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Brain Teaser

Double Your Brain Power Today!

Last month's brain teaser link appears to have been broken so this month you will have double the opportunity to win!! Click the links below to answer both the Sept and Oct Brain Teasers!

DON'T FORGET, every month, everyone who correctly answers the quiz question will be entered in a drawing to win a $10 coffee shop gift card! Seems like an easy way to stay caffeinated during those particularly exhausting shifts.

Technical Issues? Please email us!

Spotlight

Gerre Fiore, MSN, APRN, AGCNS-BC, CCRN Clinical Nurse Specialist How long have you been working in this role? About 5 ½ years. What does your typical day look like?  Every day is little different, but I generally have to do serious prioritization! My job responsibilities include: Monitoring & evaluating renal biopsy complications Monitoring & evaluating port infections Leading the IVC Filter Retrieval Program Clinical Expert for Procedural Sedation (Health System) Patient presentation at Thoracic Oncology Conference Development and maintenance of Order Sets, Policies, Clinical Practice Guidelines and Procedures for IR and Radiology Nursing. I also report to GI/Endo and Cath/EP and am available to them as needed.  Mentoring Practice Councils Trending Safety Intelligence reports to identify improvement opportunities Moderate Performance Improvement and Patient Safety Rounds Project Management: some examples include ketamine for procedural sedation, care of ICU patient in IR, management of HHT patients, Alpha Gal Syndrome awareness to name a few I’m always available for consultations General firefighting! What is the most rewarding part of your day? So many things really. I love to round in the units and be able to answer questions or listen to staff concerns. Talking to patients really fills my cup as well. I truly feel valued in this role by nursing, physician staff and ancillary partners. I can also honestly say that I learn something every single day.  Name one thing about your role that may surprise people. I’ve had to develop some mad Excel skills over the years and they don’t teach that in school!!  What advice would you give to someone interested in doing your role? Come and shadow! This role is pivotal in improving outcomes for patients and the organization as well as advancing nursing practice in an ever evolving complex healthcare environment. It’s also a lot of fun in a really nerdy way! What is your favorite streaming show, movie, podcast, or book? I am a Food Network junkie and watch any cooking related competition programs!  Best vacation you’ve been to? My mom and I went to Paris and the south of France a few years ago. It was magical and yes I went to cooking school while there! Anything else you would like to add? Love to GOLF!

What's New?

As many of you already know, we went live with Tenecteplase on September 27th. We had our first case on October 5th! Jordan Hinmon, ASRT RN helping to prepare our first tenecteplase patient to receive their medication! Kudos to the entire ASRT team involved in this case!

October 29th is World Stroke Day! This day is meant to raise awareness about stroke and talk about the ways to reduce the burden of stroke through better public awareness of the risk factors and signs of stroke. Starting next month, we will be begin prepping for our upcoming TJC site visit. Our site visit open window is currently scheduled to occur between January and March of 2023.

Sharks Don’t Sleep Fact of the Month World Stroke Day (October 29th) was established in 2003 at the World Stroke Congress in Vancouver, Canada. Several years later, the International Stroke Society & World Stroke Federation merged to form the World Stroke Organization, which is now in charge of World Stroke Day.   Most people in the United States are less familiar with World Stroke Day since we have had National Stroke Awareness Month (every year in May) since 1989 when President George H. W. Bush signed a presidential proclamation.

Case of the Month

**Some details changed to protect patient identity but kept within same risk profile*** Background: 73 YO female with a history of HTN, HLD, & tobacco was brought to the ED via EMS at 11:56 AM. She presented with acute onset of right sided weakness and aphasia, with a LKW of 10 AM that day. Arrival NIHSS = 8, and she was found to have an acute ischemic stroke & Lt. internal carotid artery occlusion with good collateral blood flow. Intervention #1: IV alteplase was administered to the patient within 10 minutes from her arrival!! She was then admitted to the NEICU for further monitoring. Several hours later, she began experiencing worsening of her stroke symptoms (NIHSS = 20) and ASRT was reactivated. Intervention #2: Upon reactivation, the patient was taken directly to IR for endovascular thrombectomy. While in IR, they found new left M1 & M2 occlusions, in addition to CCA/ICA occlusion. She underwent intervention for the tandem occlusions. Successful angioplasty was performed on her ICA, and her M1 & M2 occlusions resulted in TICI2b revascularization following mechanical suction thrombectomy. Only 56 minutes passed between the time of reactivation and the time when the IR provider reached the clot. This is well under the “Page to Device” goal of 90 minutes...which is even more impressive given that in-house stroke activations often have many compounding factors that result in delayed care!

Outcome: Following intervention in IR, the patient’s NIHSS improved to ~1 for mild aphasia. Two days following her procedures, the patient’s neuro exam remained stable and she was transferred out of the ICU. She was discharged to IPR 4 days after arriving to the hospital, and subsequently discharged from IPR to her home 1 week later.

Links Land

Patients & Community Classes & Events Stroke Health Risk Assessment Stroke Education Series

Internal Resources Resident Handbook Clinical Practice Guidelines COVID-19 S.H.E.E.P Handoff Videos & Tools

Data Central Stroke Interventions Stroke Activations Performance Measures Achievements & Awards

Demographics Dashboard

Interventions Dashboard

Save the Date!

Attend TUKHS Bistate Stroke Offering October 14th.  Join us via Zoom for our monthly Kansas Initiative for Stroke Survival (KISS) First Tuesday’s Stroke Education Series. Each month at 12:00 PM, Vascular Neurologist, Dr. Sabreena Slavin will give a 30 - minute presentation regarding stroke and the care surrounding it.   Join the ASF Education Series on from 11:00 AM - noon. Our Virtual and In-Person Stroke Support Group takes place the 3rd Wednesday of every month at our health system’s Acute Inpatient Rehab facility - 2nd Fl. This will be another resource for those patients and community who have suffered from a stroke.

The Fast & the Furious!

Congratulations to team members who achieved the below fastest intervention times!!!

Your opinions matter! Please complete the BE FAST Survey and share your recent experience with a stroke intervention and/or activation. To provide other general feedback please email us.

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