Research has shown patients who have a stroke while hospitalized for another reason have worse outcomes than patients receiving treatment in the Emergency Department (ED). There are many reasons for this such as sicker patients, more severe strokes, lower adherence to process-based quality measures, and lack of a response team. Improving response and treatment time to in-hospital strokes at Hospital A by including a physician on the Rapid Response Team is the focus of this paper.
According to the American Heart Association / American Stroke Association’s About Stroke (2014) “stroke is the number four cause of death and the leading cause of adult disability in the United States” (para.1). On average, a stroke happens every 40 seconds in the United States (Impact of Stroke, para. 1) About 4% to 17% of all patients with stroke experience symptom onset while hospitalized (Cumbler, et al., 2014). This amounts to about 35,000-75,000 in-hospital strokes in the United States annually.
While there is not a cure for stroke, there are treatments available if performed within a specific time-frame. For example, there is a clot busting medication available known as t-PA which must be administered with the 3- 4.5 hours of last known well (Stroke Treatments, 2013). Additionally, there are mechanical interventions available for stroke patients. The sooner the stroke symptoms are recognized and the patient receives treatment, the better the outcomes for these patients (Stroke Treatments, 2013).
Studies have shown that people who experience a stroke while hospitalized have poorer outcomes than if they arrived from the community to the ED (Cumbler, Zaemisch, Graves, Brega, Jones, 2012). There are several reasons for this including increase...
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4. Stroke order set usage
5. Patient outcomes
A new stroke flow sheet in the electronic health record will capture much of the needed data. This flow sheet was under development prior to the start of this project and is intended to be utilized for all stroke calls either in the ED or in-hospital. Origin of the call will help identify ED vs. in-hospital strokes.
In summary, Hospital A will implement a new process for responding to in-hospital stroke calls. This new process will improve quality outcomes of patients experiencing in-hospital strokes. There are no additional costs involved in implementing this process. Data will be collected and reported for stroke measures previously outlined. Through researching this project, additional educational opportunities were identified. Hospital A will further explore these opportunities in the future.
Since the stroke, Carole has received care from multiple healthcare providers - some were better than others and she met many great people, but her overall care experience “could have been much better in many different ways”.
Stroke occurs when the blood supply to the brain is blocked or condensed. Blood works to transport oxygen and other beneficial substances to the body’s cells and organs, as well as the brain. There are two main types of strokes that are known as Ischemic strokes and Hemorrhagic strokes. When the blood vessels that provides for the brain becomes congested, is it referred to as ischemic stroke, the most common stroke within adults. Blood clots, a cluster of blood that sticks together, are the cause of Ischemic strokes. Ischemic strokes also takes place when arteries become backed up with plague, leaving less blood to flow. Plague is cholesterol, calcium and fibrous and connective tissue that sticks to the walls of blood vessels. Ischemic strokes eternally damage the brain and cause a person's body to no longer function habitually.Some risk factors that may increase stroke are high cholesterol, diabetes, high blood pressure, and obesity. Some stroke factors are also due to old age or having a family that has a history of strokes. Men are more likely to have a stroke but the most st...
It goes without saying that everyone’s health is important and should be taken care carefully. Everyone has heard of strokes before but many people do not really know its meaning, types, and the number of individuals of that dies due to this issue. According to Centers for Disease Control and Prevention (2015), strokes kills an average of 130,000 people a year and it is one of the most common deaths that happen in the United States. An average of 800,000 of people die from cardiovascular disease and strokes and it is also a reason of long-term disability (Centers of Disease Control and Prevention, 2015). Strokes, which can also be called cerebrovascular accident or CVA happen when the blood supply to the brain is interrupted or the blood vessel going towards the brain burst. Then part of the brain dies or become seriously injured because the brain cells do not receive oxygen and they eventually die. People’s lifestyle may also impact seriously on their health and increase the possibility of having a stroke. Some of the risk that can severely increase the cause of stroke would be high blood pressure, heart disease, diabetes, cigarette smoking, as well as strokes that
It is frequently expressed by stroke patients and caregivers that they have not been afforded the suitable information related to stroke, treatments, or post discharge management and recovery, and that the information conveyed is perceived as insufficient and complex. The problem is that there is a failure of healthcare professionals in identifying the learning needs of stroke patients associated with a deficiency in knowledge of just how to access and communicate this crucial information. Indeed, while patient education can be time consuming and nurses may not be properly trained in stroke education it is a nursing duty to provide these teachings to patients and caregivers prior to discharge. This paper will propose an educational plan intended to train, assist, and support nursing staff responsible for stroke patient education, in providing accurate, individualized, guideline based stroke education to patients and families prior to discharge. This plan
Treatment for strokes is called "acute care." What is an acute care? Acute care is when you make sure the condition is caused by a stroke and not some other medical condition, determining the type of stroke where it occurred and how serious the stroke is, prevention of another stroke from happening, or maybe rehabilitation.
Stroke not only affect the life of the patient but also their significant others, especially the caregiver. Caregiver is identified as the “hidden patient” (Andolstek et al, 1988). Families maintain the primary care responsibility for elderly with chronic illness and disability (Montgomery et al, 1985). The effects of caregiving span across physical health (Grafstrom et al, 1992; Kiecolt-Glasier et al, 1991), mental well-being (Cochrane et al, 1997) and social life (Luterman, D. ,2008; Bakas et al, 2006).
... J. (2009). Heart disease and stroke statistics--2010 updated: a report from the American Heart Association. Journal of the American Heart Association. doi:10.1161/CIRCULATIONAHA.109.192667
The World Health Organisation (2013) explains that an Ischaemic stroke occurs as a result of a blood vessel becoming blocked by a clot, reducing the supply of oxygen to the brain and, therefore, damaging tissue. The rationale for selecting Mary for this discussion is; the author wishes to expand her evidenced based knowledge of stroke since it is the principal cause of disability and the third leading cause of mortality within the Scottish population (Scottish Intercollegiate Guidelines Network (SIGN), 2008) and, therefore, a national priority. In response to this priority, the Scottish Government (2009) produced their ‘Better Heart Disease and Stroke Care Action Plan’. Additionally, they have introduced a HEAT target to ensure 90% of stroke patients get transferred to a specialised stroke unit on the day of admission to hospital (Scottish Government, 2012).
Stroke survivors or anyone with chronic illness and health providers remain hopeful and “realistic” by counting on each other. The patients while being realistic about the outcome of their disease, stay hopeful that each of their health care providers will give them the appropriate care and will make sure that they can live with their disease in the best way possible.
Patient safety is a major issue in health care, especially in the public sector. Studies show that as many as 10 patients get harmed daily as they receive care in stroke rehabilitation wards in hospitals in the United States alone. Patient safety refers to mechanisms for preventing patients from getting harmed as they receive health care services in hospitals. The issue of patient safety is usually associated with factors such as medication errors, wrong-site surgery, health care-acquired infections, falls, diagnostic errors, and readmissions. Patient safety can be improved through strategies such as improving communication within hospitals, increasing patient involvement, reporting adverse events, developing protocols and guidelines, proper management of human resources, educating health-care providers on the need for patient protection, and commitment of the leadership to the task. This paper talks about patient safety and how it can be improved in stroke rehabilitation wards of both public and private hospitals.
“Time is brain” is the repeated catch phrase when addressing the treatment and management of stroke (Saver, 2006). Access to prompt and appropriate medical care during the first few hours of stroke onset is critical to patient survival and outcomes. Recent changes in the guidelines for acute stroke care released by the American Heart Association (AHA) and the American Stroke Association (ASA) have improved patient access to treatment. Stroke treatment now follows the model of myocardial infarction treatment. Hospitals are categorized into four levels based on stroke treatment capability. The most specialized treatment is available in comprehensive stroke centers followed by primary stroke centers, acute stroke-ready hospitals, and community hospitals. The use of telemedicine now enables even community hospitals, with limited specialized capabilities, to care for stroke patients. Telemedicine puts emergency hospital personnel in contact with neurologists providing expertise in the evaluation of a stroke patient and determination of their eligibility for treatment with thrombolytic medication (Jefferey, 2013).
Stroke has been classified as the most disabling chronic disease, with deleterious consequences for individuals, families, and society1. Stroke impacts on all domains in the ICF. The body dimension (body functions and structures), the individual dimension (activity), and the social dimension (participation). All domains influence each other2.
Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake. Time – it is time to dial 999 immediately if you see any of these signs or symptoms. http://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke d) Diagnosis and treatments Strokes are usually diagnosed by carrying out physical tests and studying images of the brain produced during a scan. A number of tests can be carried out to help confirm the diagnosis and determine the cause of the stroke. This may include blood tests to determine your cholesterol and blood sugar levels, checking your pulse for an irregular heartbeat, and taking a blood pressure measurement.
Stroke is a commonly known disease that is often fatal. This cellular disease occurs when blood flow to the brain is interrupted by either a blood clot halting the progress of blood cells in an artery, called an Ischemic stroke, or a blood vessel in the brain bursting or leaking causing internal bleeding in the brain, called a hemorrhagic stroke. When this happens, brain cells are deprived of oxygen and nutrients because the blood cells carrying these essential things are stopped, causing them to die. When the cells in the brain die, sensation or movement in a limb might be cut off and may limit an organism’s abilities. A person with stroke is affected depending on where in the brain the stroke occurs. In other words, symptoms of a stroke
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...