Abstract TP58: Stroke Recognition Task Force: Increasing Early Activation of Inpatient Stroke Codes

Abstract

Background: 1 in 5 strokes occur in the hospital. Patients with in-hospital stroke have increased vascular risk factors, delayed time to recognition, and increased mortality compared to patients with community-onset stroke. All staff should be able to recognize and initiate management of patients with a suspected acute stroke. Purpose The goals of this project were to increase early activation of inpatient stroke codes and confidence levels related to the recognition of stroke and management of patients during a code. Methods: An education program, providing unit specific information, was provided to each inpatient unit at an academic medical center. A survey was created for learners to take before and after the education session; including questions regarding symptom recognition, how to activate a stroke code, and tasks required following activation. Additional questions included self-assessment of the learner’s confidence level in different aspects of stroke care, including stroke recognition and management. To assess time to activation, data related to inpatient stroke code activations was analyzed pre- and post-intervention. Data included symptom discovery and stroke team activation time gathered from the electronic medical record. Results: Data from 119 codes was reviewed. Prior to intervention, only 50% of inpatient stroke codes were activated within 10 minutes of symptom discovery. Following intervention, 75% of inpatient stroke codes were activated within 10 minutes of symptom discovery. There were 61 pre-session survey responses and 39 post-session. Before the session, 56.1% of participants were slightly or moderately confident in identifying stroke, but after the session, 80.5% of participants were very or extremely confident in identifying stroke. Before the session, 81.8% of participants did not feel comfortable managing a patient during a code, but after the session, 95% of participants felt comfortable. Conclusion: An education session for hospital staff can increase knowledge and confidence level in the recognition of stroke and their management of patients. This curriculum has potential to be used nationally to reduce delays to diagnosis, increase usage of acute therapies and reduce mortality associated with in-hospital stroke.