Know Your Neuro
Standardized assessment used to quantify stroke-related neurological deficits
What is NIHSS?
Your stroke patient develops new onset right side weakness and aphasia. What do you do?
What is rapid response/code stroke?
Your stroke patient has limited mobility and the ordered SCDs are off. What do you do?
What is verify the VTE order, apply SCDs, and document?
VTE Prophylaxis - STK-1
Staff should know where evidence-based stroke resources are located
What are Clinical Practice Guidelines (CPGs)?
BEFAST
What is Balance, Vision Changes, Face Drooping, Arm Weakness, Speech Difficulty, and Terrible Headache? Time to call 911
You called a Rapid Response for your patient with NEW neurological symptoms. What information do you need to provide?
What is Last Known Well (LKW), Vital Signs, Glucose, baseline assessment and new changes?
An ischemic stroke patient is being discharged. What discharge medication do you look for?
What is antithrombotic and statin? *Anticoagulant for patient with atrial fibrillation.
Discharge Antithrombotic - STK-2, Atrial Fibrillation - STK-3, Statin at Discharge - STK-6
Share a Performance Initiative related to Stroke Core Measures
What is NIHSS, mR, VTE, stroke education, discharge medication, pt survey?
A newly admitted stroke patient asks for water, but you cannot find documentation of bedside swallow screen
What is complete Bedside Swallowing Screen?
Core Measure: Dysphagia / Safe Oral Intake
Oh NO! Your patient fails the BSS. What do you do next?
What is make the patient NPO, notify provider, and obtain consult for ST?
Case Management/Social Worker help initiate and track planning for _________.
What is discharge planning?
STK-10 Assessed for Rehab- All patients are assessed for rehab
Describe orientation and recurring stroke-specific education
What are annual stroke education, NIHSS certification, and competencies?
How do you know BP parameters for ischemic stroke patient?
What is review stroke order sets?
Post TNK: < 180/105
No Thrombolytic: <220/120
Neurological deterioration requires prompt escalation. Who do you notify?
Who is Neurology, attending provider, and/or rapid response?
Stroke warning signs, calling 911/activating EMS, the patient's individual risk factors, prescribed medications, and follow-up needs.
What is Stroke Education?
Stroke Education - STK-8
How do we gather patient feedback?
What is patient survey at discharge?
QR code on stroke education folder
Items included in handoff from the ER for post-TNK patient.
What is initial presentation, NIHSS, current assessment (VS and Neuro Check), time next assessment due, BSS completed, time TNK given, orders/parameters?
Time intervals for monitoring vital signs & neuro checks after TNK
What is q15 minutes x 2 hours, q30 minutes x 6 hours, and q1 hr x 16
Frequency for NIHSS assessment to be completed for ischemic stroke patient with no intervention
What is admission (12 hours of arrival), discharge, and if a neurological change occurs?
NIHSS - CSTK-01
How is the team updated on the plan of care for stroke patients?
What is MDR/IDRs? Provider, CM/SW, RN, Therapy, Pharmacy.