sets/procedures/algorithms for assessment and treatment of Stroke protocols/order sets, Written stroke protocols/order procedures/algorithms, etc. for each action ischemic and hemorrhagic strokes, which include: or process listed. -stroke team activation process (from prehospital notification and for “walk-ins”) -initial diagnostic tests (e.g., FAST screen at triage, NIH stroke scale, CT) -administration of medications (e.g., t-PA) -swallowing assessment prior to oral intake Transfer protocols or guidelines that include criteria specific to transferring stroke patients, although Transfer protocols according to criterion. there should be no reason to transfer stroke patients from a Level I other than disasters, equipment General EMTALA transfer protocols or failure, or severe staffing shortage. guidelines that don’t specifically address stroke transfers are not adequate documentation. Stroke unit. Practitioners working in the stroke unit demonstrate evidence of initial and ongoing Description of stroke unit, including staffing, training in the care of acute stroke patients. Stroke units may be defined and implemented in a variety operation, admission/discharge, care of ways. The stroke unit does not have to be a specific enclosed area, but will be a specified unit to protocols, census, and outcome data. which most stroke patients are admitted (Joint Commission). Refer to the for further guidance on stroke units. Organizational/administration support Coordination with Emergency Medical Services, e.g., working with county EMS councils, Description of how you work with EMS in regional councils, or medical program directors on cardiac care and transport policy and your community, e.g., attendance at procedures, system activation, training, data collection, and quality improvement. county and/or regional EMS council meetings, copies of county EMS stroke patient care procedures, joint training, etc. Laboratory or point of care testing 24 hours a day, seven days a week and results within 45 minutes Intensive care unit 24 hours a day, seven days a week Operating room coverage 24 hours a day, seven days a week and ready within hours of notification Interventional services coverage 24 hours a day, seven days a week Stroke clinic Physical therapy
Written stroke protocols/order sets/procedures/algorithms for assessment and treatment of ischemic and hemorrhagic strokes, which include: -stroke team activation process (from prehospital notification and for “walk-ins”) -initial diagnostic tests (e.g., FAST screen at triage, NIH stroke scale, CT) -administration of medications (e.g., t-PA) -swallowing assessment prior to oral intake Stroke protocols/order sets, procedures/algorithms, etc. for each action or process listed. Transfer protocols or guidelines that include criteria specific to transferring stroke patients, although there should be no reason to transfer stroke patients from a Level I other than disasters, equipment failure, or severe staffing shortage. Transfer protocols according to criterion. General EMTALA transfer protocols or guidelines that don’t specifically address stroke transfers are not adequate documentation. Stroke unit. Practitioners working in the stroke unit demonstrate evidence of initial and ongoing training in the care of acute stroke patients. Stroke units may be defined and implemented in a variety of ways. The stroke unit does not have to be a specific enclosed area, but will be a specified unit to which most stroke patients are admitted (Joint Commission). Refer to the for further guidance on stroke units. Description of stroke unit, including staffing, operation, admission/discharge, care protocols, census, and outcome data. Organizational/administration support Coordination with Emergency Medical Services, e.g., working with county EMS councils, regional councils, or medical program directors on cardiac care and transport policy and procedures, system activation, training, data collection, and quality improvement. Description of how you work with EMS in your community, e.g., attendance at county and/or regional EMS council meetings, copies of county EMS stroke patient care procedures, joint training, etc. Laboratory or point of care testing 24 hours a day, seven days a week and results within 45 minutes Intensive care unit 24 hours a day, seven days a week Operating room coverage 24 hours a day, seven days a week and ready within hours of notification Interventional services coverage 24 hours a day, seven days a week Stroke clinic Physical therapy
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