Shushanth Aroor, Desiree M. Cihelka, Dileep Yavagal
Background Stroke Coordinators (SC) should be commonly utilized in Stroke Centers to ensure provision of evidence-based services, oversee quality improvement, and support interdisciplinary and community education. Mission Thrombectomy (MT) partnered with the Association of Neurovascular Clinicians (ANVC) to understand how SCs are utilized outside the US and to compare developmental needs for this role across the world. Methods A brief survey was constructed to capture information about the use of SCs and their duties, including personnel utilized to execute the role and areas deemed important for role development. The survey was disseminated through the MT and ANVC membership rosters; returned data were assembled in SPSS (version 25) and analyzed using descriptive and X2statistical tests.Results A total of 74 surveys were returned from 17 countries (63% USA). Survey responders were SCs (41%), physicians (39%), program managers (19%) and advanced practice providers (APPs) (1%); 47% were from thrombectomy centers. The SC role was filled at 92% of centers; MDs more commonly assumed the SC role outside the USA (63%), versus registered nurses in the USA (95%; X2=25.2, p<0.001). Of the 70% of respondents interested in receiving assistance from MT and ANVC for SC development resources, the functions deemed most important were “quality improvement” and “emergency medical service personnel education” for USA respondents (36%), whereas “development of stroke systems of care” (60%) and “government policy change” (40%) were ranked highest outside the USA. Conclusions Non-USA Stroke Centers have significant SC development needs that differ markedly from those within the USA. MT provides an important platform to engage international programs and the MT/ANVC partnership is well positioned to further stroke nursing care and SC development globally.
{"title":"Stroke Coordinator Developmental Needs Around the Globe: An MT - ANVC International Survey","authors":"Shushanth Aroor, Desiree M. Cihelka, Dileep Yavagal","doi":"10.59236/sc.v1i1.16","DOIUrl":"https://doi.org/10.59236/sc.v1i1.16","url":null,"abstract":"Background Stroke Coordinators (SC) should be commonly utilized in Stroke Centers to ensure provision of evidence-based services, oversee quality improvement, and support interdisciplinary and community education. Mission Thrombectomy (MT) partnered with the Association of Neurovascular Clinicians (ANVC) to understand how SCs are utilized outside the US and to compare developmental needs for this role across the world. Methods A brief survey was constructed to capture information about the use of SCs and their duties, including personnel utilized to execute the role and areas deemed important for role development. The survey was disseminated through the MT and ANVC membership rosters; returned data were assembled in SPSS (version 25) and analyzed using descriptive and X2statistical tests.Results A total of 74 surveys were returned from 17 countries (63% USA). Survey responders were SCs (41%), physicians (39%), program managers (19%) and advanced practice providers (APPs) (1%); 47% were from thrombectomy centers. The SC role was filled at 92% of centers; MDs more commonly assumed the SC role outside the USA (63%), versus registered nurses in the USA (95%; X2=25.2, p<0.001). Of the 70% of respondents interested in receiving assistance from MT and ANVC for SC development resources, the functions deemed most important were “quality improvement” and “emergency medical service personnel education” for USA respondents (36%), whereas “development of stroke systems of care” (60%) and “government policy change” (40%) were ranked highest outside the USA. Conclusions Non-USA Stroke Centers have significant SC development needs that differ markedly from those within the USA. MT provides an important platform to engage international programs and the MT/ANVC partnership is well positioned to further stroke nursing care and SC development globally.","PeriodicalId":517115,"journal":{"name":"Stroke Clinician","volume":"72 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139894682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neuroimaging Case review","authors":"Bryan Fill","doi":"10.59236/sc.v1i1.23","DOIUrl":"https://doi.org/10.59236/sc.v1i1.23","url":null,"abstract":"Neuroimaging Case Review","PeriodicalId":517115,"journal":{"name":"Stroke Clinician","volume":"110 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139894567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Transfer challenges from primary stroke centers and acute stroke ready hospitals (PSC/ASRH) to a higher level of care are excessive. This narrative review examines the published literature for factors within and external to PSC/ASRH emergency departments that contribute to delays in the transfer of large vessel occlusion (LVO) patients to a higher level of care for thrombectomy.Methods A review of the literature was conducted incorporating findings from January 1996 to April 2020. Reference software was utilized to organize and track references. Retrieved papers were screened first by abstract to eliminate non-pertinent studies; papers selected for full review were then fully examined for relevance, and those retained were subsequently divided into thematic groups based on content. Results Guideline standardization of intrahospital practices and associated performance metrics, along with prehospital provider education and training have contributed to improved acute stroke service efficiency. Factors associated with transfer delays have not been identified nor quantified, yet delays contribute to significantly worse patient outcomes. Calls for bypass of lower levels of care with direct transport to CSC are fueled primarily by assumptions of poor PSC/ASRH internal performance. Conclusions Although transport delay times have been quantified as excessive, the reasons for delays are not fully understood. Additional research is warranted to fully understand why delays occur
{"title":"Hospital-to-Hospital Transfer Delays in Hyperacute Stroke: Known Causes and Gaps in Knowledge","authors":"Jennifer Patterson","doi":"10.59236/sc.v1i1.19","DOIUrl":"https://doi.org/10.59236/sc.v1i1.19","url":null,"abstract":"Background Transfer challenges from primary stroke centers and acute stroke ready hospitals (PSC/ASRH) to a higher level of care are excessive. This narrative review examines the published literature for factors within and external to PSC/ASRH emergency departments that contribute to delays in the transfer of large vessel occlusion (LVO) patients to a higher level of care for thrombectomy.Methods A review of the literature was conducted incorporating findings from January 1996 to April 2020. Reference software was utilized to organize and track references. Retrieved papers were screened first by abstract to eliminate non-pertinent studies; papers selected for full review were then fully examined for relevance, and those retained were subsequently divided into thematic groups based on content. Results Guideline standardization of intrahospital practices and associated performance metrics, along with prehospital provider education and training have contributed to improved acute stroke service efficiency. Factors associated with transfer delays have not been identified nor quantified, yet delays contribute to significantly worse patient outcomes. Calls for bypass of lower levels of care with direct transport to CSC are fueled primarily by assumptions of poor PSC/ASRH internal performance. Conclusions Although transport delay times have been quantified as excessive, the reasons for delays are not fully understood. Additional research is warranted to fully understand why delays occur","PeriodicalId":517115,"journal":{"name":"Stroke Clinician","volume":"101 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139894678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma-Joy Holland, Rachel Georgiou, Caroline Watkins, Clare Gordon, C. Lightbody
Background Stroke nurses are adopting extended roles to improve patient care due to limited numbers of vascular neurologists, however, little is known of this experience. We evaluated the impact of an internationally implemented fellowship education program to equip experienced stroke nurses, nationally and internationally, to undertake extended acute stroke roles.Methods We conducted semi-structured interviews with the following groups of individuals associated with the NET SMART Advanced Practice fellowship program: 1) Stroke nurse program graduates; 2) currently enrolled stroke nurse fellows; 3) local physician mentors; 4) service managers of program graduates. Interviews took place between February-August 2018 and were analysed using the Theoretical Domains Framework. Results Interviews were held with stroke nurses (n=11), mentors (n=4) and a service manager (n=1). Four themes were identified: 1) ‘The learning journey’- describing motivations for undertaking the training and course content; 2) ‘Organizational and professional change’-experiencing professional resistance to the new role, or lack of a suitable role to move into after program completion, 3) ‘What hindered the learning journey?’- small hospitals with low patient volume makes completion challenging; 4) ‘What helped the learning journey?’- a supportive team facilitated completion. Conclusion We found overwhelming skill development and professional growth by nurses, and this was echoed by mentors and managers. However, despite expanding their stroke-specific knowledge and skills, non-U.S.A. nurses faced systemic challenges in implementing theirskills including lack of acceptance of extended nurse roles from wider professions.
{"title":"Equipping Stroke Nurses to Take on Extended Roles Within Acute Stroke Care Through an Advanced Practice Fellowship: An Evaluation Study","authors":"Emma-Joy Holland, Rachel Georgiou, Caroline Watkins, Clare Gordon, C. Lightbody","doi":"10.59236/sc.v1i1.18","DOIUrl":"https://doi.org/10.59236/sc.v1i1.18","url":null,"abstract":"Background Stroke nurses are adopting extended roles to improve patient care due to limited numbers of vascular neurologists, however, little is known of this experience. We evaluated the impact of an internationally implemented fellowship education program to equip experienced stroke nurses, nationally and internationally, to undertake extended acute stroke roles.Methods We conducted semi-structured interviews with the following groups of individuals associated with the NET SMART Advanced Practice fellowship program: 1) Stroke nurse program graduates; 2) currently enrolled stroke nurse fellows; 3) local physician mentors; 4) service managers of program graduates. Interviews took place between February-August 2018 and were analysed using the Theoretical Domains Framework. Results Interviews were held with stroke nurses (n=11), mentors (n=4) and a service manager (n=1). Four themes were identified: 1) ‘The learning journey’- describing motivations for undertaking the training and course content; 2) ‘Organizational and professional change’-experiencing professional resistance to the new role, or lack of a suitable role to move into after program completion, 3) ‘What hindered the learning journey?’- small hospitals with low patient volume makes completion challenging; 4) ‘What helped the learning journey?’- a supportive team facilitated completion. Conclusion We found overwhelming skill development and professional growth by nurses, and this was echoed by mentors and managers. However, despite expanding their stroke-specific knowledge and skills, non-U.S.A. nurses faced systemic challenges in implementing theirskills including lack of acceptance of extended nurse roles from wider professions.","PeriodicalId":517115,"journal":{"name":"Stroke Clinician","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139894687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stroke Center Corner","authors":"Debbie Hill, Sarah Livesay","doi":"10.59236/sc.v1i1.14","DOIUrl":"https://doi.org/10.59236/sc.v1i1.14","url":null,"abstract":"Stroke Center Information","PeriodicalId":517115,"journal":{"name":"Stroke Clinician","volume":"51 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139894622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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