Incidences of Cardiovascular Disease

ANSWER

Incidences of Cardiovascular Diseases

Stroke is a cardiovascular condition marked by neurological deficits. The disease occurs when nutrient, blood, and oxygen flow to the brain is disrupted, causing sudden facial paralysis, slurred speech, motor weakness, etc. Approximately 70% of the disease’s survivors are often released to home settings after treatment (Magwood et al., 2020). Unfortunately, most patients and families are usually unprepared for the complex healthcare needs of the condition. Consequently, most patients fail to comply with medical advice, resulting in disease exacerbation. Also, most stroke patients rarely survive subsequent attacks, underscoring the importance of promoting post-discharge recovery (Magwood et al., 2020). Therefore, most rely on stroke recovery services provided by community healthcare workers. Nurses are usually responsible for coordinating care and delivering various interventions in the community and home settings.

Nurses can collaborate with various agencies or organizations to support these patients’ needs. The American Stroke Foundation is a national organization designed to improve the quality of life of stroke survivors, families, and caregivers. The organization offers education, counseling services, and health-promoting activities to facilitate the recovery process of the survivors (American Stroke Foundation, n.d.).The health-promoting activities are divided into four categories: communication, healthy behaviors, life after stroke, and physical fitness. The organization hosts events such as Book clubs and reading groups where stroke survivors with aphasia can improve their communication skills. The “Life after Stroke” educates patients on readjustments, while healthy behaviors give the client the techniques and resources for stress management. Some of their services are free, while others are low-cost. The organization claims it has helped thousands of people. It sponsors its programs through public donations.

Nurses can partner with the American Stroke Foundation to provide post-discharge support to their patients. Most patients are discharged to their home settings with a disability, yet no post-discharge information is provided. The American Stroke Foundation can bridge this gap. Nurses can refer patients, families, or caregivers to this organization for supportive care. For example, caregivers will benefit from the “Life after Stroke” program, which provides patients and families with information on coping with the daily challenges or disabilities associated with stroke.

What can you do to make a change in your community as an advocate or change agent? 

The primary goal of healthcare providers, especially nurses, is to advocate for the patients’ and communities’ rights. Advocacy is a systematic process that requires a lot of planning. The first step of advocating for the community starts with identifying a problem in the community. The second step is to collect data and determine which patient population is the most affected by the problem. After identifying the problem and target population, I will find community resources, including stakeholders or allies, to help with the change initiative. Then, I will co-create a vision with the team and devise strategies and activities together. The team will raise awareness of the issue and launch a campaign for the initiative. As the change agent, it is my responsibility to oversee the implementation process and manage relationships and conflicts that may arise. I will evaluate and monitor the progress of the change and acknowledge and consolidate small wins until the implemented solution becomes a standard practice at the community.

Describe the role of the nurse as an advocate and change agent for the population as a whole, including three evidence-based prevention measures

Most stroke patients, especially those living in rural areas, lack access to stroke-specific care (Magwood et al., 2020). Most have to travel long distances to find a comprehensive stroke center to attend to their needs. These long distances increase medical costs and discourage the population from accessing healthcare services. Additionally, finding a stroke expert in these areas is difficult due to the severe workforce shortage issues. These factors may increase the re-hospitalization risks.

The following strategies can help prevent hospital readmission:

• Use a case manager or care coordinator to conduct home visits and monitoring through the telephone or internet.

A study conducted by Kitzman et al. (2017) found that this intervention increased medication compliance by 92% and reduced physician and outpatient rehabilitation visits by 96% and 70%. These results demonstrate the interventions’ effectiveness.

The nurse-led tailored stroke self-management program

This intervention involves equipping patients with coping strategies to manage the new challenges of their long-term conditions. McKenna et al. (2015) conducted a study to determine the effectiveness of this intervention. The authors found that the intervention improved patients’ self-efficacy, social integration, quality of life, mood, and functional activity. Ineffective informal caregiving practices often lead to hospital readmissions. Therefore, nurses can use this intervention to improve patients’ self-efficacy and functional activity and prevent the re-hospitalizations.

• Caregiver education and training

A study conducted by Magwood et al. (2020) found that this intervention improved caregivers’ knowledge and skills in caring for stroke patients.

Advocacy

The first strategy for improving stroke outcomes in this population is to improve their access to healthcare services. Because establishing stroke centers is costly and time-consuming, nurses can use telestroke services to increase the population’s access to healthcare services. Telestroke involves using technology, e.g., videoconferencing, to provide medical services to stroke patients. Instead of making physical visits to the patient’s home, providers can use these platforms to monitor the patient’s progress. The effectiveness of this intervention has been demonstrated by various empirical research.

However, telehealth platforms require that both patients and providers access high-speed internet bandwidth. The nurse’s goal is to campaign for the local or state government to expand the community’s bandwidth to ensure those in rural areas and marginalized areas have access to high-speed internet. The nurse also needs to advocate for patients at the organizational level. Organizational level advocacy entails pushing management to invest in the interventions mentioned above.

References

American Stroke Foundation. (n.d.). Next Step Program. American Stroke Foundation. https://americanstroke.org/next-step/

Kitzman P, Hudson K, Sylvia V, et al. Care coordination for community transitions for individuals post-stroke returning to low-resource rural communities. J Community Health. 2017; 42(3):565–572. doi: 10.1007/s10900-016-0289-0

Magwood, G. S., Nichols, M., Jenkins, C., Logan, A., Qanungo, S., Zigbuo-Wenzler, E., & Ellis, C. (2020). Community-based interventions for stroke provided by nurses and community health workers: A review of the literature. Journal of Neuroscience Nursing, 52(4), 152–159. https://doi.org/10.1097/jnn.0000000000000512

McKenna S, Jones F, Glenfield P, et al. Bridges self-management program for people with stroke

in the community: a feasibility randomized controlled trial. Int J Stroke. 2015;10(5):697–704.    doi:10.1111/ijs.12195

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