Rehabilitation Patient & Family Handbook

Transcription

1 Rehabilitation Patient & Family Handbook

2 Rehabilitation Program Patient & Family Handbook The Rehabilitation Unit of Alaska Regional Hospital provides services for those experience disability from a wide range of conditions including, stroke, spinal cord injury, traumatic brain injury, and complex medical and orthopedic conditions. When you are admitted to our rehabilitation program, treatment begins with a thorough evaluation to identify functional strengths and weaknesses. The interdisciplinary team, together with you & your family, work to establish treatment goals. Your program is tailored to meet your individual needs and is modified as progress occurs. General treatment components for rehab include: o Treating the basic disease and preventing complications. o Treating the disability and improving function. o Providing adaptive tools and modifying the environment. o Educating you and your family as well as assisting you to adapt to your lifestyle changes. Your stay on the Rehabilitation Unit will differ from a routine hospital stay in that the staff will assist to you to actively pursue the simulation of a normal daily routine. The staff will encourage you to function as independently as is safely possible. You will receive 3 hours of therapy Monday through Friday. Occasionally there are circumstances that necessitate weekend therapy sessions. The 10 bed rehabilitation unit is located on the 5 th floor of Alaska Regional Hospital in the main hospital building accessed through the tower elevators. There are 2 private rooms, and 4 semi-private rooms. Private room assignment is based on numerous criteria and is based on patient care needs as decided by the rehabilitation staff.

3 Information for You, Your Family, and Friends Visiting Hours Monday through Friday 4:00PM to 9:00PM, Saturday & Sunday 9:00AM-9:00PM Primary caregivers will be able to participate outside these hours as needed. Stays after 9pm require pre-approval from staff. You will have early morning therapy sessions, and the 9pm curfew ensures that you will have time for adequate amounts of sleep. Visiting with Children under the age of 12 Children under 12, who are accompanied by an adult, are welcome to visit outside the unit in the family gathering area. A staff member can show you to this area. Clothing and Personal Items It is advisable to bring comfortable loose fitting clothing, rubber-soled shoes, under-garments, night clothes, personal hygiene and grooming products, glasses, hearing aids, dentures, and hobby items. All personal items should be labeled with your name. Valuables should be left at home, or checked in with the nursing staff upon admission. The hospital is not responsible for replacing lost items, but we do provide a safe for lockup if you are unable to send your valuables home. Laundry Laundry services are not available. Unit stamped clothing will be provided for patients without access to clean clothing. We encourage friends and family to assist you with ensuring you have clean clothing throughout your rehab stay. Medications All medications will be administered by the nursing staff unless otherwise determined by your physician. Your admitting nurse will request a list of mediations you take at home. Medications are not allowed at bedside, unless ordered by the physician. Smoking Alaska Regional Hospital is a non-smoking campus. Smoking is prohibited on the entire hospital campus. Nicotine replacement options can be provided by your rehab physician.

4 Daily Schedule Your therapy schedule is written on the therapy board one day in advance at the end of the day. In addition, your nursing staff will provide you with a written copy of your schedule to keep at your bedside. Occasionally, extenuating circumstances will cause schedule changes. Patients are expected to participate in all therapy sessions as scheduled. Rest periods will be scheduled as needed. It will be posted on the therapy whiteboard just outside the dining hall. (as seen below)

5 Meals Meals are served in the Rehab unit s dining area. Meals are not served in bed, as this would not be conducive to simulating a home environment. Bringing outside food requires pre-approval by the patient s nurse. Please do not offer food to other patient s as many of our patients are on strict swallowing precautions. Medical Equipment If you already own medical equipment, the staff may ask you to bring it in prior to discharge so the therapists can determine whether or not that particular device will still be effective for you. The rehab social worker/discharge planner will assist you with obtaining any necessary equipment prior to discharge.

6 Recreational Therapy Outings Therapies offer a once weekly outing on most weeks. Physical, Occupational, Speech, and Recreational therapists attend. They will usually bring 2-3 patients. Those selected have higher levels of activity tolerance, medical stability, and would obtain the most therapeutic benefit during that particular stage of recovery. Community re-integration outings are a key component of the rehab stay. It is during these outings that patients are encouraged to employ and practice their newly learned rehab skills with the support of their therapy team. Overnight Stays Alaska Regional partners with the Extended Stay America Hotel at 700 East 34 th Avenue, Anchorage AK, The Hotel phone number is Telephone Calls Family members and friends may reach you by dialing the Rehab nursing station at We route calls through the nurse s station as patients are often outside their rooms participating in therapy, eating, etc To call outside the Rehabilitation Unit, dial the area + code number (no 1 is required). Long distance calls require a calling card. Safety and Security All staff members wear an identification badge that shows their photo, title and unit/department. We use alarm systems to notify us if you have exited the bed or wheelchair. This is non-punitive in nature, and has been proven to decrease the amount of patient falls. Exceptions to the use of the alarm systems are made on a case by case basis by the entire therapy team.

7 FALL PREVENTION GUIDELINES Use your call light by your bed or in the bathroom and wait for a nurse/assistant to arrive to help you. Do not attempt to stand up or transfer by yourself. Remain lying or seated while waiting for assistance. Please be patient. Staff will answer your call as promptly as possible. Ask the nurse for help if you feel dizzy or weak when getting out of bed. Remember you are more likely to faint of feel dizzy after sitting or lying for a long time. If you must get up without waiting for help, sit in bed awhile before standing. Rise carefully and slowly begin to walk When out of bed, do not lean or support yourself on rolling objects such as IV poles or your bedside table. We recommend that you wear rubber soled or crepe soled slippers/shoes whenever you are up and walking. Do not tamper with side rails or protective devices that may be in use. If these items need adjustment, inform your nurse

8 Infection Control To protect yourself and others from getting sick during your stay, please wash your hands after using the toilet and before eating or handling food. You are your own best advocate, so please remind your caregiver to wash their hands if needed. Fire Safety While at Alaska Regional, you may be a part of fire drills. If the fire alarm rings, wait for instructions from the staff. If you are in a fire area, a staff member will help you to safety. If you find, or think there is a fire in the building, call for help from a staff person at once or pull the nearest fire alarm. Do not use the elevators during a fire. ATM /Newspaper An ATM machine is located on the 1 st floor near the main entrance. Newspapers are provided courtesy of local businesses and are available at the Rehab nursing station. Entertainment Videos, Board Games, Nintendo Wii, books, etc are available for your use. Please speak with the nurse to get access. Our treatment team will want to assess appropriateness of specific activities for those who suffer from cognitive impairments. Information / Resources Your nurse is the coordinator of your care. Route questions through your nurse, and they will be able to direct it to the appropriate person(s). We encourage you to write questions down as they come to mind. This will allow you to recollect your thoughts when they are needed.

9 Interdisciplinary Team Conferences Team conferences are held to develop personalized treatment plans through which you re-learn skills, develop methods to compensate for decreased functioning and resume activities of everyday living. The team meets weekly to review your progress, adjust treatment goals and discuss your date for return to the community. Within a few days of a scheduled discharged from the program, the team will meet once again to determine final recommendations. The discharge planner will keep the patient & primary caregiver informed about the team meeting synopsis and your discharge date. Estimated Length of Stay Your length of stay on rehab is determined by factors such as: Severity of your injury or illness, Age Previous state of health Potential to make significant functional improvements Ability & willingness to participate in three hours of therapy per day Quickness in which the you progress towards accomplishing your rehabilitation goals Your team will work together with your insurance company to ensure that your length of stay is befitting your needs. Average national length of stay is days. The shortest stay allowed is 4 days.

10 Discharge Planning Shortly after you are admitted, the social worker/discharge planner will meet with you and your family to talk about your rehab goals, planned d/c disposition and post discharge support needs. Although everyone is hopeful of significant improvement after a rehab stay, alternative arrangements need to be considered in the event that a patient does not make enough improvements to return to their prior living situation. Alternative arrangements that may need to be considered are: o Moving in with a friend or relative o Having a friend or relative live with you, o Consider moving to a more accessible home o Moving into an assisted living facility As the time for discharge nears, you and your family are counseled regarding available resources to ensure a smooth transition back home or into an alternate care setting. Your rehab team may recommend additional services after you leave the hospital. We will provide a list of suppliers/providers that can furnish the services or supplies recommended by your team. Examples are outpatient therapy, home health therapy, or durable medical equipment. You have the right to select any agency to provide the care/supplies ordered by your physician. Patient/Family Education & Training The Therapy & Nursing staff will offer you opportunities to learn about your condition and how to continue your recovery. Family training sessions will be coordinated by the treatment team. In those training session, the emphasis is on teaching your or your caregiver how to function as independently as possible in a home-like setting. The team members provide the hands-on training that family needs to feel comfortable in providing for your needs at home. Family also learns how to let you do what you can for yourself.

11 Family Involvement Involvement of the family & caregivers is very important to your success. Not only do family members help you feel better about being on the unit, they help staff get to know specifics about your support systems and living situations. The rehabilitation team will want to work with anyone who will be helping you upon discharge. Although we encourage active involvement of all family and caregivers, we do ask that one person be identified as the primary spokesperson in the family. The rehab team will provide your caregiver with an outline of primary caregiver expectations and a caregiver agreement document. Understanding the terms: In the Inpatient Rehab setting your level of independence is measured on a scale from 1-7 called the FIM (Functional Independence Measure). You will often here staff speaking in these terms. 1 = Total assist = able to do less than 25% of the task and/or require 2 helpers 2 = Maximal assist = able to 25-50% 3 = Moderate assist = able to do 50-75% 4 = Minimal assist = able to do 75% or more 5 = Setup/Supervision assist = able to do the task independently, but require setup or a person present to supervise 6 = Modified Independent = Able to do the task independently with use of a device 7 = Independent = Able to do the task completely independently The average functional gain is approximately 20% from admission to discharge. Recovery continues to occur after discharge from the rehab unit. Your Recovery Team Once admitted to the program, treatment begins with a thorough evaluation to identify your strengths and weaknesses. The interdisciplinary team, together with you and your family, work to establish treatment goals. Your rehabilitation program is tailored to meet your individual needs and is modified as progress occurs. The Rehab Interdisciplinary Team &Consulting Staff include

12 Rehabilitation Medical Director, Dr. Emily Church Your doctor provides medical care for unstable or complex medical conditions, actively manages your rehab program in collaboration with the interdisciplinary team, and communicates with your primary and consulting physicians as needed. Rehabilitation Nurses (RN) Your nurse conducts the initial evaluation/assessment, initiates the medical plan of care and makes the necessary revisions during the individual s hospitalization. Your nurse instructs you and your family members on topics related to your medical condition as well as self-care skills you may need to learn to increase functional independence. Your nurse will also provide carry-over of therapy interventions during non-therapy hours. Certified Nursing Attendants (CNA) Your CNA assists you with all personal care needs such as toileting, bathing and eating. Under the direction of your nurse, the CNA is responsible for taking vital signs, obtaining weights, monitoring blood sugars, providing catheter care, and monitoring for changes in your condition or level of support requirements. Physical Therapists (PT) Your Physical therapist works to improve your ability to perform activities such as moving in bed, transferring, standing, walking, and wheelchair mobility. Depending on your ability level, the PT will train you and your family on the use of assistive devices as well as prescribe exercises to increase your range of motion, strength and endurance. As it pertains to each individual, the PT will assist with learning higher level skills such as getting off the floor, getting in a car, and navigating stairs. Occupational Therapists (OT) Your Occupational therapist works to improve, regain or retain your ability to perform tasks of everyday living such as; cooking, eating, bathing, dressing, grooming, meal preparation, and visual/perceptual tasks. Your occupational therapist will occasionally assist you with showering and dressing in the morning. The OT provides education about adaptive methods such as adaptive device training, home safety, energy conservation and joint protection. Recreational Therapists They will assist with providing transportation for community outings, and will provide lifestyle/leisure modification recommendations as needed.

13 Speech and Language Pathologists (SLP) Your speech therapist provides individual therapy programs that treat cognitive, language, memory, speech, swallowing and hearing deficits/disorders that interfere with your ability to function independently. If you have swallowing difficulties the ST may conduct swallowing evaluations and instruct you in swallowing compensatory techniques. Clinical Registered Dieticians (RD) Conduct nutritional assessments for all rehabilitation patients. Nutritional Counseling and/or consultation is available as ordered. They will coordinate with the team to ensure education is provided in a way that is comprehensible to the patient and/or caregiver. Director of Inpatient Rehabilitation, Therapy & Wound Care Services & Cardiac and Oncology Outpatient Rehabilitation. Sharon Whitehead, PT - Office: Social Worker/Discharge Planner - Duane Grover, RN Case Manager Your discharge planner/social worker will explore with you and your family the changes brought about by your disability or illness. He will assist with obtaining equipment, establishing follow-up care, providing emotional support, and keeping you and your primary caregiver informed regarding ongoing discharge planning. Clinical Rehab Specialist Cynthia Decker, RN, CRS The clinical rehab specialist coordinates with the rehabilitation physician to determine which persons are candidates for intensive inpatient rehabilitation. Although the CRS is crucial to your admission to the unit, once you are admitted your care is shifted to other providers. PPS Coordinator, Sandy Stagelman, RN, PPS Coordinator Although not involved in direct patient care, the PPS coordinator works behind the scenes to ensure that the rehabilitation facility holds high standards of care in multiple arenas, as well as provides education to staff and physicians.

14 Rehabilitation Unit FAQ s Our general visiting hours are 4-8 pm Monday-Friday and 9-9pm on Saturday- Sunday. Children under 12 may visit in the common area outside the Rehab unit. Children must be attended by a responsible adult AT ALL TIMES. The cafeteria is open Monday-Friday from 11-2 for lunch and from 4-5:30pm for dinner. They are closed on the weekend. Subway is open from 6am-9pm Monday-Friday and 8am-9pm Saturday-Sunday. Vending machines are available in the cafeteria area. There is coffee, tea, hot chocolate & water available for all guests. The food in the cabinets and the refrigerator is for patients only. The hospital gift shop is open from Monday-Friday 10am-5pm. Alaska Regional Hospital is a non-smoking campus. There is no smoking allowed on the grounds. Laundry services are not available. T-shirts, Sweatpants, Sweatshirts, or gowns will be issued to patients who are not able to obtain their own clothing. Family & friends are welcome to take patients personal clothing home for laundering. Rooming-in Only one person at a time is allowed to room in. Rooming is permitted for several reasons and is determined on a case by case basis. o Family presence is required to maintain a reasonable level of calm that will allow for participation with prescribed activities. o The primary caregiver needs to room in to establish a reasonable expectation of your round-the-clock care requirements, and practice the skills taught in therapy. We have 6 semi-private and 2 private beds. Private beds are allotted for patients on isolation or with very specific care requirements. Safety We care very much about the safety of our patients. We use a bed/chair alarm on all patients, which has proven to decrease risk of falls on our unit. Exceptions to using the alarms are made by the decision of the entire rehab team. Rehab Nurses Station: (907) Discharge planning: (907) We value your feedback. Please ask your nurse for a comment card if desired. Thank you for choosing Alaska Regional Hospital!