September 20, 2007
John C. Lincoln North Mountain Hospital in Phoenix has become the Valley's newest hospital accredited as a Primary Stroke Center by The Joint Commission.
"North Mountain demonstrated that its stroke care program follows national standards and guidelines that can significantly improve outcomes for stroke patients," says Jean E. Range, MS, RN, CPHQ, executive director of The Joint Commission's Disease-Specific Care Certification program.
"I am so proud of our nursing team members who all jumped at the opportunity to earn this recognition of our caregiving capability from The Joint Commission," says Sharon Siewert, RN, BS, CCRN, Director of Neurosciences for John C. Lincoln Hospitals.
Stroke is the third most prevalent cause of death, and the leading cause of adult disability, in the U.S. Strokes affect 700,000 Americans every year. A stroke occurs when blood flow to the brain is disrupted, Sharon explains. Stroke may be caused by a blood clot or by bleeding from a burst blood vessel — either of which impairs the brain's ability to function.
When someone suffers a stroke, time is of the essence, Sharon says. Rapid medical treatment — started less than 3 hours after onset of symptoms — can save many stroke patients from a lifetime of disability. Think of a stroke as a "brain attack," she says, and call 9-1-1 without delay.
It's important for patients and families to insist that EMS providers take them to a Primary Stroke Center, where staff is trained to correctly diagnose the cause of stroke as well as to recognize symptoms of stroke, Sharon says. Diagnosing the cause is key to ensuring receipt of the best care, she explains. Treatment for strokes caused by clots is different from treatment for strokes caused by bleeding in the brain.
"If the stroke is caused by a clot and patients meet specific medical criteria, clot-busting medication must be given intravenously within 180 minutes of the advent of symptoms in order to prevent permanent damage," she says. "However, if the stroke is caused by bleeding in the brain, different treatment is essential."
The accreditation as a Primary Stroke Center is based on submitted documentation and an unannounced site visit by The Joint Commission surveyors to check the hospital's compliance in 10 designated areas of which four are mandatory:
- Consideration of clot-busting medication.
- Appropriate administration of anti-thrombotics, such as aspirin or Plavix.
- Diagnosing atrial fibrillation, an independent risk factor for stroke; and prescribing anticoagulants like Coumadin at time of patient discharge from the hospital.
- Deep vein blood clot prevention with mobilization, compression hose and/or medication and patient education.
All patients who arrive at North Mountain's Emergency and Level I Trauma Center are screened for stroke with a physical check. If stroke symptoms are observed, care is expedited, including by consultation with a neurologist, CT scans and blood tests.
How to Identify Stroke Symptoms
Stroke symptoms can be identified with the "F.A.S.T." system, Sharon said:
- F — Face: Does it droop on one side? Can the patient smile and show all teeth?
- A — Arms: Are they equally strong? Can the patient raise both arms and hold them up.
- S — Speech: Is it slurred or garbled? Can the patient speak normal sentences?
- T — Time: Don't waste it! If the patient has any symptoms of stroke, call 9-1-1 immediately!
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