Stroke of time
Maintain the brain is the mantra when it comes to dealing with a stroke. The faster a stroke is recognized and treated - optimally within 4.5 hours - the greater the chances of avoiding disabilities, including loss of brain function.
To ensure a speedy and proven approach to delivering stroke care at the highest level, Community Hospital of the Monterey Peninsula has achieved certification as a primary stroke center. The designation by the Joint Commission, the nation's leading healthcare accreditation organization, recognizes that Community Hospital has put into place a series of evidence-based protocols to take a stroke patient from emergency care through rehabilitation. It is the only certified stroke program in Monterey County.
"What's so important about this accreditation," says Sherry Houston, executive director of the Stroke Awareness Foundation, "is that without it, stroke patients would have to go outside Monterey County to receive this level of care. That doesn't work with a stroke because time is everything. Most people are not afraid of dying from stroke but of living with the effects of it.
"One of our board members, who has a home on the Monterey Peninsula, had a stroke in his 50s and fully recovered because he was taken to a hospital that was prepared to treat strokes. Community Hospital, as a primary stroke center, is now prepared to treat him, you, and your family for what can be the devastating effects of stroke."
In Monterey County, there are nearly 700 stroke-related cases annually - an average of nearly two people every day. Stroke is the third-leading cause of death in the United States. On average, someone suffers a stroke every 45 seconds and someone dies of a stroke every 3.1 minutes.
A stroke occurs either when the blood supply to a vessel in the brain becomes blocked, or when a blood vessel in the brain bursts and causes brain cells in the vicinity of that blood vessel to die. The signs or symptoms are usually sudden and include numbness or weakness in the face, arms, or legs, usually on one side of the body; confusion; severe headache; trouble comprehending; difficulty speaking, seeing, or walking; and loss of balance or coordination. Read more about stroke symptoms.
At Community Hospital, every stroke patient is considered an emergency, says Laura Hodge, RN, stroke program coordinator. When a stroke is suspected, a "code stroke" alert is called and a designated rapid-response team assembles. An immediate evaluation determines whether the patient is a candidate for tissue plasminogen activator (tPA), a clot-busting drug, or whether he or she needs a stent procedure to open a blood vessel, neurological intervention through surgery, or a procedure to pull out the clot.
A standardized program of care follows patients throughout their stay.
"What differentiates our stroke care," Hodge says, "is that it is evidence-based, built on the work of the American Stroke Association and American Heart Association and the Joint Commission's disease-specific care measures. Their guidelines are put into practice through protocols followed from the moment the patient arrives all the way through discharge and rehabilitation. We are following proven methods of caring for stroke patients."
Certification came after more than a year of work. A surveyor from the Joint Commission examined months' worth of patient data and did a rigorous on-site review, following cases through the hospital and testing the knowledge of staff members.
In addition to the certification, Community Hospital has been awarded the Bronze Performance Achievement Award from the American Stroke Association's "Get with the Guidelines" program. The award recognizes commitment and success in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations.
"Our nurses and doctors are specially trained in stroke care," Hodge says. "They understand the significance of risk factors, and they monitor stroke patients for progression or resolution of symptoms. Patients are cared for by a multidisciplinary team of professionals, including staff from our Main Pavilion nursing unit, Emergency, Diagnostic and Interventional Radiology, the Intensive Care Unit, Pharmacy, Rehabilitation Services, and Laboratory Services, which all work together to provide this essential service to our community.
"When patients are discharged, we provide them with written material so they can learn or be reminded about their personal risk factors, what they can do to minimize the chances of recurrence, the warning signs of stroke, and why it is so important to call emergency medical services as soon as possible if they recognize the symptoms of stroke."
Education is also part of Community Hospital's stroke program. Community outreach efforts are designed to familiarize area residents with the risk factors for stroke, how to recognize signs and symptoms, and how to seek help. These efforts are funded in part by two gifts to Community Hospital - a $50,000 grant from the Grainger Foundation, as well as a $100,000 commitment to establish the F. Robert Nunes Fund for Stroke Awareness.
"Preventing stroke through education," Hodge says, "is a key part of our mission. If we can educate the public, we can reduce the number of people who suffer from this devastating disease."