Post on 28-Jul-2020
Stroke Team
Newsletter
Primary Stroke Center
Certification
UConn Health’s John Dempsey Hospital has been
doing an exceptional job with Stroke care since
the program began this summer. In December,
UConn Health’s Stroke Program welcomed a
certification visit by The Joint Commission. This
was an extremely positive experience. The
surveyor congratulated the Stroke Program and
UConn Health for its collaborative efforts
between the Stroke Units, Lab, Pharmacy,
Radiology, Neurology, and Rehabilitation
Services. As the surveyor looked through records,
policies/procedures and spoke with the
interdisciplinary teams, patients, and families, the
result of hard work and dedication in providing
excellence in stroke care was apparent.
We received our final award letter which
certifies UConn Health as a Primary Stroke
Center as of 12/13/2014!
Primary Stroke Center Certification: Recognizes
hospitals that meet established standards to
optimize stroke care outcomes and provide
clinical excellence.
Congratulations to our stroke units, ED, ICU,
CSDU, and Med 4, John Dempsey Hospital, and
our prehospital and post hospital care teams.
Every area prepped themselves for the
certification visit, we could not have been
successful without you all. The team work and
collaboration demonstrated to create his program
is indescribable.
March 2015, Issue 2
Stay Tuned for Future Issues of our Stroke Team
Newsletter as we continue to focus on ways to
improve Door-to-Needle times and patient outcomes.
2015 Stroke Core Measures 1. VTE prophylaxis by admission day 2
2. Antithrombotic therapy at D/C
3. Afib/Aflutter patient D/C with anticoagulation
4. Arrives w/in 2 hrs. of LKW, receive TPA w/in 3 hrs.
5. Antithrombotic therapy by end of hospital day 2
6. LDL measured
7. Educational materials given at D/C
8. Assessed for rehabilitation services
2015 Performance Measures
Dysphagia Screen 100% of patients
NIHSS scale (provider) per protocol
VS/Neuro on TPA patients per protocol
Door to Needle (TPA) within 60 min
D/C on Intensive Statin Therapy
American Heart/American Stroke Honor Roll: Door to needle within 60 minutes 50 % or more of the
time. Last year our average was 64 minutes, we can meet
this goal!
Performance Goals: Door to Stroke Team (≤ 15 min) Door to Doc (≤ 10 min) Team arrival: (≤ 10 min) Door to CT/MRI time (≤ 25 min)
Door to CT/MRI Results (≤ 45 min) Door to Labs (≤ 45 min) Door to Lab Results (≤ 55 min) Door to needle: TPA time(≤ 60min) Door to stroke unit: (≤3 hours)
POST TPA VS/NEURO CHECK FREQUENCY Q15 minutes x 2 hours , Q 30 minutes x 6 hours, then Q1hour x 16
hours (for a total of 24 hours)
POST TPA NIHSS FREQUENCY Initial, 2 hours Post TPA, 24 hours Post TPA, Discharge.
Neurology or trained ED physicians or APRNs use stroke
specific scoring tool called a NIHSS
Case Study–
Door to Needle 36 minutes American Medical Response paramedics
Ron Gosselin and Ross Chagnon responded
in West Hartford for a 86 year old male with sudden onset of
right-sided facial droop, aphasia and inability to follow
commands. They called in a Stroke Alert to John Dempsey
Hospital. The patient was met by the hospital ED team,
Michelle Bordonaro RN, Kate Ireland RN, Leslie Mulhall
RN, Dr. Hunter-Anderson, Jen Sposito Stroke Coordinator,
and Neurology Residents Dr. Khan and Dr. Al-Zahmi, and
went straight to CAT SCAN on the EMS stretcher. The CT
scan showed no evidence of acute infarct or intracranial
hemorrhage. The patient met the criteria for TPA, which is
the only FDA approved treatment for ischemic stroke (it
dissolves the clot and improves blood flow and may improve
outcomes) when given within 3 hours on onset. The patient
was given TPA just 36 minutes after arriving in the ED, and
56 minutes after EMS arrival at the patient side. The patient
was admitted to the ICU and later transferred to the stroke
unit, where he received rehabilitation services. A repeat CAT
Scan showed the patient had suffered a left cortex stroke. He
has shown minor improvement during his stay was
discharged back to his SNF for further rehabilitation. While
the patient has not returned to his baseline, the speedy work
of the EMS/ED/Neurology team gave him the best possible
chance at limiting the terrible disability of stroke.
UConn Primary Stroke Center Updates
Please visit The Stroke Program’s new website:
http://www.uchc.edu/patients/services/stroke/
Update has been made to Stroke D/C checklist
NEW TPA Vs/Neuro and NIHSS checklist
Bedside Swallow electronic for inpatient units.
Located under shift assessment
Stroke Data Quarter 1: Door to Stroke alert Average is 6 minutes
100% EMS stroke alerts go directly to CT on EMS
stretcher
Stroke alert labs turn around time : 14 minutes.
100% Stroke Joint Commission Core Measures
>85% American Heart Performance Measures
Stroke Education given: Stroke Stoplight document
Stroke Recovery Book
Multidisciplinary Stroke Prevention Patient Education Form
Dysphagia Screening
prior to PO intake:
Stroke Volume: Increasing
EMS & Community Outreach EMS feedback forms:
Check out the EMS room for up
to date EMS feedback forms.
They include the EMS stroke
check list:
Discovery Series: 2/10/15-
Our stroke booth
implemented stroke screens
with F.A.S.T. and stroke
education to over 150
community members!
UPCOMING EVENTS Prehospital Stroke Care Conference-
May 16, 2015 -UConn Health will be holding an
EMS Stroke Conference on Saturday May 16 from
8:30-12pm. Topics will include Anatomy and
Physiology of Stroke, Prehospital Assessment, Stroke Alerts, In
Hospital Stroke Treatment/TPA, Vague Stroke Symptoms,
Stroke Mimics, Future of Stroke Treatment. 3 Hours CME for
EMS providers. Work-books provided. Registration Required.
Space Limited, but Free of Cost. More Details Soon. Open to all
staff. Neurocritical Care Educational Series: Date/time has
been changed to Tuesdays from 12-1pm in Low Learning Center.
This lecture is videotaped on Mediasite and offers with 1 hour
nursing CE for attendance of the live session and completion of
an evaluation. Upcoming dates: 4/28, 5/5, 5/26, 6/16, 6/30, 7/7, 7/21, 8/4,
8/18, 9/1, 9/22, 10/6, 10/20, 11/3, 11/24, 12/1, 12/15
Upcoming topics: ICH, Door to Needle
Stroke survivor group: First session May 27th 12-1pm 3rd
floor OPP clinic. Reoccurring the 4th Wed of every month.