Transcript Presentation 1 - GLRSN stroke Education

Fresh Approaches to
Patient Education
Susan Savastuk MEd, BSN
Stroke Program Coordinator
Neuroscience Institute
Bloomington Hospital
Bloomington, IN
1
OBJECTIVES
• Discuss the Joint Commission measurement
for patient stroke education
• Review education initiatives and tools to
increase compliance
2
ASA Policy Statement Recommendations
for the establishment of stroke systems of
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 2005
3
Joint Commission Performance Measure:
Stroke Education
Data Elements
Five essentials of stroke education
Stroke Education Materials
Exclusions
Concerns
Data Sources
Where stroke education can be documented
4
Education 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
5
Educational 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
6
Education 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
7
Things 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 documented
8
Where 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)
9
Bloomington Hospital Stroke
Education Tools and Initiatives
10
Quality Improvement Initiatives
•
•
•
•
•
•
11
Discussions with stroke unit staff
Mentoring
Identify “Stroke Champions”
Modifications to pathway and order sets
Daily rounds
Bi-weekly interdisciplinary rounds
Ischemic Stroke
Orders
Added Pathway
to Admission
orders
12
Stroke Pathway
Added
Reminder on
Pathway
13
14
Day of
Discharge
Check List
15
TIA Admission
Orders and
Pathway
16
Stroke
Discharge
Orders
17
18
19
Measurement of Stroke Education and Pathway
Use 2007-2009
Percentage
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Education Provided
Pathway Use
2007
20
2008
2009