Basics Flashcards
How to reach Stroke Response Team
Dial 33-911, ask operator to active the Stroke Response Team
WHAT ARE THE SUDDEN SIGNS AND SYMPTOMS OF STROKE?
BE FAST
Balance :sudden trouble walking or dizziness
Eyes: sudden trouble seeing in one of both eyes
Face: One side of the face droops or is numb
Arm: Is one arm weak or numb?
Speech: is speech slurred or hard to understand
Time: If a person shows ANY of these symptoms activate the Stroke Team right away
WHAT DO YOU DO IF YOUR PATIENT SHOWS SIGNS OF A NEW ONSET STROKE?
Relevant to acu:
Stay with the patient
Activate the Stroke Response Team
Prepare patient for transport to CT scan (remove needles)
IF THERE IS A MEDICAL ISSUE FOR A STROKE PATIENT WHO DO YOU CONTACT FIRST?
Contact the Primary Team
Also contact the Stroke Team for new neurology symptoms
HOW DO YOU ADDRESS RISK FACTORS FOR STROKE? (As acupuncturist)
- Rehabilitation Notebook documentation of patient education
- Patient Education Documentation Tab in EPIC
WHAT IS YOUR TRAINING SPECIFIC TO CARING FOR A STROKE PATIENT AND WHERE IS IT DOCUMENTED?
2 hours annul training specific to stroke support (4 hours for the first year as part pf the team)
Your general professional qualifications.
- received training at professionally accredited educational program (ie, PCOM)
- Board licensed to practice in NYS
- Credentialing and CPR certification that’s been verified by HR
- Orientation to stroke rehab program/guidelines when first hired
- In-service education and CEU’s
WHERE IS YOUR EDUCATION FOR THE PATIENT DOCUMENTED?
In the body of all rehabilitation notes in EPIC.
WHAT ARE 3 JOINT COMMISSION CERTIFICATION STANDARDS FOR THE STROKE REHABILITATION PROGRAM?
- use of performance measures relevant to the services provided and populations served
- The program follows a code of ethics
- The program has an organized, comprehensive approach to the performance improvement
3 Clinical Practice Guideline (CPG) Sources
- American Stroke Association (ASA)
- Veteran’s Administration Guidelines
- Acupuncture Stroke Maual
3 of the 14 topics for Clinical Practice Guidelines (CPG)
- Dysphagia
- Lower Extremity Function
- Bowel and Bladder Incontinence
WHERE ARE THE STROKE REHABILITATION CPG’S DOCUMENTED?
- Evaluations
- All Treatment Notes in Epic
- Re-evaluations
- Discharge Summary
When are the stroke rehabilitation CPG’s Documented?
Daily
HOW OFTEN ARE STROKE REHABILIATION SPECIFIC PROTOCOLS REVIEWED?
Stroke specific protocols are reviewed annually.
WHEN ARE STROKE REHABILITATION PATIENTS ASSESSED ON REHABILITATION
Therapy Services: Upon admission, every 7 days and discharge
Nursing: Every shift (AM and PM)
PM and R: Daily assessments
WHAT IS THE REHABILITATION NOTEBOOK?
An interdisciplinary communication journal
Given to all stroke rehabilitation patients admitted to acute rehabilitation.
Taken home at discharge.
How often do we document in the rehabilitation notebook?
Daily
What is documented in the patient’s portable health profile?
Abilities in 5 ares:
Communication Memory Toileting Transfer Ambulation
What is discussed in team conference?
- Barriers to discharge.
- Patient care plan.
- Team goals (that we all work toward in every session with patient)
- Equipment needed for discharge to home.
Patient’s initial ability vs Current ability
What are the performance initiatives that J.C. is tracking?
- Total FIM Change (goal is >29)
- Discharge to Community (goal is 75%)
- CPG Compliance (goal is 95%)
- Complete Patient Ed. Documenting (95%)
What is SSQOL?
“Stroke Specific Quality of Life Scale”
A patient centered outcome measure.
Was created by stroke survivors.
Completed at day 2 and 90 days later.
How do we manage interdisciplinary communication?
Daily Rounds
Team Conference
EPIC Medical Records
What are the pain management patient rights?
- All patients have a right to appropriate pain assessment and management.
- Lutheran uses a 0-10 pain scale
- Score of 3 or greater requires intervention. Should be reported to physician or nurse.
How can we assess non verbally?
Use FLACC assessment:
Face Legs Activity Cry Consolability
What is the protocol if a patient who is marked as non-english speaker doesn’t want an interpreter?
An interpreter must be used to make that request before treatment.
What is the preferred method for interpretation for non english speaking patients?
In person interpretation with someone whose ID has a gold start to indicate that they can serve as interpreter.
Use the Marty video translator, or ext 6537 as backup.
What PI Initiatives do we have?
- Rehab notebook
- 72 hour discharge call
- Motor FIM Change
- Fall prevention protocols
