Abstract NS 7: Code 1 (Acute Stroke Response Team): Improving Patient Outcomes Utilizing Simulation Training
The use of innovative blended learning for stroke program training has enabled the Washington Hospital Center’s Stroke Program in Washington, D.C. to decrease their patient “door presentation time” to Tissue Plasminogen Activator (tPA) “needle time” by 30minutes. Stroke programs always seem to be in a constant state of performance improvement and looking for way s to create seamless care from admission to treatment. A review of stroke response times and needs assessment in 2008 led the MedStar Health Washington Hospital Center Stroke Coordinator to collaborate with MedStar Health Simulation and Training Environmental Lab (SiTEL) to develop team training and individual stroke nurse responder training that includes both online modules and clinical simulation scenarios. Over the past three years this program has evolved and now includes online modules on stroke diagnosis and treatment, didactic instruction, preceptorship with an experienced stroke nurse responder and the use of clinical scenarios with live actors as patients to give nurses and the rest of the team practice with running a stroke code.
Initial objectives/goals included testing the team that had been trained and developing practice and validation scenarios for the nurse stroke responders so they could practice how to assess potential stroke victims, carrying out the stroke protocol and administer tPA. A second scenario is conducted quarterly for the entire team and is used to evaluate the entire process. Throughout this immersive simulation the team of physicians, nurses and radiology technicians must make crucial assessments, critical treatment decisions, follow a stroke protocol, transport the patient, administer tPA, monitor the patient and escalate care as complications arise. This scenario is timed and videotaped to allow the team to debrief after the scenario and review decisions made and actions taken thus increasing their efficiency and effectiveness of critical decision making regarding patient care. The overall success of this education program can be seen in the shortened door to tPA administration time for the acute stroke patient.
- © 2012 by American Heart Association, Inc.