he action of restoring someone to health or normal life through training and therapy after imprisonment, addiction, or illness. "she underwent rehabilitation and was walking within three weeks"

1. UNIT-VII
REHABILITATION
DR.ANJALATCHI
M.SC(N)MD(AM)MBA(HA)
VICE PRINCIPAL
ERA COLLEGE OF NURSING

2. CONTENT OF THE CHAPTER
• Introduction
• Definition
• Goal
• Concept
• Types
• Principles
• Trends
• Issues
• Rehabilitation team
• Role of CHN in rehabilitation

3. Learning objectives
• To introduce the topic
• To define the rehabilitation
• To meaning the rehabilitation
• To discuss the concepts of rehabilitation
• To list out the goal of rehabilitation
• To enlist the need of rehabilitation
• To explain the cornerstones of rehabilitation
• To list out the types of rehabilitation
• To describe the principles of rehabilitation
• To explain the trends and issues of rehabilitation
• To understand the aspect of rehabilitation
•

4. Key facts about rehabilitation
• Rehabilitation is an essential part of universal health coverage along with
promotion of good health, prevention of disease, treatment and
palliative care.
• Rehabilitation helps a child, adult or older person to be as independent
as possible in everyday activities and enables participation in education,
work, recreation and meaningful life roles such as taking care of family.
• Globally, an estimated 2.4 billion people are currently living with a
health condition that benefits from rehabilitation.
• The need for rehabilitation worldwide is predicted to increase due to
changes in the health and characteristics of the population. For example,
people are living longer, but with more chronic disease and disability.
• Currently, the need for rehabilitation is largely unmet. In some low- and
middle-income countries, more than 50% of people do not receive the
rehabilitation services they require. Rehabilitation services are also
amongst the health services most severely disrupted by the COVID-19
pandemic.

5. Introduction

6. What is rehabilitation ?
• Rehabilitation is defined as “a set of
interventions designed to optimize
functioning and reduce disability in
individuals with health conditions in
interaction with their environment”.

7. Meaning

8. Definition

9. Definition

10. Goal of Rehabilitation

11. Need of Rehabilitation

12. Continued

13. Cornerstones of Rehabilitation

14. Principles of rehabilitation

15. Continued

17. Type of Rehabilitation

18. Based on the treatment

19. Types of team consist of :

20. Type of team work

21. Rehabilitation applied in
• Anybody may need rehabilitation at some
point in their lives, following an injury, surgery,
disease or illness, or because their functioning
has declined with age.

22. Some examples of rehabilitation
include:
• Exercises to improve a person’s speech, language and
communication after a brain injury.
• Modifying an older person’s home environment to improve their
safety and independence at home and to reduce their risk of falls.
• Exercise training and education on healthy living for a person with a
heart disease.
• Making, fitting and educating an individual to use a prosthesis after
a leg amputation.
• Positioning and splinting techniques to assist with skin healing,
reduce swelling, and to regain movement after burn surgery.
• Prescribing medicine to reduce muscle stiffness for a child with
cerebral palsy.
• Psychological support for a person with depression.
• Training in the use of a white cane, for a person with vision loss.

23. The benefits of rehabilitation
• Rehabilitation can reduce the impact of a broad
range of health conditions, including diseases
(acute or chronic), illnesses or injuries.
• It can also complement other health
interventions, such as medical and surgical
interventions, helping to achieve the best
outcome possible.
• For example, rehabilitation can help to reduce,
manage or prevent complications associated with
many health conditions, such as spinal cord
injury, stroke, or a fracture.

24. Continued
• Rehabilitation helps to minimize or slow down
the disabling effects of chronic health
conditions, such as cardiovascular disease,
cancer and diabetes by equipping people with
self-management strategies and the assistive
products they require, or by addressing pain
or other complications.

25. Continued
• Rehabilitation is an investment, with cost
benefits for both the individuals and society. It
can help to avoid costly hospitalization, reduce
hospital length of stay, and prevent re-
admissions. Rehabilitation also enables
individuals to participate in education and
gainful employment, remain independent at
home, and minimize the need for financial or
caregiver support.

26. Continued
• Rehabilitation is an important part of universal
health coverage and is a key strategy for
achieving Sustainable Development Goal 3 –
“Ensure healthy lives and promote well-being
for all at all ages”.

27. Issues in rehabilitation

28. Continued

29. Misconceptions about rehabilitation
• Rehabilitation is not only for people with long-term or physical
impairments. Rather, rehabilitation is a core health service for anyone with
an acute or chronic health condition, impairment or injury that limits
functioning, and as such should be available for anyone who needs it.
• Rehabilitation is not a luxury health service that is available only for those
who can afford it. Nor is it an optional service to try only when other
interventions to prevent or cure a health condition fail.
• For the full extent of the social, economic and health benefits of
rehabilitation to be realized, timely, high quality and affordable
rehabilitation interventions should be available to all. In many cases, this
means starting rehabilitation as soon as a health condition is noted and
continuing to deliver rehabilitation alongside other health
interventions.

30. Unmet global need for rehabilitation
• Global rehabilitation needs continue to be unmet due to multiple factors,
including:
• Lack of prioritization, funding, policies and plans for rehabilitation at a
national level.
• Lack of available rehabilitation services outside urban areas, and long
waiting times.
• High out-of-pocket expenses and non-existent or inadequate means of
funding.
• Lack of trained rehabilitation professionals, with less than 10 skilled
practitioners per 1 million population in many low- and middle-income
settings.
• Lack of resources, including assistive technology, equipment and
consumables.
• The need for more research and data on rehabilitation.
• Ineffective and under-utilized referral pathways to rehabilitation.

31. Rehabilitation team consist of
• The rehabilitation workforce is made up of
different health workers, including but not
limited to physiotherapists, occupational
therapists, speech and language therapists
and audiologists, orthotists and prosthetists,
clinical psychologists, physical
medicine and rehabilitation doctors, and
rehabilitation nurses.

32. Rehabilitation team

33. Continued

34. Pectoral presentation

35. Rehabilitation team

36. Continued

37. Function of team

38. Continued

39. Patient education

40. Patient education

41. Scope of Rehabilitation
• Rehabilitation nursing requires inter-sectoral
and intra-sectoral discipline or specialties. So,
there is a wide scope of rehabilitation nursing.

42. Scope of Rehabilitation

44. Family, family centered care

45. Continued

46. Continued

47. Pediatric rehabilitation care

48. Gerontological rehabilitation care

49. Ethical issues in Rehabilitation

52. Role of nurse in rehabilitation

56. Important area in nursing role

58. List of role
• Teacher
• Shares information about the disease processes underlying
disabilities and teaches nursing techniques to help clients and their
families develop the self-care skills necessary to move toward
wellness on the illness-wellness continuum
• Prepares clients and their families for future self-management and
decision-making responsibilities by fostering clients' independence
and goal achievement
• Reinforces the teaching done by specialists in rehabilitation and
other healthcare disciplines, provides resource materials for clients'
changing needs, and provides on-going patient education after
discharge
• Provides in-service education for healthcare team members and
members of the community regarding the prevention of disabilities

59. Caregiver
• Assesses the physical, psychological, sociocultural, and spiritual
dimensions of clients and their families, as well as their educational
and discharge needs in order to formulate nursing diagnoses
• Plans nursing care while acknowledging that rehabilitation nursing
is practiced within a dynamic, therapeutic, and supportive
relationship that is constantly changing, as nurses and clients
influence one another
• Implements a plan of care by providing nursing care and education
directly or through ancillary personnel, as needed, to maintain and
restore function and prevent complications and further loss
• Evaluates the nursing care that is being provided and modifies the
plan, as needed, to achieve measurable goals and objectives

60. Collaborator
• Develops goals, in collaboration with clients, their families, and the
rehabilitation team, that are oriented to wellness behavior and are
reality based and that encourage socialization with others, and
promote maximal independence for patients with disabilities or
chronic disabling conditions
• Participates in the interdisciplinary team process at team
conferences and other team meetings and offers input into team
decision making
• Intervenes with team members and other healthcare professionals
to ensure that the optimal opportunity for recovery is made
available to the client, the most significant member of the
rehabilitation team
• Collaborates with team members to achieve cost-effective care by
utilizing appropriate clinical measures to meet emergent physical,
psychosocial, and spiritual situations

61. Client Advocate
• Actively listens, reflects, and guides clients and their families
through the stages of the grieving process to mourn the loss of
abilities and roles while also "instilling hope"
• Advocates for policies and services that promote the quality of life
for individuals with disabilities and participates in activities that will
positively influence the community's awareness of disabilities
• Contributes to a safe and therapeutic environment and supports
activities that promote the clients' return of function and prevent
complications or chronic illness
• Intervenes on behalf of clients to ensure that medical professionals
and nonmedical professionals work to maximize clients' success
when they return to work or school

62. Practitioner
• Performs on-site and/or record review,
including telephone preadmission screening
and clinical assessment
• Completes all required preadmission
screening documentation to determine that
services are appropriate, reasonable and
necessary
• Provides recommendations for appropriate
level of care

63. Educator
• Educates clients, family members or
significant others, referral sources,
interdisciplinary team members, external
payers, and external case managers about
rehabilitation program benefits and services
and post-acute care services

64. Consultant
• Serves as a rehabilitation nurse consultant, with
attention to the client’s rehabilitation potential,
therapy and functional progress, discharge plan
and feasibility, special equipment needs,
rehabilitation services across the continuum of
care, and care transitions
• Demonstrates a high level of knowledge of
regulations and external payer requirements
• Assists in facilitation benefit eligibility and
precertification, including providing a plan of care
and participating in external payer negotiations

65. Outreach Coordinator
• Maintains a thorough knowledge of rehabilitation
settings, post-acute care services, acuity trends
and outcomes
• Develops relationships with referral sources
• Assumes accountability for outreach activities,
including data management and outcomes
analysis
• Develops rapport with clients and their family
members or significant others
• Conducts other outreach activities including
exhibiting and providing tours

66. Facilitator
• Provides information necessary to facilitate referrals
and subsequent admissions
Negotiator
• Provides referral sources with cost-effective plans for
rehabilitation
• Provides outcome data
• Negotiates approval for a client’s stay
• If necessary, negotiates rates with payers
Collaborator
• Serves as a contact person for the rehabilitation team,
internal admissions team, clients, and external sources
to enhance outcomes

67. Promoter
• Promotes effective public relations with clients
and families, healthcare providers, and the
community
• Exhibits professional behavior as a facility
representative
Quality Control
• May provide regulatory oversight to maintain
compliance with regulatory agencies governing
the post-acute program.

68. SUMMARY
• Still we discussed about rehabilitation and its
importance in nursing like introduction ,
definition, goal, objective, type, core , issues ,
trends , scope ,ethical issues and role of CHN
in rehabilitation etc.

69. Conclusion
• I hope you all understand the rehabilitation
and its importance of health care services
• Rehabilitation of patients rests on accurate
diagnosis, proper identification of roles,
cooperation among the different disciplines
and a potent but practical goal setting.
• The patient is always the focus of treatment,
and should have a quality of life that is
deemed most acceptable.

70. Questions related to topic
• Define the rehabilitation ?
• List the aim of rehabilitation
• Enlist the objectives of rehabilitation
• List the type of rehabilitation ?
• Discuss the issues related to rehabilitation?
• Describe the trends in rehabilitation ?
• Describe the principles of rehabilitation?

71. References
• K.Park Text Book Of Preventive And Social Medicine ,
Jaypee Brothers, New Delhi Page No. 55,355
• Kumari Neelam, Community health nursing, 1st
edition, P.V. books publication,Jalandhar city
India,2011.pg no-
• Basavanthapa BT, Community health nursing, Jaypee
brother,Ansari Road Daryagenz,New Delhi, 1st
edition,2006. pg no-
• Swarekar Keshav,Community health
nursing.N.R.Brother.M.Y. Hospital Road Indore.1st
edition,2004.pg no-328-334