2.50
Hdl Handle:
http://hdl.handle.net/10755/344151
Category:
Abstract
Type:
Poster
Title:
Code Stroke with Telemedicine and Emergency Alert Integration
Author(s):
Pepito, Bella
Lead Author STTI Affiliation:
Non-member
Author Details:
Bella Pepito, MHA, RN, CEN
Abstract:
Evidence-based Practice Abstract Purpose: The Emergency Department (ED) previously relied on telephone communication with the on- call neurohospitalist to care for a patient with stroke like symptoms. The purpose of the project is to expeditiously facilitate the care of stroke patients through the use of telemedicine (RP Lite robot) which allows neurohospitalists to remotely and conveniently perform patient interview and assessment and the use of emergency alert system for early diagnosis and treatment. Design: This is a quality assurance project to ensure timely management of acute ischemic stroke in adults for optimal neurological outcomes. Setting: The facility is a not-for-profit, comprehensive, Magnet designated hospital, licensed for 296 beds, with 31 ED beds (70,000 visits in 2013). It is a Primary Stroke Center, Chest Pain Cycle III with Percutaneous Coronary Intervention and Heart Failure Accredited Center. It provides 24/7 neurology and intermittent neurosurgery on- call coverage. Participants/Subjects: All adult patients who present to the ED with stroke like symptoms using the FAST (facial droop, arm drift, slurred speech, time) acronym. Methods: Immediately upon patient identification, the nurse calls the nursing supervisor to activate a Code Stroke alert. Code Stroke notification consists of patient’s name and room number, time of arrival in the ED and last known well time. Notification is sent to radiology, pharmacy, laboratory, stroke coordinator and ED leadership team by email, telephone or text message via the emergency notification system. The ED provider completes a quick National Institute of Health Stroke Scale (NIHSS) before transport of the patient to radiology. The ED physician calls the neurohospitalist on-call within the first 15 minutes. A nurse accompanies patient to radiology for head CT scan without contrast. The nurse starts an IV and draws blood before transfer of patient to CT table. The robot is on standby in the patient’s room upon completion of CT. The radiologist reads the head CT and calls the results stat. The ED provider calls the neurohospitalist the second time. The neurohospitalist remotely obtains own patient history and NIHSS through the robot and collaborates plan of care with ED provider. Results/Outcomes: There has been a total of 58 Code Stroke activations since the use of the robot in June 2013. All Core Measure targets were met in the last 6 months with 100% compliance on NIHSS performed within 45 minutes. Nineteen patients received Tissue Plasminogen Activator. The facility also received stroke process commendation by Joint Commission in the recent mid cycle review. One patient was featured on local television to share her success story on the use of telemedicine and how it saved her. Implications: The early alert notification followed by the use of telemedicine helps facilitate treatment and the exchange of medical information from one site to another for early diagnosis, timely intervention and improved neurological outcomes.
Keywords:
Code Stroke; Telemedicine; Telemedicine and Emergency Alert Integration
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleCode Stroke with Telemedicine and Emergency Alert Integrationen_GB
dc.contributor.authorPepito, Bellaen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsBella Pepito, MHA, RN, CENen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344151-
dc.description.abstractEvidence-based Practice Abstract Purpose: The Emergency Department (ED) previously relied on telephone communication with the on- call neurohospitalist to care for a patient with stroke like symptoms. The purpose of the project is to expeditiously facilitate the care of stroke patients through the use of telemedicine (RP Lite robot) which allows neurohospitalists to remotely and conveniently perform patient interview and assessment and the use of emergency alert system for early diagnosis and treatment. Design: This is a quality assurance project to ensure timely management of acute ischemic stroke in adults for optimal neurological outcomes. Setting: The facility is a not-for-profit, comprehensive, Magnet designated hospital, licensed for 296 beds, with 31 ED beds (70,000 visits in 2013). It is a Primary Stroke Center, Chest Pain Cycle III with Percutaneous Coronary Intervention and Heart Failure Accredited Center. It provides 24/7 neurology and intermittent neurosurgery on- call coverage. Participants/Subjects: All adult patients who present to the ED with stroke like symptoms using the FAST (facial droop, arm drift, slurred speech, time) acronym. Methods: Immediately upon patient identification, the nurse calls the nursing supervisor to activate a Code Stroke alert. Code Stroke notification consists of patient’s name and room number, time of arrival in the ED and last known well time. Notification is sent to radiology, pharmacy, laboratory, stroke coordinator and ED leadership team by email, telephone or text message via the emergency notification system. The ED provider completes a quick National Institute of Health Stroke Scale (NIHSS) before transport of the patient to radiology. The ED physician calls the neurohospitalist on-call within the first 15 minutes. A nurse accompanies patient to radiology for head CT scan without contrast. The nurse starts an IV and draws blood before transfer of patient to CT table. The robot is on standby in the patient’s room upon completion of CT. The radiologist reads the head CT and calls the results stat. The ED provider calls the neurohospitalist the second time. The neurohospitalist remotely obtains own patient history and NIHSS through the robot and collaborates plan of care with ED provider. Results/Outcomes: There has been a total of 58 Code Stroke activations since the use of the robot in June 2013. All Core Measure targets were met in the last 6 months with 100% compliance on NIHSS performed within 45 minutes. Nineteen patients received Tissue Plasminogen Activator. The facility also received stroke process commendation by Joint Commission in the recent mid cycle review. One patient was featured on local television to share her success story on the use of telemedicine and how it saved her. Implications: The early alert notification followed by the use of telemedicine helps facilitate treatment and the exchange of medical information from one site to another for early diagnosis, timely intervention and improved neurological outcomes.en_GB
dc.subjectCode Strokeen_GB
dc.subjectTelemedicineen_GB
dc.subjectTelemedicine and Emergency Alert Integrationen_GB
dc.date.available2015-02-04T11:27:25Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:25Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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