St Vincent’s is seeking accreditation of its Stroke Center by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an independent not-for-profit organization dedicated to improving the quality of care in organized health care settings. The accreditation is “a prestigious seal of approval” according to Ms Nascimento, and “means that St Vincent’s is following national standards that dramatically improve outcomes for stroke patients.”

The medical center already passed the first hurdle earlier this year when it received the first level of recognition from the American Stroke Association’s (ASA) “Get with the Guidelines” process (ASA is a division of the American Heart Association). The “Get with the Guidelines — Stroke” was developed to help hospitals develop a comprehensive system for providing rapid diagnosis and treatment of stroke when patients are admitted to the emergency department.

A national coalition of physicians is now using the word “brain attack” to describe a stroke and help people to understand the importance of immediate response. Likewise, hospitals are refocusing their care into a “Stroke Center” concept that involves new protocols and teamwork to save lives and minimize damage from strokes.

“A person suffers a stroke every 45 seconds in the United States, and one person dies from stroke every 3.1 minutes,” says Dr Kadimi. “Stroke is the third leading cause of death.”

Last month, St Vincent’s treated more than 40 people admitted with stroke symptoms. 

St Vincent’s continues to work toward accreditation of its Stroke Center by preparing for a JCAHO site survey sometime this summer or early autumn. The St Vincent’s Stroke Center team is complimented by the talents of Karen Nefores, RN, director of patient safety.

“We have all the protocols in place,” says Ms Nascimento. She notes that St Vincent’s is already functioning as a Stroke Center, but is looking forward to receiving the official JCAHO recognition.

Much of the treatment of stroke from new imaging technology to life-saving drugs has been available for years, but new protocols and a comprehensive approach to care are refocusing care into Stroke Centers. From the moment of the 911 call, the Stroke Center’s rapid response team works to make sure that everything is in place to save lives and minimize damage.

When a person arrives at the St Vincent’s ER complaining of symptoms peculiar to stroke, a BAT (brain attack) protocol goes into effect, with the team of doctors and nurses assembling within minutes, and a neurologist notified immediately. A CT scan is performed and read within 45 minutes.

If the CT scan reveals that a stroke has occurred, then a drug called Tissue Plasminogen Activator or TPA, is administered, which is only effective if given within three hours of the onset of stroke symptoms.

St Vincent’s also has a dedicated unit for stroke patients where nurses have undergone more specialized education and training.

Stroke services at St Vincent’s include: 24/7 team available; a stroke director and coordinator; a designated stroke unit; stroke rounds; stroke protocols/pathways; stroke clinical trials; stroke support group; stroke screenings; rehabilitation team/PT/OT Speech; and stroke nutritionist

Public education is an important part of the new Stroke Center concept, and Dr Kadimi has been a leader in getting the message out into the community. He recently visited Bridgeport City Hall Annex to speak to members of the African American community about symptoms and warning signs.

Both Dr Kadimi and Ms Nascimento are also working to reeducate staff and heighten awareness about stroke, because every minute counts after the onset of the attack.

                                                            

Anatomy Of A Stroke

Dr Kadimi said stroke is essentially a blood clot in one of the arteries that leads to the brain. The most common type of stroke is ischemic in which the clot or loose plaque clogs the artery, much in the same way a clot blocks vessels to the heart and leads to a heart attack. In hemorrhagic strokes, which are less common, the blood vessel wall breaks.

In either case, the brain is deprived of blood, leading to sudden numbness or weakness of the face, arms or leg on one side of the body. A person may also suffer sudden confusion or loss of balance, have trouble speaking, or trouble seeing in one or both eyes.

 Dr Kadimi says that time is of the essence because the quicker the intervention, the more likely a person is to survive a stroke with minimal damage. Likewise, stroke-stopping drugs such as TPA are most effective if administered within the first three hours.

That is why it is so important for people to know the warning signs and respond quickly, says Ms Nascimento.

“We still have too many people who think they should wait or that they can go to sleep and feel better in the morning,” she said. 

Part of the public campaign is to make all people more aware of the warning signs because many people who suffer stroke are not aware that it is happening. The most important person in the diagnosis may be the spouse or companion who recognizes the symptoms and calls 911.