Northeastern Ontario Stroke Network has created a number of stroke resources to assist you in your practice. For any of these resources below, email us to obtain more information or to request the documents.
Stroke Orientation Checklists for Allied Health and Nursing
The Ontario Regional Stroke Education Group (OREG) is in the process of creating stroke specific orientation checklists for use by Regional Stroke Networks and organizations across the province.
The purpose of these checklists is to support orientation of new staff members, both allied and nursing, working in stroke along the continuum of care. They are not intended for use in developing a new stroke unit.
This checklist can be modified to either add/remove topics that may/may not apply to your organization. Certain topics were not included in this checklist because they are not limited to stroke patients. For example, you may include some of your organization’s policies on topics that may not be stroke specific (i.e. skin care, falls, diabetes, etc.)
Below are the checklists to assist with your orientation needs. There is a Word version that is printable and editable to suit your preferences, and a PDF version that is AODA accessible.
Interprofessional Stroke Orientation Checklist
The Ontario Regional Stroke Education Group (OREG) has developed a Stroke-specific Orientation Checklist to support Regional Stroke Networks and stroke programs/organizations across Ontario.
This checklist is designed to support the orientation of new allied health and nursing staff working across the stroke care continuum. It is not intended for use in developing a new stroke unit, but rather to strengthen and standardize stroke-specific orientation practices.
The checklist is modifiable to meet your organizational needs. You may add or remove topics as appropriate, and consider incorporating relevant organizational policies that are not stroke-specific (e.g., skin care, falls prevention, diabetes management).
Key features include:
- Stroke-specific content for use across the continuum of care
- Interdisciplinary focus for multiple healthcare professions
- Practical support for orienting new staff
- Flexible format that can be tailored to your organization
Contact strokeprogram@hsnsudbury.ca for a copy of the Interdisciplinary Stroke Orientation Checklist.
GRASP – Graded Repetitive Arm Supplementary Program
The Graded Repetitive Arm Supplementary Program (GRASP) was developed by Dr. Janice Eng and her team at the University of British Columbia and GF Strong Rehab Centre in Vancouver, Canada. It is an evidence-based program to improve upper extremity post-stroke, and has been successfully used for in-patient, as well as chronic populations. It is currently recommended as a method to improve hand and arm function in the Canadian Stroke Best Practice Recommendations. It is used in thousands of sites in over 50 countries.
Modifications of GRASP have been developed and evaluated to deliver it 1:1, in-person, in groups, by phone and by Zoom videoconferencing. The archived webinar can be found on our youtube channel.
As well, we have put together a document to assist with finding materials for the grasp kit. Please email us at strokeprogram@hsnsudbury.ca and ask for the GRASP Toolkit Items Needed document. A French version of this document is available upon request.
Video Series: Self-management tools and resources for people recovering from stroke
An 11-episode series of free videos, exploring issues such as physical, cognitive and psychological challenges people recovering from stroke may face and aims to provide tools and resources to help.
The series delivers short sessions (most are about 10 minutes in length) on topics including memory, anxiety, fatigue, attention, stress, unilateral spatial neglect, upper extremity movement, organization and planning, resilience, leisure and functional communication.
Access the Video Series (link opens in a new widnow).
Stroke Core Competency Framework
There is Level A Evidence that Stroke Unit care reduces the likelihood of death and disability by as much as 30% for men and women of any age with mild, moderate, or severe stroke. One of the key components of Stroke Unit Care is that the core interprofessional team should consist of healthcare professional with stroke expertise. Furthermore, Quality Based Procedures for Stroke recommend that interprofessional stroke teams across the continuum receive education and training to promote stroke expertise.
The purpose of the Core Competencies Framework is to provide health care professionals working in stroke with a clear, comprehensive way to achieve the core competencies needed for evidence-based stroke care.
How to use the Stroke Core Competency Framework:
- Rate yourself on your level of expertise using Benner Stages of Clinical Competence
- Identify areas for improvement and develop professional learning plans.
- Seek professional development opportunities to fulfill professional learning plans.
- Leadership may use learning plans to support professional development reviews.
- Leadership may collate results to inform organizational priorities for stroke care that can be integrated into strategic planning.
**Steps 4 and 5 require organizational support and collaboration
Please visit the Stroke Core Competency Framework page (link opens in new window) on the CorHealth Ontario website.
New Educational Modules Now Available – Support Your Team’s Learning
We are excited to share the Standardized Stroke Education Series, designed to supplement the Stroke Core Competency Framework and support foundational stroke care knowledge for all healthcare providers across the continuum of care. The series consists of 23 evidence-informed modules aligned with the Canadian Stroke Best Practice Recommendations and is available in PowerPoint format. These modules are well suited for team meetings, education days, staff training sessions, onboarding of new staff, and self-directed, self-paced learning.
To request any or all of the modules listed below, please send an email to strokeprogram@hsnsudbury.ca.
Module 1 – Introduction to Stroke Care
Module 2 – Brain Anatomy and Physiology
Module 3 – Stroke Pathophysiology
Module 4 – Hyperacute Stroke Care
Module 5 – Ischemic and Intracerebral Hemorrhage Stroke Care
Module 6 – Dysphagia
Module 7 – Nutrition and Hydration
Module 8 – Oral Care
Module 9 – Activity Post Stroke and Safe Patient Handling
Module 10 – Changes in Communication
Module 11 – Changes in Cognition
Module 12 – Changes in Vision and Perception
Module 13 – Sensorimotor Recovery
Module 14 – Fatigue and Changes in Mood and Behaviour
Module 15 – Changes in Physical Function
Module 16 – Maintaining and Promoting Continence
Module 17 – Prevention and Management of Post-Stroke Pain and Spasticity
Module 18 – Stroke Prevention
Module 19 – Transition and Community Reintegration
Module 20 – Participation in Social and Life Roles
Module 21 – Advanced Care Planning
Module 22 – Palliative and End-of-Life Care
Module 23 – Patient, Family, Caregiver Education
Range of Motion Exercise Packages
Range of motion exercise packages have been created by the Northeastern Ontario Stroke Network which were designed to be used by a client's family/caregiver/support worker to assist in properly carrying out passive, or self-ranging, range of motion exercises with a client.
It is the intent of the authors that a regulated health professional will select the most appropriate exercises from these packages and provide them to their client. You will notice that there are separate packages for both the right and left side.
We feel it is imperative that the second page of the package entitled 'Before Getting Started...' be provided with every package handed out, whether only one or multiple exercises are being prescribed, therefore please ensure you do so.
Each package provides key points about the importance of exercise, general proper positioning tips and then specifics of each individual exercise. One exercise is provided per page, text provides the details of the positioning of the person with stroke, the hand positioning of the helper, the movement, the length of time to hold the position and the number of repetitions. Photos are also provided of the starting position and the movement involved.
Passive Range of Motion Exercises (to be performed by a care provider):
Self-Ranging Exercises (to be performed by the client themselves):
French versions of these documents are available upon request.
Posters: Stroke Care Topics
We have printable posters for these topics:
- Hemiplegic Arm and Hand - this poster outlines, in words and pictures, how to protect the hemiplegic arm and hand. It also has a picture on how to properly apply a sling.
- Neglect - this poster defines neglect and lists ways that you can help.
- Aphasia - this poster illustrates strategies to utilize when communicating with someone who has aphasia.
Please email us for copies of these posters. French versions of these posters are available upon request.
Handout: Visual Field Deficit
We have a one-page handout that can be used to educate persons with stroke and their families to better understand visual problems after stroke. The handout includes a description of visual field deficits and possible treatment options.
- Please email us for a copy of this handout.
Self-Learning Program: Mobility and Positioning to Assist a Person with Stroke
The goal of assisting a person with stroke is to maximize functional recovery and promote independence of movement in a safe manner.
How you position, mobilize and transfer is KEY in:
- preventing pain or injury
- encouraging safe active participation
- contributing to normal movement
- increasing independence
This self-learning program includes pictures, written content and a quiz.
The learning objectives are to understand:
- Unique considerations regarding persons with stroke
- General principles to follow when assisting a person with stroke
- Key principles of body mechanics for positioning, mobilizing and transferring patients
- The hemiplegic shoulder and how to prevent injury
- Positioning, bed mobility, transfer and ambulation assistance techniques
Please email us to obtain a copy of the Mobility and Positioning Self-learning Program.
NIHSS Pocket Guide
The National Institutes of Health Stroke Scale (NIHSS) is a standardized clinical tool used to objectively measure the severity of a stroke at the time of assessment. It helps clinicians:
- Quantify neurological deficits
- Determine stroke severity
- Guide treatment decisions (e.g., thrombolysis eligibility)
- Monitor changes over time
- Communicate findings consistently among healthcare providers
To support accurate and consistent administration of the NIHSS, the Northeastern Ontario Stroke Network has developed:
- A poster outlining the NIHSS scoring criteria
- A pocket guide for quick bedside reference
These tools help healthcare practitioners perform structured, reliable assessments during acute stroke evaluations and improve inter-rater consistency.
Please email strokeprogram@hsnsudbury.ca to request a downloadable copies of these resources.
SMART TIPS for Stroke Care: A Healthcare providers guide to caring for a person with stroke
“Smart Tips for Stroke Care” was developed through a joint effort of Ontario’s 11 Regional Stroke Networks, with valuable contributions from subject matter experts and individuals with lived experience from across the province. The 2023 edition of Smart Tips for Stroke Care was prepared by members of the Regional Stroke Networks of Ontario. This resource was designed primarily for Personal Support Workers (PSWs) working in Long-Term Care settings throughout Ontario, but it can also be helpful for community-based PSWs, family caregivers, and anyone seeking to expand their knowledge of stroke care.
The purpose of the Smart Tips guide is to outline common effects of stroke and provide practical approaches to support and manage these changes. Each topic can be used on its own or combined with others as part of a broader learning series.
The Smart Tips materials are available for free download or printing, either as a complete guide or as individual sections, depending on staff and organizational needs. These resources may be distributed without requesting permission, provided they remain unaltered and the original source is acknowledged.
Smart Tips Topics:
- Introduction to Stroke
- Hemiplegic Arm & Hand
- Bowel & Bladder Function After Stroke
- Eating & Swallowing After Stroke
- Communication After Stroke: Aphasia
- Depression After Stroke
- Fatigue After Stroke
- Cognition After Stroke
- Vision & Perception Changes After Stroke
- Behaviour After Stroke
- Mobility After Stroke
- Bed Mobility, Transfers and Ambulation After Stroke
- Positioning in Bed After Stroke
- Positioning in a Chair After Stroke
- Meaningful Activity After Stroke
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