London, United Kingdom 2013 Poster Session Nurses/AHP’s Cerebrovasc Dis 2013; 35 (suppl 3)1-854 203 2015 Emergency management, stroke units and complications for nurses Nurse led Stroke Clinic in the Emergency Department Can we reduce hospital admissions, increase efficiency of our limited stroke beds and improve stroke patient experience in the Emergency Department? A.J. JAMES1 Royal Cornwall Hospital Trust, Truro Cornwall, Truro, UNITED KINGDOM1 Background Patients following minor stroke or TIA need timely investigation and management. Our Trust was failing the UK target of admitting all patients following stroke directly to the stroke unit and for all patients to spend 90% of their time during admission on the stroke unit. This audit reports results of a stroke nurse practitioner led approach to ensure limited stroke beds were used efficiently, that the experience of stroke patients coming into Emergency Department was improved and also identifting those patients that could be discharged directly from ED following all required investigations, thus releasing the limited number of beds for stroke patients disabled by their stroke. Methods A retrospective notes audit revealed that some patients did not require admission to the stroke unit. After 8 weeks a prospective audit of the stroke nurse led clinic of those patients presenting to the Emergency Department at the Royal Cornwall Hospital (UK) with suspected minor stroke or TIA. A patient satisfaction questionnaire was also done. The stroke nurse requested all investigations, liaised with the ED and stroke medical team, pre-scribed required medication as well as arranging follow up, outpatients and rehabilitation service care. Results During 40 working days 17 patients diagnosed with stroke or TIA were discharged by the nurse from ED. In total 34 bed days were saved. Three patients were referred for ongoing rehabilitation to the early supported discharge team for follow up. As a result more patients with stroke that required admission to the stroke unit spent more than 90% of their admission on stroke unit. None of the pa-tients seen by the stroke nurse were readmitted with 2 following months and patients were very sat-isfied with their care. Discussion A Stroke Nurse Practitioner working in the Emergency Department can reduce stroke admissions, improve the 90% target and be a very positive experience for patients. 2016 Emergency management, stroke units and complications for nurses Service Improvement for Acute Stroke Scanning, illustrating the power of Multidisciplinary working across a Trust in order to improve CT scanning times, Thrombolysis and Direct ad-mission rates A.J. JAMES1, C. Eade2 Royal Cornwall Hospital Trust Truro, TRURO, UNITED KINGDOM1, Royal Cornwall Hospi-tal Trust Truro, Truro, UNITED KINGDOM2 The original aims of the Acute Stroke Scan Project in Truro were to accelerate immediate access to the CT Head scanner from the ambulance for all stroke patients. There was engagement of all stakeholders across the Stroke Pathway in Cornwall from the Ambu-lance Service, the Friends of the hospital and General Practitioners to all clinicians and managers across the Acute Trust Education and skills training was provided for all clinicians involved across Cornwall Data is continually collected to monitor improvement with weekly exception reporting done on all stroke patients A Stroke Bleep alert was commenced to alert the team of all admissions The data revealed an exceptional rate of admission to scan rate within an hour for all Acute Stroke Patients but also an increased rate of Thrombolysis and Direct Admission the Acute Stroke Unit from the Emergency Department. The care of Stroke patients in Cornwall has improved greatly due to the introduction of a dedicated Head Scanner in the Emergency Department provided by the work of the Friends of the Hospital, and effective collaboration of Stroke team, Emergency department team and the Radiography ser-vice. This has led to improvement in the skills and knowledge base of the TAG radiographers, the South West Ambulance teams and the Emergency Department Team and Stroke clinicians. This work has been recognised by the Trust with the Stroke team accepting a local Excellence Award and other teams are now emulating this pathway work. This cultural change and ownership, has enhanced overall clinical practice of all staff involved and improved the quality of stroke patient investigation, treatment and care at Royal Cornwall Hospital Trust in Truro
Karger_ESC London_2013
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