Population ageing is a challenge across the world, and China is no exception. Due to the one-child policy, rural/urban migration and other social changes, the traditional long-term care (LTC) for the elderly which was through direct family care in the past will no longer suffice. Barely existent now, both institutional and community-based services are expanding to meet the growing need. China is still at an earlier stage in economic development and will be challenged to build these services and train staff.
After a stroke, you may need rehabilitation (rehab) to help you recover. Before you are discharged from the hospital, social workers can help you find care services and caregiver support to continue your long-term recovery. It is important to work with your health care team to find out the reasons for your stroke and take steps to prevent another stroke.
A stroke, also called a brain attack, occurs when blood flow to the brain is disrupted. This disruption is caused when either a blood clot block one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke). The brain needs a constant supply of oxygen and nutrients in order to function and its cells begin to die after just a few minutes without either.
The American Heart Association/American Stroke Association strives to ensure that everyone who has heart disease or a stroke receives treatment at a hospital with the resources necessary to correctly make time-critical decisions. This recognition demonstrates Marshall Medical's high commitment to following the procedures outlined in a national program known as “Get With The Guidelines-Stroke," proven to improve patient outcomes.
When someone is having symptoms of a stroke – slurred speech, sudden leg or arm weakness, facial drooping, loss of balance or visual changes – getting them to the hospital quickly can mean the difference between recovery and permanent disability. One of the best treatments for ischemic stroke is treatment with the clot-busting drug, intravenous tissue plasminogen activator, or IV tPA. If given in the first three hours after the start of stroke symptoms, IV tPA has been shown to significantly reduce the effects of stroke and lessen the chance of permanent disability. UofL Hospital Stroke Center staff strive to deliver IV tPA to appropriate patients within 45 minutes to one hour from the time they arrive at the hospital.
tPA improves the chances of recovering from a stroke. Studies show that patients with ischemic strokes who receive tPA are more likely to recover fully or have less disability than patients who do not receive the drug.2,3 Patients treated with tPA are also less likely to need long-term care in a nursing home.4 Unfortunately, many stroke victims don’t get to the hospital in time for tPA treatment. This is why it’s so important to recognize the signs and symptoms of stroke right away and call 9-1-1.
Betty Coffman is a Health Communications Specialist, working on the Health Sciences Campus with departments in the School of Medicine. A UofL alumna and Louisville native, she served as a writer and editor for local and national publications and as an account services coordinator and copywriter for marketing and design firms prior to joining UofL’s Office of Marketing and Communications.
According to the American Heart Association/American Stroke Association’s website, numerous published studies demonstrate the Get With The Guidelines®- Stroke program’s success in improving patient outcomes. Since it started in 2003, more than 2,000 hospitals have entered more than 5 million patient records into the Get With The Guidelines®- Stroke database.
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The Acute Stroke Management module provides guidance to healthcare providers caring for people who present to the healthcare system with current or very recent symptoms of acute stroke or transient ischemic attack (TIA). This module also addresses the issue of public and healthcare provider’s recognition of the signs of stroke and immediate actions to take, including contacting emergency medical services, arriving at a stroke – enabled emergency department, and launching local healthcare institution code stroke protocols. It represents care at the outset and in the middle of the stroke continuum (Figure 1). Stroke patients may move back and forth between different stages of care as their healthcare needs and situation changes.
The GWTG-Stroke program is a voluntary program created by the American Heart Association and made available to all hospitals in the U.S. in 2003. To receive a PAA from the program, participating hospitals must meet each of seven individual performances measures -- such as prescription of anti-thrombotic medication within 48 hours of admission -- in 85% of hospitalizations for at least 1 year.
Before the inspection, we reviewed the information we held about the service. This included the previous inspection report and notifications since the last inspection. Notifications are changes, events and incidents that the service must inform us about. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.