Stroke Service

CSH Surrey provides nursing and therapy support for people who have had a stroke. Patients who are on a 'supported discharge' are visited by our Stroke Specialist Nurse within 24 hours of discharge from the acute hospital. They and their families/carers are invited to attend two, 2-hour 'Life after Stroke' workshops that provide information and advice on nutrition and diet, psychological support, occupational therapy support and signposting to other services within the community. Plenty of time is given to questions and discussion.

The workshops run on the 2nd and 3rd Wednesdays of each month, 11am to 1pm​. 

In 2014 the workshops were recognised by the NHS South East Coast Clinical Senate as an example of best practice stroke care. ​In late 2015 and early 2016 the workshops were shortlisted for three national awards.

Patients receive a follow up with the stroke nurse after six months.

"I felt like I was lost in the ocean and you were my rock." This lady had been a supported discharge patient, had attended the workshops and learnt about signs and symptoms of stroke. After attending the workshops she was was able to act on her new-found knowledge and attended A&E immediately on suspecting a further stroke. She was thrombolysed successfully and was left with only minor finger tingling as evidence of a possible major stroke.

Patient

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The Life after Stroke workshops comprise two, 2-hour sessions run by our specialist stroke nurse and therapists from our wider neuro rehabilitation service, including a dietitian, psychologist, occupational therapist and physiotherapist.

Patients are invited to attend the workshops when the stroke nurse completes their initial home assessment within 24 hours of hospital discharge. She actively encourages family, friends and carers to attend. Those unable to attend are always invited again and some attend more than once, bringing different relatives or friends.

The workshops covering a variety of topics:

  • Psychological and cognitive problems, depression, fatigue
  • Secondary prevention (how to notice the signs and symptoms of stroke so care can be given more quickly, thus avoiding longer term affects)
  • Diet and nutrition
  • Occupational therapy
  • Signposting to local groups and social opportunities to reduce isolation and help people connect within local communities.

The workshops are flexible so participants can influence the agenda by focusing on topics and sharing experiences relevant to them, from continence and mobility to speech and diet.

Within the diet and nutrition session our stroke nurse emphasises the importance of good hydration as patients often try to manage continence by reducing fluid intake, so she covers medication as well as control techniques and continence products. She also encourages questions and conversation during the workshop and facilitates networking during the break to help patients overcome feelings of isolation.

To ensure attendees benefit and learn from others' perspectives, the nurse encourages sharing of experiences. She also invites stroke survivors who are further along their journey to attend the workshops so recent stroke patients can hear from survivors as well as health professionals.

Feedback forms are completed after both workshops so the service can continue to respond to patient needs. Feedback suggests the workshops are meeting their objectives of helping people feel better supported and empowered to deal with life after stroke:

  • 93% of participants (Jul-Nov 2015) found the sessions 'Very useful'
  • 76% better understand how to manage their condition
  • 100% felt able to ask questions.

Patients, relatives and caregivers also report:

  • Better understanding behaviour changes
  • Feeling better able to provide the right care while encouraging their relative or patient to achieve as much as possible
  • Many participants say they'll change behaviour, eg do more exercise, eat a healthier diet, monitor blood pressure regularly.

Relatives and caregivers say they find the information on mood and the psychological effects of stroke incredibly beneficial, eg improving awareness and knowledge of how to recognise and cope with emotional outbursts (inappropriate laughter or tears). Attendees also report increased reassurance and comfort from talking to others, eg hearing how people have been affected, sharing examples of care and how they have coped with new situations at home and out in the community.