Stroke Education Research Articles

A cross-sectional population survey on stroke knowledge and attitudes in Greater Kampala, Uganda.

Stroke is a neurological condition with rapidly increasing burden in many low- and middle income countries. Africa is particularly hard-hit due to rapid population growth, patterns of industrialization, adoption of harmful western diets, and increased prevalence of risk factors such as hypertension and obesity. Reducing stroke risk factors and teaching people to respond to stroke warning signs can prevent stroke and reduce burden. However, being able to address gaps in knowledge and improving both preventative and early-response care requires a clear understanding of practical and potentially modifiable topics. In this cross sectional study, we assessed the knowledge and attitudes among an urban population residing within the greater Kampala, Uganda. A population cross sectional survey was conducted in urban Mukono, district, central Uganda. Through the systematic sampling method, data were gathered from 440 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception using a pretested structured questionnaire. A total of 440 study participants were enrolled. The leading risk factors for stroke identified by the participants were stress (75.7%) and hypertension (45.2%) respectively. Only two (0.5%) of the study participants identified cigarette smoking as a stroke risk factor. Individuals with hypertension have poor knowledge regarding stroke in spite their high risk for stroke. Stroke knowledge is poor while, stress and hypertension are the leading perceived risk factors in our settings. While stress is contributing factor, hypertension is likely a more amenable and practical intervention target. Targeting individuals with stroke risk factors to increase stroke knowledge and education is crucial for engagement in healthcare. Implementing a self-management program to support and motivate this high-risk group as well as adopting healthy life-styles may be a way to reduce stroke burden in Uganda.

Stroke Knowledge Level Among Stroke Patients Admitted to Hospital Raja Perempuan Zainab II, Kelantan, Malaysia

Level of stroke knowledge among stroke patients determine their immediate response during stroke attack. Thus, this study was to determine the level of stroke knowledge among stroke patients at Hospital Raja Perempuan Zainab II, Kelantan, Malaysia. A crosssectional survey was carried out among stroke patients admitted to medical and surgical wards of Hospital Raja Perempuan Zainab II. Stroke patients were selected conveniently and the data was collected within eight months period. The Malay version Stroke Knowledge Test scale with 20 items was used to evaluate knowledge on stroke disease. Overall, there were 178 stroke patients involved in this study. The participants’ mean age were 59.07 years old with majority falls between 56 to 65 years old (74.7%). Most of them were female (53.4%), Malays (95.5%) and they had multiple medical morbidities. In terms of stroke knowledge level, 45% answered correctly on 9 items, 35% had misconception on 7 items (35%), while 20% wrongly answered on 4 items. This study highlighted that stroke patients had lack of knowledge towards stroke disease. Therefore, conducting stroke education session in routine prior to hospital discharge is important.

Delivering Knowledge of Stroke to Parents Through Their Children Using a Manga for Stroke Education in Elementary School

School-based intervention would be promising to spread stroke knowledge widely. This study aimed to clarify the effectiveness of our new educational aids that were developed for elementary school children to impart information about stroke to children and their parents in 2 different ways: with or without stroke lessons by a neurologist. We enrolled 562 children (aged 11 to 12 years) and their parents (n = 485). The students were divided into 2 groups: 323 received a lesson on stroke by a stroke neurologist without watching an animated cartoon (Group I), and 239 watched an animated cartoon without the lesson (Group II). All of the children took the manga home, and talked about stroke with their parents. Questionnaires on stroke knowledge were administered at baseline (BL), immediately after the lesson (IL), and 3 months (3M) after the lesson. There were significant increases in the adjusted mean scores for risk factors as well as stroke symptoms at 3M in both groups compared with BL scores, although the children in Group I scored significantly better than those in Group II at IL and 3M (P < .05). In both children and parents, the correct answer rates of the FAST mnemonic at 3M were around 90%, with no significant differences between groups. Stroke education for elementary school children using our educational aids provided knowledge of stroke symptoms to the children as well as their parents even without lessons on stroke, although a better understanding of stroke was obtained from lessons led by stroke neurologists.

Impact of stroke education on middle school students and their parents: A cluster randomized trial.

Background School students are an attractive target for stroke education due to the potential impact on stroke prevention and recognition. Additionally, these students can drive behavioral changes in their families. Aim To evaluate the impact of stroke education on school students, in terms of students' and parents' acquired stroke knowledge. Methods A structured questionnaire on knowledge of stroke was filled out by eighth-grade students and one of their parents in seven public schools. In four of these schools, students attended a stroke lecture; educational flyers and magnetic posters were distributed and parent education was encouraged. Students and parents of the other three schools were included in a control group. Students and parents, of both intervention and control groups, were resubmitted to the initial structured questionnaire within one week of the stroke lecture and three months later. Results We included 764 students and 344 parents, 383 (50.1%) and 210 (61.0%) in the intervention group. Correct test scores for students before, within one week, and three months after the intervention were 54.49% versus 55.03% (p = 0.418), 98.69% versus 60.89% (p < 0.001), and 95.58% versus 75.7% (p < 0.001) in the intervention and control groups, respectively. Correct test scores for parents at the same time points were 68.78% versus 64.47% (p = 0.107), 96.89% versus 71.42% (p < 0.001), and 94.58% versus 76.54% (p < 0.001) in the intervention and control groups, respectively. Conclusions School-based interventions may improve stroke knowledge in middle school students and their parents.

Elaboration and implementation of the program for prevention of acute disorders of cerebral circulation as exemplified in Rybnaya Sloboda district of the Rebublic of Tatarstan

Aim. Improvement of activities aimed at reduction of morbidity of stroke and recurrent stroke, mortality and disability rates for stroke of the population of the Republic of Tatarstan, by means of implementation of primary and secondary prevention program.Methods. Activities that would reduce mortality rate and improve the quality of life of the population of Rybnaya Sloboda region for 2013-2015 were developed. Differentiated approach to stroke prevention for different groups of patients based on individual assessment of stroke risk was suggested. At Rybnaya Sloboda Central District Hospital the project of Stroke education Center was developed and implemented. It provides an opportunity for personified prevention of first-ever and recurrent stroke, massive preventive measures for the whole population aimed at maintaining awareness of present risk factors and methods of their reduction. Statistic analysis of mortality and morbidity rates for acute disorders of cerebral circulation for the population for the Republic of Tatarstan, Chistopolskiy, Tetushi and Rybnaya Sloboda districts for the period from 2013 to 2015 was performed.Results. In the Republic of Tatarstan, mortality rate in 2015 decreased by 1.6%, compared to the level of 2014, and the mortality rate of working age population reduced by 3.1%. During the last 10 years mortality rate of the population of the Republic of Tatarstan decreased by 13%. In Rybnaya Sloboda district, it was possible to reduce total mortality by 11% in 2015. In the last three years in the Republic of Tatarstan mortality from circulatory system diseases is decreasing, including mortality from stroke which reduced by 1.25 times (or by 25%). In Rybnaya Sloboda district mortality from circulatory system diseases decreased by 2.48 times, from myocardial infarction by 1.83 times, from stroke by 2.29 times. Mortality of working-age population from stroke was not registered in 2015.Conclusion. The implemented program has demonstrated its efficacy: due to undertaken activities in 2015 it was possible to reduce total mortality in Rybnaya Sloboda district, mortality of working-age population including that from stroke.

Community-Level Measures of Stroke Knowledge among Children: Findings from Hip Hop Stroke

Community-level determinants of stroke knowledge among children are unknown but could meaningfully impact public stroke education campaigns. We explored for associations between community- and school-level quality measures relative to baseline stroke knowledge among children participating in the Hip Hop Stroke program. Baseline stroke knowledge assessments were performed in 2839 fourth-, fifth-, and sixth-grade students (ages 9-11 years) from November 2005 to April 2014. Knowledge was assessed relative to school performance grade (SPG, graded A-F; a school-level measure determined by the New York City [NYC] Department of Education) and economic need index (ENI, range: 0-2; a community-level, within-school measure of subsidized housing and meals with higher scores indicating more socioeconomic distress). Schools studied included those with SPG = B (n = 196), SPG = C (n = 1590), and SPG = D (n = 1053) and mean ENI = .85 (standard deviation: .23). A composite assessment of knowledge, including 4 stroke symptoms (blurred vision, facial droop, sudden headache, and slurred speech), was conducted consistently since 2006. Overall, students correctly identified a mean of 1.74 stroke symptoms (95% confidence interval: 1.70-1.79; possible range: 0-4, expected value of chance response alone or no knowledge = 2). For quartiles of ENI, mean knowledge scores are as follows: ENIQ1 = 2.00, ENIQ2 = 2.09, ENIQ3 = 1.46, and ENIQ4 = 1.56 (ENIQ3 and ENIQ4 versus ENIQ1, P < .001). For SPG, SPG = B schools: 2.09, SPG = C: 1.83, and SPG = D: 1.56 (SPG = C and SPG = D versus SPG = B schools, P ≤ .05). Children's stroke knowledge was lowest in NYC communities with greater economic need and lower school performance. These findings could guide stroke education campaign implementation strategies.

Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China

Stroke is a leading cause of death in China. Yet the adherence to guideline-recommended ischemic stroke performance metrics in the past decade has been previously shown to be suboptimal. Since then, several nationwide stroke quality management initiatives have been conducted in China. We sought to determine whether adherence had improved since then. Data were obtained from the 2 phases of China National Stroke Registries, which included 131 hospitals (12 173 patients with acute ischemic stroke) in China National Stroke Registries phase 1 from 2007 to 2008 versus 219 hospitals (19 604 patients) in China National Stroke Registries phase 2 from 2012 to 2013. Multiple regression models were developed to evaluate the difference in adherence to performance measure between the 2 study periods. The overall quality of care has improved over time, as reflected by the higher composite score of 0.76 in 2012 to 2013 versus 0.63 in 2007 to 2008. Nine of 13 individual performance metrics improved. However, there were no significant improvements in the rates of intravenous thrombolytic therapy and anticoagulation for atrial fibrillation. After multivariate analysis, there remained a significant 1.17-fold (95% confidence interval, 1.14-1.21) increase in the odds of delivering evidence-based performance metrics in the more recent time periods versus older data. The performance metrics with the most significantly increased odds included stroke education, dysphagia screening, smoking cessation, and antithrombotics at discharge. Adherence to stroke performance metrics has increased over time, but significant opportunities remain for further improvement. Continuous stroke quality improvement program should be developed as a national priority in China.

Using a Tablet Device to Compensate for Underestimation of Cognitive Function due to Impaired Dominant Hand Function in Stroke Patients

ABSTRACTThis study aimed to investigate whether a touch-screen tablet device can be used to avoid underestimation of cognitive function due to hand disability in patients with stroke. Thirty patients with stroke and hemiplegia were divided according to whether the paretic side corresponded to their dominant or non-dominant hand. They were given the cube-copying task twice, once via paper and once via tablet. The results between paper- and tablet-based tasks were more likely to be concordant in participants with a non-paretic dominant hand (z = 2.80, p = 0.005) when the stroke type, education years, and sex were included in the model. All participants with discordant test results had a paretic dominant hand and showed lower muscle power in the wrist and hand muscles. In conclusion, cognitive function in patients with a paretic dominant hand may be underestimated in the cube-copying task, because it requires handwriting ability. This could be prevented by using a touch-screen device.

The effectiveness of a comprehensive reminder system in the secondary prevention of hypertensive ischaemic stroke: randomized controlled trial protocol.

The aim of this study was to determine whether the Comprehensive Reminder System based on the Health Belief Model improves health belief, health behaviours, medication adherence and blood pressure control as a means of decreasing the rate of stroke recurrence among hypertensive ischaemic stroke. Hypertensive patients having experienced recent ischaemic strokes are at high risk for stroke recurrence. Several trials attempted to improve secondary stroke prevention via patient education, however, patient outcomes remained poor. Long-term follow-up studies regarding secondary stroke prevention are limited. A multi-centre, 12-month, assessor-blinded, parallel-group, randomized controlled longitudinal trial. Hypertensive patients having experienced an ischaemic stroke are the target population. The intervention consists of health belief education, a calendar handbook, a weekly automated short-message service and four telephone follow-up interviews. Outcomes will be assessed at baseline and at 3, 6 and 12months following discharge. The primary outcome is blood pressure control. The secondary outcomes include health belief, health behaviours and medication adherence. The clinical endpoint is the rate of stroke recurrence. Although many efforts to improve secondary stroke prevention have been undertaken, research indicates that improvements remain possible and warranted. This research protocol based on the Health Belief Model will improve our understanding of stroke education and transitional care needed in China and with the world-wide target population.

Weekend Discharge and Stroke Quality of Care: Get With The Guidelines-Stroke Data from a Comprehensive Stroke Center

Get With The Guidelines-Stroke collects data on hospital compliance with evidence-based stroke quality of care indicators. Prior work has investigated a link between weekend hospital admission and increased mortality after stroke. There is, however, a paucity of work investigating a similar association between weekend hospital discharge and quality of care. We aimed to determine if weekend discharge affects care to enlighten opportunities for quality improvement. Through a retrospective analysis of records from a Comprehensive Stroke Center from July 2010 to June 2015, we identified patients with ischemic stroke, subarachnoid hemorrhage, and intracerebral hemorrhage. Our quality of care indicators were dysphagia screening, rehabilitation assessment, smoking cessation counseling, stroke education, and weight reduction counseling. We created regression models to find adjusted differences in quality of care measure compliance for patients discharged on the weekend. Our analysis included 2737 patients, of which 431 were discharged on the weekend. After adjustment, weekend discharge was significantly associated with reduced stroke education (odds ratio .67, confidence interval .51-0.88, P = .004) and reduced weight reduction counseling (odds ratio .65, confidence interval .45-0.93, P = .018). Hospital discharge on the weekend was associated with an adjusted one-third decrease in odds of stroke education and weight reduction counseling. There is an opportunity for quality improvement in educating stroke patients before hospital discharge on the weekend.

A Community-Engaged Assessment of Barriers and Facilitators to Rapid Stroke Treatment.

Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stakeholder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome. © 2016 Wiley Periodicals, Inc.

Corrigendum.

Jenkins, C., Arulogun, O. S., Singh, A., Mande, A. T., Ajayi, E., Calys-Tagoe, B., . . . the SIREN Team (2016). Stroke Investigative Research and Education Network: Community engagement and outreach within phenomics core. Health Education & Behavior, 43(1 Suppl.), 82S-92S. (Original DOI: 10.1177/1090198116634082).

Patients' and caregivers' self-perceived stroke education needs in inpatient rehabilitation

Background: Identifying patients' and caregivers' learning needs and perspectives on provided education activities is vital for the development of effective education in rehabilitation, yet it may not be deemed important. This study explored the stroke education perspectives in a Canadian rehabilitation centre to illustrate one approach for addressing this problem. Methods: This qualitative description study was overlaid by phenomenology; in-depth interviews were transcribed then analysed using a foundational thematic analysis approach. The concepts of reflexivity and credibility were employed to enhance trustworthiness. Findings: Three patients and three caregivers were interviewed. Conveyed education focuses included secondary prevention, rate of recovery, knowledge collection, adherence to home programmes, transition to home, and personal responses to caregiving. Client-centred education, including providing personally relevant exercises, facilitating interaction with other patients, and incorporating print materials, trial discharges, and technology, empowered patients and caregivers to benefit from ‘teachable moments’. Conclusions: If education programmes are to achieve expected outcomes, input from targeted learners about their learning needs and the effectiveness of received education programmes is essential. Qualitative description is one approach for gathering information which can yield valuable insights for those designing education programmes and contribute to improved patient-centred care and rehabilitation outcomes.

Can Children Reduce Delayed Hospital Arrival for Ischemic Stroke?: A Systematic Review of School-Based Stroke Education.

Delayed hospital arrival after onset of ischemic stroke reduces the number of patients eligible for tissue plasminogen activator, which must be given soon after stroke onset. There are conflicting results about the impact of mass media stroke education on timing of hospital arrival and tissue plasminogen activator administration rates. School-based programs are a new way to communicate stroke information. A search of MEDLINE, CINAHL, PsycINFO, and ERIC databases from 1995 to 2014 identified school-based stroke education interventions. Twelve studies involving 3,312 children and 612 parents met criteria for review. School-based stroke education interventions were effective to improve knowledge of stroke symptoms among children in kindergarten through junior high. Improvement for stroke risk factors was less robust. Interventions were effective regardless of format, length, or who delivered the information. Despite low parental response rates in some studies, there was evidence that children transmitted stroke information to parents. School-based stroke education programs appear effective to improve knowledge of stroke symptoms. Research is needed to determine if children who participate are able to recognize stroke and respond appropriately by calling 911 in the real world. More study is needed about transfer of stroke knowledge from child to parent. Strategies to improve parent participation are needed.

Knowledge, attitude, and practice of stroke among high school students in Nepal.

Background:Baseline stroke knowledge in a targeted population is indispensable to promote the effective stroke education. We report the baseline knowledge, attitude, and practice (KAP) of high school students with respect to stroke from Nepal.Materials and Methods:A self-structured questionnaire survey regarding KAP about stroke was conducted in high school students of 33 schools of Bharatpur, Nepal. Descriptive statistics including Chi-square test was used, and the significant variables were subjected to binary logistic regression.Results:Among 1360 participants, 71.1% had heard or read about stroke; 30.2% knew someone with stroke. 39.3% identified brain as the organ affected. Sudden onset limb/s weakness/numbness (72%) and hypertension (74%) were common warning symptom and risk factor identified. 88.9% would take stroke patients to a hospital. Almost half participants (55.5%) felt ayurvedic treatment be effective. 44.8% felt stroke as a hindrance to a happy life and 86.3% believed that family care was helpful for early recovery. Students who identified at least one risk factor were 3.924 times (P < 0.001, confidence interval [CI] = 1.867–8.247) or those who identified at least one warning symptom were 2.833 times (P ≤ 0.023, CI = 1.156–6.944) more likely to take stroke patients to a hospital.Conclusion:KAP of high school Nepalese students regarding stroke was satisfactory, and the students having knowledge about the risk factors and warning symptoms were more likely to take stroke patients to a hospital. However, a few misconceptions persisted.

Stroke Investigative Research and Education Network: Community Engagement and Outreach Within Phenomics Core.

Stroke is the leading cause of neurological hospital admissions in sub-Saharan Africa (SSA) and the second leading cause of death globally. The Stroke Investigative Research and Education Network seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other noncommunicable diseases in SSA. One of the first steps to address this goal is to effectively engage the communities that suffer the high burden of disease. The purpose of this article is to describe plans to elucidate information about knowledge, attitudes, beliefs, and practices about stroke and genomics from patients, caregivers, and local leaders, to recruit participation in research activities and dissemination of ongoing results, as well as to facilitate research uptake and impact within the broader communities of scientists, health professionals, policy makers, and others. We describe the (a) study sites and their communities; (b) plans for community advisory boards, focus groups, and surveys; (c) methods for data management in REDCap database; (d) analyses of qualitative data; (e) evaluation of community and public engagement across multiple sites and research teams in SSA and the United States; (f) use of RE-AIM for presentation of evaluation data; and (g) community indicators of success. This is the first of its kind public outreach engagement initiative to evaluate stroke and genomics in SSA, and has implications as a model for assessment in other high-stroke risk populations.

Organizational Update

The burden of stroke on individuals, families, healthcare systems, and societies in Asia is enormous and increasing in relation to rapid sociodemographic and lifestyle changes in a large and diverse range of populations. However, challenges also present opportunities for experts from within and outside Asia to facilitate improvements in population health through advocacy, engagement, training, and the conduct and promotion of evidence-based strategies. With a total population that exceeds 4 billion, over half of the world’s population, increasing numbers of patients are accessing clinical services, technologies, and databases, and clinicians are gaining training, experience, and reliable information on a broad range of aspects of stroke care. Clinical research experience is improving through international links and fellowships, and health professionals from the region are eager to engage (and prove themselves) through participation in high-quality research and clinical practice. The Asia Pacific Stroke Organization (APSO) covers a vast and heterogenous geographical area, with much variability in language, governments, culture, historical links, socioeconomic development, and organization of health services. APSO seeks to improve the standard of stroke care in the whole region by improving communication and cooperation between stroke professionals and organizations in the region and peers in other regions, by means of annual congresses, workshops, and continued medical education. In the past year, we have achieved this through strengthened cooperation with other organizations such as the European Stroke Organization and the Asia-Oceanian Society for Neurorehabilitation and increased participation by nurses and other health professionals and had active consultation with nongovernmental organizations with shared commitments to those affected by stroke. APSO originated from an amalgamation of the Asian Stroke Forum and Asia Pacific Conference Against Stroke. Before September 2009, these organizations held large annual conferences, independently: Asian Stroke Forum, primarily based in Japan, had conferences in Tokyo and Kyoto, in 2005 and 2007, …

Abstract TP394: Stroke Education- Are you REaDy?

Introduction/Background: Patients stay healthier when informed, making communication the key to better outcomes. An informed and educated patient actively participates in their own treatment, improves outcomes, and reduces length of stay. We call and evaluate every patient 30 days post discharge. We found that many reported either not receiving stroke education, or could not recall if they had received it. The principle of Occam’s razor states: “The simplest idea is usually the best idea.” This principle was utilized to solve our problem. Quality Questions: 1. How do we increase the likelihood that patients will remember that they have received stroke education? 2. How do we assure that patients recall health information provided to them. Methods: Stroke patients are given extensive, personalized stroke education during their admission, and reinforced daily by stroke team. Education materials were given to patients in white folders with a Cedars-Sinai logo. Stroke patients are phoned in 30 days and asked a series of 18 questions to assess well-being &amp; assess patient’s experience during hospital stay, and after discharge. These calls revealed an unusual number of patients who were unable to recall being educated or receiving educational materials. We decided to simply change the stroke education folder from white to bright red. We instructed the call center to use the red folder as a prompt to help the patient recall receiving stroke education. Conclusion: A collaborative approach was used to ascertain an appropriate stimulus for the patient to recall their stroke specific education. Stroke education had to stand out amidst the myriad of information patients are bombarded with in the hospital. The team came up with the simple idea of using a bright red folder. When patients were called the call center would prompt the patient by saying “The stroke education was given to you in a bright red folder.” Prior to implementation of the red folders, only 81.5% of patients recalled receiving stroke education. After implementation of the red folders, 96.8% recalled receiving stroke education. The principle of Occam’s Razor proved to be correct in our study. A very simple idea such as changing the color of the folders to bright red proved to have very meaningful results.

Abstract WP327: Implementation of a Pharmacist Driven Comprehensive Stroke Education Program

Background: Stroke education (SE) is an important quality measure that has been shown to be inconsistently provided and ineffectively delivered. In response we have developed a pharmacist driven stroke education program (SEP) for patients admitted with stroke/TIA. Here, we describe the development, implementation, and encounters from this initiative. Methods: A stroke service team (SST) consisting of a board-certified cerebrovascular physician, cerebrovascular fellows, and a clinical pharmacist specialist (CPS) was established at the VA Greater Los Angeles Healthcare System. The CPS is alerted when any stroke/TIA patients are admitted and follows the patient until time of transfer/discharge. At that time, most diagnostic studies are complete and a likely stroke etiology has been determined, allowing for the development of a patient centered comprehensive stroke care and prevention plan based on individualized stroke risk factor analyses with input from interdisciplinary fields including the SST, rehabilitation specialists, and speech therapists. SE is provided at the time of discharge and addresses risk factors for stroke, stroke warning signs, activation of emergency medical services, need for follow-up after discharge and medications prescribed. The CPS also reviews stroke location, nature and quality of the stroke, and relays the initial patient centered comprehensive care plan to the patient in patient-level language. Visual aids assist in educating patients and a personalized education sheet is provided. The CPS is also responsible for documentation of SE for future evaluation of process measures. Results: Consistent implementation of the pharmacist driven comprehensive stroke education program (SEP) began in July 2013. To date, there have been 172 SE encounters documented. Quality improvement audits indicate close to 100% of all patients admitted for stroke receive SE. Conclusions: Here we show the successful implementation of a pharmacist driven comprehensive SEP designed to improve patient satisfaction/knowledge and improve hospital adherence to stroke quality measures. As pharmacists are trained to communicate with medical personnel and patients, they may be the ideal candidate to provide comprehensive and quality SE.

Abstract TMP75: The Georgia Stroke Professional Alliance (GA-SPA) - a Six Year Review, of a Collaborate, State-wide Stroke Professional Network, Reaching Across State-lines and the Nation to Improve Stroke Care, Professional Education, and Community Outreach

Background: In 2009, the Georgia Stroke Professional Alliance (GA-SPA) was established. GA-SPA success has been marked by unsurpassed transparency and collaboration among the members and their partners. GA-SPA continues to make professional stroke education and community outreach as one of their greatest priorities. A focus and commitment to improvements of stroke care is an underpinning for sustained success. Purpose: To expand the state-wide collaboration of health care professionals committed to improving the quality of stroke care and stroke education throughout the region. Methods: GA-SPA members meet regularly at varying locations throughout the state and participate in exchanges of professional knowledge, provide clinical expertise regarding process improvement and best practices. GA-SPA collaborates closely with key stakeholders like the AHA/ASA, the Georgia Coverdell Acute Stroke Registry, the Department of Public Heath, the State Office of EMS, and key industry supporters to provide up to date stroke education and community outreach efforts. Results: GA-SPA serves as a subject matter resource on the delivery of stroke care and prevention for healthcare professionals across the continuum of care. Web based communication, a Facebook page and a membership list serve enhances the experience of professional collaboration and information exchange. Accomplishments: Proclamation by the Governor for a Stroke Awareness Day, FAST regional stroke awareness campaign, and annual community events with the Atlanta Braves, partnering with schools for stroke education, SCRN and CNRN review courses, promoting ASLS, ISC presentations. Mentoring amongst GA-SPA members has contributed to the successful certification and re-certification for many of the 35 certified Primary Stroke Centers and 4 Comprehensive Stroke Centers in Georgia, and 4 Remote Stroke Treatment Centers. GA-SPA consults with other states interested in these common goals, and assist with the creation of similar alliances. Conclusion: An alliance of state wide health professionals has been an effective method to promote professional stroke education and community stroke outreach. Other states should consider creating similar professional alliances to advance stroke care.