Abstract TP456: Code Brain or Code Cluster: The Significance of Stroke Education for In-House Patients

Abstract

Background: The AHA/ASA guidelines for acute stroke management recommends stroke education. Rapid recognition and response to acute stroke warning signs is linked to improved functional outcome. Delays in recognition and inefficiencies during the code process lead to delays in care, which correlate with poorer outcomes. Purpose: Does increasing staff education via Code Brain In-services impact patient care for in-house stroke patients? Method: The target population was in-house stroke patients and 42 units were identified. Education highlighted Stroke Team Nurses as staff resources, stroke warning signs, Code Brain Pathway, and strategies to improve efficiency during a code. A retrospective analysis of the Acute Stroke Quality Improvement database was done. We compared the number of in-house Code Brain Activations and the number of Patients Treated for acute stroke. Results: 3/17-7/17 average of 25.2 calls per month and patients treated for acute stroke was 4%. 8/17 -12/17 average number of calls increased to 39 and patients treated increased to 7%. During 9/17 when most in-services had been completed, a surge was noted. There were 56 calls and 6 patients were treated for acute stroke, compared to an average of only 1 per month prior to in-services. The trend for increased number of patients who were treated, continue to be evident through 12/17. Implications: Preliminary data suggests that Code Brain In-services provided to the nurses, appears to have directly led to an increased number of stroke patients identified and treated. Data review is ongoing. We continue to experience higher call volumes and treatments than before the education was implemented. This preliminary study demonstrates the merit of increased education over the standard practice of annual competencies. The hurdles of staff turnover and infrequent exposure to code brain, are best surmounted with frequent education. We seek to improve efficiency and effectiveness by focusing our attention to units that require more education and recognize units that are high performing. Our hope is that with these efforts, we will continue inspiring excellence in stroke care and demonstrate the value of a stroke-educated staff nurse.