6. Themed Days - Primary Care

6.4. Mobility and Stroke

Preparatory work 

In preparation you should have: 


  • Watched this NHS video on how to ACT FAST.  You should be able to recall what FAST stands for.  Thinking specifically about Health promotion, what do you think makes this an effective video or not? 

 

  • Visit the NHS Act FAST website.  Read 2 of the patient portrait stories on here.  Reflect upon these stories.  Think of 3 key messages you have taken from this that you will discuss on the day.  Think of the impact on the patient, how it has affected them and what it means to them going forward.  

 

  • Watch Rosie talk about her experience as a speech and language therapist in Stroke care.  Laura discusses her role as a senior occupational therapist occupational therapist.  Katie is a physiotherapist and talks about her role in stroke after care.   What was significant about when physiotherapy might start?  What were the significant things Rosie might prevent?  Did you know what activities of daily living were?  Why do you think a multi-disciplinary team is critical to good care in stroke patients?  Be ready to discuss these points on the day. 

  

Aims   

To introduce you to the effects of stroke, particularly in relation to mobility and the part played by environmental factors, healthcare and other agencies in supporting the impaired person.  

Learning outcomes  

By the end of the day, you should be able to:  

  • Discuss the impact of stroke on an individual and their family and the role of voluntary agencies in providing support  

  • Demonstrate an understanding of the effect of poor mobility on the individual and the changes needed within the community to be more inclusive of them  

  • Identify important members of the MDT in assessment and care of patients with impaired mobility  

  • Identify and review a health promotion intervention that can reduce the risk of stroke in an individual at risk  

  • Practise pulse checks, blood pressure measurement, examination of central and peripheral pulses and communication skills  

  

Example timetable  

  

9.30 – 10.30   

Tutorial on stroke.  Discuss the key points from the preparatory work. 

  

10.30 – 10.45   

  

Tea break   

10.45 – 11.45  

Prepare for patient encounters  

  • Plan questions and observations   

  

Patient encounters  

  • Interview a patient who has experienced a stroke or TIA  

  • Home visit to patient, and if appropriate their family/carer, with loss of mobility/function  

  

11.45 – 12.45  

  

Students feedback to group on their patient encounters and discuss the impact of stroke on an individual and their family/carers  

  

Set up afternoon activity;  

In small groups visit or research local services/facilities providing support for stroke survivors and their families/carers or people with mobility problems or other disabilities and/or meet someone involved with delivering these services.   

  

12.45 – 13.45  

Lunch  

  

13.45 – 15.00  

Small group research/visits/interviews as planned  

  

1:1 formative feedback meeting with GP tutor (for 4-6 students)  

  

Includes tea break  

  

15.00 – 16.00  

Feedback to group about visit/research/interview and discuss the role of voluntary agencies in providing support  

  

Check in on small groups for health promotion posters  

Set homework for next session.  

  

  

   

Suggested Activities  

  • Tutorial on stroke – could cover stroke and TIA, risk factors, possible short and long term sequalae, stroke MDT members and roles, and health promotion interventions that can reduce a patient’s risk; students could work on these areas in breakout groups then present back to whole group.   Discuss the key points from the preparatory work. 

  • Meet with member of MDT to discuss role of team members for stroke / disability care; or join an MDT meeting.  

  • Research into or visit to a local voluntary agency providing support to stroke patients, and/or interview person working for such an organisation.   

  • Prepare questions to interview  a patient who has problems with mobility.  Include a brief review of their home and work circumstances etc with respect to how well different environments are adapted to help overcome the patient’s disability  

  • Visit a patient with impaired mobility at home, discuss with them any home modifications, impact on travel, work and accessibility.   

  • Session teaching clinical skills e.g. pulse checks, blood pressure measurement, examination of central and peripheral pulses and practise these. Possibility for students to observe new patient checks and/or work alongside practice nurse/HCA to complete initial examinations, including pulse, BP, weight, height. Also, consider how these parameters are being carried out remotely using telemedicine.  

  • Have an individual formative feedback discussion with GP tutor on progress on the course so far, including first written assessment, plan for poster assignment and professional attitude and conduct.  

  

  

Questions for you to consider  

   

  • How did you feel meeting a person that had suffered a stroke/had a mobility problem?  What aspects of the meeting were most difficult?  Did the patient seem comfortable with you?  Were you surprised at the impact it has had on their life?  

  • Did anything about the MDT surprise you? Were you aware that so many different professionals were involved in the care of patients with mobility problems?  What role did the GP play?  Was this what you had expected the GPs role to be?  

  • Consider the health promotion interventions you have heard about or observed today; what effect do you think that being told you are at high risk of stroke or heart disease has on an individual?