April 18, 2022

Patient Safety at Blue Ridge Regional Hospital, Part II: The Importance of Stroke Care

Last month we talked about Patient Safety in the context of the many factors that impact keeping our patients safe while they are hospitalized and after they return home. We learned that every department of Blue Ridge Regional Hospital (BRRH) impacts patient safety somehow, from preventive practices, like incorporating safety features into the design of the hospital rooms so patients do not sustain falls, to handwashing and care protocols that lower the risk for infection.

The topic is broad, and this month I am focusing on the patient safety practices surrounding a serious health emergency: stroke. Your brain requires oxygen that is delivered through your blood vessels, as well as nutrients from your blood. Stroke occurs when a blood vessel either ruptures or becomes blocked by a clot.

Stroke is a life-threatening condition because once a portion of your brain is deprived of essential oxygen and blood, brain cells die. You cannot get them back and this is why a stroke is such an urgent, time-sensitive emergency. We often say “time is brain” to indicate the importance of prompt treatment to prevent irreversible cell death during a stroke.

According to the American Stroke Association, stroke is the fifth leading cause of death in the United States, and a leading cause of adult disability. The CDC states that about 795,000 people suffer strokes annually.

The two types of stroke are ischemic and hemorrhagic. An ischemic stroke is caused when a clot blocks blood flow to the brain, while a hemorrhagic stroke is the result of a blood vessel rupturing and obstructing blood flow to the brain.

Recently, BRRH received the American Heart Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes BRRH’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Gold Plus recognizes performance for 24 months or more.

Dana McGee-Haynes, who we met last month, is BRRH’s Administrative Director of Quality and Patient Safety. She has in-depth knowledge about the intricacies of ensuring safety for stroke patients specifically, or patients who are being evaluated because it is thought that they may be having a stroke.

“Because we have prepared and applied for the Acute Stroke Ready Hospital certification,” says McGee-Haynes, “we have protocols present to ensure that any patient suspected of experiencing a stroke receives immediate care, the ability to receive telehealth evaluation by a Mission Hospital neurologist at any time, and a multitude of other safeguards and treatments.”

McGee-Haynes adds that supporting patient safety is also related to providing community education. Megan McKinney, Emergency Department (ED) Nurse Manager and Amber Miller, ED Clinical Nurse Coordinator, have made a concentrated effort to teach the community how to recognize early stroke symptoms. BE-FAST is an easy acronym to use to recall stroke symptoms:

  • B: watch for sudden loss of BALANCE
  • E: EYES, check for vision loss
  • F: FACE, look for an uneven smile
  • A: ARM, check if one arm is weak
  • S: SPEECH, listen for slurred speech
  • T: TIME, call 911 immediately

Attaining the Acute Stroke Ready Hospital certification is a widely understood recognition that indicates BRRH is equipped to treat stroke patients immediately, with evidence-based approaches, before they are transferred to Mission Hospital. It also means that we have the capability of teleconferencing with the multidisciplinary team of experts at the Mission Hospital Stroke Center.

Finally, it is a point of pride for BRRH that we are a Pathway to Excellence? (PTE) hospital. This designation is given by the American Nurses Credentialing Center (ANCC), a highly respected national institution. It recognizes healthcare facilities that work to expand educational and professional growth opportunities for nursing professionals so they can achieve excellence, work to their highest potential, and in turn, create the safest care experiences for their patients. The program legitimizes workplaces as well, because to earn PTE status, the nursing staff must affirm that their hospital is focused on supporting its nursing staff in this way.

I hope that this month’s column, along with my March column, serve to reassure community members that their safety is our top priority at all times. We are dedicated to providing the most advanced care to our patients, and keeping patients safe is the foundation on which our care is built.

Tonia W. Hale, DNP, MAOM, BSN, RN, is Chief Executive Officer and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Hale is a proven leader with 35 years of progressive healthcare experience. A native of East Tennessee, she holds an associate’s degree in nursing from Walters State Community College, a baccalaureate degree in nursing from the University of Tennessee, a master’s degree in organizational management from Tusculum University, and a doctor of nursing practice degree in executive leadership from East Tennessee State University. Ms. Hale is currently a resident of Burnsville.