Abstract TP349: Advanced Practice Registered Nurses Provide Cost-effective, Quality Stroke Care
Background: Our institution is a nationally known stroke center. The number of stroke patients treated yearly grew from 235 in 2000 to 917 in 2011. We are challenged to provide clinically excellent, ground breaking care in a fiscally responsible manner to this growing population.
Purpose: To meet this challenge our institution utilizes Advanced Practice Registered Nurses (APRNs) to improve and streamline stroke care.
Methods: An APRN was part of the stroke team at the inception and continues as Coordinator. In 2008 the team implemented an additional APRN role to provide acute inpatient care to stroke and general Neurology patients. There are now 3 Board Certified APRNs who meet Certified Stroke Center requirements and fill this role. Their backgrounds are Emergency Medicine, Intensive Care, and Internal Medicine, and they are Certified Neurology Registered Nurses. They work collaboratively with the Neurologists in 12 hour shifts, 7 days a week. The APRNs complete History and Physicals, participate in research, provide education, assist with acute strokes and perform patient rounds.They address patient and staff concerns, and maintain collaborative care with other disciplines.
Results: APRN collaboration assures continuous patient monitoring and allows physicians to address more acute issues. The Interval Summary dictation improves accurate coding of patient visits, assists in documenting core stroke measures, and provides current follow up to referring facilities. The APRNs designed and utilize a Neuroscience History and Physical form, which provides uniform and streamlined documentation. Their productivity logs show during June of 2012, a completion of 139 new consults, 169 routine follow ups, and monitoring of 97 ICU patients. This is in addition to dictation and multiple workplace demands. The Neurologists requested additional APRN coverage and are favorable of collaborative practice.
Conclusion: In conclusion, the organized, streamlined, evidenced- based APRN care results in cost effectiveness meeting the challenges of the growing stroke population. Future plans for the APRN role include continued efficient care, educational efforts, preceptors for APRN students and residents, and participation in the hospital APRN Council.
- © 2012 by American Heart Association, Inc.