1. Fresh Approaches to Patient Education Susan Savastuk MEd, BSN Stroke Program Coordinator Neuroscience Institute Bloomington Hospital Bloomington, IN 1

2. OBJECTIVES Discuss the Joint Commission measurement for patient stroke education Review education initiatives and tools to increase compliance 2

3. ASA Policy Statement Recommendations for the establishment of stroke systems of care suggest that a stroke system should: ASA Policy Statement Recommendations for the establishment of stroke systems of care suggest that a stroke system should: Develop support tools to assist patients in long-term adherence to stroke prevention. Develop multiple education strategies along with health literacy targets appropriate to the education levels of the targeted population Stroke March 2005 3

4. Joint Commission Performance Measure: Stroke Education Data Elements Five essentials of stroke education Stroke Education Materials Exclusions Concerns Data Sources Where stroke education can be documented 4

5. Education Data Elements Education Data Elements Personalized Risk Factors for Stroke Warning Signs and Symptoms of Stroke Activation of Emergency Medical Services Follow up after Discharge Medications Prescribed at Discharge 5

6. Educational Materials DVD, CD, Video, brochures, personalized teaching sheets can be used –Content of these items needs to be described within your documentation Documentation can occur any time during admission JC recommends that stroke education occurs throughout the hospital admission 6

7. Education Requirement Exclusions If patient is “Comfort Measures Only” –Does NOT include “DNR” status –Does include patients with Hospice Referrals, etc. Patients being Discharged to Inpatient Rehab, Nursing Home, Long Term Acute Care (this is new for Jan 2010 JC submissions) Patients admitted for Elective Carotid Endarterectomies 7

8. Things That Impede the Education Process If patients or family refuse education Patient has severe cognitive impairment, AND there is no family or caregiver available. These instances must be documented 8

9. Where to Document Med Reconciliation sheet signed by MD, Nurse, and Patient Pathway/ Care Plans DC Instruction Sheet Nurse’s Note documentation MD documentation (i.e. DC Summary) 9

10. Bloomington Hospital Stroke Education Tools and Initiatives 10

11. Quality Improvement Initiatives Discussions with stroke unit staff Mentoring Identify “Stroke Champions” Modifications to pathway and order sets Daily rounds Bi-weekly interdisciplinary rounds 11

12. Ischemic Stroke Orders Added Pathway to Admission orders 12

13. Stroke Pathway Added Reminder on Pathway 13

14. 14

15. Day of Discharge Check List 15

16. TIA Admission Orders and Pathway 16

17. Stroke Discharge Orders 17

18. 18

19. 19

20. 20