Abstract W P286: Effect of a Dedicated In-House Stroke Nurse on Stroke Quality Outcome Measures: A Single Center Experience
Background and Purpose: As a comprehensive stroke program with a large transfer population, the transfer process initially was coordinated by the Intensive Care Unit charge nurse. As the program grew, a strain was placed upon the nurses. The focus of the Code Neuro Nurse role was to coordinate all stroke transfer patients and responding to all internal strokes. We sought to determine the efficacy of the Code Neuro Nurse role in improving documentation and education as it relates to the stroke population.
Methods: A retrospective analysis of seven quality indicators was performed before and after program inception. Dysphagia screening (n=1071), Stroke education (n=870), National Institute of Health Stroke Scale (NIHSS) on admission (n=1197), NIHSS on discharge (n=2302), modified rankin score (mRS) on admission (n=1567), mRS on discharge (n=2302) and door to intravenous (IV) tissue plasminogen activator (tPA) within 60 minutes (n=35). A two tailed t-test was performed analyzing data from July 2011 through June 2013 comparing two twelve month data groups (2012 and 2013).
Results: Significant improvement from 2012 to 2013 quality indicators was demonstrated in documented stroke education from a mean of 95.6% to 100% (p= 0.0153), NIHSS on discharge from mean 72.6% to 82.3% (p=0.0416), mRS documentation at admission from a mean 67.7% to 92.6% (p<0.0001) and mRS documentation at discharge mean 62.5% to 78.4% (p=0.0049). Although not statistically significant, quality indicator improvement was demonstrated 2012 to 2013 in NIHSS reporting on admission from mean 96.1% to 98.5% (p=0.074), dysphagia screening from mean 85.4% to 89.1% (p=0.053), and door to IV tPA in 60 minutes from mean 31.3% to 58.7% (p=0.15).
Conclusions: The “Code Neuro Nurse” program demonstrated an increase in documentation related to the care of the stroke patient. While other areas showed increased improvement related to testing and process, the results were not statistically significant. Further evaluation is warranted to determine the opportunities for further growth and development of the program.
Author Disclosures: A.M. Doerr: None. A. Lindstrom: None. M. Ferguson: None. J. Carlson: None. B. Diane: None. H. Shownkeen: None. K. Linsner: None. J. Davis: None. L. Pittner: None. J. Biede: None.
- © 2014 by American Heart Association, Inc.