Streamlining Stroke Diagnostics: A Multidisciplinary Approach Involving Nursing, Radiology, Public Health and Laboratory Departments
Main Article Content
Keywords
Stroke management, multidisciplinary approach, nursing in stroke care, radiology in stroke, public health in stroke, laboratory services in stroke, acute stroke care, stroke diagnosis.
Abstract
The management of stroke involves a multidisciplinary approach encompassing nursing, radiology, public health, and laboratory services. Early diagnosis and immediate treatment are critical for optimizing patient outcomes and minimizing complications. Nurses play an essential role in initial assessments, acute care, and rehabilitation efforts. Radiological imaging facilitates the diagnosis of different stroke types and guides treatment decisions. Public health initiatives focus on improving awareness and access to timely care, while laboratory services support diagnosis and monitoring of complications. Effective collaboration among these disciplines can lead to improved patient outcomes and enhanced quality of life for stroke patients. Challenges such as varying protocols and gaps in multidisciplinary communication can hinder optimal management. This review highlights the importance of a coordinated, evidence-based approach in managing stroke patients across the continuum of care and identifies opportunities for future research.
References
Aghaebrahim, A., Streib, C., Rangaraju, S., Kenmuir, C. L., Giurgiutiu, D. V., Horev, A., ... & Jadhav, A. P. (2017). Streamlining door to recanalization processes in endovascular stroke therapy. Journal of Neurointerventional Surgery, 9(4), 340-345.
Alberts, M. J., Perry, A., Dawson, D. V., & Bertels, C. (1992). Effects of public and professional education on reducing the delay in presentation and referral of stroke patients. Stroke, 23(3), 352-356.
Amort, M., Fluri, F., Schäfer, J., Weisskopf, F., Katan, M., Burow, A., ... & Engelter, S. T. (2011). Transient ischemic attack versus transient ischemic attack mimics: frequency, clinical characteristics and outcome. Cerebrovascular Diseases, 32(1), 57-64.
Blacker, D. J. (2003). In-hospital stroke. The Lancet Neurology, 2(12), 741-746.
Chang, P., Ruff, I., Mendelson, S. J., Schwamm, L. H., & Biddinger, P. D. (2018). Development of a novel inpatient stroke detection tool. Stroke, 49(12), 2866-2871.
Cumbler, E., & Simpson, J. (2015). Code stroke: multicenter experience with in-hospital stroke alerts. Journal of Hospital Medicine, 10(3), 179-183.
Cumbler, E., Anderson, T., Neumann, R., Jones, W. J., Brega, K., & Vallurupalli, S. (2010). Stroke alert program improves recognition and evaluation time of in-hospital ischemic stroke. Journal of Stroke and Cerebrovascular Diseases, 19(6), 494-496.
Cumbler, E., Murphy, P., Jones, W. J., Wald, H. L., Kutner, J. S., & Smith, D. B. (2011). Quality of care for in-hospital stroke: analysis of a statewide registry. Stroke, 42(1), 207-210.
Fassbender, K., Grotta, J. C., Walter, S., Grunwald, I. Q., Ragoschke-Schumm, A., & Saver, J. L. (2017). Mobile stroke units for prehospital thrombolysis, triage, and beyond: benefits and challenges. The Lancet Neurology, 16(3), 227-237.
Fayyaz, J., Dmytriw, A. A., Yu, E., Tyrrell, P., Manoharan, M., Kehrer, M., ... & Montanera, W. (2019). Predicting large vessel occlusion with transcranial Doppler in patients with stroke. Journal of Neurointerventional Surgery, 11(5), 524-528.
Hart, R. G., Diener, H. C., Coutts, S. B., Easton, J. D., Granger, C. B., O'Donnell, M. J., ... & Connolly, S. J. (2014). Embolic strokes of undetermined source: the case for a new clinical construct. The Lancet Neurology, 13(4), 429-438.
Heldner, M. R., Zubler, C., Mattle, H. P., Schroth, G., Weck, A., Mono, M. L., ... & Fischer, U. (2013). National Institutes of Health Stroke Scale score and vessel occlusion in 2152 patients with acute ischemic stroke. Stroke, 44(4), 1153-1157.
Johnston, S. C., Rothwell, P. M., Nguyen-Huynh, M. N., Giles, M. F., Elkins, J. S., Bernstein, A. L., & Sidney, S. (2007). Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet, 369(9558), 283-292.
Kassardjian, C. D., Willems, J. D., Skrabka, K., Nisenbaum, R., Barnaby, J., Kostyrko, P., ... & Kapral, M. K. (2017). In-patient code stroke: a quality improvement strategy to overcome knowledge-to-action gaps in response time. Stroke, 48(8), 2176-2183.
Kim, J. T., Fonarow, G. C., Smith, E. E., Reeves, M. J., Navalkele, D. D., Grotta, J. C., ... & Saver, J. L. (2017). Treatment with tissue plasminogen activator in the golden hour and the shape of the 4.5-hour time-benefit curve in the National United States Get With The Guidelines-Stroke Population. Circulation, 135(2), 128-139.
Lima, F. O., Silva, G. S., Furie, K. L., Frankel, M. R., Lev, M. H., Camargo, É. C., ... & Nogueira, R. G. (2016). Field assessment stroke triage for emergency destination: a simple and accurate prehospital scale to detect large vessel occlusion strokes. Stroke, 47(8), 1997-2002.
Merwick, Á., Albers, G. W., Amarenco, P., Arsava, E. M., Ay, H., Calvet, D., ... & Kelly, P. J. (2010). Addition of brain and carotid imaging to the ABCD2 score to identify patients at early risk of stroke after transient ischaemic attack: a multicentre observational study. The Lancet Neurology, 9(11), 1060-1069.
Mikulik, R., Alexandrov, A. V., Ribo, M., Garami, Z., Porche, N. A., Fulep, E., ... & Wojner-Alexandrov, A. W. (2006). Telemedicine-guided carotid and transcranial ultrasound: a pilot feasibility study. Stroke, 37(1), 229-230.
Moreau, F., Asdaghi, N., Modi, J., Goyal, M., & Coutts, S. B. (2019). Usage of ASPECT Score on Computed Tomography and Outcome in Patients Undergoing Endovascular Therapy. Stroke, 50(4), 988-993.
Mulkerin, W. D., Spokoyny, I., Francisco, J. T., Barker, S. A., Schwartz, T. H., Simmons, S., ... & Meyer, B. C. (2021). Prehospital identification of large vessel occlusions using Modified National Institutes of Health Stroke Scale: A Pilot Study. Frontiers in Neurology, 12, 643356.
Nolan, S., Naylor, G., & Burns, M. (2003). Code gray--an organized approach to inpatient stroke. Critical Care Nursing Quarterly, 26(4), 296-302.
Saltman, A. P., Silver, F. L., Fang, J., Stamplecoski, M., & Kapral, M. K. (2015). Care and outcomes of patients with in-hospital stroke. JAMA Neurology, 72(7), 749-755.
Scheitz, J. F., Abdul-Rahim, A. H., MacIsaac, R. L., Cooray, C., Sucharew, H., Kleindorfer, D., ... & SITS Scientific Committee. (2017). Clinical selection strategies to identify ischemic stroke patients with large anterior vessel occlusion: results from SITS-ISTR (Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry). Stroke, 48(2), 290-297.
Schürmann, K., Nikoubashman, O., Falkenburger, B., Tauber, S. C., Wiesmann, M., Schulz, J. B., ... & Reich, A. (2016). Risk profile and treatment options of acute ischemic in-hospital stroke. Journal of Neurology, 263(3), 550-557.
Yoo, J., Song, D., Baek, J. H., Lee, K., Jung, Y., Cho, H. J., ... & Heo, J. H. (2016). Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients. International Journal of Stroke, 11(6), 656-662.
Alberts, M. J., Perry, A., Dawson, D. V., & Bertels, C. (1992). Effects of public and professional education on reducing the delay in presentation and referral of stroke patients. Stroke, 23(3), 352-356.
Amort, M., Fluri, F., Schäfer, J., Weisskopf, F., Katan, M., Burow, A., ... & Engelter, S. T. (2011). Transient ischemic attack versus transient ischemic attack mimics: frequency, clinical characteristics and outcome. Cerebrovascular Diseases, 32(1), 57-64.
Blacker, D. J. (2003). In-hospital stroke. The Lancet Neurology, 2(12), 741-746.
Chang, P., Ruff, I., Mendelson, S. J., Schwamm, L. H., & Biddinger, P. D. (2018). Development of a novel inpatient stroke detection tool. Stroke, 49(12), 2866-2871.
Cumbler, E., & Simpson, J. (2015). Code stroke: multicenter experience with in-hospital stroke alerts. Journal of Hospital Medicine, 10(3), 179-183.
Cumbler, E., Anderson, T., Neumann, R., Jones, W. J., Brega, K., & Vallurupalli, S. (2010). Stroke alert program improves recognition and evaluation time of in-hospital ischemic stroke. Journal of Stroke and Cerebrovascular Diseases, 19(6), 494-496.
Cumbler, E., Murphy, P., Jones, W. J., Wald, H. L., Kutner, J. S., & Smith, D. B. (2011). Quality of care for in-hospital stroke: analysis of a statewide registry. Stroke, 42(1), 207-210.
Fassbender, K., Grotta, J. C., Walter, S., Grunwald, I. Q., Ragoschke-Schumm, A., & Saver, J. L. (2017). Mobile stroke units for prehospital thrombolysis, triage, and beyond: benefits and challenges. The Lancet Neurology, 16(3), 227-237.
Fayyaz, J., Dmytriw, A. A., Yu, E., Tyrrell, P., Manoharan, M., Kehrer, M., ... & Montanera, W. (2019). Predicting large vessel occlusion with transcranial Doppler in patients with stroke. Journal of Neurointerventional Surgery, 11(5), 524-528.
Hart, R. G., Diener, H. C., Coutts, S. B., Easton, J. D., Granger, C. B., O'Donnell, M. J., ... & Connolly, S. J. (2014). Embolic strokes of undetermined source: the case for a new clinical construct. The Lancet Neurology, 13(4), 429-438.
Heldner, M. R., Zubler, C., Mattle, H. P., Schroth, G., Weck, A., Mono, M. L., ... & Fischer, U. (2013). National Institutes of Health Stroke Scale score and vessel occlusion in 2152 patients with acute ischemic stroke. Stroke, 44(4), 1153-1157.
Johnston, S. C., Rothwell, P. M., Nguyen-Huynh, M. N., Giles, M. F., Elkins, J. S., Bernstein, A. L., & Sidney, S. (2007). Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet, 369(9558), 283-292.
Kassardjian, C. D., Willems, J. D., Skrabka, K., Nisenbaum, R., Barnaby, J., Kostyrko, P., ... & Kapral, M. K. (2017). In-patient code stroke: a quality improvement strategy to overcome knowledge-to-action gaps in response time. Stroke, 48(8), 2176-2183.
Kim, J. T., Fonarow, G. C., Smith, E. E., Reeves, M. J., Navalkele, D. D., Grotta, J. C., ... & Saver, J. L. (2017). Treatment with tissue plasminogen activator in the golden hour and the shape of the 4.5-hour time-benefit curve in the National United States Get With The Guidelines-Stroke Population. Circulation, 135(2), 128-139.
Lima, F. O., Silva, G. S., Furie, K. L., Frankel, M. R., Lev, M. H., Camargo, É. C., ... & Nogueira, R. G. (2016). Field assessment stroke triage for emergency destination: a simple and accurate prehospital scale to detect large vessel occlusion strokes. Stroke, 47(8), 1997-2002.
Merwick, Á., Albers, G. W., Amarenco, P., Arsava, E. M., Ay, H., Calvet, D., ... & Kelly, P. J. (2010). Addition of brain and carotid imaging to the ABCD2 score to identify patients at early risk of stroke after transient ischaemic attack: a multicentre observational study. The Lancet Neurology, 9(11), 1060-1069.
Mikulik, R., Alexandrov, A. V., Ribo, M., Garami, Z., Porche, N. A., Fulep, E., ... & Wojner-Alexandrov, A. W. (2006). Telemedicine-guided carotid and transcranial ultrasound: a pilot feasibility study. Stroke, 37(1), 229-230.
Moreau, F., Asdaghi, N., Modi, J., Goyal, M., & Coutts, S. B. (2019). Usage of ASPECT Score on Computed Tomography and Outcome in Patients Undergoing Endovascular Therapy. Stroke, 50(4), 988-993.
Mulkerin, W. D., Spokoyny, I., Francisco, J. T., Barker, S. A., Schwartz, T. H., Simmons, S., ... & Meyer, B. C. (2021). Prehospital identification of large vessel occlusions using Modified National Institutes of Health Stroke Scale: A Pilot Study. Frontiers in Neurology, 12, 643356.
Nolan, S., Naylor, G., & Burns, M. (2003). Code gray--an organized approach to inpatient stroke. Critical Care Nursing Quarterly, 26(4), 296-302.
Saltman, A. P., Silver, F. L., Fang, J., Stamplecoski, M., & Kapral, M. K. (2015). Care and outcomes of patients with in-hospital stroke. JAMA Neurology, 72(7), 749-755.
Scheitz, J. F., Abdul-Rahim, A. H., MacIsaac, R. L., Cooray, C., Sucharew, H., Kleindorfer, D., ... & SITS Scientific Committee. (2017). Clinical selection strategies to identify ischemic stroke patients with large anterior vessel occlusion: results from SITS-ISTR (Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry). Stroke, 48(2), 290-297.
Schürmann, K., Nikoubashman, O., Falkenburger, B., Tauber, S. C., Wiesmann, M., Schulz, J. B., ... & Reich, A. (2016). Risk profile and treatment options of acute ischemic in-hospital stroke. Journal of Neurology, 263(3), 550-557.
Yoo, J., Song, D., Baek, J. H., Lee, K., Jung, Y., Cho, H. J., ... & Heo, J. H. (2016). Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients. International Journal of Stroke, 11(6), 656-662.
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Published
May 19, 2022
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How to Cite
Norah Nasser Rajeh Alqahtani7, Mousa Helal Sammar Almutairi8, Ahmed Makhfur Ali Alqarni9, Adel Ali Manea Alahmari10, Saleh Radan Hala Alharthi11, Khalid Ruzayq Sammar Almutairi12, A. F. M. A.-H. H. H. S. A. A. S. T. A. A. M. A. G. S. S. T. A. O. S. S. A. A. (2022). Streamlining Stroke Diagnostics: A Multidisciplinary Approach Involving Nursing, Radiology, Public Health and Laboratory Departments. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1104-1111. https://doi.org/10.53555/jptcp.v29i04.5696
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Norah Nasser Rajeh Alqahtani7, Mousa Helal Sammar Almutairi8, Ahmed Makhfur Ali Alqarni9, Adel Ali Manea Alahmari10, Saleh Radan Hala Alharthi11, Khalid Ruzayq Sammar Almutairi12, A. F. M. A.-H. H. H. S. A. A. S. T. A. A. M. A. G. S. S. T. A. O. S. S. A. A. (2022). Streamlining Stroke Diagnostics: A Multidisciplinary Approach Involving Nursing, Radiology, Public Health and Laboratory Departments. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1104-1111. https://doi.org/10.53555/jptcp.v29i04.5696