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Hospital aims to improve the odds for stroke victims
1130healthyMonday
Registered nurse Debbie Callahan prepares a vial of a new clot busting medicine used to treat victims of stroke. The drugs activace and the generic alteplase have shown remarkable results in some stroke patients.
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Each year, about 700,000 people suffer a stroke, according to the American Stroke Association, and of those who survive the stroke, 21 percent of men and 24 percent of women die within a year.

The percentage grows for people aged 65 and older.

Health care professionals at Northeast Georgia Medical Center aim to reduce those numbers with comprehensive stroke care. The hospital was recognized with a bronze award by the American Stroke Association for its initial efforts to create and maintain a stroke program.

“You can imagine if a person has a stroke and they come to the hospital, and you can’t get that three-hour window treatment just unless things have been prepared and organized and prior to that,” Penix said. “So that’s why it’s important for the hospital to develop these things ahead of time.”

The stroke association’s Get With the Guidelines program creates national standards by which hospitals should treat stroke patients. Northeast Georgia Medical Center has participated in the pilot program for Get With the Guidelines since 2003, said Tricia Westbrook, nurse practitioner at Northeast Georgia Medical Center.

“It’s been kind of a slow process to get everything where we want it and all the resources that we need,” Westbrook said.

The program primarily focuses on 10 standardized measures of treatment of stroke patients, including being equipped to provide brain imaging scans, always having neurologists on hand to evaluate patients and using clot-busting medications that could, in some instances, reverse the effects of a stroke. The standards guide doctors through therapy of a stroke patient throughout the entirety of his or her hospital stay, including physical, occupational and speech therapies, Westbrook said.

The program made health care providers at Northeast Georgia take a look at the way it treats stroke patients and evaluate the type of equipment and medications used.

“Doing that monitoring helped us see barriers that were in our own processes and systems so that we could change those and help it flow better,” Westbrook said.

Now, if a patient comes to the hospital within three hours of having had a stroke, the hospital routinely administers tPA or thrombolytic therapy that breaks up the clot causing the stroke, said neurologist LaRoy Penix, the head of Northeast Georgia’s Stroke program.

Other therapies include preventing future strokes with lifestyle changes and medications.

“We know that high blood pressure, diabetes, high cholesterol, cigarette smoking are classic stroke risk factors,” Penix said.

But having suffered a prior stroke or having an irregular heartbeat called atrial fibrillation are also large risk factors for strokes — 30 percent of people who have one stroke will have a second one, Westbrook said.

Part of the Get With the Guidelines program mandates putting these patients on anticoagulation medications such as coumadin to keep them from forming future blood clots, Westbrook said. And some patients leave the hospital on antithrombotic therapy, which also prevents future blood clots.

“Patients who even got just a plain aspirin early enough, it reduced their risk of having a second stroke,” Penix said.

Northeast Georgia won’t stop with the bronze level performance award, however, Westbrook said. The hospital will continue to evaluate and build its stroke treatment practices to improve treatment and receive higher levels of the award.

“Our next goal is the silver award, which is maintaining those standards at a greater than 85 percent level for a full year,” Westbrook said. “...If you continue to maintain those levels then you would get the gold award; one step at a time.”

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