What began as a Clinical Scene Investigator (CSI) Academy project at Fairbanks Memorial Hospital in 2019, will be presented during the American Association of Critical Care Nurses (AACN) 2022 NTI conference May 16-18 in Houston, Texas. The national conference, which draws anywhere from 7-10 thousand critical care nurses from across the country, offers over 200 educational sessions covering both clinical and professional development topics. Dawn Brefczynski, AAS, RN, CCRN and Nellie Toy, MSN, RN, CCRN will present FHP’s stroke education program during a breakout session at the conference.

“Our intent was to present this as a poster presentation,” Toy said. “After speaking with our mentor at AACN we were encouraged to apply for a live presentation and were thrilled to be accepted.”

Both Brefczynski and Toy are adamant that they are only presenting the work, and by no means take full credit for it. Sponsored by Patient Education, the CSI team that originally developed the project consisted of Deseree Baker, BSN, RN; Dawn Brefczynski, AAS, RN, CCRN; Sena Gilbert, CCC-SLP; Helen Graves, CCC-SLP; Rachel Osborn, BSN, RN; and Sandy Scrase, AAS, RN. The project, dubbed Spot a Stroke Fast, sought to provide consistent, high quality stroke education for patients through the American Heart Association (AHA) Get with The Guidelines® program.

“Everybody was teaching something different,” Brefszynski said. “We were failing to meet the needs of our patents.”

Recognizing that short-coming, the CSI team redesigned the education tool into a simple one-page tip sheet, written in a manner that the average patient could understand, to help recognize the early signs of stroke using the FAST (Face, Arms, Speech, Time) acronym. The FHP Stroke Committee, with the blessing from FHP leadership, recently updated to BEFAST (adding Balance and Eyes). The tool also included a check list for the bedside nurse to review with their patients during discharge, and a prompt to document the education.

CSI team members Sandy Scrase, AAS, RN and Deseree Baker, BSN, RN brought the project to the FHP Stroke Committee, which quickly approved the tool and began sharing it with bedside units throughout the health system.  

“The buy-in has been phenomenal,” Toy said. “I round in ICU every day and see how it has become such an integral part of what the nurses automatically do. We as educators don’t have to prompt them at all.  We have seen stratospheric change in the percentage of provided patient education, even through COVID which I think is huge.”

Audits from Get with The Guidelines® show a 12.7% increase in quality measures focused on stroke education from 2018 (81.8%) to 2021 (94.5%). The stroke committee has begun to push the tool to non-bedside areas of the hospital, health system and community.

“We are continuing the work,” Toy said. “We are teaching stroke recognition to every employee of the system and asking them to take it to the community. That was an additional factor that impressed AACN.”

The power of this work hit home when Rose Wingerter, OR, RN began showing symptoms of a stroke while at work. The staff immediately recognized the symptoms and got her to the ED for scans and medicine. She was eventually flown to Providence in Anchorage for further evaluation and has since recovered and returned to work. Toy notes that this incident occurred shortly after the OR team received stroke education. She has Rose’s permission to share the experience and the powerful quote on the slide below during the NTI conference.

This marks the third time FHP has presented at AACN. Stay tuned for updates from Houston, as in addition to our presenters, FHP will send a large contingent critical care staff to the conference.