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St. Joseph Attains Stroke Certificate
By REBECCA WATTS

St. Joseph Regional Health Center recently received certification as a Primary Stroke Center by the Joint Commission. The health facility announced early this month that they had been granted the seal in January. The certification is the only advanced level offered in stroke treatment and is the first the hospital has earned.

St. Joseph Stroke and Chest Pain Coordinator nurse Amy Plotts said, “The people in our community no longer have to travel to Houston or Austin or Temple to receive stroke care that follows national standards.”

The national standards are based upon recommendations by the American Stroke Association and the Brain Attack Coalition. Requirements include having a round-the-clock stroke team and 24-hour access to neuroimaging and lab services, written care protocols, EMS agreements and services, and a public education program, in addition to meeting 10 standardized performance measures. All of this translates into a rapid response and streamlined care for stroke patients from their arrival to their discharge.

At the first alert of an incoming stroke patient, a room is cleared in the emergency room and physicians and staff meet the patient upon his or her arrival and evaluate signs and symptoms to determine the stage of treatment. Patients then receive appropriate care.

“A Certified facility has implemented evidence-based practices that insure the patient is rapidly evaluated for treatment and receives all the appropriate care to improve patient outcomes,” Plotts said. “There is no guarantee that level of care will be provided at non-certified facilities. That gold seal is proof that we are doing what we say we’re doing and that is following national standards.”

According to the American Heart Association, stroke is the number three cause of death in the nation and is the leading cause of serious, long-term disability in the United States. Every 40 seconds a person suffers from a stroke, and some do not receive the care they need in time to prevent permanent damage.

As with heart attacks, the time between symptoms and treatment is critical. Stroke symptoms include sudden weakness, paralysis or a numbing sensation in the face, arm, or leg on one side of the body; trouble swallowing; sudden loss of speech, trouble talking or understanding speech; impaired judgment or thought; and sudden severe headaches, dizziness or unsteadiness. Plotts said that early treatment would eliminate these symptoms. If the time between symptom onset and treatment is shortened, fewer areas of the brain are affected. Some stroke patients qualify for treatment with tissue plasminogen activator (tPA), and the goal for the stroke team is to have this medicine delivered intravenously within an hour of the patient’s arrival at the hospital.

May is National Stroke Month and the American Heart Association/American Stroke Association in collaboration with the American Academy of Neurology and the American College of Emergency Physicians has developed an awareness campaign called “Give Me 5” for Stroke. The campaign uses walk, talk, reach, see and feel as memory reminders to check for balance, speech, numbness, vision and headaches. The campaign is seeking to draw awareness to strokes and encourage those that may experience a stroke to call 911.

“Although only a small percentage of patients qualify for treatment,” Plotts said, “I cannot stress the importance of calling 911 and getting to the hospital when symptoms are recognized. The treatment window for acute stroke is three hours from the time of onset.”

Texas ranks as one of the top ten stroke states in the nation. Strokes result in death in over half of all Texas stroke patients. These facts prompted Texas to issue legislation for the implementation of stroke systems. The Governor’s EMS/Trauma Advisory Council developed the Stroke Committee to aid in meeting mandates in the legislation and in as little as 18 months will mandate EMS providers to follow protocol that requires the delivery of stroke patients to a primary stroke facility.

In the meantime, the Brazos Valley Regional Advisory Council serves the local community in coordinating interaction among health facilities and EMS services. In February, the BVRAC approved criteria to begin evaluating area facilities for their stroke treatment capabilities. Current BVRAC protocol already follows future state-mandated protocols for stroke patients. Director of Emergency and Trauma Services for St. Joseph Regional Health Center, Beverly Welsh, R.N. said, “Based on the BVRAC protocols, the patient is to be taken to the nearest certified Primary Stroke Center because the patient care provided at Certified centers has been proven to improve patient outcomes. We don’t expect any changes to occur when the state mandates compliance.”