Stroke/TIA Core Measures
This is the documented time before a patient's hospital arrival when they were last known to be without stroke symptoms at their baseline state of health.
What is Last Known Well Time (LKWT) or Time of Discovery of Stroke Symptoms?
These two questions are asked to help determine a patient's level of consciousness when performing the NIH Stroke Scale.
What is the current month and the patient's age?
This scoring system is used by healthcare professionals to help assess the severity of a stroke.
What is the National Institutes of Health Stroke Scale or NIH Stroke Scale (NIHSS)?
Sudden numbness or weakness of face, arm, or leg, especially on one side of the body are common symptoms of this.
What is a stroke?
This is the most common type of stroke.
What is Ischemic?
This type of screening that must be performed and documented on day one of admission at least one minute prior to administering any oral medications, food, or drink.
What is a Dysphagia Screening?
When you have the patient to show teeth (smile) or raise eyebrows and close eyes is assessing for this on the NIH Stroke Scale.
What is Facial Palsy?
This common POC test must be performed to rule out Hypo-/Hyper-glycemia if you suspect your patient is having a stroke.
What is a finger stick blood glucose or Accucheck?
Numbness, trouble speaking, loss of balance or coordination that disappears usually within an hour, but can last up to 24 hours are common signs & symptoms of this.
What is a TIA?
This is what you should announce overhead 3 times if you suspect your patient is having a stroke.
What is "Code Stroke, Department, Room Number?"
This mechanical prophylaxis is used to prevent venous thromboembolism complications after a stroke/TIA.
What is Sequential Compression Devices SCD's?
OR
What is Intermittent Pneumatic Compression?
When the nurse asks the patient to read or repeat words from a list of words during the NIHSS, they are assessing for this on the NIH Stroke Scale.
What is Dysarthria?
A non-contrast CT of the Head performed within 25 minutes of arrival is done to rule out this type of stroke.
What is a hemorrhagic stroke?
These are other conditions that may resemble common signs and symptoms of a stroke. (name at least 2)
What is alcohol intoxication, new onset confusion, cerebral infections, drug overdose or toxicity, epidural hematoma, hypoglycemia, metabolic disorders, hypertensive encephalopathies, migraines, seizures, brain tumors, or neuropathies?
Anticoagulants and thrombotics increase the risk of this.
What is intracranial hemorrhage?
By the patient's discharge, this should be provided and documented as provided to the patient and/or family.
What is Stroke Education?
This should be documented when a patient refuses mechanical VTE prophylaxis.
What is refusal and education provided?
If the patient is eligible, this clot busting drug must be initiated within 60 minutes of arrival.
What is tPA or Alteplase?
This is the earliest sign of neurologic change.
What is altered level of consciousness (ALOC)?
Patients on bedrest with dysphagia should be kept in this position.
What is Semi-Fowlers (30 degreed) or higher?
When the patient has a suspected stroke, this type of consult is performed immediately after the patient has had a non-contrast CT of the Head.
What is a Telestroke Neuro Consult (aka Teladoc)?
VTE prophylaxis (mechanical or pharmacological) must be documented by day __ of admission.
What is by day 2 of admission?
The non-contrast CT of brain or MRI must be interpreted within ___ minutes of presentation.
What is 45 minutes?
These are some less common symptoms of a stroke. (name at least 1)
What is sudden nausea and vomiting, brief loss of consciousness (fainting, confusion, convulsions, or coma)?
Patient's that have received tPA or Alteplase must be admitted to this department for at least 24 hours.
What is the Intensive Care Unit (ICU)?