Big changes in stroke care

Professor Geoffrey Cloud, Director of Stroke Services at The Alfred said 2021 AuSCR ( Australian stroke care registry) data showed the hospital was below average for prescribing targeted stroke secondary prevention medications to patients on discharge. 

“Our change, was to give pharmacists a more prominent role, including having them join the stroke ward rounds where they were empowered to take a more proactive approach.” 

The Alfred also asked pharmacists to educate new nurses, doctors and new pharmacists on the stroke ward, and added a reminder about secondary stroke prevention medications into each discharge summary. 

“One year later, after making the changes, I’m pleased to say we’re above the benchmark for prescribing antihypertensive and antithrombotic medications, and above the national average for lipid-lowering medications,” Prof Cloud said. 

Senior Pharmacist with Alfred Brain Service, Sookyung Yoo, said the improved data this year is not just a reflection of pharmacists but testament to the collaboration between dedicated members of the stroke team working towards the common goal.

“One of our goals was to improve awareness through pharmacist led education to the clinical staff on the strokewWard, focusing on the “four pillars” of secondary stroke prevention which includes antithrombotic therapy, lipid lowering therapy, anti-hypertensive therapy and smoking cessation therapy,” Soo said.  

“It’s great to see the hard work pharmacy has put in has made a difference. But it’s not just pharmacy, we have lots of people coming together with the same goal.” 

Soo said another initiative has been calling patients one week after discharge, to check how they are going and whether they need any further information – which has been very successful.   

The Alfred stroke unit is also home to Advanced Neurovascular Practitioner Estelle Hamson, who is one of only two in Australia. 
 
In November this year, stroke clinical nurse consultant Estelle completed the NETSMART fellowship (Neurovascular Education and Training in Stroke and Acute Reperfusion Therapies), in Phoenix, Arizona. This is an online advanced stroke education course run out of the US for stroke advanced practice nurses. Estelle also completed an onsite clinical validation and received a clinical excellence award. 

“Completing the course has made a phenomenal difference with my examination skills, scan interpretation – there are so many benefits for patients,” she said. 

“Nurses make a huge difference in the outcomes of stroke care. At The Alfred we have a culture that strives for the best evidence-based stroke care, and improving outcomes for patients.”