Journal of the Australasian Rehabilitation Nurses' Association

The need for rehabilitation is increasing worldwide. This need, however, is largely unmet (World Health Organization, 2017). One of the World Health Organization’s (WHO’s) strategies to meet this need is for local and international bodies to increase investment in the rehabilitation workforce, including strengthening evidence-based service delivery through education, up-skilling and training (World Health Organization, 2023). Competency-based certification for the rehabilitation workforce is one way to help realise this strategy. The aim of this commentary is four-fold: firstly (i) to inform rehabilitation nurses about the newly developed Global Rehabilitation Certification Program (GRCP) and specifically, the associated competency-based certifications for rehabilitation nurses; (ii) to provide information on the impetus behind the GRCP; (iii) to discuss why the nursing profession may need specialty specific certification; and lastly (iv) to discuss why of all the disciplines providing rehabilitation, perhaps nursing has the most to gain from such an initiative.

Introduction The Nursing Sleep Assessment Form (NSAF) was developed for integration into electronic medical records (EMRs), enabling 24-hour bedside nurses to document patient sleep quickly and consistently. Effective communication is fundamental to healthcare, and documentation of patient observations is a critical component of safe, quality care. However, aspects of patient wellbeing, such as sleep are often under recorded, potentially limiting better outcomes. Restorative sleep is important during rehabilitation, for neurocognitive, emotional, social, spiritual and physical recovery. Rehabilitation nursing care plays a vital role in recovery, and nurses report concerns about patient sleep in research literature. Despite this, opportunities to communicate about sleep within clinical settings are limited, largely due to the absence of structured EMR forms. To address this gap, the NSAF tool was developed to support consistent assessment and communication of sleep in a low acuity settings, such as rehabilitation wards.

Design The Model for Improvement and the Plan Do Study Act (PDSA) quality improvement designs were implemented for the activity.

Methods A traditional paper-based sleep diary was modified for bedside nursing and was digitised for integration into the EMR.

Results The electronic form has ease of use, can be completed in less than 30 seconds and could be adapted to organisational needs, it does, however, require further testing in clinical populations.

Discussion Providing tools to document and communicate sleep problems for patients in rehabilitation may improve outcomes at minimal cost.

This vignette of practice is a clinical case study that demonstrates the application of the Australasian Rehabilitation Nurses’ Association (ARNA) Competency Standard Domain 2: Teaching and Coaching for the purpose of further introducing readers to the applied use of ARNA Rehabilitation Competency Standards for Registered Nurses.

The reconditioning process of an older single adult in an in-patient rehabilitation setting who had previously lived independently in a retirement complex is explored. This real-life clinical scenario was initially a case study used in a face-to-face workshop to examine the implications of using the Functional Independence Measure (FIM) to set priorities during an ARNA NSW/ACT study day. Facilitation of learning is a key component of Domain 2, and there were many opportunities to facilitate rehabilitation learning throughout the patient’s stay.

All situational context has been changed, and general information only has been presented with an emphasis on the nurses’ practice and the patient’s responsiveness to the approach. No patient details have been included, and fictional names are used. No specific patient information that would require consent has been used, however the original patient gave verbal consent for her rehabilitation journey to be used for educational purposes.