.
A week later, Aunt Wu can be discharged from the hospital. When she was discharged from the hospital, she was already able to walk on her own. Except for her speaking speed and a little slower, the rest was basically the same as before she fell ill.
Every second counts for the treatment of stroke patients
The stroke care team did a lot of work
The earlier the stroke is treated, the greater the benefit for the patient. For every minute of delay, 1.9 million brain cells will die, and every hour of hypoxia, the brain will age at a rate of 3.6 years.
The time window for thrombolysis with drugs after a stroke is 4.5 hours. In order to allow patients to use thrombolytic drugs as soon as possible, the nursing team moved the thrombolysis site from the original ward to the CT room, which can shorten the time by about 10 minutes.
“For the treatment of acute stroke patients, our nursing team does our best to make every minute and second count.” Director Lan Meijuan said, from pre-hospital contact and card establishment, to the opening of the green channel after admission, and the use of stroke kits, every step is necessary. Seamless connection to shorten the time spent in the hospital as much as possible. From the time a patient enters the hospital to the imaging examination, the emergency nurse usually takes about 5 minutes.
In addition, the nurses in the ward are constantly improving and innovating to reduce the time, starting the thrombolytic process pre-notification, ward reserved thrombolytic beds, moving the stroke unit to the CT room thrombolytic and a series of measures, from decision-making thrombolysis to the use of thrombolytic drugs, nursing care The team’s work is also time-controlled within 5 minutes.
In recent years, the nursing team has promoted early bedside rehabilitation care in the ward, improved the implementation process and evaluation indicators, formulated the early stroke clinical rehabilitation implementation manual, and promoted the early rehabilitation rate of stroke patients to more than 90%, which is conducive to the function of patients. recover.
With the vigorous promotion of the nursing team, the average length of hospital stay for stroke patients in the Second Hospital of Zhejiang University has continued to decline in recent years, and the Barthel index (self-care ability in daily life) has increased significantly.
In recent years, the stroke nursing team has also gone to the grassroots level to conduct blood glucose and blood pressure measurement for local residents, and carry out a series of public welfare activities such as stroke science popularization and education and free clinics. The prevention and early identification of stroke risk factors have been popularized and improved. The public’s awareness of stroke.
At the same time, stroke subspecialty nurses provide on-site guidance for secondary prevention of stroke patients and home guidance for stroke patients, so that stroke patients can get better home care.
In addition, in recent years, the stroke nursing team has used the hospital’s Internet + nursing platform to provide free online consultations for stroke patients. At present, the number of consultations per month has reached more than 100.
Source: Metropolis Express Author: Reporter Yu Xiqian, Correspondent Fang Xu, Lu Qing Editor: Zheng Haiyun