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

Monday, October 17, 2016

Evaluating use of the Siebens domain management model during inpatient rehabilitation to increase functional independence and discharge rate to home in stroke patients

Mumbo jumbo statistic reciting, totally fucking useless.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J74456&phrase=no&rec=131638&article_source=Rehab&international=0&international_language=&international_location=

NARIC Accession Number: J74456.  What's this?
ISSN: 1934-1482.
Author(s): Kushner, David S.; Peters, Kenneth M.; Johnson-Greene, Doug.
Project Number: 90DP0046 (formerly H133A120099).
Publication Year: 2015.
Number of Pages: 11.
Abstract: Study evaluated the use of the Siebens Domain Management Model (SDMM) during stroke inpatient rehabilitation (IR) to increase functional independence and rate of discharge to home. The SDMM involved weekly adjustments of IR care focused on potential barriers to discharge home including medical/surgical issues, cognitive/emotional coping issues, physical function, and living environment/community re-entry needs. This study entailed a comparison of pre-intervention and post-intervention participant outcome metrics for the purpose of assessing the use of SDMM in stroke IR. The pre-intervention group included 154 patients with ischemic/hemorrhagic strokes who were, on average, admitted to an IR facility 9.1 days after receiving acute care in 2010. The post-intervention group included 151 patients with ischemic/hemorrhagic strokes who were, on average, admitted to IR 7.3 days after receiving acute care in 2012. Results showed that pre-intervention Functional Independence Measure (FIM) score change during IR length of stay (FIM-LOS efficiency) was 1.44 and post-intervention FIM-LOS efficiency of 2.24, which was significant. Comparison of the 2012 Uniform Data System for Medical Rehabilitation (UDSMR) national FIM-LOS efficiency score (1.72) to the post-intervention score of 2.24 also reached significance. In the pre-intervention group, 57.8 percent were discharged to home/community, 14.9 percent to long-term care (LTC), and 27.3 percent back to acute care whereas in the post-intervention group, 81.2 percent were discharged to home/community, 9.4 percent to LTC, and 9.4 percent back to acute care. Comparison of 2010 to 2012 facility data then showed a 23.4 percent increase in discharge to the community compared with an increase of 5.8 percent for the UDSMR 2010 to 2012 data, representing a community discharge rate that is 4 times greater for the post-intervention group. Findings suggest that use of the SDMM during stroke IR may convey improvement in functional independence and is associated with an increased discharge rate to home/community and a reduction in institutionalization and acute-care transfers.
Descriptor Terms: CASE MANAGEMENT, FUNCTIONAL STATUS, HEALTH CARE, OUTCOMES, REHABILITATION FACILITIES, SERVICE DELIVERY, STROKE, SYSTEMS CHANGE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Kushner, David S., Peters, Kenneth M., Johnson-Greene, Doug. (2015). Evaluating use of the Siebens domain management model during inpatient rehabilitation to increase functional independence and discharge rate to home in stroke patients.  PM & R , 7(4), Pgs. 354-364. Retrieved 10/15/2016, from REHABDATA database.

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