Stroke Core Measures

1.  VTE prophylaxis

[YES] VTE prophylaxis was provided with TED stockings and sequential compression devices on the day of admission.  

[NO] Pharmacologic VTE prophylaxis was not initiated becuase patient had a hemorrhagic stroke.

2.  Antithrombotic Therapy

[YES] This patient presented with ischemic stroke, and is discharged on antithrombotic therapy with [aspirin, Plavix].

Antithrombotic Therapy by the end of Day 2

[YES] Antithrombotic therapy with [aspirin, Plavix] was administered by the end of hospital day 2.

3.  Anticoagulation Therapy

[YES] Etiology of stroke for this patient is most likely due to cardioembolic event [atrial fibrillation].  Anticoagulation therapy with [coumadin, Xarelto, Pradaxa, Eliquis] has been  prescribed at discharge to prevent recurrent ischemic stroke. [Coumadin reduces the relative risk of thromboembolic stroke by 68%.]

[NO] Anticoagulation therapy is not indicated in this patient.

 

Thrombolytic Therapy

[YES]  Intravenous TPA was administered to this patient with acute ischemic stroke within 3 hours of symptom onset based on the evidence provided by the NINDS Studies [part 1 and 2].

[NO] Intravenous TPA was not given to this patient because the patient presented to the emergency department greater than 2 hours from the time he was last known to be well, and will not fall within the 3-hour window period for TPA administration.

[NO]  Intravenous TPA was not given to this patient because of the following contraindication/s:  ___.

4.  Statin Medication

[YES]  Lipid profile was measured within 48 hours of admission. [Lipid profile was available from within th epast 30 days].  LDL in this patient measured more than 100 mg/dL [or is less than 100mg/dL while on statins] and he/she is prescribed statin medication [atorvastatin] at hospital discharge based on the SPARCL study which demonstrated that the use of statin was associated with dramatic reduction in the rate of recurrent ischemic stroke.

5.  Stroke Education

[YES] Patient and/or the caregivers were given educational materials during the hospital stay addressing activation of EMS, need for follow-up after discharge, medications prescribed at discharge, risk factors for stroke, and warning signs and symptoms of stroke.

6.  Assessed for Rehabilitation

[YES]  Patient was assessed for rehabilitation services by the physical and occupational therapists to prevent complications, minimize impairments, and maximize his function.

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