Stroke/TIA Core Measures
The 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?
What questions are asked to help determine a patient's level of consiousness when performing the NIHSS?
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.
What are common symptoms of a stroke?
What is the most common type of stroke?
What is Ischemic?
This type of screening should be performed and documented on day one of admission prior to administering any oral medications, food, or drink.
What is a Dysphagia Screening?
Having the patient to show teeth (smile) or raise eyebrows and close eyes is assessing for what on the NIH Stroke Scale?
What is Facial Palsy?
If you suspect your patient is having a stroke, what common POC test can be performed to rule out Hypo-/Hyper-glycemia?
Numbness, trouble speaking, loss of balance or coordination that disappears usually within an hour, but can last up to 24 hours.
What are common symptoms of TIA?
If you suspect your patient is having a stroke what should be announced overhead?
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?
What is Dysarthria?
A non-contrast CT of the Head is performed within 25 minutes of arrival to rule out what type of stroke?
What is a hemorrhagic stroke?
Name one other condition at may resemble common signs and symptoms of a stroke.
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?
If a patient refuses to use mechanical VTE prophylaxis, what should be documented?
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?
What is the earliest sign of neurologic change?
What is altered level of consciousness (ALOC)?
What is the preferred position for patient's with dysphagia?
What is Semi-Fowlers (30 degreed) or higher?
What type of consult is performed after the patient has had a non-contrast CT of the head?
What is a Telestroke Neuro Consult (aka Teladoc)?
When should you document VTE (mechanical or pharmacological) measures by?
What is by day 2 of admission?
The non-contrast CT of brain or MRI should be interpreted within ___ minutes of presentation.
What is 45 minutes?
What are some less common symptoms of a stroke?
What is sudden nausea and vomiting, brief loss of consciousness (fainting, confusion, convulsions, or coma)?
Patient's receiving tPA or Alteplase will require admission to what department for 24 hours?
What is the Intensive Care Unit (ICU)?