By Zohra Saleem Abdullah and Samina Pyarali, Karachi
The Nurse Case Manager plays significant role in discharge planning of Stroke survivors. She is a link between the patient, families and multidisciplinary team. Families are hesitant to take care of Stroke patients at home so Nurse Case Manager educate and trained them to take care of Stroke survivors at home. She coordinate with multidisciplinary team to provide all necessary facilities at home which eventually decrease length of stay and cost burden on families. Stroke is the third leading cause of death and the leading cause of long term disability worldwide. Individual with strokes have problems with mobility, swallowing, language, communication and performance of daily life chores. All Stroke patients leaving the hospital require formal discharge planning keeping in view their social back ground, physical, psychological, and functional status. The process of discharge planning started at the time of admission but it carried out once patient is medical stable to be managed at home. The purpose of early discharge planning is to maintain benefits of rehabilitation and prevent patients from nosocomial infections. Hence in third world countries like Pakistan where there are no stabilized nursing homes and rehabilitation units. However in developed countries, after discharge from hospitals, stroke patients are shifted to rehabilitation units or nursing homes. Stroke patients usually require nursing care and equipment’s at home as they are dependent and bed ridden.
The Nurse Case Manager plays significant role in discharge planning. The role functions of NCM includes care coordination, facilitation, education, advocacy, resource management, focusing on positive outcomes and discharge planning. NCMs are trained to eliminate frustration, confusion, unnecessary delays and to help patients go smoothly through their recovery process as smoothly as possible. NCM conducts formal session with family members three to four days prior to discharge in order to discuss appropriate place to live after discharge, nursing care assistance and special equipment’s required at home, arrange rehabilitation service at home, training and education of care giver. The Nurse Case Manager nurse case manager provides a list ofequipment’s, names and contact number of medical surgical supplies and shops that will be needed at home. The families who cannot purchase equipment’s so she provides contact no of welfare trust who give equipment’s on rent or deposit.NCM makes sure, that patients and families are imparted detailed information about rehabilitation at home and coordinates with occupational therapist, speech language pathologist to teach patients and families about required care at home. At the time of discharge follow up appointment schedule is also provided to them.NCM is responsible to teach one person among the members regarding all patient care that is required. She makes sure that caregivers understands the physical and emotional needs of stroke survivors. At the time of discharge NCM explains about the prescribed medication its side effects, hygiene care, dietary precautions, rehabilitation programme, communication, follow-up and other health practices. In the nut shell nursing profession is not limited to bedside nursing but now nursing has widespread scope and nurse can play different roles in which nurse case manager have a significant importance worldwide and we should promote this magnificent role.