Latin American Stroke Centers Certification
To verify the classification of your center fill this form - TEST
Email address *
I. Identification
Name of Hospital *
Address of Hospital *
Country *
City *
State *
Person responsible *
Person responsible for answering the questionnaire (Name and position in the hospital)
Coordinator stroke program *
Name of coordinator of stroke program
Eletronic Records *
Does your hospital use electronic records?
SITS-QR/RES-Q *
Is your hospital using SITS-QR or RES-Q registries?
Other registry? *
Is your hospital using other quality indicators registry for stroke? (no SITS-QR or RES-Q)
II. Characteristics of hospital
Your hospital is: *
Number of beds in the hospital *
Number of strokes in 1 year *
Number of IV thrombolysis in 1 year *
Number of thrombectomies in 1 year - if not available, please answer 0 (zero) *
Type of stroke center: *
Are you applying for certification of your stroke center as?
ACCESS TO HYPERACUTE STROKE CARE *
Are there protocols for rapid evaluation and diagnosis of stroke patients in Hospital/Emergency department 24hours/day, 7days/week, with time metrics assessment?
ACCESS TO BASIC DIAGNOSIS SERVICES
Which one(s) of the following are available in your hospital?
Laboratory blood test 24/7 *
Complete blood count, electrolytes, urea, glucose, INR, PT available 24 hours a day, 7 days a week
Electrocardiogram 24/7 *
Electrocardiogram (12 lead) available 24 hours a day, 7 days a week
Computed Tomography (CT) brain scan available 24/7 *
Computed Tomography (CT) brain scan in the hospital (on site) available 24 hours/day, 7 days/week
CTA capability 24/7 *
capability to do Computed Tomography Angiography (CTA) in the hospital (on site) 24h/7 days
Transthoracic Echocardiogram *
Echocardiography is available in your hospital?
Vascular Doppler ultrasound *
Extracranial Doppler ultrasound is available in your hospital?
Holter monitors *
Prolonged ECG monitoring devices (Holter monitors) are available in your hospital?
ADVANCED DIAGNOSTIC SERVICES
Which one(s) of the following are available in your hospital?
Magnetic Resonance Imaging (MRI) *
MRI is available in your hospital (on site)?
MR Angiography *
MRA is available in your hospital (on site)?
CT or MR Perfusion scans *
CT or MR perfusion are available in your hospital (on site)?
Prolonged ECG monitoring *
Prolonged ECG monitoring devices is available in your hospital (on site)?
Transcranial Doppler *
Transcranial Doppler is available in your hospital?
Transesophageal Echocardiogram *
Transesophageal Echocardiogram is available in your hospital?
ACCESS TO AMBULANCE *
Is there access to emergency medical services (EMS - ambulance)?
Ambulance - training *
Training of ambulance crews to identify stroke signs using FAST mnemonic or similar?
Ambulance - priority *
Work with ambulance systems to have stroke identified as a high priority transport emergency
NURSING AVAILABILITY
Access to nurses and nursing assessment with stroke training (tick all that apply):
Nurse for acute care *
Access to nurses and nursing assessment with stroke training in acute care
Nurse for stroke unit *
Access to nurses and nursing assessment with stroke training in stroke unit settings
STROKE SPECIALISTS 24/7 FOR THROMBOLYSIS *
Access to neurologist with expertise in stroke 24/7 or other doctors with expertise in stroke (should include expertise TO TREAT ACUTE STROKE). Check below the specialist responsible for THROMBOLYSIS treatment in your hospital (check all available):
Required
STROKE SPECIALISTS FOR PREVENTION AND REHABILITATION *
Access to physicians with stroke expertise in stroke prevention and stroke rehabilitation
PROGRAM TO DEVELOP COMPETENCIES *
Is there a program to develop and maintain core competencies in stroke care?
Stroke Unit inpatient stroke care *
Access to acute inpatient stroke care in a stroke unit (exclusive or clustered)
Stroke Unit (Exclusive) *
Access to a Stroke Unit (a defined group of beds, staff, and protocols that are used for the acute care of patients with a stroke)
Clustered stroke unit *
Access to a clustered model of stroke unit on same ward
THROMBOLYSIS *
Access to IV thrombolysis 24h/day, 7days/week:
INTERDISCIPLINARY STROKE TEAM
Are there members of an interdisciplinary stroke team?
Neurologist with stroke expertise (or Stroke physician) *
Stroke Nurses *
Nurses with training in stroke
Nursing assistants *
Pharmacist *
Social worker/case manager *
Palliative Care team *
Physiotherapist *
Occupational Therapist *
Speech Therapist *
Neurosurgeon *
Neurointerventionalist 24/7 *
Access to Neurointerventionalist available 24/7 ((Interventional Neurologist OR Endovascular Neurosurgeon OR Interventional Neuroradiologist)
STROKE UNIT PROTOCOLS
Is there access to stroke unit protocols to guide acute stroke care based on best practice guidelines?
Swallowing assessment *
You can check "yes" If is described that swallowing has not been evaluated because the patient is intubated or in coma,
Nutrition, hydration *
Mobility and prophylaxis *
Functional status, mobility, DVT risk and prophylaxis protocols
Level of dependency *
Evaluation of level of dependency
Skin Integrity *
Evaluation of skin Integrity
Continence *
Evaluation of bladder and bowel continence
Temperature *
Temperature management
Positioning, mobilization *
Prevention therapies *
Access to stroke prevention therapies such as antiplatelet therapy, anticoagulants, statins, lifestyle change recommendations, blood pressure management
ADVANCED INTERVENTIONS
Which of the following advanced interventions are available?
Endovascular thrombectomy 24/7 *
Is endovascular thrombectomy available 24/7?
Neurosurgery for hemorrhagic stroke *
Hemicraniectomy for ischemic stroke *
Acute inpatient stroke units *
Intensive care unit on site *
Products to reverse coagulopathy *
REHABILITATION
Access to stroke rehabilitation services (tick all that are available):
Early Rehabilitation *
Early access to rehabilitation therapies – including cross training of skills to nurses, nursing assistants and family members
Early Functional Assessment *
Early functional assessments, goal setting and individualized rehab plans developed
STROKE CARE ORGANIZATION
Stroke Care Organization (with or without stroke unit)
Weekly meetings *
Interdisciplinary meetings weekly to discuss patient progress against treatment goals; update management plans
Patient and family education *
Are patient and family education, skills training, and involvement in care planning being applied?
Discharge *
Is a discharge planning always available?
Stroke training *
Stroke training programs for all levels of healthcare providers:
Quality assessment *
Participation in quality assessment of services (registry):
Material for patients *
Printed stroke patient educational materials:
GEOGRAPHICALLY DISCRETE REGIONS
Fully coordinated stroke care provided across geographically discrete regions
Stroke pathways in the region *
Stroke pathways that define movement of stroke patients across region to higher and lower levels of services as required
Coordinated referral system *
Telestroke *
Provide telestroke consultations to smaller and more rural centres
Ambulance agreement *
Ambulance bypass agreements in place in the region
Ambulance agreement *
Ambulance bypass agreements in place in the region
Research in stroke *
Research in stroke implemented
PASSWORD REQUEST FOR APPLICATION
To officially apply for certification, include here the name, email and phone number of the person responsible for application. We will send a password for application. It can be the director of hospital (or the representative of the director) or the coordinator of stroke center/stroke unit
A copy of your responses will be emailed to the address you provided.
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