Amid its many certifications and designations as a top stroke center, Tampa (Fla.) General Hospital has at its base a throng of passionate and knowledgeable nurses who have changed the outcomes of innumerable stroke patients. Since becoming a stroke designated center in 2002, the hospitals nurses have consistently maintained and raised the bar in stroke care.
Our door-to-CT time is a process change we did for the hospital, said Noella West, RN, ARNP-C, MSN, CNL, an NP with the stroke program.
West said the hospital is part of the American Heart Associations Target: Stroke initiative. This [door-to-CT] process means that a stroke or potential stroke patient is able to bypass admission and other details that can delay a patients arrival for CT,
West said the door-to-CT process means nurses aim to get a stroke patient into the CT scanner within 60 minutes of a stroke, whether its ischemic, hemorrhagic or a TIA. If were in that window, we use the National Institutes of Health stroke scale, assess the risks and benefits, and we can provide the patient with clot-busting medication within 4.5 hours after the first symptoms, West said.
Stroke Program Coordinator Karen Wilson, RN, BSN, CNRN, explained that the nurses worked with other departments, including physicians and radiology, to attain the high levels of performance necessary to reach and keep the hospitals certifications and designations. That includes The Joint Commissions advanced certification as a primary stroke center.
West credits the nurses for their role in the process of reaching Target: Stroke. The nurses are a primary contact to alert when a stroke patient is about to arrive at the ED, so they assist in making sure that an imaging scanner, such as the CT, is free and available to have the patient be directly admitted. Nurses also assist with obtaining lab values and pre-stroke admission information. Making arrangements to call our bed [management] system to ensure a neuro ICU bed is also very important.
Several hundred nurses work in neuroscience and stroke units, including rehab. The hospital has one of the largest neuro ICUs in the U.S., West said.
In 2006, Wilson said, the hospital put into place the Code Gold process. Any nurse in the hospital who thinks a patient is having a stroke calls a Code Gold. Wilson developed the protocol that provides immediate response in the same way a STAT or Code Blue team responds to cardiac situations. She said RNs throughout the hospital have been educated in an ongoing process about the signs and symptoms of stroke, such as altered mental status, slurred speech, numbness or weakness, altered vision and sudden headache.
The improvement process has been challenging, West and Wilson affirmed.
Its been exciting for us, and its been exciting for our nurses, too, Wilson said.
Strokes often are life-altering events. Tampa General Hospitals annual Stroke Retreat offers stroke survivors and their caregivers the opportunity to receive support, medical follow up and education about their condition.West organizes the event each May.
In addition to breakfast and lunch, West said, she brings in experts to talk about stroke topics.
Weve had a therapist teaching relaxation techniques, West said. We address emotional side effects, such as memory and depression.
This years retreat included 65 people, the largest group to date. Participants range in age from 8