Abstract WP438: Monthly Patient Stroke Education Prevalence Rounds Increase Nursing Engagement While Positively Affecting Quality Patient Outcomes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Dena R Brown ◽  
Maureen F Buttrick
Keyword(s):  
Patient Education ◽  
Patient Outcomes ◽  
Nursing Leadership ◽  
Quality Outcomes ◽  
Stroke Prevalence ◽  
Improve Compliance ◽  
Stroke Education ◽  
Bedside Nursing ◽  
Stroke Center ◽  
Education Initiative

Background and Purpose: Understanding stroke and factors in the prevention of stroke are fundamental in improving quality outcomes and patient healthcare compliance. Daily individualized patient education is an accreditation requirement, and as a certified stroke center the goal is to exceed national care standards for patients with stroke. Documentation of daily individualized patient education compliance was found to be below the required expectations with initial audits. Bedside nurses were surveyed on documentation requirements of every stroke patient, and a knowledge gap was identified. The purpose of this quality initiative was to improve compliance of daily individualized stroke education and increase bedside nursing accountability and engagement in the care of stroke patients. Methods: The quality initiative consisted of a monthly one day snapshot of daily stroke education documentation compliance (average n=34). Results are shared with executive nursing leadership, unit managers and bedside nurses. Stroke Champions facilitate one-on-one education with their nursing peers when opportunities for improvement of required stroke education have been identified. This nurse driven collaboration was augmented with daily education reminders during unit huddles, patient stroke education posters on the unit, and caregiver award recognition for those nurses with high compliance. Results: Significant improvements in documentation of daily individualized stroke education were found following the stroke prevalence education initiative. A pre-initiative audit was conducted 4th quarter of 2015, revealing compliance was at 65%. After implementation, 2016 compliance improved to an overall 86%; 2017 was 84%; 2018 was 90% and the first half of 2019 remains at 90%. Conclusions: In conducting monthly stroke prevalence rounds, nurse driven collaboration has shown significant improvements in consistently documenting daily individualized stroke education, therefore increasing required patient stroke education compliance and producing the potential for better outcomes for patients.

Abstract 3888: Use of Electronic Triggers to Insure Compliance with Nursing Driven Stroke Measures

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Elizabeth J MARCOTTE ◽  
Coletta C Barrett
Keyword(s):  
Patient Education ◽  
Health System ◽  
Medical Center ◽  
Stroke Care ◽  
Geographic Region ◽  
Fiscal Year ◽  
Admission Diagnosis ◽  
Adult Care ◽  
Stroke Education ◽  
Stroke Center

Background and Purpose: Our Lady of the Lake Regional Medical Center is the largest hospital in Louisiana with 734 Bed licensed beds. Patient care in the adult care units is delivered by over 1200 nurses in 20 acute care units and 5 intensive care units. There are over 25,000 Inpatient discharges from the medical center annually. Stroke discharges for the fiscal year 2010 were 867. The Medical Center utilizes an electronic medical record and is supported by a health system department that drives the development and oversight for the IT implementation in the 4 hospitals within our system. With only 5 Certified Stroke Centers in Louisiana, none in our geographic region; OLOL set a goal to become stroke center certified. With competing priorities and multiple quality initiatives in the medical center and across our health system, OLOL was challenged to develop processes to insure compliance in meeting the nursing driven stroke measures; dysphagia screen and stroke patient education. Our task was to develop electronic triggers to insure that screenings and education occurred at the appropriate time during the patient stay. Methods: This effort required work across disciplines and the health system. Our caregivers (nurses, physicians, and pharmacists), quality leaders, technology team members, and process experts worked together to reach our collective goal. The team developed triggers, or tasks required to be completed, based on an admission diagnosis or suspected diagnosis of stroke. When completing either task, the electronic record would auto populate a specific form for the task to be completed. For stroke education, the electronic form navigates the nurse through the 5 required components of stroke education, allowing the nurse to print a hardcopy of the required education for patient review. For the dysphagia screen, the auto form directs the nurse how to complete the task and automatically implements orders based on a pass or fail of the screen. Results: Data collected from Get with the Guidelines, Stroke at our organization pre and post implementation of the triggers were measured. Compliance with dysphagia screen increased from 59% to 87%. Stroke education increased from 0% to 94.9%. Conclusion: Electronic triggers improved compliance with meeting nursing driven stroke measures for patient education and dysphagia screen. The need to provide quality stroke care and improvement efforts for documentation was identified as a need before the application for Stroke Center Certification. Stroke meaningful use requirements for stimulus dollars helped to provide the organizational focus of resources that otherwise might not have appropriated for Stroke.

scholarly journals Value of repeated imaging in patients with a stroke who are transferred for endovascular treatment

2021 ◽  
pp. neurintsurg-2020-017050
Author(s):  
Laura C C van Meenen ◽  
Nerea Arrarte Terreros ◽  
Adrien E Groot ◽  
Manon Kappelhof ◽  
Ludo F M Beenen ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Clinical Improvement ◽  
Treatment Delay ◽  
Clinical Deterioration ◽  
Large Vessel Occlusion ◽  
Intracranial Hemorrhages ◽  
Vessel Occlusion ◽  
Quality Outcomes ◽  
Comprehensive Stroke Center ◽  
Stroke Center

BackgroundPatients with a stroke who are transferred to a comprehensive stroke center for endovascular treatment (EVT) often undergo repeated neuroimaging prior to EVT.ObjectiveTo evaluate the yield of repeating imaging and its effect on treatment times.MethodsWe included adult patients with a large vessel occlusion (LVO) stroke who were referred to our hospital for EVT by primary stroke centers (2016–2019). We excluded patients who underwent repeated imaging because primary imaging was unavailable, incomplete, or of insufficient quality. Outcomes included treatment times and repeated imaging findings.ResultsOf 677 transferred LVO stroke, 551 were included. Imaging was repeated in 165/551 patients (30%), mostly because of clinical improvement (86/165 (52%)) or deterioration (40/165 (24%)). Patients who underwent repeated imaging had higher door-to-groin-times than patients without repeated imaging (median 43 vs 27 min, adjusted time difference: 20 min, 95% CI 15 to 25). Among patients who underwent repeated imaging because of clinical improvement, the LVO had resolved in 50/86 (58%). In patients with clinical deterioration, repeated imaging led to refrainment from EVT in 3/40 (8%). No symptomatic intracranial hemorrhages (sICH) were identified. Ultimately, 75/165 (45%) of patients with repeated imaging underwent EVT compared with 326/386 (84%) of patients without repeated imaging (p<0.01).ConclusionsNeuroimaging was repeated in 30% of patients with an LVO stroke and resulted in a median treatment delay of 20 minutes. In patients with clinical deterioration, no sICH were detected and repeated imaging rarely changed the indication for EVT. However, in more than half of patients with clinical improvement, the LVO had resolved, resulting in refrainment from EVT.

Abstract W P290: Stroke Nurse Fellowship: Improving Quality and Coordination in Complex Stroke Patient Care

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Domonique Banks, MS, RN ◽  
Karen Yarbrough, MS, ACNP ◽  
Christine Ball, BSN, RN, CNRN
Keyword(s):  
Patient Education ◽  
Patient Care ◽  
Interdisciplinary Collaboration ◽  
Staff Retention ◽  
Learning Program ◽  
Program Outcomes ◽  
New Graduate ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Education Performance

Background: Aligned with our Primary Stroke Center’s goal to achieve Comprehensive Stroke Center (CSC) designation, nursing leadership met to discuss strategies to increase bedside expertise following an influx of new graduate nurses. CSCs are required to operate inpatient stroke units staffed by qualified stoke caregivers, comply with professional standards, and demonstrate a commitment to providing stroke related education. Thus, a stroke nurse fellowship (SNF) program was developed. The SNF serves as an essential resource for nursing/patient education, performance improvement, and staff retention. The purpose of this abstract is to provide an overview of the SNF Program content, implementation, and feasibility. Methods: The SNF curriculum was developed from the American Board of Neuroscience Nursing’s new Stroke Certified Registered Nurse (SCRN) credentialing. The program reviews CSC standards/performance measures and provides interdisciplinary neurology rounding experiences, mock survey tracer exercises, rehab facility observation, and BAT code simulated learning. Program classes are 4 hours biweekly for 6 months and culminate with a mentored process improvement (PI) project. Potential applicants are recruited from the pool of less experienced nursing staff. Results: Nine candidates from 3 nursing units submitted applications. Seven were selected to begin the fellowship program in September, 2013. Program outcomes include percent of stroke related patient education standards documented, percent of candidates successful on SCRN examination, PI project impact, and increased nurse retention. Also, barriers and facilitators of the program will be reviewed. Conclusion: Developing a SNF program was feasible due to interdisciplinary collaboration and use of existing resources, thereby minimizing financial constraints. The SNF Program supports the UMMC’s commitment to the regulatory and educational standards of a CSC. There is potential for other specialty services to use this program as a model for developing unit based experts and improving the quality of patient care.

The Importance of Pharmacist Providing Patient Education in Oncology

2014 ◽  
Vol 28 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Mia Avery ◽  
Felecia Williams
Keyword(s):  
Patient Education ◽  
Cultural Values ◽  
Patient Outcomes ◽  
Health Care Professionals ◽  
Cultural Practices ◽  
Medical Profession ◽  
Team Approach ◽  
Education Outcomes ◽  
Medication Therapy ◽  
Values And Beliefs

The world’s increasing diversity requires health care professionals to adjust delivery methods of teaching to accommodate different cultural values and beliefs. The ability to communicate effectively across languages and various cultural practices directly affects patient education outcomes. Pharmacist should be aware of varying modalities and considerations when counseling a patient diagnosed with cancer and undergoing chemotherapy. In more recent years, the medical profession has seen an increase in patient outcomes due to using the multidisciplinary team approach and has benefited by implementing Medication Therapy Management (MTM) programs at various institutions. For the clinical pharmacist, this would mean documentation for these services should be precise and accurate based on the specific patients needs. There are several factors involved in the care and therapy of the patient with cancer. Clinical oncology pharmacist should be aware of the ever-changing role in oncology and be able to implement new practices at their facility for better patient outcomes.

Primary to comprehensive stroke center transfers: Appropriateness, not futility

2018 ◽  
Vol 13 (6) ◽  
pp. 550-553 ◽  
Author(s):  
Mayank Goyal ◽  
Bijoy K Menon ◽  
Alexis T Wilson ◽  
Mohammed A Almekhlafi ◽  
Ryan McTaggart ◽  
...  
Keyword(s):  
Decision Making ◽  
Endovascular Treatment ◽  
Patient Outcomes ◽  
Stroke Patients ◽  
Endovascular Thrombectomy ◽  
Nuanced Understanding ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Post Hoc ◽  
Transfer Decisions

Background and purpose Ischemic stroke patients must be transferred to comprehensive stroke centers for endovascular treatment, but this transfer can be interpreted post hoc as “futile” if patients do not ultimately undergo the procedure or have a poor outcome. We posit that transfer decisions must instead be evaluated in terms of appropriateness at the time of decision-making. Methods We propose a classification schema for Appropriateness of Transfer for Endovascular Thrombectomy based on patient, logistic, and center characteristics. Results The classification outline characteristics of patients that are 1. Appropriate for transfer for endovascular treatment; 2. Inappropriate for transfer; and 3. Appropriate for transfer for higher level of care. Conclusions Appropriate transfer decisions for endovascular treatment are significant for patient outcomes. A more nuanced understanding of transfer decision-making and a classification for such transfers can help minimize inappropriate transfers in acute stroke.

scholarly journals Small interface changes have dramatic impacts: how mandatory fields in electronic medical records increased pertussis vaccination rates in Australian obstetric patients

2019 ◽  
Vol 26 (1) ◽  
pp. e000013
Author(s):  
Roberto Orefice ◽  
Julie A Quinlivan
Keyword(s):  
Clinical Practice ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Quality Outcomes ◽  
Health Records ◽  
Vaccination Rates ◽  
Time Points ◽  
Improve Compliance ◽  
Single Difference ◽  
Women And Children

IntroductionElectronic health records have been widely introduced into clinical practice. The aim of this study was to determine whether a small interface change could improve compliance with a key quality indicator, namely antenatal pertussis vaccination.MethodsAudits were performed between 1–31 July 2015 and 1–31 July 2017 of all deliveries at the Centenary Hospital for Women and Children to determine compliance with antenatal pertussis vaccination. The single difference between time points was changing the interface so the antenatal pertussis vaccination field became compulsory.Results275 and 299 women delivered in the audit periods. Vaccination rates almost doubled (52.7% vs 91.4%, p<0.0001).ConclusionSmall interface changes increase compliance. Interface change could be considered for key quality outcomes in patient care.

Nursing leadership and patient outcomes

2013 ◽  
Vol 21 (5) ◽  
pp. 707-708 ◽  
Author(s):  
Greta G. Cummings
Keyword(s):  
Patient Outcomes ◽  
Nursing Leadership
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