Purpose: Nurse led patient education programs to improve patient understanding of the signs and symptoms (s/s) of a stroke and their personal stroke risk factors can play a significant role in preventing secondary stroke. No such initiatives could be found for an urban academic medical center in the United States when conducting a literature search, despite a Healthy People 2020 edict to address stroke awareness in adults. The goal of this project was to improve patient understanding of s/s of stroke as well as personal risk factors, and to ensure smooth patient transitions to the community.
Method: A tool was developed for charge nurses to use when providing education to patients. The tool included patient demographic information and patient specific stroke risk factors. The previously used script for phone calls included signs and symptoms but was modified to include personal risk factors and corresponding behavior modification. All patients, discharged to home with a diagnosis of stroke or transient ischemic attack (TIA), were called within two weeks of discharge per the Joint Commission Comprehensive Stroke Center recommendation. Two attempts were made to reach each patient and a detailed log was maintained to track patient’s response to questions.
Results: In the two months prior to the project being initiated, there were 37 patients reached via phone who had been discharged home from the stroke unit with a diagnoses of stroke or TIA. Of the 37 called, there were 5 who were unaware of the s/s of a stroke. For the two months since beginning the intervention, 42 successful calls were made to patients discharged home. Of these 42, only 2 patients did not know the s/s of stroke or their personal risk factors (p value: 0.16).
Conclusions: This project allowed for a new approach to patient focused, nurse led education to improve patient understanding of the s/s of a stroke and individual risk factors. There was a ten percent improvement in the number of patients with an understanding of the s/s of a stroke. An encouraging outcome from this project was an improvement in RN Communication scores on patient’s HCAHPS surveys in the two months since starting the intervention.