LAUSR

Background: While our stroke education (stroke education= patient, family and caregiver stroke education) documentation demonstrated that we met Joint Commission education requirements 94% of the time, we found that this teaching was usually being documented all at one time, typically on the day of discharge. Given that most adult learners can only retain 1 to 2 teaching points at a time and that repetition increases learning, we identified the need to revise our teaching process. Purpose: To improve the quality and frequency of stroke education. Methods: RNs from the neuro ICU, neuro intermediate care unit (NIMU) and the acute care stroke unit reviewed, revised and supplemented the institution’s written stroke education materials, and created standard work for providing initial and ongoing stroke education. The standard work focuses on providing a personalized stroke education packet within 24 hours of admission, breaking down key concepts into individual teaching points, and daily documentation of education. This standard work was then shared with the RNs from all three units via e-mail, flyers, and review at change of shift huddles and staff meetings. Daily audits were performed with email reminders going out to RNs who cared for patients who had no stroke education documented for >24 hours. Public recognition was given to RNs who consistently documented stroke education including a drawing for a $50 gift card on each unit. Results: To evaluate the effectiveness of the new standard work we compared the number of days with documented stroke education for 6-week periods before and after implementation of the standard work. In the neuro ICU and NIMU, the number of patient days with documented stroke education increased from 10% (8/79) prior to implementation to 65% (126/194) after implementation. In the stroke unit, days with documented stroke education increased from 31% (40/129) to 72% (156/216). Conclusion: Developing and implementing standard work for the process of stroke education and following up with documentation audits, one-on-one feedback, public recognition and prize drawings led to earlier stroke education and significantly increased the frequency of stroke education.