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Fresh Approaches to Fresh Approaches to Patient Education Patient Education
Susan Savastuk MEd, BSNSusan Savastuk MEd, BSNStroke Program CoordinatorStroke Program Coordinator
Neuroscience InstituteNeuroscience InstituteBloomington HospitalBloomington Hospital
Bloomington, INBloomington, IN
1
OBJECTIVESOBJECTIVES
• Discuss the Joint Commission measurement for patient stroke education
• Review education initiatives and tools to increase compliance
2
ASA Policy Statement Recommendations ASA Policy Statement Recommendations for the establishment of stroke systems of for the establishment of stroke systems of care suggest that a stroke system should: care suggest that a stroke system should:
• Develop support tools to assist patients in long-term adherence to stroke prevention.
• Develop multiple education strategies along with health literacy targets appropriate to the education levels of the targeted population
Stroke March 20053
Joint Commission Performance Measure: Joint Commission Performance Measure: Stroke EducationStroke Education
Data Elements Five essentials of stroke education
Stroke Education Materials
Exclusions
Concerns
Data Sources Where stroke education can be documented
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Education Data ElementsEducation Data Elements
• Personalized Risk Factors for Stroke
• Warning Signs and Symptoms of Stroke
• Activation of Emergency Medical Services
• Follow up after Discharge
• Medications Prescribed at Discharge
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Educational MaterialsEducational Materials
• DVD, CD, Video, brochures, personalized teaching sheets can be used– Content of these items needs to be described
within your documentation
• Documentation can occur any time during admission
• JC recommends that stroke education
occurs throughout the hospital admission
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Education Requirement ExclusionsEducation Requirement Exclusions
• If patient is “Comfort Measures Only”– Does NOT include “DNR” status– Does include patients with Hospice Referrals, etc.
• Patients being Discharged to Inpatient Rehab, Nursing Home, Long Term Acute Care (this is new for Jan 2010 JC submissions)
• Patients admitted for Elective Carotid Endarterectomies
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Things That Impede the Education ProcessThings That Impede the Education Process
• If patients or family refuse education
• Patient has severe cognitive impairment, AND there is no family or caregiver available.
These instances must be documentedThese instances must be documented
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Where to DocumentWhere to Document
• Med Reconciliation sheet signed by MD, Nurse, and Patient
• Pathway/ Care Plans
• DC Instruction Sheet
• Nurse’s Note documentation
• MD documentation (i.e. DC Summary)
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Bloomington Hospital Stroke Bloomington Hospital Stroke Education Tools and InitiativesEducation Tools and Initiatives
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Quality Improvement InitiativesQuality Improvement Initiatives
• Discussions with stroke unit staff
• Mentoring
• Identify “Stroke Champions”
• Modifications to pathway and order sets
• Daily rounds
• Bi-weekly interdisciplinary rounds
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Ischemic Stroke Ischemic Stroke
OrdersOrders
Added Pathway Added Pathway to Admission to Admission
ordersorders
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Stroke PathwayStroke Pathway
Added Added Reminder on Reminder on
PathwayPathway
13
14
Day of Day of Discharge Discharge Check ListCheck List
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TIA Admission TIA Admission Orders and Orders and
PathwayPathway
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Stroke Stroke Discharge Discharge
OrdersOrders
17
18
19
0%10%20%30%40%50%60%70%80%90%
100%
Percentage
2007 2008 2009
Measurement of Stroke Education and Pathway Use 2007-2009
Education Provided
Pathway Use
20
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