Initiation of a Stroke Alert in a Rural Emergency Department

• Published in: Journal of emergency nursing 2011-03, Vol.37 (2), p.148-151
• Main Authors: Pelton, Mary M., DeWees, Terri
• Format: Article
• Language: English
• Subjects: Accident and emergency departments; Emergency medical care; Emergency Service, Hospital - organization & administration; Hospital administration; Hospitals, Rural - organization & administration; Humans; Initiation; North Carolina; Nurse patient relationships; Nursing; Nursing Process; Organizational Objectives; Patient Care Team - organization & administration; Program Development; Quality of care; Quality of Health Care; Risk factors; Rural communities; Stroke; Stroke - diagnosis; Stroke - therapy; Strokes; Time Factors; Tomography, X-Ray Computed
• ISSN: 0099-1767; 1527-2966
• DOI: 10.1016/j.jen.2009.12.020

Situated along the buckle of the stroke belt, Carteret County in eastern North Carolina has an estimated population of 63,195 according to a 2008 population estimate by the US Census Bureau. Carteret General Hospital is the only health care facility in a county whose land area totals 519.84 square miles. The geography of the county is such that it presents extensive EMS and private vehicle transport times. The county is approximately 7 miles wide and 100 miles long, surrounded by water from the Atlantic Ocean and its tributaries. Classified as a comprehensive, rural hospital, Carteret General Hospital has a 13-bed emergency department, a 6-bed fast track area, and 5 overflow beds. Because of the work of the American Heart Association, community educators, and others, appropriate care of the patient presenting to the emergency department with signs and symptoms of stroke have come to the forefront as an expectation of the public. Here, Pelton and DeWees emphasize that to ensure that the delivery of care provided to patients meets or exceeds standards and expectations, a team was developed to explore and improve the timeliness and appropriateness of the care-delivery process for stroke patients. Accordingly, review of the literature indicates that although much education has occurred in both the professional and lay circles, many patients having stroke symptoms do not receive timely treatment. This is due in part to delayed arrival as well as delay in diagnosis and treatment upon arrival to the emergency department.