Abstract TP251: The Direct and Indirect Impact of the Acute Stroke Nurse Role on Thrombolysis Treatment Times and Rates

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Skye Coote ◽  
Poh Sien Loh ◽  
Andrea Moore ◽  
Chris Bladin
Keyword(s):  
Acute Stroke ◽  
Fast Track ◽  
Positive Impact ◽  
Full Time ◽  
Stroke Patients ◽  
Nurse Role ◽  
Indirect Impact ◽  
Part Time ◽  
After Hours ◽  
Stroke Thrombolysis

Background: The Acute Stroke Nurse (ASN) role at Box Hill Hospital is a business hours (weekday 8am - 4.30pm) first responder role designed to fast track acute stroke patients through thrombolysis screening in the Emergency Department. Since 2004, this role has been filled in either a full-time (FT) or part-time (PT) capacity, except for a 5-month period in 2010 where the role was vacant. We sought to explore the influence of having a full-time ASN, compared to part-time or no ASN, on thrombolysis rates and times. Methods: Data was extracted from the hospital’s stroke thrombolysis database for the period 2004 to 2012. Comparisons were made for those patients seen by the ASN, when FT and PT and those who saw medical staff only. Statistical comparisons were made using Mann-Whitney Rank Sum test. Results: Almost half (43% n=182) of the 428 thrombolysis cases occurred during business hours, the ASN attended 84% of cases when the role was filled FT and 15% when PT. No difference was seen in median door-to-CT times (25 minutes.) Faster median door-to-needle times were achieved during business hours when the patient was seen by the ASN compared to those who were not (66 mins vs. 83 mins, p=<0.001.) Faster times were seen when the ASN role was FT (68 min) or PT (79 min) compared to vacant (89 mins, p=0.006,) with more patients treated within 60 minutes of arrival (35% FT, 27% PT and 8% vacant, NS). While the ASN only works within business hours, faster door-to-needle times were seen after hours when the ASN role was filled FT and PT compared to vacant (87mins and 100 mins vs. 103 mins, p=0.013;) and treatment was only commenced under 60 minutes when the ASN was employed FT. Conclusion: The Acute Stroke Nurse role seems to have a positive impact on thrombolysis treatment times and rates, with the best results being achieved during and outside business hours when the ASN is employed FT.

Abstract TP278: Positive Impact of a Stroke Bundle Program

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Deborah Murphy ◽  
Colleen Boyle ◽  
Elissa Della Monica ◽  
Heather Peiritsch ◽  
Laura Schmidt ◽  
...  
Keyword(s):  
Care Coordination ◽  
Positive Impact ◽  
Hospital Readmissions ◽  
Transitions Of Care ◽  
Hospital Length Of Stay ◽  
Care Process ◽  
Full Time ◽  
Stroke Patients ◽  
Nurse Navigator ◽  
The Impact

Introduction: There are limited comparative data on the impact of a stroke bundle program on patient outcomes. We aimed to assess the magnitude of change that could occur during transitions of care process by implementation of a stroke bundle program. Methods: Six skilled nursing facilities (SNF) participated with a Joint Commission certified Comprehensive Stroke Center to implement a Bundled Payment Care Initiative (BPCI) program. The stroke leadership developed a charter and additional support teams (care coordination and SNF). Three smart goals were identified and reflected organizational strategic goals: reduction of the number of stroke patients that are admitted to a SNF by 5% (baseline 27.9%); reduction of preferred provider SNF days for stroke patients by 10% (baseline 35.5%) and reduction of hospital readmissions for stroke by 5% (baseline 31.5%). A strong infrastructure supported the care coordination teams including the hiring of a full time stroke nurse navigator. The kick off for the program was October 1, 2015. Several strategic and operational initiatives were developed and successfully implemented at SNFs: utilization of stroke clinical practice guidelines: stroke education programs; stroke summit for all SNF administrators, physicians and staff; bi-monthly, face to face/conference call meetings with SNF administrators and bundle team leadership; case reviews between caregivers at acute setting and SNF; SharePoint site to enhance communication; stroke nurse navigator interaction with patients, families, SNF staff, 90 day follow up and readmission case reviews. Results: Smart goal achievement over a 6 month period demonstrated: reduction of the number of stroke patients that were admitted to SNF by .4% (21.9%); reduction of preferred provider SNF days for stroke patients by 16% (16%) and reduction of hospital readmissions for stroke by 7% (23.3%). Comparison of hospital length of stay variance between bundle (3.78) and non-bundle patients (5.08) patients was 1.3%. Conclusions: A stroke bundle program impacts positively on transitions of care at preferred provider SNF facilities. Standardization of care and a unified care team attributes to stroke patients returning to their life at home in a much more efficient and timely manner.

The importance of farmers' markets for West Virginia direct marketers

2007 ◽  
Vol 22 (1) ◽  
pp. 20-29 ◽  
Author(s):  
Cheryl Brown ◽  
Stacy M. Miller ◽  
Deborah A. Boone ◽  
Harry N. Boone ◽  
Stacy A. Gartin ◽  
...  
Keyword(s):  
West Virginia ◽  
Household Income ◽  
Positive Impact ◽  
Ordinary Least Squares ◽  
Lower Percentage ◽  
Farmers Markets ◽  
Full Time ◽  
Farmers Market ◽  
Part Time ◽  
The Impact

AbstractIn the winter of 2004–2005, over 300 of West Virginia's farmers' market vendors were surveyed with regard to sales levels, promotional techniques and operational characteristics such as hours worked, types of products produced and length of season. Vendors were categorized based on part-time, full-time or retired status, and full-time farmers, both with and without off-farm jobs, were found to be distinct from part-time and retired vendors with respect to 2004 total farmers' market sales and the percentage of household income from farmers' markets. Econometric analysis [ordinary least squares (OLS)] was performed to identify the impact of explanatory variables on total farmers' market sales, percentage of household income from farmers' market sales and amount of household income from farmers' market sales. Independent variables such as bargaining, cost-plus pricing, selling at markets outside West Virginia and providing print materials were found to have a positive impact on annual sales. The number of products produced, distance traveled to market and number of weeks at market were also positively related to the percentage of income obtained from farmers' market sales. Both part-time and retired producers received a lower percentage of household income from farmers' markets relative to full-time producers. Retired and part-time, along with limited-resource vendors (with annual household income less than $20,000) were also found to have lower total sales in the 2004 season. Identifying the characteristics associated with greater farmers' market sales and a higher reliance on such sales for household income will help in the sustained success of markets as engines of economic development and small farm viability.

scholarly journals Thrombolytic therapy for acute ischemic stroke

CJEM ◽  
2001 ◽  
Vol 3 (01) ◽  
pp. 8-12 ◽  
Author(s):  
Keyword(s):  
Thrombolytic Therapy ◽  
Acute Stroke ◽  
Current Evidence ◽  
Small Subset ◽  
Stroke Patients ◽  
Eligibility Criteria ◽  
Widespread Application ◽  
Increased Risk ◽  
Stroke Thrombolysis ◽  
Neuro Imaging

ABSTRACTCurrent evidence suggests that, in a small subset of acute stroke patients who can be treated within 3 hours of symptom onset, the administration of tissue plasminogen activator (tPA) confers a modest outcome benefit, but that this benefit is associated with an increased risk of intracranial hemorrhage that can be severe or fatal. The data show that tPA therapy must be limited to carefully selected patients within established protocols. Further evidence is necessary to support the widespread application of stroke thrombolysis outside research settings. Until it is clear that the benefits of this therapy outweigh the risks, thrombolytic therapy for acute stroke should be restricted to use within formal research protocols or in monitored practice protocols that adhere to the NINDS (the rt-PA Stroke Study Group trial of the National Institute of Neurological Disorders and Stroke) eligibility criteria. All data on protocol compliance and patient outcomes should be collated in a central Canadian registry for the purposes of tracking safety and efficacy.Stroke thrombolysis should be limited to centers with appropriate neurological and neuro-imaging resources that are capable of administering treatment within 3 hours. In such centres, emergency physicians should identify eligible patients, initiate low risk interventions and facilitate prompt computed tomography. Only physicians with demonstrated expertise in neuroradiology should interpret head CT scans used to determine whether to administer thrombolytic agents to stroke patients. Neurologists should be directly involved prior to the thrombolytic administration.

scholarly journals Assessing the Library’s Influence on Freshman and Senior Level Outcomes with User Surveys

2015 ◽  
Vol 10 (2) ◽  
pp. 8 ◽  
Author(s):  
John K. Stemmer ◽  
David M. Mahan
Keyword(s):  
Learning Outcomes ◽  
Student Outcomes ◽  
Positive Impact ◽  
Demographic Factors ◽  
Positive Influence ◽  
Student Outcome ◽  
Full Time ◽  
Big Picture ◽  
Part Time ◽  
Multiple Variables

Abstract Objectives – This study seeks to identify areas where relationships exist between a student’s library usage and student outcomes at Bellarmine University, a private master’s level institution. The study has two primary aims. The first is to see if an operationally oriented user survey can be used to provide evidence of the library’s support for institutionally important student outcomes. The second is to develop a regression model that provides a big picture with multiple variables to determine if library factors are still significant in student outcomes when controlling for significant demographic factors. Methods – The library regularly conducts student user surveys, and this study examines the results of the first three surveys, from 2007, 2008 and 2010. These surveys include individually identifiable data on why students come to the library and how often they use it in person and online. Researchers aggregated student responses into class-based cohorts and used regression analysis to analyze the extent and significance of the relationships, if any, that exist between student use of the library and student outcomes such as retention, graduation and cumulative GPA. The study takes into consideration known significant student demographic factors such as American Collect Testing (ACT) composite score, full- or part-time status, and their session GPA. Results – The study identifies specific library services and resources that have significant correlations with the selected student learning measures and outcomes. For freshman students, the ability to access the library online influences both retention and graduation. In looking at freshman learning outcomes represented by GPA, the results again indicate that the library has a positive influence on a student’s GPA. The library’s influence appears through two factors that highlight the library as a place: providing a place to study alone and as a place that has specialized equipment available to students. The library influences seniors’ cumulative GPA differently than for freshmen, primarily through the library’s role as an information resource. The variable check out books had a positive impact on senior’s GPA. Conclusions – This study indicates that the library does have an influence on student outcomes, whether learning outcomes, represented by cumulative GPA, or more typical student success outcomes, represented by second-year retention and graduation. This is true even when controlling for certain demographics, including the student’s ACT score, whether the student is part-time or full-time, and their session GPA. The factors that influence an individual student’s outcome change depending on the point in time in the undergraduate experience. These statistical analyses provide significant evidence for the value the library provides in support of institutionally important student outcome goals.

Clinical Pharmacy Service Contributions on a Part-Time Basis

1979 ◽  
Vol 13 (5) ◽  
pp. 282-285
Author(s):  
Timothy H. Self ◽  
James C. Eoff
Keyword(s):  
Positive Impact ◽  
Clinical Pharmacy Service ◽  
Pulmonary Medicine ◽  
Full Time ◽  
Clinical Services ◽  
Percent Time ◽  
Large Patient ◽  
Large Patient Population ◽  
Part Time ◽  
Time Basis

Staffing a majority of hospitals with full-time clinical pharmacists is an aim that will not be attainable for many years. In an effort to demonstrate an interim approach to clinical practice that could be applied to a large percentage of hospitals, a part-time clinical pharmacist's services were documented. Serving a teaching hospital with an average census of 97 patients, the pharmacist, with a 50 percent time allotment for clinical services, monitored 229 total admissions during an eleven week period. The majority of patients were on either a pulmonary medicine or urology service. The total number of actions taken as a result of pharmacy consultations was 106, with 70 percent of these being related to dosing problems. It was concluded that a pharmacist providing clinical services to a large patient population on a less than full-time basis can have a positive impact on drug therapy.

Impact of prehospital stroke code in a public center in Paraguay: A pilot study

2019 ◽  
Vol 14 (6) ◽  
pp. 646-649
Author(s):  
Alan Flores ◽  
Laia Seró ◽  
Christian Otto ◽  
Ricardo Mernes ◽  
Silvia Gonzalez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pilot Study ◽  
Endovascular Treatment ◽  
Acute Stroke ◽  
Positive Impact ◽  
Reperfusion Therapy ◽  
Single Center ◽  
Stroke Management ◽  
Stroke Patients ◽  
The Right

Prehospital stroke code activation results in reduced pre- and in-hospital delays and triage and transport of stroke patients to the right centers. In Paraguay, data about acute reper fusion treatment are not available. Recently, a pilot prehospital stroke code program was implemented in the country in November 2016. In an observational, single-center cohort study with a before–after design, from April 2015 to July 2018, we found that 193/832 (23.1%) of stroke patients were stroke code activated, and from these, 54 (6.5%) were brought to hospital under the prehospital stroke code protocol. Fifty-eight patients (58 alteplase and 2 additional endovascular treatment) received reperfusion therapy. Prehospital stroke code patients had a lower mean door-to-CT time (24 vs. 33 min, p = 0.021) and lower mean door-to-needle time (35.3 vs.76.3 min, p < 0.001) compared to in-hospital stroke code patients. Prehospital stroke code is feasible in Paraguay and has a positive impact on in-hospital acute stroke management, reducing delays and increasing the rates of reperfusion treatments.

Clinical Faculty

2009 ◽  
Vol 20 (1) ◽  
pp. 71-81
Author(s):  
Scott Ziehm ◽  
Dorrie K. Fontaine
Keyword(s):  
Clinical Teaching ◽  
Full Time ◽  
Staff Nurse ◽  
Clinical Faculty ◽  
Faculty Role ◽  
Nurse Role ◽  
Teaching Position ◽  
Expert Nurses ◽  
Part Time ◽  
Good Career

There has never been a more urgent time for clinically expert nurses to consider the clinical faculty role. Whether they are making a full-time “leap” into academia or combining a successful staff nurse role with a part-time clinical teaching position, nurses should consider teaching as a good career move. Practical tips and resources are described for making the transition into a clinical faculty role a smooth one.

Exploring Barriers to Doctoral Education in Communication Sciences and Disorders: Insights From Practicing Professionals

2020 ◽  
Vol 5 (6) ◽  
pp. 1552-1563
Author(s):  
Denise A. Tucker ◽  
Mary V. Compton ◽  
Sarah J. Allen ◽  
Robert Mayo ◽  
Celia Hooper ◽  
...  
Keyword(s):  
Doctoral Students ◽  
Online Survey ◽  
Academic Research ◽  
Doctoral Degree ◽  
Full Time ◽  
Doctoral Study ◽  
Doctoral Research ◽  
Part Time ◽  
Advance Research ◽  
Doctor Of Philosophy

Purpose The intended purpose of this research note is to share the findings of a needs assessment online survey of speech and hearing professionals practicing in North Carolina to explore their interest in pursuing a research-focused PhD in Communication Sciences and Disorders (CSD) and to document their perceptions of barriers to pursing a PhD in CSD. In view of the well-documented shortage of doctor of philosophy (PhD) faculty to attract, retain, and mentor doctoral students to advance research and to prepare future speech and hearing professionals, CSD faculty must assess the needs, perceptions, and barriers prospective students encounter when considering pursuing a doctoral research degree in CSD. Method The article describes the results of a survey of 242 speech and hearing professionals to investigate their interest in obtaining an academic research-focused PhD in CSD and to solicit their perceived barriers to pursuing a research doctoral degree in CSD. Results Two thirds of the respondents (63.6%) reported that they had considered pursuing a PhD in CSD. Desire for knowledge, desire to teach, and work advancement were the top reasons given for pursuing a PhD in CSD. Eighty-two percent of respondents had no interest in traditional full-time study. Forty-two percent of respondents indicated that they would be interested in part-time and distance doctoral study. The barriers of time, distance, and money emerged as those most frequently identified barriers by respondents. Conclusion The implications inform higher education faculty on how they can best address the needs of an untapped pool of prospective doctoral students in CSD.

The role of nursing in the rehabilitation of acute stroke patients: Toward a unified theoretical perspective

Pflege ◽  
1999 ◽  
Vol 12 (1) ◽  
pp. 21-27
Author(s):  
Marit Kirkevold
Keyword(s):  
Acute Stroke ◽  
Theoretical Perspective ◽  
Stroke Patients ◽  
Role Of Nursing ◽  
Rolle Der Pflegenden

Eine Übersicht der bestehenden Literatur weist auf Unsicherheiten bezüglich der spezifischen Rolle der Pflegenden in der Rehabilitation von Hirnschlagpatientinnen und -patienten hin. Es existieren zwei unterschiedliche Begrifflichkeiten für die Rolle der Pflegenden, keine davon bezieht sich auf spezifische Rehabilitationsziele oder Patientenergebnisse. Ein anfänglicher theoretischer Beitrag der Rolle der Pflege in der Genesung vom Hirnschlag wird als Struktur unterbreitet, um die therapeutischen Aspekte der Pflege im Koordinieren, Erhalten und Üben zu vereinen. Bestehende Literatur untermauert diesen Beitrag. Weitere Forschung ist jedoch notwendig, um den spezifischen Inhalt und Fokus der Pflege in der Genesung bei Hirnschlag zu entwickeln.

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