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Ischemic stroke case study
Ischemic stroke case study
Ischemic stroke case study
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Early treatment of acute ischemic stroke
Introduction
Each year ischemic strokes account for 87% of all strokes in the United States being the leading cause of disability (American Heart Association [AHA], 2013). Preventable disabilities related to strokes not only decrease the quality of life, but also cause a significant financial impact on a community. Early treatment of acute ischemic strokes with thrombolytic therapy or mechanical interventions helps to improve patient outcomes and decrease disability (Ashraf, Maneesh, Praveenkumar, Saifudheen, & Girija, 2015). Time is brain, thus let us get to it!
Current setting
Recently, our hospital has passed the re-accreditation from the Healthcare Facilities Accreditation Program (HFAP) which allows
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Implementation of EBP The hospital is currently in the process of designing the necessary steps.
Evaluation
Once the hospital implements the new stroke process the data will need to be collected to reflect the evidence on the effectiveness of EBP. One of the means is the retrieval of data through the reported metrics to ASA database on all stroke patients receiving the treatment at the hospital. One of the major outcome measures would be the future re-accreditation by HFAP. The role of an advanced practice nurse will allow to collect the evidence and propose the necessary alterations. Once the project in place an APN involved in acute care setting can assist in advocating and instituting the EBP into the current
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The implementation of various guidelines in the health care intends to target some of the IOM major aims, thus improving the quality of health care related to that
Stroke survivors or anyone with chronic illness and health providers remain hopeful and “realistic” by counting on each other. The patients while being realistic about the outcome of their disease, stay hopeful that each of their health care providers will give them the appropriate care and will make sure that they can live with their disease in the best way possible.
In 2011, Barbara Safriet published an article “Federal options for maximizing the value of Advanced Practice Nurses in providing quality, cost-effective health care” from a legal perspective. The article focused on the benefits of utilizing Advance Practice Nurses to the full extent of their abilities as well as the current barriers that APNs encounter in their practice. The aim of this paper is to discuss two regulatory provisions to full deployment of APNs in current health care system, as well as three principle causes of current barriers to removal of the restrictive provisions for the APN. Furthermore, I will discuss the critical knowledge presented in the article and how it relates the APN practice. This article was incorporated into a two-year initiative was launched Institute of Medicine (IOM) and by the Robert Wood Johnson Foundation (RWJF) in 2008 which addressed the urgency to assess and transform the nursing profession.
The model discusses the impact of new regulations on education for APRN, Licensure Accreditation, Certification & Education Document, certification and practice. The model is implemented to grasp the general understanding and definition of advance practice registered nurse APRN role, inconsistencies with state by state recognition of APRN roles, and determining eligibility for APRN licensure (Consensus Model for APRN Regulation, 2015). The consensus model definition of APRN is a nurse who is educationally rounded to assume the responsibility of assessing, diagnosis, treating, teaching health promotion and disease maintenance, acquired advanced clinical knowledge and skills to provide direct patient care, has passed a national certification examination, and licensed to practice in one of the four roles (Consensus Model for APRN Regulation, 2015).
Ischemic Stroke is caused due to a blood clot in an area of the brain, leading to loss of neural function if last for more than 24 hours. In the United States, ischemic stroke affects 2.7% of men and 2.5% of women of age range 18 years and older. In addition, it has reported that annually about 610,000 and 185,000 of new strokes and recurrent strokes cases occur in US1. Moreover, it has reported that patients who have suffered from a stroke have more chances of recurrent stroke, Myocardial infarction, and death from vascular causes2. One of the risk factor of ischemic stroke is formation of plaque in the blood vessels causing blood clot3. Several randomized trials have also reported that antiplatelet medications are efficient in preventing recurrences of stroke in patients who had an incident of ischemic stroke. Antiplatelet medications for preventing recurrences of stroke are aspirin, combination of aspirin and extended-release dipyridamole, and clopidogrel alone4. It ha...
“Chronic diseases and illnesses are the leading causes of death and disability in the United States” (CDC.gov, 2014). These types of illnesses are the most common health problems that people in this country face today and they are also the most preventable (CDC.gov, 2014). Every year the cost to help care for and manage people with these types of illnesses increases and there is less being done about educating people about prevention. Venous Thromboembolism is one such chronic disease that is very deadly but also very preventable if the right precautions are taken. This paper will aim to educate about the disease, courses and costs of treatment, clinical microsystems that are involved and what barriers if any exist to achieving generative relationships among the various clinical microsystems involved.
1. What is the difference between a. and a. Introduction The main aim of this report is to present and analyse the disease called Cerebrovascular Accident, popularly known as stroke. This disease affects the cerebrovascular system, which is a part of the cardiovascular system.
To gain accreditation, TJC sets rigorous safety and quality of care standards and evaluates organizations to see whether or not they meet their standards. After the survey, TJC provid...
It goes without saying that everyone’s health is important and should be taken care carefully. Everyone has heard of strokes before but many people do not really know its meaning, types, and the number of individuals of that dies due to this issue. According to Centers for Disease Control and Prevention (2015), strokes kills an average of 130,000 people a year and it is one of the most common deaths that happen in the United States. An average of 800,000 of people die from cardiovascular disease and strokes and it is also a reason of long-term disability (Centers of Disease Control and Prevention, 2015). Strokes, which can also be called cerebrovascular accident or CVA happen when the blood supply to the brain is interrupted or the blood vessel going towards the brain burst. Then part of the brain dies or become seriously injured because the brain cells do not receive oxygen and they eventually die. People’s lifestyle may also impact seriously on their health and increase the possibility of having a stroke. Some of the risk that can severely increase the cause of stroke would be high blood pressure, heart disease, diabetes, cigarette smoking, as well as strokes that
Cerebrovascular disease or the term stroke is used to describe the effects of an interruption of the blood supply to a localised area of the brain. It is characterized by rapid focal or global impairment of cerebral function lasting more than 24 hours or leading to death (Hatano, 1976). As such it is a clinically defined syndrome and should not be regarded as a single disease. Stroke affects 174-216 people per 10,000 population in the UK per year and accounts for 11% of all deaths in England and Wales (Mant et al, 2004). The risk of recurrent stroke within 5 years is between 30-43%. One problem is that the incidence of stroke rises steeply with age and the number of elderly people in the UK is on the increase. To date people who experience a stroke occupy around 20 per cent of all acute hospital beds and 25 per cent of long term beds (Stroke Association, 2004). The British Government now identifies stroke as a major economic burden on the National Health Service (DoH, 2002).
Notably, there are 6.4 million or 2.7% of adults who had a Cerebrovascular Accident (CVA, Stroke) (Cerebrovascular Disease and Stroke, 2015). In fact, there are 15 million individuals who endure a stroke worldwide, while 5 million die and 5 million become permanently disabled (Stroke Statistics, 2015). Also, each year about 795,000 people suffer a stroke, while 600,000 are first attacks, 185,0000 individuals have recurrent attacks (Stroke Statistics, 2015). As a matter of fact, someone on average in the United States have a stroke every 40 seconds, which can occur at any age, as about ¼ of strokes happen less than 55 years old. Besides, ¾ of people beyond 65 years old have a stroke, while doubling each decade between
Defining the role of an advanced nurse practitioner (ANP) is complex and commonly open to interpretation. Internationally there are many variances in what the role of the advanced practitioner entails, and the characteristics of individual roles are often shaped by the country and particular speciality in which they are practising (Mantzoukas & Watkinson 2006), (Sheer & Wong 2008), (Stasa et al 2014), (ICN 2008), (Dalton 2013), (NHS Wales 2010), (Haidar 2014), (Lowe et al 2011), (Pearson 2011).
According to the American Heart Association / American Stroke Association’s About Stroke (2014) “stroke is the number four cause of death and the leading cause of adult disability in the United States” (para.1). On average, a stroke happens every 40 seconds in the United States (Impact of Stroke, para. 1) About 4% to 17% of all patients with stroke experience symptom onset while hospitalized (Cumbler, et al., 2014). This amounts to about 35,000-75,000 in-hospital strokes in the United States annually.
“Time is brain” is the repeated catch phrase when addressing the treatment and management of stroke (Saver, 2006). Access to prompt and appropriate medical care during the first few hours of stroke onset is critical to patient survival and outcomes. Recent changes in the guidelines for acute stroke care released by the American Heart Association (AHA) and the American Stroke Association (ASA) have improved patient access to treatment. Stroke treatment now follows the model of myocardial infarction treatment. Hospitals are categorized into four levels based on stroke treatment capability. The most specialized treatment is available in comprehensive stroke centers followed by primary stroke centers, acute stroke-ready hospitals, and community hospitals. The use of telemedicine now enables even community hospitals, with limited specialized capabilities, to care for stroke patients. Telemedicine puts emergency hospital personnel in contact with neurologists providing expertise in the evaluation of a stroke patient and determination of their eligibility for treatment with thrombolytic medication (Jefferey, 2013).
My presentation proposal involves stroke education and prevention. My target audience is men, over the age of 60. I will cover the multiple types of strokes and describe each precursor. I will refer to several case studies in order to demonstrate how particular factors may increase the risk of stroke. I will describe why my chosen age group is at higher risk than younger ones. I aim to introduce appropriate ways to respond to such an event, as well as health management after an event. Knowing that symptoms may be different in any given stroke victim means I will cover multiple risk factors and how they affect the brain.
Stroke is an important leading cause of disability among adults in the United States. About 0.4% of people over the age of 45 years have a first stroke each year in the United States, Australia, and Europe. It is the second most common cause of death after myocardial infarction and is a leading cause of acquired disability. In some regions, the combined incidence of stroke and transient ischemic attacks (TIAs) exceeds the incidence of coronary vascular events.1 Despite advances in preventive strategies and initial therapy for stroke, nearly 800,000 strokes occur per year in the United States,1 and 87% of all strokes worldwide are ischemic in origin. 1 The risk of stroke is higher among men than among women, among blacks than among whites, and in older than in younger age groups. More than 85% of fatal strokes occur in low- and middle- income countries.2,3. In 2007, stroke accounted for 1 of every 18 deaths in the United States. The cost of related care is among the fastest-growing expenses for Medicare .1 The estimated direct medical cost of stroke in United States in 2007 was $25 b...