Objective:

To enhance hospital staff members’ confidence recognizing and managing patients with an acute stroke and increase early activation of stroke codes in the inpatient setting.

Background:

One in five strokes occur in the hospital and are more likely to have worse clinical outcomes compared to community-onset strokes. All hospital staff members should be able to recognize and initiate management of patients with a suspected acute stroke.

Design/Methods:

A tailored education program was held on each inpatient unit at a large academic medical center. A survey was created for participants to take before and after the education session, including questions on identifying signs and symptoms of stroke, how to activate a stroke code, and tasks required during a code. Additional questions included self-assessment of the individual’s confidence level in different aspects of stroke care. Survey results and data obtained through electronic medical record (EMR) on inpatient stroke code activations were analyzed pre- and post-intervention.

Results:

Before the session, most participants (56.1%) were slightly or moderately confident in identifying stroke signs and symptoms, but after the session, most participants (80.5%) were very or extremely confident. Before the session, 18% of patients felt comfortable managing a patient during a code, but after the session, 95% of participants felt comfortable. Pre-intervention data showed that only 50% of inpatient stroke codes were activated within 10 minutes of symptom recognition. Following intervention, 75% of inpatient stroke codes were activated within 10 minutes of symptom discovery.

Conclusions:

A dedicated education session targeting hospital staff can increase knowledge and confidence in recognition and management of patients with a suspected acute stroke. This curriculum has potential to be used nation-wide to reduce delays to diagnosis of in-hospital stroke, increase the use of acute stroke therapies, and ultimately reduce the morbidity and mortality associated with in-hospital stroke.