English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

P229 Objectives Written care protocols and quality  improvement efforts have recently been included in published guidelines  on care of the ischemic stroke patient. We describe revisions to the  quality management process that resulted in increased protocol use at a  469-bed medical school affiliate private hospital.Methods An earlier clinical pathway for ischemic stroke was ineffectively  implemented as shown by pathway use in less than half of appropriate  cases. A multidisciplinary team addressed barriers identified in that  early experience to modify strategies in the development of a new set  of quality management tools (QMT) for ischemic stroke. The revised QMT  included: standing orders, clinical pathway, NIH Stroke Scale flow  sheet, diagnostic summary form, and variance tracking tool. QMT use  rates were calculated by medical record abstraction during a 3-month  pilot study and physician and nurse usage rates determined. Factors  contributing to QMT usage were analyzed.Results Twenty-eight ischemic stroke patients were admitted to the pilot unit  during the study. Usage rates for components of the QMT driven by  physicians were: standing orders 93%; IV tPA standing orders 100%;  and diagnostic summary form 46%. Nurse related QMT usage was: clinical  pathway 96%; NIH Stroke Scale flow sheet 75%; and variance tracking  tool 75%. Key strategies that contributed to improved implementation  were: 1) early involvement and continuous communication between the  expanded multidisciplinary team, staff nurses and physicians 2)  empowerment of nurses through NIH Stroke Scale training 3) perception  of mutual accountability between nurses and physicians through use of  QMT documents 4) clearly defined administrative directives.Conclusion Effective implementation of quality management  protocols for ischemic stroke requires active participation of related  disciplines at working levels, clear administrative support, and mutual  accountability of physicians and nurses. Continuous critical appraisal  of the process can afford eventual strategic solutions.

Lessons Learned in the Process of Stroke Quality Management: Revised tools and strategies in a follow-up study