The Integration of Rehabilitative Practices in a Baccalaureate Nursing Curriculum in Haiti

Friday, 28 July 2017: 11:25 AM

Janice L. Cotrone, DNP
Division of Nursing Sciences, Global Partners, Fishers, IN, USA

Patients in Haiti needing rehabilitative services are often unable to access quality healthcare thus not achieving expected and desired outcomes. A four-year baccalaureate program of nursing developed and integrated numerous nurse-appropriate rehabilitative treatment modalities in collaboration with doctorally prepared physical therapists. Rehabilitative practices for infants with spina bifida, cerebral palsy, and zika-related complications, young and middle-aged adults with injuries secondary to athletic and motorcycle injuries, and older adults with stroke were developed. Interprofessional collaboration supported the integration of rehabilitative therapy into the nursing curriculum. Students learned and practiced skills and techniques in the care of hospitalized patients and in outpatient arenas. Physiotherapy and rehabilitative techniques focused on “early mobilization, task-oriented exercises related to daily activities, and preparing individuals with different disabilities for optimal capacity and physical function” (Langhammer & Verheyden, 2013, p. 67) from admission to discharge.

First-year nursing students studied the physiology of disease pertaining to the concepts of disability, impairment, and handicap. Fundamentals of Nursing included basic bedside care of patients with functional disabilities. Second-year students studied treatments for patients with illness and injury requiring rehabilitative therapies. Skills taught included assessment of functional mobility, range of motion, and specific muscle-strengthening techniques (Hafsteinsdóttir, et al., 2012). Such techniques were taught to caregivers as well. Third-year studies focused on transitioning from the acute care setting to the home setting. Restorative practices began on the first day of hospitalization and continued throughout the restoration process, regardless of whether the disability was mild, moderate, or severe. The goal of restorative care is to improve the physical performance of the patient, enhancing the ability to perform activities of daily living as independently as possible. Frequent evaluation and re-evaluation of patients resulted in the revision of the plan of care. Additionally, students assessed home and community environments, evaluating the presence or absence of resources. As students enter the fourth year of baccalaureate nursing studies, the focus broadens to include public health models. Village health fairs and school-based education provided opportunities to explain how to prevent and decrease injuries and thus disability with the ultimate goal of offering hope to patients and families.

Opportunities for further research include measuring levels of progression (or regression) and evaluating caregiver knowledge of rehabilitative practices post-teaching sessions. Rehabilitative practices will help overcome the challenges of the disability.