Objective measures of sleep and wakefulness in patients with moderate to severe brain injury on an inpatient rehabilitation unit. Pearls and pitfalls of actigraph monitoring

2018 ◽  
Vol 43 (3) ◽  
pp. 277-285 ◽  
Author(s):  
Michael J. Makley ◽  
Kimberley R. Monden ◽  
Angela Philippus ◽  
Patrick M. Tarwater ◽  
Jody Newman ◽  
...  
Keyword(s):  
Brain Injury ◽  
Inpatient Rehabilitation ◽  
Objective Measures ◽  
Severe Brain Injury ◽  
Rehabilitation Unit

scholarly journals In-patient neuropsychiatric brain injury rehabilitation

2000 ◽  
Vol 24 (7) ◽  
pp. 264-266 ◽  
Author(s):  
Fernando Lazaro ◽  
Rob Butler ◽  
Simon Fleminger
Keyword(s):  
Brain Injury ◽  
Verbal Aggression ◽  
Clinical Implications ◽  
Severe Brain Injury ◽  
Rehabilitation Unit ◽  
Injury Rehabilitation ◽  
Physical Problems ◽  
Cognitive Behavioural ◽  
Wide Range ◽  
The Mean

Aims and MethodTo discuss the service offered by an in-patient neuropsychiatric brain injury rehabilitation unit. To examine the demographic details of patients admitted to the unit. To find the commonest reasons for referral.ResultsThe notes of 78 patients admitted to the unit, over a two-year period, were examined. Seventy-three per cent were male and the mean age was 45 years. Seventy-five per cent of admissions had a severe brain injury. Two-thirds of the patients were admitted within six months of their injury. The most common reasons for referral were memory difficulties (n=61), verbal aggression (n=31) and temper control(n=25).Clinical ImplicationsIn-patient neuropsychiatric brain injury rehabilitation units offer management of patients referred with a wide range of cognitive, behavioural, functional and physical problems.

Complicated Mild Traumatic Brain Injury on the Inpatient Rehabilitation Unit

2006 ◽  
Vol 21 (3) ◽  
pp. 260-271 ◽  
Author(s):  
Richard E. Kennedy ◽  
Lee Livingston ◽  
Jennifer H. Marwitz ◽  
Shana Gueck ◽  
Jeffrey S. Kreutzer ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Unit

scholarly journals Activity, Participation, and Goal Awareness After Acquired Brain Injury: A Prospective Observational Study of Inpatient Rehabilitation

2021 ◽  
Vol 45 (6) ◽  
pp. 413-421
Author(s):  
Zoe Adey-Wakeling ◽  
Laura Jolliffe ◽  
Elizabeth O’Shannessy ◽  
Peter Hunter ◽  
Jacqui Morarty ◽  
...  
Keyword(s):  
Brain Injury ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Program ◽  
Activity Participation ◽  
Activity Levels ◽  
Rehabilitation Unit ◽  
Injury Rehabilitation

Objective To examine the frequency and timing of inpatient engagement in meaningful activities within rehabilitation (within and outside of structured therapy times) and determine the associations between activity type, goal awareness, and patient affect.Methods This prospective observational study performed behavioral mapping in a 42-bed inpatient brain injury rehabilitation unit by recording patient activity every 15 minutes (total 42 hours). The participants were randomly selected rehabilitation inpatients with acquired brain injury; all completed the study. The main outcome measures included patient demographics, observation of activity, participation, goal awareness, and affect.Results The inpatients spent 61% of the therapeutic day (8:30 to 16:30) in their single room and were alone 49% of the time. They were physically socially inactive for 76% and 74% of their awake time, respectively, with neutral affect observed for about half of this time. Goal-related activities were recorded for only 25% of the inpatients’ awake time. The odds of physical activity were 10.3-fold higher among in patients receiving support to address their goals within their rehabilitation program (odds ratio=10.3; 95% confidence interval, 5.02–21.16).Conclusion Inpatients in a mixed brain injury rehabilitation unit spent a large amount of their awake hours inactive and only participated in goal-related activities for a quarter of their awake time. Rehabilitation models that increase opportunities for physical, cognitive, and social activities outside of allied health sessions are recommended to increase overall activity levels during inpatient rehabilitation.

Confronting the grey zone after severe brain injury

2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen
Keyword(s):  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Clinical Care ◽  
Grey Zone ◽  
Severe Brain Injury ◽  
New Methods ◽  
Legal Decision Making ◽  
Technological Developments ◽  
The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

Capture Rates of Comorbidity Measures at Inpatient Rehabilitation Facilities After a Stroke or Brain Injury

PM&R ◽  
2021 ◽  
Author(s):  
Gregory T. Robbins ◽  
Richard Goldstein ◽  
Sameer Siddiqui ◽  
Donna S. Huang ◽  
Ross Zafonte ◽  
...  
Keyword(s):  
Brain Injury ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Facilities ◽  
Capture Rates

scholarly journals Simplified evaluation of CONsciousness disorders (SECONDs) in individuals with severe brain injury: A validation study

2021 ◽  
Vol 64 (5) ◽  
pp. 101432
Author(s):  
Charlène Aubinet ◽  
Helena Cassol ◽  
Olivier Bodart ◽  
Leandro R.D. Sanz ◽  
Sarah Wannez ◽  
...  
Keyword(s):  
Brain Injury ◽  
Validation Study ◽  
Severe Brain Injury ◽  
Consciousness Disorders

Improving WeeFIM score completion rates: An interdisciplinary inpatient rehabilitation unit quality improvement project

2021 ◽  
pp. 1-8
Author(s):  
Ashlee Jaffe ◽  
Maura Powell ◽  
Tami Konieczny ◽  
Carlene Osweiler ◽  
Genna Kreher
Keyword(s):  
Quality Improvement ◽  
Interdisciplinary Team ◽  
Inpatient Rehabilitation ◽  
Visualization Tool ◽  
Completion Rates ◽  
Intervention Period ◽  
Rehabilitation Unit ◽  
Improvement Project ◽  
Comprehensive Therapy ◽  
Therapy Services

PURPOSE: The WeeFIM is a tool commonly used in pediatric rehabilitation settings to measure objective patient progress while receiving comprehensive therapy services on inpatient rehabilitation units. This Quality Improvement (QI) project aimed for 95%of inpatients to have complete, on-time documented and displayed WeeFIM scores upon admission and discharge by 12/2017. METHODS: An interdisciplinary team examined historic WeeFIM completion rates. Using Plan-Do-Study-Act cycles, a unified flowsheet was developed in the electronic health record (EHR) to revamp workflow and identify opportunities for improvement, data accuracy, and finally sustainability. Progress was monitored in real time via an automated data visualization tool which monitored score timeliness and completeness. RESULTS: On-time admission completion rates increased from 0%to 95%during the intervention period. On-time discharge completion rates increased from 0%to 89%during the intervention period. This change has been sustained over 2 years with on-time admission and discharge scores averaging 79.4%and 77.9%respectively, and 96.4%of scores completed. CONCLUSION: Changes in the completion rate of WeeFIMs are sustainable, evidenced by ongoing maintenance of our initial gains over the course of multiple months. The incorporation of WeeFIM documentation into the workflow increased on-time and completion rates. The success of this project shows that integrating new tasks into provider workflows helps drive completion.

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