NICE has published NICE Guideline 211, Rehabilitation after traumatic injury
Traumatic injury is a significant cause of early death and morbidity in the working population. NICE defines ‘traumatic’ injury as those injuries requiring hospitalisation at the time of injury, including musculoskeletal, visceral, nerve, soft tissue, spinal, and limb injuries (including loss of limbs).
This guideline also includes minor injuries that require hospital admission, and NICE estimates that this covers the approximately 545,000 people who are affected by both severe and less severe traumatic injury every year.
The recommendations offered by NICE Guideline 211 cover the complex rehabilitation needs of both adults and children after traumatic injury, including:
- initial assessment and early intervention
- multidisciplinary team rehabilitation needs assessment
- setting goals, developing a plan, and making referrals
- rehabilitation programmes of therapies and treatments
- principles for sharing information and involving families and carers
- coordination of care in hospital and at discharge
- supporting access and participation in education, work, and the community
- commissioning and organisation of rehabilitation services
- physical, cognitive, and psychological rehabilitation
- injury-specific advice.
Traumatic brain injury is not covered by the guideline, with the exception of when screening and coordinating services for multiple injuries, within which one might be traumatic brain injury.
Care beyond hospital
For patients who are being discharged following traumatic injury, the guideline advises considered multidisciplinary planning to ensure a smooth transition to outpatient and community services, including a reassessment of their needs and their rehabilitation plan. This process may include:
- with consent, actively including family and carers in the transition from acute care
- further help with assistive equipment, information, and support to ensure work or education can continue with their rehabilitation needs in mind
- other forms of rehabilitation available in their home, education, or workplace settings
- offering direction to providers of legal, financial, employment, and welfare advice
- proper communication with the person and their GP, particularly with respect to ongoing pain management planning
- handover of patients with significant ongoing needs following discharge to community practitioners.
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