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Greater Manchester Assessment of Stroke Rehabilitation (G-MASTER) Toolkit Users' Manual

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Greater Manchester Assessment of Stroke Rehabilitation (G-MASTER) Toolkit Users' Manual The University of Manchester Research Greater Manchester Assessment of Stroke Rehabilitation (G-MASTER) Toolkit Users' Manual Link to publication record in Manchester Research Explorer Citation for published version (APA): Tyson, S., Burton, L., & McGovern, A. (2013). Greater Manchester Assessment of Stroke Rehabilitation (G- MASTER) Toolkit Users' Manual. No publisher name. Citing this paper Please note that where the full-text provided on Manchester Research Explorer is the Author Accepted Manuscript or Proof version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version. General rights Copyright and moral rights for the publications made accessible in the Research Explorer are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. Takedown policy If you believe that this document breaches copyright please refer to the University of Manchester’s Takedown Procedures [http://man.ac.uk/04Y6Bo] or contact [email protected] providing relevant details, so we can investigate your claim. Download date:07. Oct. 2021 Acknowledgements Authors Louisa Burton, Project Manager, Greater Manchester & Cheshire Cardiac and Stroke Network Sarah Tyson, Professor of Rehabilitation, University of Manchester Alison McGovern, Quality Improvement Manager, Greater Manchester & Cheshire Cardiac and Stroke Network Sudi Sharifi, Senior Lecturer, University of Salford With considerable thanks to the Greater Manchester Stroke Rehabilitation teams who participated in the G-MASTER project: Bolton NHS Foundation Trust Central Manchester & Manchester Children’s Hospital NHS Trust Pennine Acute Hospital Trust, Fairfield General Hospital Pennine Acute Hospital Trust, Royal Oldham Hospital Pennine Acute Hospital Trust, North Manchester General Hospital Salford Royal NHS Foundation Trust Stockport NHS Foundation Trust Tameside Hospital Foundation Trust Trafford Healthcare NHS Trust University Hospital of South Manchester NHS Foundation Trust Wrightington, Wigan & Leigh NHS Foundation Trust 1 Contents Introduction ...................................................................................................................................................................... 3 Swallow Screening ............................................................................................................................................................ 5 Greater Manchester Stroke Water Swallow Screening Tool: Instruction Manual ....................................................... 6 Greater Manchester Stroke Water Swallow Screening Tool ........................................................................................ 9 Nutritional Screening ...................................................................................................................................................... 11 Malnutrition Universal Screening Tool (BAPEN) ......................................................................................................... 12 Communication Screening .............................................................................................................................................. 18 National Institutes of Health Stroke Scale (NIHSS) Communication sections ............................................................ 19 Mood Screening .............................................................................................................................................................. 24 Greater Manchester Algorithm for Selecting Appropriate Mood Screening Measures for Patients with Stroke ...... 27 The Stroke Aphasic Depression Questionnaire (SADQ–H10)...................................................................................... 28 Depression Intensity Scale Circles (DISCs) .................................................................................................................. 29 Depression Intensity Scale Circles (DISCs) – Instructions for administration ............................................................. 29 GAD-7 .......................................................................................................................................................................... 32 Cognitive Screening ......................................................................................................................................................... 33 Montreal Cognitive Assessment (MoCA) .................................................................................................................... 34 Montreal Cognitive Assessment (MoCA): Administration and Scoring Instructions .................................................. 35 Measuring functional outcomes ..................................................................................................................................... 39 Independence in Activities of Daily Living – Barthel Index ......................................................................................... 39 The Barthel Index ............................................................................................................................................................ 40 Barthel Index Scoring Criteria ..................................................................................................................................... 41 Monitoring communication and swallowing abilities over time – Therapy Outcome Measures .................................. 42 Therapy Outcome Measures (Dysphasia/Aphasia) ..................................................................................................... 42 Therapy Outcome Measures (Dysphagia) ................................................................................................................... 44 Therapy Outcome Measures (Dysarthria) .................................................................................................................. 45 How to run an effective Stroke Multi-Disciplinary Team meeting ................................................................................. 46 Sample MDT Meeting Agenda ........................................................................................................................................ 49 Initial MDT form .......................................................................................................................................................... 51 Weekly MDT form ....................................................................................................................................................... 52 References ...................................................................................................................................................................... 54 2 Introduction Background Use of standardised measurements tools in practice can: Assessment is a crucial part of stroke rehabilitation, providing a means of identifying Promote use of a common language to and measuring patients’ needs. enhance team communication Although national guidance recommends the Facilitate transfer of information use of standardised assessment tools and between services, allowing them to outcome measures, clinicians have reported provide the best care for the patient pragmatic difficulties in selecting the best Help to ensure that multidisciplinary tools to use in their practice. Research discussions are patient-centred evidence has demonstrated that using standardised measures can be beneficial to Use of same tools across services can rehabilitation team communication, allowing prevent repetition of similar information about patients’ problems and assessments for patients functional abilities to be shared in an efficient way (Tyson et al., 2010). Measures can also How did we decide what to measure? be used to monitor patients’ progress, to inform clinical decision-making and to Practicing stroke rehabilitation professionals demonstrate service effectiveness. were asked about the domains of functioning, which: What did we aim to achieve? Are necessary to measure during rehabilitation The G-MASTER project aimed to: All members of the rehabilitation team Provide meaningful ways to measure need to know about to treat their patient progress through rehabilitation patient effectively Provide clinicians with information Focus groups of patients were also asked about valid and reliable tools that are about their most important problems after feasible to use in the clinical setting they had a stroke and the ways these were measured. Finally national guidelines were explored to identify the areas requiring “I think we all struggled to find measurement using standardised tools. standardised assessments that we can use and it was really nice to have something that’s been assessed as being a suitable tool” OT 3 What process did we use to identify tools? For further information… The literature was searched to identify For further information on how the tools appropriate validated tools to measure each were selected and other tools which were domain and the psychometric properties of considered, please contact: tools were assessed. In addition, tools were Louisa Burton, G-MASTER Project Manager assessed for clinical feasibility, including: [email protected] Time taken to administer and score the tool Need for specialist training for staff
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