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

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 and body

Stroke Awareness seminar Two types • Haemorrhage •Infarct (clot)

Stroke Awareness seminar

Stroke Awareness seminar

Stroke Awareness seminar

Stroke Awareness seminar

Stroke Awareness seminar Thrombolysis (clot busting) − Not suitable for all − Needs to be given within 4.5 hours of onset − Other exclusions apply

Stroke Awareness seminar Thrombolysed Patients Thrombolysed patients 20 18 16 14 12 Patients 10 8 6 4 2 0 Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- 11 11 11 11 11 11 11 11 11 11 11 11 12 12 12 12 12 12 12 12 12 12 12 12 13 13 Date

Stroke Awareness seminar Increase in Thrombolysis Thrombolysed patients by year 140 120 100 80 Thrombolysed patients 60 40 20 0 year 2009 year 2010 year 2011 year 2012

Stroke Awareness seminar Outcomes April 12 - date Discharges 100 90 80 70 60 50 patients 40 30 20 10 0 Home Died Com Hospital Nursing home Other hospital Not yet discharged Discharge destination

Stroke Awareness seminar Fast but safe THROMBOLYSIS CHECK LIST Date Time Patient Label Sign Print name 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?

Stroke Awareness seminar

Stroke Awareness seminar Thrombolysis Nurses

Stroke Awareness seminar Medical Team

Stroke Awareness seminar Radiographers

Stroke Awareness seminar Alteplase

Stroke Awareness seminar Infusion pump

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

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

Stroke Awareness seminar Transfer of care − Home (approx 67%) − Home with Early Supported Discharge team − Community hospital (approx 8%)

Stroke Awareness seminar Early Supported Discharge − Up to 6 weeks − Each discipline (OT, PT, S&LT, Psych) − Full 45 minute session if tolerated

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

Stroke Awareness seminar MDT Meeting

Stroke Awareness seminar Carer & Family Support

Stroke Awareness seminar www.berkshirewest.nhs.uk

Stroke Awareness seminar Monthly meeting with Ed Donald - CEO

Stroke Awareness seminar Review meetings for the team

Stroke Awareness seminar Teaching

Stroke Awareness seminar Multidisciplinary Review

Stroke Awareness seminar Public Generosity

Stroke Awareness seminar What’s it like to have a stroke?

Stroke Awareness seminar Thank you − Liz.barber@royalberkshire.nhs.uk