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Discharge after stroke

Evaluation of callback data

Nursing made Incredibly Easy: July/August 2019 - Volume 17 - Issue 4 - p 1
doi: 10.1097/01.NME.0000568816.18501.fb
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GENERAL PURPOSE: To provide information about a study to evaluate the clinical advantages of instituting telephone callbacks for patients discharged after stroke. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Explain the rationale for instituting a telephone callback system for patients discharged after stroke. 2. Identify the parameters for the callback schedule and the resulting data obtained from the patients contacted.

  1. Discharge planning for patients who've experienced a stroke should be started
    1. once the patient is stabilized.
    2. no less than 1 week before discharge.
    3. at admission.
  2. After discharge, patients who've had a stroke are more likely to experience adverse events within
    1. 1 week.
    2. 3 weeks.
    3. 5 weeks.
  3. The patients most vulnerable to adverse outcomes are those who are
    1. older and/or have lower literacy levels.
    2. younger with a smoking history of more than two packs a day.
    3. middle-aged inactive men.
  4. Postdischarge follow-up calls have been shown to achieve all of the following except
    1. decreased ED visits.
    2. increased staff satisfaction in working with the patients.
    3. reduced hospital readmissions.
  5. For this study, patients discharged after stroke received follow-up telephone calls from an RN
    1. within 24 hours of discharge.
    2. to make appointments for follow-up care.
    3. from 48 to 72 hours after discharge.
  6. The telephone follow-up calls were made between
    1. 10 a.m. and 12 p.m., and then 4 p.m. and 6 p.m.
    2. 9 a.m. and 6 p.m.
    3. 10 a.m. and 4 p.m., Monday through Saturday.
  7. If the RN received no response to the first telephone call, the second attempt took place no later than the
    1. third postdischarge day.
    2. fifth postdischarge day.
    3. seventh postdischarge day.
  8. According to the CMS,
    1. readmission for stroke is one of the 10 most preventable poststroke complications.
    2. sticking to a healthy diet significantly reduces the possibility of future stroke.
    3. smoking cessation is as important as clinic follow-up in preventing hospital readmissions.
  9. The authors state that the array of deficits experienced by patients who've had a stroke demands
    1. that rehabilitation for improved quality of life be started as soon as possible.
    2. that caregivers must be given authority to carry out important decisions.
    3. effective communication among systems, providers, and patients.
  10. The major goals of transitional care
    1. include ensuring that caregivers understand the significance of their role.
    2. are to prevent readmission and diminish adverse events.
    3. focus on the patient's ability to become more independent.
  11. A study referenced by the authors reported that stroke or cerebrovascular disease readmissions were avoidable at the rate of
    1. 53%.
    2. 63%.
    3. 73%.
  12. This study revealed that 65% of stroke patients with a 30-day readmission failed to
    1. take their prescribed medications every day.
    2. give up smoking.
    3. attend stroke clinic appointments.
  13. One of the main reasons that the authors initiated a study of the value of telephone callbacks for patients discharged after stroke was
    1. the presence of supporting literature affirming the value of this practice.
    2. patients' requests for access to hospital staff after discharge.
    3. the failure of previous programs to reduce adverse events in this patient population.
  14. Among the discharged patients and caregivers called for feedback, the largest proportion (67%) expressed concern about
    1. patients' adherence to their medication regime.
    2. transitions of care.
    3. patients' failure to give up smoking.
  15. In their callback responses, patients reported that the issue causing the most difficulty was
    1. prescriptions.
    2. obtaining outpatient therapy services.
    3. obtaining follow-up appointments.
  16. Of the 207 patients surveyed in this study, hospital readmissions were reported by
    1. 3%.
    2. 5%.
    3. 7%.
  17. Evidence shows that stroke patients with certain cardiovascular risks are four times more likely to have another stroke if their adherence to their medication regime is only
    1. 55%.
    2. 65%.
    3. 75%.
  18. Reduced readmission rates of patients discharged after stroke have resulted from
    1. setting up neurologist appointments before discharge.
    2. having patients sign a “contract” to adhere to their discharge instructions.
    3. assigning a dedicated staff member to ensure that patients keep all appointments.
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