Journal of the Australasian Rehabilitation Nurses' Association

Introduction While the central role of goals in rehabilitation is acknowledged by nursing, an explicit understanding of how this belief fits with the everyday demands of nursing work in inpatient rehabilitation is missing.

Aim This study sought to address this issue through the design, implementation and evaluation of a nursing education intervention aimed at teaching nurses how to use on-the-spot goals with rehabilitation patients.

Methods Mixed methods longitudinal study using three surveys

Findings The on-the-spot goals technique was well received and a good fit with everyday nursing practice. However, despite an increase in confidence immediately following the workshop, there was no difference in reports of actual use of the technique and confidence in use at the 4-month follow up. Nurses identified both enablers and barriers to use of the technique in practice.

Discussion The on-the-spot goals technique fits well with nursing’s teaching and coaching role. It can be used by nurses individually and collectively to enhance nurse rehabilitation-effectiveness regardless of the setting.

This vignette of practice is a clinical case study to demonstrate the application of the ARNA Competency Standard Domain 1: The Rehabilitative Approach, for the purpose of introducing readers to the applied use of ARNA Rehabilitation Competency Standards for Registered Nurses (2023) to enhance their understanding of the competency standards in action.

This vignette has been based on real-life clinical practice as observed by the first author, an experienced clinician and educator. All situational context has been changed, and general information only has been presented with an emphasis on the nurse’s practice and the patient’s responsiveness to the approach. No patient details have been included, injury level has been changed, and fictional names are used only. No specific patient information that would require consent has been used.

Purpose This review aims to explore the expectations, experiences and perceptions of people returning home after a sudden-onset disability, and to investigate barriers and enablers to a smooth transition process. Looking across impairment groups, including stroke and traumatic brain injury or spinal cord injury, can generate understandings more applicable to those working with cohorts of mixed impairment groups.

Methods An integrative review was conducted via Medline, Embase, CINAHL and Scopus using multiple search strategies. Entire findings sections of the included studies were extracted, and results synthesised through an iterative process.

Results Two overarching themes were generated. Firstly, ‘the journey back home’ explored the process of adjusting to life after discharge. This was broken down into four subthemes: looking forward to going home; the day of discharge; encountering challenges and recognising changes; and constructing a new way of life. Secondly, enablers and barriers were described, including home-based therapies, education and information provision, desire for more rehabilitation, social supports, time, and experience.

Conclusion Returning home after a sudden-onset disability is challenging regardless of the type or severity of impairment. There was a shared trajectory towards adjusting to life at home and commonalities across enabling and limiting factors.