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Rehabilitation Nursing

Rehabilitation Nursing. Objectives. Student should be able to: Define rehabilitation Describe the philosophy of rehabilitation Discuss the cornerstones of rehabilitation Identify the primary goals of rehabilitation Describe the role of rehabilitation

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Rehabilitation Nursing

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  1. Rehabilitation Nursing

  2. Objectives • Student should be able to: • Define rehabilitation • Describe the philosophy of rehabilitation • Discuss the cornerstones of rehabilitation • Identify the primary goals of rehabilitation • Describe the role of rehabilitation • Describe the purpose of the team approach • Discuss the “stigma” and attitude barriers faced by a person with a disability • Discuss with a disability

  3. Rehabilitation • Rehabilitation Nursing • Formal Definition • “A dynamic process in which a disabled person is helped to achieve optimum physical, emotional, psychological, social, or vocational potential in order to maintain dignity and self-respect in a life that is as independent and self-fulfilling as possible.”

  4. Rehabilitation DefinedTranslated Achieve to best capacity Why? • Physically • Emotionally • Psychologically • Socially • Vocationally • Maintain personal dignity • Maintain self-respect

  5. What would be the result?

  6. Rehabilitation Nursing • Discussion : Who can come to rehab?

  7. Impairment

  8. Woman and Man with Disability at Work

  9. Handicap • Create limits • Dependent on: • Age • Gender • Social factors • Cultural factors Think

  10. Chronic Illness • Usually Irreversible • Whole person involved • Requires: • Supportive care • Functional ability • Prevention

  11. History Rehabilitation Medicine

  12. Rehabilitation Nursing • Latin Word • Ancient societies RehabilitationHabilitation

  13. Wars Brought Attention

  14. Further Need • Social Security Act of 1935 • Polio epidemics of the 1930-1940s • Post WWII • 1960s • Rehabilitation Act of 1973 • American Disabilities Act of 1990 • Adult Polio patients

  15. Philosophy

  16. Philosophy • Main Focus • FIM Scoring • One condition • The BestRehab continues until____________?

  17. Cornerstone Principles

  18. Cornerstone Principles • Patient –Centered • Community Reentry • Independence • Functional ability • Team approach • Quality of life • Prevention/wellness • Change process • Adaptation • Patient/Family Education

  19. Primary Goals

  20. Primary Goals for the Patient • Reasonable • Restoration • Maintain • Address specific needs • Adjust • Reenter community

  21. Characteristics of aComprehensive Rehab Unit • Prevention through teaching • Early recognition • Offers both In and Outpatient rehab services

  22. Rehabilitation Desired Outcomes • Increased independence • Improved quality of life

  23. Rehab Focus: • Education • Improved workable capacity of the client • Proof

  24. Issues

  25. Issues • Quality vs. quantity of life • Care vs. cure • Resource allocation/Personal productivity • Society’s views • High cost of comprehensive interdisciplinary treatment vs. continued low maintenance cost of LTC • Different terms used in society • Persons with disabilities vs. a disabled person

  26. Nurses Role

  27. Rehab Nurses Role • 50% Know-how • 50% open-minded encouragement • My Role

  28. Successful Nursing Characteristics • Must be assertive • Low level of anxiety • High self-concept and esteem

  29. Nursing Roles in Rehab Caregiver Coordinator Educator Advocate Case Manager Leader Collaborator Facilitator Liaison Consultant Discharge planner Researcher Counselor Coach

  30. Rehab Nursing Focused Assessment on Coping • Watch/ Listen • Effective vs. ineffective coping behaviors • Pre-morbid behavior • Family/support systems • Strengths/limitations • Financial assessment

  31. Interventions for Coping Issues • Encourage • Assess q shift • Focus on understanding/accepting client • Prevent family/caregiver fatigue • Prevent medical crisis • Prevent social isolation • Encourage to use community resources • Relieve helplessness • Minimize stress levels • Counsel/listen • Encourage cognitive restructuring • Encourage spiritual support • Educate • Relaxation • Involve family ASAP

  32. Purpose Team Conflict Resolution Coordination of Rehab Team

  33. Rehab Team Approach • Team has many members • Each therapy is called a “discipline” • One therapy vs. team of therapists • Focus of team

  34. Team Conference • Held when best time for all • Weekly • Lasts 5-10 minutes/client • Informal • Disciplines discuss recent FIM scores/problems • Room for civil disagreement • Focus on best plan to accomplish goals • Team evaluates itself based on outcomes

  35. Client and Family • Also team members • Key member • Attend/contribute to team conference • Open communication encouraged • Problems are brought out/discussed/resolved • Boundary setting set as needed

  36. Team Members Characteristics

  37. Client/Family • Client most important member • Center of team • Client included: • Decision making • Team planning • Must be willing/active participant to reach goals • Demonstrates commitment to rehab program

  38. Rehabilitation Nurse • Advocate • Educator • Team player • Coordinator • Understands discipline’s jargon • Reinforces each discipline’s training • Extremely important member for client’s success

  39. Medical Doctor • Physiatrist • Responsible for primary medical management • Directs overall POC • Devises Treatment plan • Then all disciplines put it into action • Team coordinator

  40. Physical Therapy (PT) • Movement/Comfort • Performs Treatments • Assess by Home Evaluations, client’s physical environment

  41. Occupational Therapy (OT) • Focus on function • ADL’s • Self-care • Improving fine motor control/skill • Reeducation of muscles • Perception/motor difficulties evaluated • Home evaluation for safety with ADL’s

  42. Speech Therapy (ST) • Evaluate/Treat: • Communication problems • Developmental speech problems • Post surgical procedures • Swallowing disorders • Assess: • Receptive abilities • Integrative abilities • Expressive language abilities • Swallowing evaluations

  43. Social Worker (SW) • Assists with personal problems of client/family • Assess: • Lifestyle • Discharge needs

  44. Respiratory Therapy (RT) • Assess pulmonary status • Begins Respiratory rehab program if needed

  45. Therapeutic Recreational Therapy (TR) • Assists: • Restoring self-confidence • Re-socialization • Basic functional skills • Directs social activities/outings • Encourages group interaction • Utilizes both rehab center/community facilities for client to: • Interact with society • Overcome physical barriers

  46. Chaplain/Religious Leader • Assess Client/Family: • Coping • Spiritual needs • Counsel as needed

  47. Dietician/Nutritionist • Evaluates: • Nutritional status • Dietary needs • Consults

  48. Psychologist • Treats psychological impairments • Provides behavior modification program • Assesses: • Cognitive status • Emotional status

  49. Vocational Rehab Specialist(VRS) • Found in larger facilities • Assesses: • Potential to return to work • Other work possibilities

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