Can you identify.....
Can you identify what it means to be a comprehensive stroke center?
24/7 Neurointerventional
TPA capability
When should the patient be screened for dysphagia?
Screened for dysphagia prior to PO meds/intake.
What education does each team member on 10NT receive as a stroke dedicated unit?
BEFAST
Neuro-essentials that has stroke and care of stroke patients
Stroke education at summit and at UPC.
Stroke alert activated, what time frame does the MD have to perform does the MD have to complete a quick assessment?
15 minutes but our goal is 10minutes
Change in LOC Sharp elevation in BP Deterioration in motor examination new onset of severe HA Nausea/Vomiting Pupil changes
What are signs of intracranial hemorrhage!
Can you identify what acronym we use to educate and identify if patients have had a stroke?
B.E.F.A.S.T
Who is at risk for dysphagia?
All stroke patients.
Where is the education and references located on the unit that support our Clinical Practice Guidelines?
The Stroke Center on OH Share point page, supports our Clinical practice guidelines that we get from The American Heart/Stroke Association.
What is the time goal for the first image NCCT
25minutes of arrival
Sudden swelling of the face, lips, eyes, tongue, throat, hands, feet and genitals.
What are signs and symptoms of angioedema.
Can you identify 5 risk factors for stroke?
Diabetes
HTN
Smoking
ETOH/drug abuse
A-fib
Hyperlipidemia
previous stroke
obesity
How are dysphagia screening results communicated?
During handoff and it is in the EHR.
What are stroke resources available to each nurse or patient?
Corporate Stroke Program Director-Darlene or Dr. Rosado
Stroke Clinical Coordinator- Cherice
Nursing Leadership, SR, LS
What is our Goal for IV thrombolytic
60minutes
ORMC is 30 minutes
VTE prophylaxis • Discharged on Antithrombotic therapy • Anticoagulation therapy for A-Fib/flutter • Anti-thrombotic therapy by day 2 • Discharged on statin • Stroke Education • Assessed for Rehab • NIHSS for ischemic stroke
What are the core measures for stroke?
Can you identify 1 safety aspect related to a stroke patient?
Risk for fall r/t impaired mobility.
Risk for aspiration r/t dysphagia.
Risk for ineffective communication of needs.
What happens if the pt. fails the dysphagia screen?
MD is notified, pt. is made NPO until evaluated by ST.
What education should be provided to the stroke patient and their family?
BEFAST, s/s of stroke
Risk factors of stroke- specific to pt.
Importance for compliance w/ medications/POC
What is goal for vascular reperfusion?
Within 90 minutes of arrival for Direct arrivals
Within 60 minutes of arrival for Transfers
Hypertension
What is the number one cause of stroke?
Can you identify what actions you can implement to keep our patients safe?
Frequent monitoring
Hourly rounding
Assist with ambulation
Call lights within reach
NPO until after swallow screen completed
Do stroke patients need ST if they pass the dysphagia screen?
Yes, they are followed for language and cognition with MD order.
What education would you provide a patient that has a stroke and a history of diabetes?
How DM impacts stroke
Blood sugar management/ medication adherence
Lifestyle modifications: diet, physical activity, smoking/EtOH
BP/Cholesterol monitoring
What thrombolytic do we use to treat stroke patients at Orlando Health?
Tenecteplase
CBC w/ platelet count, CMP, Trop, PT/INR EPOC creatinine to prevent delay if CTA indicated.
What labs are ordered for an acute stroke?