title: 'Can practice undertaken by patients be increased simply through implementing agreed national guidelines?' An observational study.
abstract: OBJECTIVE
  To increase autonomous practice time of patients on the stroke unit of a nursing home.
  
  
  METHODS
  Nurses stimulated and coached patients with the help of four interventions (muscle strengthening, sitting balance and reach, getting up from a chair, walking) from the evidence-based Clinical Nursing Rehabilitation Stroke Guidelines.
  
  
  METHODS
  An observational study. Practice time of elderly stroke patients in this study was compared with the time observed in our previous study in the same setting.
  
  
  METHODS
  Rehabilitation units of a nursing home in the Netherlands.
  
  
  METHODS
  Seventeen frail stroke patients, including 8 men, 9 women, with a mean age of 75.8 (SD ± 9) and 17 subjects with the same characteristics who participated in a previous observational study.
  
  
  METHODS
  Time spent on therapeutic activities was measured using the Behavioral Mapping method.
  
  
  RESULTS
  The time spent on therapeutic activities increased significantly from 103.5 minutes measured in our previous study to 156.5 minutes in this study (Z = 2.86; P < 0.005; d' = 1.09) The mean Barthel Index score was 8.8 (SD ± 4.1). The patients with more possibilities were more active, resulting in a significant positive Barthel Index-therapy time relationship (r = 0.73, P ≤ 0.001).
  
  
  CONCLUSIONS
  The autonomous practice time of older fragile comorbid stroke patients increased during the weekdays. Patients, stimulated and challenged by nurses, exercise harder and more according to their possibilities. Since this guideline was developed especially for nurses, nurses can stimulate stroke patients to contribute more to autonomous practice and therefore help their recovery.
authors: Innovation and Knowledge Centre, ROC West-Brabant and Gerontology, Avans University for Applied Sciences, Breda, Hoeven, The Netherlands. marleenhuijben@gmail.com
authors: Marleen
authors: M
authors: Huijben-Schoenmakers
authors: Arno
authors: A
authors: Rademaker
authors: Erik
authors: E
authors: Scherder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005081:Exercise Therapy; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D009426:Netherlands; D024802:Nurse's Role; D009735:Nursing Homes; D010358:Patient Participation; D017410:Practice Guidelines as Topic; D011214:Practice, Psychological; D020521:Stroke / Q000150:complications / Q000523:psychology; D000071939:Stroke Rehabilitation; D013997:Time Factors
keywords: Clinical Nursing Rehabilitation Stroke Guidelines; Stroke; autonomous practice; nursing care; rehabilitation