![[ Visit Client Website ]](images/banner.gif)
Monday, 31 October 2011
Learning Objective 1: Identify the nurse leadership needed to improve care and recommend changes at a designated stroke center.
Learning Objective 2: Describe the nurse lead collaboration among various professional disciplines required for the acute care of patients with stroke/TIA that is stroke rounds.
Purpose: To evaluate patient care for improvement and align the resources and professional personnel for consistent multidisciplinary collaboration of inpatient stroke and transient ischemic (TIA) care. Methods: Sisters of Charity Hospital in Buffalo, New York is a medium size city teaching hospital that is a New York State designated stroke center. The stroke team is multidisciplinary with; physicians, nurses, physical and occupational therapists, speech pathologists, nutrition and care management. The department of nursing took on the responsibility for leadership of twice weekly stroke rounds. Stroke rounds were conceptualized by the director of emergency and critical care nursing and supported by the neurological unit nurse manager to set direction and a communication process to direct caregivers of patients with stroke/TIA. This direction was according to the evidenced based stroke/TIA clinical practice guidelines. These rounds not only provided direction but also a painstaking process to gather and analyze information about the patients and their care in the hospital and recommend changes. Various levels of nursing have leadership roles for stroke rounds. The nurse practitioner for the hospital’s vascular services became the point leader ensuring that the group meets twice a week for the past three years. The clinical nurse specialist for critical care leads the discussion for those patients in intensive care and the emergency room. The staff nurses of the neurological unit lead with the details of the patient’s daily progress, education and family input. Results: patients with stroke/TIA: 2003; 92 2008; 293 2010; 408. When compared to 2008 quality stroke indicators there were 3% to 37% increases in all of the indicators except, “Discharged on Anti-thrombotic Therapy” which remained the same at 95%. Conclusion: Twice a week stroke rounds with nursing leadership have contributed to improved care to a growing number of patients with stroke/TIA at a designated stroke center.