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Queen of the Valley Nurses Get Special Training in Stroke Assessment

03/14/2017

Jill Ford, RN, and Sarah Leon, RN, are among 450 nurses at Queen of the Valley Medical Center being trained to fine-tune their stroke assessment skills using a very special “patient.” This training is critical because early detection of stroke may minimize its long-term effects and even prevent death. Funding for the training was provided through an $88,020 grant from The Doctors Company Foundation.

In this training session, Hal®—an advanced medical simulation mannequin—is a middle-aged man who rarely visited a doctor. He presents to the ER and is placed in an exam room with a bed, fully equipped medicine cart, and vital signs monitor. The nurses ask Hal to describe his symptoms.

“I feel okay now, but I keep getting headaches that come and go,” he says in a garbled voice. “I’m having a pins-and-needles sensation, but only on the right side of my face.”

“Can you lift your arms?” Leon asks.

“I can only move my left arm,” Hal responds.

The caregivers identify the warning signs of a stroke, which occurs when blood stops flowing to the brain. They identify facial drooping, arm weakness, and speech difficulty. Ford shines a light in Hal’s eyes, but his pupils remain dilated. He then suffers an apparent seizure.

“If you’ve had a stroke, you’re at a 30 percent greater risk of seizure,” trainer Karen Canepa, RN, informs the five nurses in the training—Ford and Leon, who do the initial assessment, and three others who observe the scenario.

“Hal, we think you may have had a stroke and a seizure,” Leon says as they wrap up the scenario. “We’ve paged a neurologist and called the Rapid Response Team. We’re going to take you to have a CT scan so we can take a closer look at your brain.”

According to the Agency for Healthcare Research and Quality, simulation training allows healthcare providers to apply theoretical knowledge in a controlled environment without risks to patients.

“Simulation training supports our goal of providing patients with the highest quality of care,” said JoAnn Munski, RN, nursing director of orthopedic, neuroscience, and rehabilitation services at the Queen.

Many aspects of a real-life situation can be simulated, according to trainers Suzy Banuelos, RN, and Nancy Stump, RN. Hal breathes and blinks. His pupils react to light. He can talk through pre-programmed or real-time speech controlled by a trainer. Trainers can add a bluish tint to his skin tone to show lack of oxygen. They can change his body temperature, blood pressure, pulse, and respiratory rate. Nurses can inject medicine into his veins and perform a tracheotomy.

“This training ensures that all of our nurses—whether they are in the ER, intensive care unit, or elsewhere in the hospital—are proficient at finding risk factors so they can make safer and faster assessments,” said neurohospitalist Matthew Ho, MD, stroke director at the Queen.

Queen of the Valley nurses (left to right) Nancy Stump, Suzy Banuelos, and Jill Ford assess Hal for stroke.

Jill Ford (left) and JoAnn Munski, nursing director of the hospital’s neuroscience program, care for Hal.

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