Acute Stroke and Emergency Department Collaboration. To BE F.A.S.T.

Mr Daniel Van Vorst1, Mrs Angela Firtko
1SWSLHD, Liverpool, Australia, 2Western Sydney University, Liverppol , Australia

The Stroke and ED team have collaborated on new processes to B.E F.A.S.T and introduced new guidelines to maximise stroke management to streamline the stroke service.

A new acute stroke guideline has been written and approved outlining the newly developed processes for acute stroke patient’s presenting to Liverpool Hospital. We have included triage level 1 and level 2 to maximise time critical therapies. Our implementation and communication plan including  in-servicing, posters, shifty huddles run by the NUM/CNE of the Emergency department, memos, intranet has been given to ED staff on the new processes .This education includes Assist and TPA administration accreditations and introduction of using apps. A new pathology and radiology order set has been created on eMR to expedite processes for acute stroke presentations. TPA is now being given in CT speeding up door to needle time which is imperative as time=brain.

There is now stroke Neurology coverage 24/7 that sees all stroke patients  in the ED and escorts each patient to INR. A wardsperson now turns up to every stroke call to expedite the transfer to CT and radiology are on board clearing the CT table for stroke calls as a priority.

We utilised the PDSA cycle and AIM methodology and conducted a Quantitative review of SWSLHD TPA/ECR data. We reviewed the new stroke foundation guidelines and current evidence on acute stroke in light of new finding to widen the window time for this procedure for Endovascular Clot Retrieval (ECR)

The development of the new policy and procedures in regards to stroke management have incorporated the latest evidence based practice. Regular collaboration with the ED, Stroke team and radiology have led to the development of processes that should improve the way stroke patients are managed when they present to Liverpool Emergency Department.  Ensuring timely access to treatment and efficient triage will ultimately yield the greatest stroke outcomes and present less disability to patients

Clinical Nurse Educator in Liverpool Emergency Department for 3 years and worked in department and emergency management for 9 years. Am also a Sessional Academic at Western Sydney University teaching nursing. I have a Masters in Emergency Nursing and am passionate about emergency and education.