Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Wednesday, October 5, 2016

Applying Clinical Practice Guidelines to the Complex Patient: Insights for Practice and Policy from Stroke Rehabilitation

Oh you poor babies, having to deal with real world patients. Survivors have it much worse, having to deal with doctors that don't know one damn thing about stroke recovery.
https://www.researchgate.net/profile/Michelle_Nelson9/publication/307951994_IMPROVING_EVIDENCE_AND_MEASURES_OF_PERFORMANCE_Applying_Clinical_Practice_Guidelines_to_the_Complex_Patient_Insights_for_Practice_and_Policy_from_Stroke_Rehabilitation/links/57d2e8f008ae0c0081e26ad0.pdf
Abstract
In Canada, policy makers are working to align services with the Stroke Rehabilitation Best Practice Recommendations (SRBPR). Complicating the application of clinical practice guidelines (CPGs) is the fact that most strokes occur in the context of other diagnoses. We sought to understand clinicians’ use of the CPGs and ascertain how much guidance regarding multimorbidity was available in the SRBPR. Study results  indicated  that  using  the  recommendations was problematic due to a perceived lack of guidance regarding comorbidities and multimorbidity, and concerns regarding
the applicability to “real-life patients.” Comorbidities were mentioned in less than half of the recommendations, but no explicit guidance was provided regarding the management
of comorbidities. Given the prevalence of multimorbidity in stroke rehabilitation, this clinical context is ideal for development and testing of CPGs that account for multimorbidity and  other  complexity  factors.  Results  may  also  suggest limitations to using CPGs in the development of activity-
based funding models.

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