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Stroke: A process improvement project

Stroke: A process improvement project. Niloufar Hadidi, APRN, BC Neuroscience Clinical Nurse Specialist PhD student, University of Minnesota School of Nursing. Statistics. 3 rd leading cause of death in the United States 1 1 st leading cause of long term disability 1

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Stroke: A process improvement project

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  1. Stroke: A process improvement project Niloufar Hadidi, APRN, BC Neuroscience Clinical Nurse Specialist PhD student, University of Minnesota School of Nursing

  2. Statistics • 3rd leading cause of death in the United States 1 • 1st leading cause of long term disability 1 • 700,000 Americans 1 • Leading cause of serious long term disability 1 • Cost: $57.9 billion per year 1

  3. Current Situation • 2-3 percent of stroke patients currently receive t-PA 2 • Nationally, only 26% of the population can name the most commonly recognized warning signs of stroke • Medical professional are reluctant to use the acute care treatment because of its risk and because it hasn’t been used extensively

  4. Primary Stroke Center • The extreme sensitivity of neuronal tissues to ischemia mandates that stroke be treated as emergency2 • Primary stroke center (PSC) was specifically assigned by Brain Attack Coalition for hospitals that develop an infrastructure necessary to care for stroke patients in a timely manner2 • Recent articles regarding PSC

  5. Gap Analysis 2 • Acute stroke team • Written Care Protocols • Emergency Medical Services • Stroke Unit • Neurosurgical Services • Neuroimaging/lab • Database • Educational programs

  6. DVT ProphylaxisUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  7. AntithromDC: Discharged on AntithromboticsUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  8. Rehab:A Plan for Rehabilitation was ConsideredUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  9. Afib:Patients with Atrial Fibrillation Receiving Anticoagulation TherapyUniversity of Minnesota Medical CenterTime period: Q1 2004 - Q1 2005

  10. TPAconsid:Tissue Plasminogen Activator (t-PA) ConsideredUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  11. TPAadmin:Tissue Plasminogen Activator (t-PA) AdministeredUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  12. Antithrombotic Medication within 48 Hours of HospitalizationUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  13. Lipids:Lipid ProfileUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  14. Dysphagia:Screen for DysphagiaUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  15. Edu:Stroke EducationUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  16. Smoke:Smoking CessationUniversity of Minnesota Medical CenterTime Period: Q1 2004 - Q1 2005

  17. Change in practice • Change in standing orders • Development of patient education • Development of stroke website (community outreach) • Development of protocols for patient admission • All leading to change in practice

  18. References • Alberts et al (2000). Recommendations for the establishment of primary stroke centers. JAMA 283(23), 3102-3109. • American Stroke Association web site at www.americanstrokeassociation.org

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