Stroke

Percent of acute ischemic stroke patients who arrive at the hospital within 120 minutes (2 hours) of time last known well and for whom IV t-PA was initiated at this hospital within 180 minutes (3 hours) of time last known well

To receive a clot busting treatment, such as t-PA, your condition must be diagnosed as an ischemic stroke (caused by a blocked artery) If given within tree hours of the start of symptoms, a clot busting drug can reduce long-term disability. Timing is very important.

Percent of patients with ischemic stroke or TIA who receive antithrombotic therapy by the end of hospital day two

Antithrombotic therapy works by improving blood flow. Two agents are used: Anticoagulants (blood thinners) are medicines that delay the clotting of blood. They make it harder for clots to form or keep existing clots from enlarging your heart veins or arteries. Antiplatelet medicines keep blood clots from forming by preventing blood platelets from sticking together.

Percent of patients with an ischemic stroke, or a hemorrhagic stroke and who are non-ambulatory who receive VTE prophylaxis by end of hospital day two

Patients experiencing a stroke that involves some loss of movement to a lower extremity or who are maintained on bed rest are at increased risk of developing venous thromboembolism (VTE). Deep venous thrombosis is a process in which blood clots occur and travel through the veins. Studies show that early initiation of prophylaxis (preventative) measures has been shown to lower the risk of VTE.

Percent of patients with an ischemic stroke or TIA prescribed antithrombotic therapy at discharge.

When doctors want to help patients prevent strokes caused by a blood clot, medical therapies that improve blood flow are prescribed. Antithrombotics are medicines that interfere with the blood’s ability to clot in an artery, vein or the heart.

Percent of patients with an ischemic stroke or TIA with atrial fibrillation/flutter discharged on anticoagulation therapy

Anticoagulants (or blood thinners) are medicines that delay the clotting of blood. They can make it harder for clots to form or keep existing clots form enlarging in your heart, veins or arteries. Two examples are heparin and warfarin. Patients with certain medical conditions will benefit from this therapy.

Percent of Ischemic stroke patients with LDL >= 100, or LDL not measured, or on cholesterol-reducer prior to admission, who are discharged on Statin Medication

Recent evidence from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial supports the use of statins to lower LDL (bad) cholesterol in stroke patients without prior Coronary Artery Disease and a fasting LDL > 100 mg/dL.

Percent of patients with ischemic, TIA, or hemorrhagic stroke with a history of smoking cigarettes, who are, or whose caregivers are, given smoking cessation advice or counseling during hospital stay.

Smoking increases your risk for developing blood clots and heart disease, which can result in a stroke, heart attack or heart failure. Smoking causes your blood vessels to thicken. Fat and plaque then stick to the wall of your blood vessels, which makes it harder for blood to flow. Cigarette smoking is the single most alterable risk factor contributing to premature morbidity and mortality, accounting for approximately 430,000 deaths in the United States. Smoking nearly doubles the risk of ischemic stroke. It is important for your health that you get information to help you quit smoking before you leave the hospital. Quitting may help prevent another stroke

Percent of patients with ischemic, or hemorrhagic stroke who undergo screening for dysphagia with an evidenced-based bedside testing protocol approved by the hospital before being given any food, fluids, or medication by mouth

Dysphagia (difficulty swallowing) is a potentially serious complication of stroke. It is important to assess a patient’s ability to swallow, before approving the oral intake of fluids, food or medication. It has been estimated that 27-50% of stroke patients develop dysphagia. Guidelines include a recommendation that all stroke patients be screened for their ability to swallow and those with abnormal results be referred for a complete examination by a speech and language pathologist or other qualified individual.

Stroke Education

Percent of patients with ischemic, TIA, or hemorrhagic stroke or their caregivers who were given education and/or educational materials during the hospital stay addressing ALL of the following: personal risk factors for stroke, warning signs for stroke, activation of emergency medical system, need for follow-up after discharge, and medications

Percent of patients with ischemic or hemorrhagic stroke who were assessed for rehabilitation services.

The effects of a stroke may mean that you must change or relearn how you live day to day. Rehabilitation may reverse some of a stroke’s effects and can include improving walking, balance, coordination, speech and swallowing. The goals of rehabilitation are to increase independence, improve physical functioning, help you lead a satisfying quality of life after stroke and help you prevent another stroke.

Percent of ischemic stroke and stroke not otherwise specified patients with a score reported for NIH Stroke Scale (Initial).