Stroke Awareness Seminar Liz Barber, Stroke Service Development - - PowerPoint PPT Presentation

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Feb 17, 2023 367 likes •713 views

Stroke Awareness seminar Stroke Awareness Seminar Liz Barber, Stroke Service Development Sister Stroke Awareness seminar What is a stroke? A stroke is a brain attack Strokes are sudden and have an immediate effect A stroke can damage mind

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Stroke Awareness seminar

Stroke Awareness Seminar

Liz Barber, Stroke Service Development Sister

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Stroke Awareness seminar

What is a stroke? A stroke is a brain attack Strokes are sudden and have an immediate effect A stroke can damage mind and body

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Stroke Awareness seminar

Two types

Haemorrhage
Infarct (clot)

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Stroke Awareness seminar

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Stroke Awareness seminar

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Stroke Awareness seminar

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Stroke Awareness seminar

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Stroke Awareness seminar

Thrombolysis (clot busting)

− Not suitable for all − Needs to be given within 4.5 hours of onset − Other exclusions apply

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Stroke Awareness seminar

Thrombolysed Patients

Thrombolysed patients 2 4 6 8 10 12 14 16 18 20 Jan- 11 Feb- 11 Mar- 11 Apr- 11 May- 11 Jun- 11 Jul- 11 Aug- 11 Sep- 11 Oct- 11 Nov- 11 Dec- 11 Jan- 12 Feb- 12 Mar- 12 Apr- 12 May- 12 Jun- 12 Jul- 12 Aug- 12 Sep- 12 Oct- 12 Nov- 12 Dec- 12 Jan- 13 Feb- 13 Date Patients

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Stroke Awareness seminar

Increase in Thrombolysis

20 40 60 80 100 120 140 year 2009 year 2010 year 2011 year 2012

Thrombolysed patients by year

Thrombolysed patients

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Stroke Awareness seminar

Outcomes April 12 - date

10 20 30 40 50 60 70 80 90 100 Home Died Com Hospital Nursing home Other hospital Not yet discharged Discharge destination

Discharges

patients

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Stroke Awareness seminar

Fast but safe

Please ensure that the doctor making the decision to thrombolyse has answers to all the questions below before commencing the infusion. Is the most likely diagnosis Stroke? Are you certain of the onset time? Is the blood pressure within limits? Is the patient on anticoagulants and if yes do you have blood clotting results? Has the patient had any recent surgery? Has the patient suffered a head injury?

THROMBOLYSIS CHECK LIST

Patient Label Date Time Sign Print name

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Stroke Awareness seminar

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Stroke Awareness seminar

Thrombolysis Nurses

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Stroke Awareness seminar

Medical Team

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Stroke Awareness seminar

Radiographers

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Stroke Awareness seminar

Alteplase

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Stroke Awareness seminar

Infusion pump

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Stroke Awareness seminar

HASU

− Thrombolysed patients − Haemorrhagic strokes − Nursing ratio of 1:2 − Continuous physiological monitoring − All usual assessments performed − To ASU when medically stable

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Stroke Awareness seminar

ASU

− Majority of stay (>90%) on Stroke Unit − Specialist stroke consultant within 24 hours − Specialist nursing − Specialist therapy team − Identify risk factors & treat

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Stroke Awareness seminar

Transfer of care

− Home (approx 67%) − Home with Early Supported Discharge team − Community hospital (approx 8%)

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Stroke Awareness seminar

Early Supported Discharge

− Up to 6 weeks − Each discipline (OT, PT, S&LT, Psych) − Full 45 minute session if tolerated

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Stroke Awareness seminar

TIA

Mobile phone service (40595) Clinics 5 days a week Aim to see patients within 24 hours of referral – patients decline appointments! 578 patients seen in clinic in 2009 340 were TIAs 65% high risk seen within 24 hours

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Stroke Awareness seminar

MDT Meeting

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Stroke Awareness seminar

Carer & Family Support

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Stroke Awareness seminar

www.berkshirewest.nhs.uk

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Stroke Awareness seminar

Monthly meeting with Ed Donald - CEO

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Stroke Awareness seminar

Review meetings for the team

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Stroke Awareness seminar

Teaching

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Stroke Awareness seminar

Multidisciplinary Review

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Stroke Awareness seminar

Public Generosity

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Stroke Awareness seminar

What’s it like to have a stroke?

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Stroke Awareness seminar

Thank you

− Liz.barber@royalberkshire.nhs.uk