Running head: Improving Stroke Education and Patient

Improving Stroke Education and Patient Outcomes

Spencer May
Dixie State University

Improving Stroke Education and Patient

Improving Stroke Education and Patient Outcomes

Stroke patients on the medical/surgical floor of Valley hospital are asked many questions
at discharge. All of these questions are about the patient perception of how their stay was and
about the quality of care they received. These patient outcomes are measured and help the staff
on the floor to find out which areas they are lacking and so that they can continue to improve in
the areas they are not as strong or lacking. These measured patient outcomes help show the
medical professional how their interventions worked and also show if the outcomes from the
treatment were effective according to the patients perspective (Boyce & Browne, 2013, p. 2276).
There are two areas that show the highest patient dissatisfaction. The first area after the doctor
put in the discharge order and transport has been called and the pickup has been scheduled, many
times transport comes hours after the scheduled pickup time. The second area of patient
dissatisfaction is the patient feel they are taught about strokes they day or night they are
admitted. After that they feel the nurses do not go over the information anymore. One patient
said, I feel that they go over the most important information about the disease when I am at the
sickest point of my hospital stay. The unit manager on the floor has shown great initiative in
improving the patient satisfaction scores and for the staff to continue to grow and make their
weaknesses strengths. This project uses the principles of the relationship care and the goal of this
project is to try to help improve patient satisfaction scores and to improve the unit efficiency in
several different areas. These patient satisfaction scores are also a way are a way to measure
patient outcomes. It is a wat to show the staff how their unit has been doing the past three months

Improving Stroke Education and Patient

and also compared the data to all the other units in the hospital. The results of the data show
there is much room for improvement in many area on the unit and that something needs be done
differently.
After looking into the issues for the late pickups and stroke education, the nurses on both
the night and day shift were interviewed. There were several reasons for the pickup delays, but
only the areas that the nurses could control were considered. One recurring issue was that the
schedule pickup time was scheduled at the end of the day during shift change or well after. Many
times the transport contact information was not given to the night staff so when the pickup time
passed there was no way for the nurse to contact the company to find out an estimated arrival
time. It is important that the patient feels they are informed on what is going on in all stages of
their hospital stay and this includes the discharge process (Schneider& Fake, 2010, 376). There
were also many reasons that came up for the stroke education. Many times the nurses had been
teaching the patient about strokes but the patient and family did not recognize it. Another issue
was the concern that the patient was not going to retain the information well due to
complications from the stroke so the education was pushed back. Another reason that nurses
have not taught these things is because of lack of time in their shift. This is an issue that affects
nurses everywhere and has been shown to be an ongoing issue in nursing (Friedman, Cosby,
Boyko, Hatton-bauer, & Turnbull, 2011, 18). Unfortunately, many of the nurses admitted to just
quickly going over the main points of the stroke core measure packet and giving to the patient to
go over on their own time. This should not be done because the learning needs of each patient
must be taken into account and cannot be applied in the same way to every patient (Friedman,
Cosby, Boyko, Hatton-bauer, & Turnbull, 2011, 20). Many times patients are flooded with
packets of paperwork about their disease process but never learn anything because nothing is

Improving Stroke Education and Patient

said to them. Nothing should replace the verbal teaching method to patients and communication
is an important part of the teaching process (Woolley, Perkins, Laird, Palmer, Schitter, Tarter,
Woolsey, 2012).
It was decided that the best way to address the late pickup issue was for the day nurse to
be sure to tell the night nurse the name of the company picking up and patient and the phone
number. This way if the transport was not on time the nurse could call the company to get a
better estimated arrival time and this information could be passed on the patient and their family.
That was the patient would feel like they are being kept up to date about their plan of care and
the nurse can address their concerns with more certainty.
It was also decided that it should be a team effort in teaching the patient more
information about strokes. The day shift would focus more on teaching the patient and their
families about the signs and symptoms of a stroke, while the night shift would talk about the risk
factors. Also in every shift report it would be mentioned at the bedside what was taught to the
patient. This is important because both the patient and their families are getting the education on
how to recognize and prevent stroked from recurring (Holzemer, Thanavaro, Malmstrom, &
Cruz-Flores, 2011, 375).
There was a mixed reaction from both the night and day staff when they were told about
the plan. Some nurses thought it was a great idea but the majority of nurses did give some
pushback. It took about a week to get the nurses to get used to having the transport information
ready and a few weeks for the nurses to get used to and implement the stroke teaching changes
into their plan of cares.
The October and November scores have both had a slight increase in patient satisfaction.
Many of the patients are still unhappy about transport not arriving when the initially say they are

Improving Stroke Education and Patient

going to but patients are satisfied with the nurses and their communication during the process.
Also the patients and their families have felt better informed about strokes. This is an ongoing
process and does not show that this plan was a success because results can vary from a month to
month basis.
Education on stroked and how to prevent them is extremely important. It is also
important to remember that even after teaching patients about the risk factors and how to prevent
them it does not mean the patient is going to follow these teachings (Watkins, Leathley,
Chalmers, Curley, Fitzgerald, Reid, Williams, 2012, 38). Patients and their families not only need
to learn about these changes they may have to make in their life but actually understand the
information. Stroke patient may have a hard time understand or remembering the information
that has been given to them that is why it is important that family is involved in the patient
teaching (Cameron, 2013, 54). Patients and their families should be assessed on the information
that has been taught to see how they are retaining the information. Also, before a patient is
discharged, patients should be given outside resource information so that they can go and
continue to learn more about their disease process after leaving the hospital setting. Teaching
methods should be applied to the patients needs and understanding and that not every patient is
going to learn or retain information the same as another. Information should be catered according
to the patients needs to help prevent the recurrence of a stroke and re-admittance into the
hospital setting.
It will be interesting to see how the progress of this unit is going to be over the next few
months. Patient outcomes will continue to be measured on a month to month basis and any
changes that need to be made will be done accordingly. All plans will be continue to be based off

Improving Stroke Education and Patient

the Relationship Based Care model because it does improve the quality of patient care, and this
model will be used continuously to help better change healthcare institutions.

Improving Stroke Education and Patient

7
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