Stroke patients need specific discharge instructions to ensure they receive continuous medical care after leaving the hospital. This can help to reduce complications, readmissions, and improve outcomes. Per the AHA Get With The Guidelines Stroke guidelines, the education provided should be provided in writing to the patient and/or caregiver and should address the following five topics: Risk Factors, How to Activate EMS, Their Prescribed Medications, Warning Signs and Symptoms, and Need for Follow-Up After Discharge. See below for more detail:
- Risk Factors: must specifically address risk factors related to stroke. For example: AFib, smoking, diabetes, hypertension, obesity, prior stroke.
- Activate EMS: must address activation of EMS if signs or symptoms of stroke occur. For example: “Call 911 immediately if you experience signs or symptoms of stroke, such as numbness or weakness of an extremity”.
- Their Prescribed Medications: must be listed on the discharge instructions by name. This is a two step process. First you need to compile a list of all of the medications prescribed at discharge and then you need to check the list of discharge medications against the written discharge instructions given to the patient. This is to ensure that the discharge instructions address at least the name of all of the discharge medications prescribed.
- Stroke patients need specific medications to treat the effects of a stroke and to reduce their risk of another. Some medications they may need are Antithrombotic and/or Anticoagulant medications, Cholesterol-Reducing medications, antihypertensive medications, and antihyperglycemic medications if they have a diagnosis of diabetes.
- Warning Signs and Symptoms: must address what to do if warning signs or symptoms of stroke or TIA are noted. For example: “Call 911 immediately if you experience signs or symptoms of stroke, such as numbness or weakness of an extremity”.
- Need for Follow-Up After Discharge: must address follow-up after discharge. For example: “It is important for you to keep all follow-up appointments with your physician and rescheduled appointments that you cannot make as soon as possible”.
A Stroke Badge Buddy has been created by Registry Partners to help remind all staff what is needed at discharge for a Stroke patient. This can be downloaded here or request a physical copy mailed directly to you and your team.
References:
AHA GWTG-Stroke Coding Instructions June 2024