Abstract TP389: Utilizing A Stroke Protocol to Improve Stroke Prevention Education

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Allison Wells ◽  
Lisa Bellamy ◽  

Background: Although stroke is a preventable disease, it remains a leading cause of death and disability in the United States. Public knowledge of stroke prevention is relatively low. Stroke education is necessary to improve this knowledge deficit. Primary care providers play an important role in stroke education due to their ability to reach more patients and their ability to help manage the patient’s modifiable risk factors. The purpose of this project is twofold: to increase stroke knowledge in patients and to increase the amount of stroke education provided by the primary care provider. Methods: A stroke prevention protocol was created for primary care providers to utilize. The protocol helps the provider decide which patients benefit the most from stroke prevention education. If the patient has more than four stroke risk factors, the provider should initiate the stroke prevention protocol. The protocol assists the provider in delivering the stroke prevention education. Brochures were created for the provider to give to the patient. The goal of the project is to include five providers in Kentucky primary care offices. Each provider will complete an evaluation of the protocol after using it for a month. Results: Although the implementation is currently in progress, it is anticipated that the stroke protocol will improve stroke prevention education in the primary care office. Ultimately, practice will be changed by increasing the number of people who receive stroke prevention information by their primary care provider. Conclusion: Stroke education can be incorporated into primary care office visits to improve community awareness regarding stroke prevention. It is anticipated that the implementation of the stroke protocol will increase the amount of stroke education delivered to patients in the primary care setting. The evaluations completed by each healthcare provider are predicted to reflect an increase in the number of patients who receive stroke education. These evaluations will include the healthcare provider’s insight of the protocol which will assist in improving it for future use in primary care office visits.

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Raymond Reichwein ◽  
Alicia Richardson ◽  
Cesar Velasco

Introduction: The majority of patients who present with acute ischemic stroke (AIS) have known stroke risk factors which are not optimally managed. It has been suggested that a CHADS-VASC score can assist with primary prevention by calculating future stroke risk. This however, has not been widely adapted in the primary care setting. Methods: From 2018-2019, 686 AIS patients were included in retrospective analysis. Data elements included: historical stroke risk factors, historical CHADS-VASC score, antiplatelet/anticoagulant use at time of presentation, discharge location, and mRS. Results: Of the 686 AIS patients, 77% were age > 60, and 52% were male. Etiology subtypes were small vessel/lacunar 20%, large vessel 22%, cardioembolic 20%, undetermined 31% (cryptogenic 15%), and other determined 5%. On presentation, the majority of patients had 2 or more stroke risk factors and a calculated historical CHADS-VASC score > 2 (Table 1). Over half of the patients with large vessel or small vessel/lacunar etiology were not on any antiplatelets and 53% of patients with known history of atrial fibrillation weren’t on anticoagulants. Forty-nine percent of patients had a mRS > 3 at discharge. Conclusion: Patients with several stroke risk factors are sub optimally managed by primary care providers. Primary prevention education for PCPs in management of higher stroke risk individuals and additional analysis of the CHADS-VASC tool for this setting is needed. If widely adapted, this tool may prevent strokes by providing adequate risk reduction in the primary care setting.


Vascular ◽  
2021 ◽  
pp. 170853812110443
Author(s):  
Sultan Alsheikh ◽  
Hesham AlGhofili ◽  
Omar A Alayed ◽  
Abdulkareem Aldrak ◽  
Kaisor Iqbal ◽  
...  

Introduction Patients with peripheral artery disease (PAD) are often underdiagnosed and undertreated. This study aimed to assess the knowledge of the recommended target levels of blood pressure, low-density lipoprotein cholesterol, glycosylated hemoglobin A1C, and knowledge and attitude about PAD risk reduction therapies among physicians working in primary care settings in Saudi Arabia. Methods This observational cross-sectional study included family medicine consultants, residents, and general practitioners working in a health cluster in the capital city of Saudi Arabia using a self-administered questionnaire. Results Of the 129 physicians who completed the survey, 55% had completed PAD-related continuing medical education hours within the past 2 years. Despite this, the knowledge score of the recommended target levels was high in only 13.2% of the participants. Antiplatelet therapy was prescribed by 68.2% of the participants. Conclusion Here we identified the knowledge and action gaps among primary care providers in Saudi Arabia. Physicians had an excellent attitude about screening for and counseling about risk factors. However, they showed less interference in reducing these risk factors. We recommend addressing these knowledge gaps early in medical school and residency programs.


2011 ◽  
Vol 4 (4) ◽  
pp. 87-98 ◽  
Author(s):  
Andrea C Ely ◽  
Christie A Befort ◽  
Angela Banitt Duncan ◽  
Jianghua He ◽  
Cheryl Gibson ◽  
...  

Background. Obesity is a chronic disease of epidemic proportions. Primary care providers are on the front line of diagnosing and treating obesity and need better tools to deliver top-notch obesity care. Methods. A pilot randomized trial was conducted to test a chronic care model (CCM) program for obesity compared to usual care. Primary care patients, 18 years and older, with a body mass index (BMI) between 27 and 45 were enrolled. Sixteen weekly 90-minute group office visits were structured with the first 30 minutes encompassing individualized clinical assessments and the final 60 minutes containing the group-based standardized intensive lifestyle training. The primary outcome was weight change at 16 weeks. Secondary outcomes were weight change at 24 weeks, change in diet and physical activity behaviors, self-efficacy for weight control behaviors, and physiologic markers of cardiovascular risk at 16 and 24 weeks. Results. The participants (19 in the active arm and 10 in the control arm) were 49.8 ± 11.5 years old (mean ± SD), 97% women, 55% white, and 41% black. Weight change in the control arm at week 16 was 0.25+ 2.21 kg (mean + SD) and that for the active arm was -5.74 + 4.50 kg (n=16). The difference between the two arms was significant (p = 0.0002). Both the intent-to-treat analysis using the last observation carried forward approach and the analysis including completers only provided similar siginificant results. Conclusions. This study demonstrated that a CCM program incorporating group office visits was feasible and effective for obesity treatment in primary care settings.


2019 ◽  
Vol 55 (4) ◽  
pp. 600-606 ◽  
Author(s):  
Muna Alshekaili ◽  
Naser Al‐Balushi ◽  
Mohammed Al‐Alawi ◽  
Hassan Mirza ◽  
Salim Al‐Huseini ◽  
...  

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joseph Mojares ◽  
Sherydahn Aldrich ◽  
Maria Novales-Fiel

Background: This project attempts to discover the subjective response needs of 30-day post-acute stroke patients and their family members that were treated in two Northern California hospitals. The goal is to determine the functional level of the Stroke Survivor (SS) as measured by the Modified Rankin Scale (mRS) and to identify post-discharge needs. Purpose: The objective of this project is to identify the patient’s mRS score and post-discharge needs. The study includes stroke education reinforcement, primary care physician follow-up, ancillary services follow-up, discern hospital readmissions rates, and increase patient satisfaction. Methods: A list of discharged acute ischemic stroke patients over a three month period was provided to the Stroke Nurse Champion (SNC). A stroke phone call template was created to elicit the patient’s history, diagnosis, and mRS score. Patients with intracranial hemorrhage diagnosis, patients discharged to Skilled Nursing Facilities, and deceased patients were excluded from the study. The SNC performed chart review to determine patient course of hospitalization and stroke care management; places follow-up phone call to patient or family member; and identify the SS needs. When needs were discovered, they were addressed using electronic in-house messaging to patient’s primary care providers and ancillary staff. Results: Of the 63 participants, nine required stroke resource follow-up. The average mRS score of 1.84 revealed the patient’s knowledge of self-management to be 100%. There were 13 cases that needed outpatient therapy and Home Health therapy with mRS >2. The study outcome includes readmission rate of 0.03% (n=2) and stroke patient satisfaction >12.5%. Conclusions: Based on the mRS score, the SS appropriately met the level of care including rehabilitation needs at home. Post discharge needs of SS included psychosocial support, medication modification and appropriate durable medical equipment. Overall, the SS were satisfied with their care with low incidence of hospital readmission due to their stroke education provided during their hospitalization. Further plans for each hospital facility to consider continuing this project or to change the focus to outpatient support services as well.


2019 ◽  
Vol 12 (1) ◽  
pp. 46-58
Author(s):  
Jeanne Potts ◽  
Erik Southard

BackgroundHuman papillomavirus (HPV) vaccines are available to prevent HPV-associated cancers. However, parents are reluctant to make the decision to immunize their children. Nationally, HPV vaccination rates remain low.ObjectiveThe objectives were to improve parents' attitudes and knowledge about HPV/HPV vaccine, increase parental intent to vaccinate, and increase HPV vaccination rates in a primary care office.MethodsA one-group, pretest/posttest design was used to assess participants' attitude, knowledge, and intent to vaccinate before and after viewing an HPV educational video. Pre–post project HPV vaccination rates were compared.ResultsParticipants' attitudes toward HPV/HPV vaccine improved while knowledge increased. Intent to vaccine increased by 31% after viewing the HPV educational video. HPV vaccination rates increased 6% (females) and 9% (males).ConclusionsPrimary care providers (PCPs) should look for innovative ways to educate parents about HPV, help parents make informed decisions about the HPV vaccine, and work toward a common goal of preventing HPV-associated cancers.Implications for NursingImplications are three-fold benefiting parents, PCPs, and society. Parents will be more knowledgeable, providers will understand they are an important key in the vaccine process, and society will benefit from a decrease in HPV-associated cancers.


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