A Consensus on Stroke Early Supported Discharge

被引：122

作者：

Fisher, Rebecca J. ^{[1
]}

Gaynor, Catherine ^{[2
]}

Kerr, Micky ^{[1
]}

Langhorne, Peter ^{[3
]}

Anderson, Craig ^{[4
]}

Bautz-Holter, Erik ^{[5
]}

Indredavik, Bent ^{[6
]}

Mayo, Nancy E. ^{[7
]}

Power, Michael ^{[8
]}

Rodgers, Helen ^{[9
]}

Ronning, Ole Morten ^{[10
]}

Holmqvist, Lotta Widen ^{[11
]}

Wolfe, Charles D. A. ^{[12
]}

Walker, Marion F. ^{[1
]}

机构：

[1] Univ Nottingham, CLAHRC NDL Nottinghamshire Derbyshire & Lincolnsh, Nottingham NG7 2GT, England

[2] Nottingham Univ Hosp NHS Trust, Nottingham, England

[3] Univ Glasgow, Div Cardiovasc & Med Sci, Glasgow, Lanark, Scotland

[4] Royal Prince Alfred Hosp, George Inst Int Hlth, Sydney, NSW, Australia

[5] Oslo Univ Hosp, Dept Phys Med & Rehabil, Ulleval, Norway

[6] Norwegian Univ Sci & Technol, Dept Neurosci, N-7034 Trondheim, Norway

[7] McGill Univ, Div Clin Epidemiol, Ctr Hlth, Montreal, PQ, Canada

[8] Ulster Hosp, Stroke Unit, Ulster, Ireland

[9] Newcastle Univ, Inst Ageing & Hlth, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[10] Akershus Univ Hosp, Dept Neurol, Akershus, Norway

[11] Karolinska Inst, Div Neurol, Dept Clin Neurosci, Stockholm, Sweden

[12] Kings Coll London, Div Hlth & Social Care, London WC2R 2LS, England

来源：

STROKE | 2011年 / 42卷 / 05期

关键词：

evaluation; health policy; health services research; patient discharge; rehabilitation; stroke delivery; stroke management;

D O I：

10.1161/STROKEAHA.110.606285

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

Background and Purpose-Research evidence supporting Early Supported Discharge (ESD) services has been summarized in a Cochrane Systematic Review. Trials have shown that ESD can reduce long-term dependency and admission to institutional care and reduce the length of hospital stay. No adverse impact on the mood or well-being of patients or carers has been reported. With the implementation of many national and international stroke initiatives, we felt it timely to reach consensus about ESD among trialists who contributed to the review. Methods-We used a modified Delphi approach with 10 ESD trialists. An agreed list of statements about ESD was generated from the Cochrane review and three rounds of consultation completed. ESD trialists rated statements regarding team composition, model of team work, intervention, and success. Results-Consensus of opinion (>75% agreement) was obtained on 47 of the 56 statements. Multidisciplinary, specialist stroke ESD teams should plan and co-ordinate both discharge from hospital and provide rehabilitation in the community. Specific eligibility criteria (safety, practicality, medical stability, and disability) need to be followed to ensure this service is provided for mild to moderate stroke patients who can benefit from ESD. Length of stay in hospital, patient and carer outcome measures and cost, need to be routinely audited. Conclusions-We have created a consensus document that can be used by commissioners and service providers in implementing ESD services. Our aim is to promote the use of recommendations derived from research findings to facilitate successful implementation of stroke services nationally and internationally. (Stroke. 2011;42:1392-1397.)

引用

页码：1392 / 1397

页数：6

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