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Jeffrey Wagner - One of the best experts on this subject based on the ideXlab platform.

  • The Presence of an Advanced Practice Nurse Stroke Program Coordinator Decreases Door-to-Needle Times (P5.149)
    Neurology, 2015
    Co-Authors: Michelle Whaley, Lisa M Caputo, Jeffrey Wagner
    Abstract:

    OBJECTIVE: The purpose of this study was to determine if the presence of an Advanced Practice Nurse stroke Program Coordinators (APN SPC) decreases door-to-needle (DTN) times in acute stroke patients. BACKGROUND: Benefits of intravenous tissue plasminogen activator (IV-tPA) are greatest when patients are treated immediately. Our Comprehensive Stroke Center hires APN SPC9s to respond to the bedside of acute stroke alert calls. Between 08:00-17:00, an APN SPC works with dedicated on-duty neurologists to rapidly treat acute stroke patients with IV-tPA. DESIGN/METHODS: Data were collected by stroke Coordinator abstractors from January 1, 2010 to June 14, 2014. DTN times were compared using a Student’s t-test between times when an APN SPC was on duty with times the APN SPC was not present. Patient age, time between symptom onset to hospital arrival, and NIH Stroke Scale (NIHSS) categories were compared between groups using Student’s t-test and chi-squared test. RESULTS: There were 245 patients who received IV-tPA over the study period. Over half (52[percnt], n=127) of patients were treated in the presence of an APN SPC; 48[percnt] of patients (n=118) were not treated in the presence of an APN SPC. There were no significant differences in age, time between symptom onset to hospital arrival, or NIHSS values between groups. Median DTN time for patients treated with an APN SPC present was 36 minutes versus 45 minutes for patients treated without an APN SPC present; this 9-minute difference in median DTN time was borderline statistically significant (p=.051). CONCLUSIONS: The presence of an APN SPC was associated with reduced median DTN times. The presence of an APN SPC, in addition to an on duty neurologist, may reduce time between door and needle, engendering improvements in patient outcomes. Disclosure: Dr. Whaley has nothing to disclose. Dr. Caputo has nothing to disclose. Dr. Wagner has received personal compensation for activities with Genentech, Inc.

  • Abstract T P348: The Presence of an Advanced Practice Nurse Stroke Program Coordinator Decreases Door-to-Needle Times
    Stroke, 2015
    Co-Authors: Michelle Whaley, Lisa M Caputo, Jeffrey Wagner
    Abstract:

    Background: Benefits of intravenous tissue plasminogen activator (IV-tPA) are greatest when patients are treated immediately. Our Comprehensive Stroke Center hires Advanced Practice Nurse stroke Program Coordinators (APN SPC) to respond to the bedside of all acute stroke alert calls. Between 08:00-17:00, an APN SPC works with dedicated on-duty neurologists to rapidly treat acute stroke patients with IV-tPA. Purpose: The purpose of this study was to determine if the presence of an APN SPC decreases door-to-needle (DTN) times in acute stroke patients. Methods: Data were collected by stroke Coordinator abstractors from January 1, 2010 to June 14, 2014. DTN times were compared using a Student’s t-test between times when an APN SPC was on duty with times the APN SPC was not present. Patient age, time between symptom onset to hospital arrival, and NIH Stroke Scale (NIHSS) categories were compared between groups using Student’s t-test and chi-squared test. Results: There were 245 patients who received IV-tPA over the study period. Over half (52%, n=127) of patients were treated in the presence of an APN SPC; 48% of patients (n=118) were not treated in the presence of an APN SPC. There were no significant differences in age, time between symptom onset to hospital arrival, or NIHSS values between groups. Median DTN time for patients treated with an APN SPC present was 36 minutes versus 45 minutes for patients treated without an APN SPC present; this 9-minute difference in median DTN time was borderline statistically significant (p=.051). Conclusion: The presence of an APN SPC was associated with reduced median DTN times. The presence of an APN SPC, in addition to an on duty neurologist, may reduce time between door and needle, engendering improvements in patient outcomes.

Katherine Clarkson - One of the best experts on this subject based on the ideXlab platform.

  • Abstract 3635: Mentoring a Stroke Program Coordinator: A Planned, Staged Approach
    Stroke, 2012
    Co-Authors: Donna Nolten, Katherine Clarkson
    Abstract:

    Background and Issues: Transitions between stroke Coordinators can have a deleterious effect upon stroke Program development and operations. Typically, a one-month notice of resignation is given. This allows insufficient time to advertise, interview, hire and train or orient new staff. Complicating the issue, the number of experienced stroke Coordinators has not kept pace with demand. Hence, extensive training may be required for the replacement if one with experience is not available. Purpose: The purpose of our project was to prepare for a seamless transition between a retiring stroke Coordinator and her replacement while maintaining quality and adding neurovascular intervention to the Program. Methods: Our facility provides a phased-retirement Program that allows gradual transition between full time employment and retirement. In July 2009, a eighty percent stroke Coordinator position was split between a Coordinator mentee and the experienced Coordinator mentor. Over an eighteen-month period, responsibilities were gradually shifted to the replacement with ongoing education, guidance and support from the previous Coordinator. For the first six months, orientation and coaching took place on an almost daily basis. Over the following year, progressive periods were planned for independent Program management with available backup and support Results: A cerebrovascular intervention Program was successfully implemented during the period. Primary Stroke Center Certification was maintained. Compliance with stroke performance measures did not decrease. The Get with the Guidelines Gold Plus Award was received for 2009, 2010 and 2011. Acute stroke treatment rates increased due to Program enhancements and improvements during the period. Conclusions: This planned, progressive approach to Program leadership transition allowed sufficient training for the replacement Coordinator. At the conclusion of the process, the mentee stepped into the full-time position. This seamless transition provided for successful Program operations and development.

Michelle Whaley - One of the best experts on this subject based on the ideXlab platform.

  • The Presence of an Advanced Practice Nurse Stroke Program Coordinator Decreases Door-to-Needle Times (P5.149)
    Neurology, 2015
    Co-Authors: Michelle Whaley, Lisa M Caputo, Jeffrey Wagner
    Abstract:

    OBJECTIVE: The purpose of this study was to determine if the presence of an Advanced Practice Nurse stroke Program Coordinators (APN SPC) decreases door-to-needle (DTN) times in acute stroke patients. BACKGROUND: Benefits of intravenous tissue plasminogen activator (IV-tPA) are greatest when patients are treated immediately. Our Comprehensive Stroke Center hires APN SPC9s to respond to the bedside of acute stroke alert calls. Between 08:00-17:00, an APN SPC works with dedicated on-duty neurologists to rapidly treat acute stroke patients with IV-tPA. DESIGN/METHODS: Data were collected by stroke Coordinator abstractors from January 1, 2010 to June 14, 2014. DTN times were compared using a Student’s t-test between times when an APN SPC was on duty with times the APN SPC was not present. Patient age, time between symptom onset to hospital arrival, and NIH Stroke Scale (NIHSS) categories were compared between groups using Student’s t-test and chi-squared test. RESULTS: There were 245 patients who received IV-tPA over the study period. Over half (52[percnt], n=127) of patients were treated in the presence of an APN SPC; 48[percnt] of patients (n=118) were not treated in the presence of an APN SPC. There were no significant differences in age, time between symptom onset to hospital arrival, or NIHSS values between groups. Median DTN time for patients treated with an APN SPC present was 36 minutes versus 45 minutes for patients treated without an APN SPC present; this 9-minute difference in median DTN time was borderline statistically significant (p=.051). CONCLUSIONS: The presence of an APN SPC was associated with reduced median DTN times. The presence of an APN SPC, in addition to an on duty neurologist, may reduce time between door and needle, engendering improvements in patient outcomes. Disclosure: Dr. Whaley has nothing to disclose. Dr. Caputo has nothing to disclose. Dr. Wagner has received personal compensation for activities with Genentech, Inc.

  • Abstract T P348: The Presence of an Advanced Practice Nurse Stroke Program Coordinator Decreases Door-to-Needle Times
    Stroke, 2015
    Co-Authors: Michelle Whaley, Lisa M Caputo, Jeffrey Wagner
    Abstract:

    Background: Benefits of intravenous tissue plasminogen activator (IV-tPA) are greatest when patients are treated immediately. Our Comprehensive Stroke Center hires Advanced Practice Nurse stroke Program Coordinators (APN SPC) to respond to the bedside of all acute stroke alert calls. Between 08:00-17:00, an APN SPC works with dedicated on-duty neurologists to rapidly treat acute stroke patients with IV-tPA. Purpose: The purpose of this study was to determine if the presence of an APN SPC decreases door-to-needle (DTN) times in acute stroke patients. Methods: Data were collected by stroke Coordinator abstractors from January 1, 2010 to June 14, 2014. DTN times were compared using a Student’s t-test between times when an APN SPC was on duty with times the APN SPC was not present. Patient age, time between symptom onset to hospital arrival, and NIH Stroke Scale (NIHSS) categories were compared between groups using Student’s t-test and chi-squared test. Results: There were 245 patients who received IV-tPA over the study period. Over half (52%, n=127) of patients were treated in the presence of an APN SPC; 48% of patients (n=118) were not treated in the presence of an APN SPC. There were no significant differences in age, time between symptom onset to hospital arrival, or NIHSS values between groups. Median DTN time for patients treated with an APN SPC present was 36 minutes versus 45 minutes for patients treated without an APN SPC present; this 9-minute difference in median DTN time was borderline statistically significant (p=.051). Conclusion: The presence of an APN SPC was associated with reduced median DTN times. The presence of an APN SPC, in addition to an on duty neurologist, may reduce time between door and needle, engendering improvements in patient outcomes.

James E. Murphy - One of the best experts on this subject based on the ideXlab platform.

  • Expansion of the Coordinator role in orthopaedic residency Program management.
    Clinical orthopaedics and related research, 2008
    Co-Authors: Richard E. Grant, Laurie A. Murphy, James E. Murphy
    Abstract:

    The Accreditation Council of Graduate Medical Education’s (ACGME) Data Accreditation System indicates 124 of 152 orthopaedic surgery residency Program directors have 5 or fewer years of tenure. The qualifications and responsibilities of the position based on the requirements of orthopaedic surgery residency Programs, the institutions that support them, and the ACGME Outcome Project have evolved the role of the Program Coordinator from clerical to managerial. To fill the void of information on the Coordinators’ expanding roles and responsibilities, the 2006 Association of Residency Coordinators in Orthopaedic Surgery (ARCOS) Career survey was designed and distributed to 152 Program Coordinators in the United States. We had a 39.5% response rate for the survey, which indicated a high level of day-to-day managerial oversight of all aspects of the residency Program; additional responsibilities for other department or division functions for fellows, rotating medical students, continuing medical education of the faculty; and miscellaneous business functions. Although there has been expansion of the role of the Program Coordinator, challenges exist in job congruence and position reclassification. We believe use of professional groups such as ARCOS and certification of Program Coordinators should be supported and encouraged.

Donna Nolten - One of the best experts on this subject based on the ideXlab platform.

  • Abstract 3635: Mentoring a Stroke Program Coordinator: A Planned, Staged Approach
    Stroke, 2012
    Co-Authors: Donna Nolten, Katherine Clarkson
    Abstract:

    Background and Issues: Transitions between stroke Coordinators can have a deleterious effect upon stroke Program development and operations. Typically, a one-month notice of resignation is given. This allows insufficient time to advertise, interview, hire and train or orient new staff. Complicating the issue, the number of experienced stroke Coordinators has not kept pace with demand. Hence, extensive training may be required for the replacement if one with experience is not available. Purpose: The purpose of our project was to prepare for a seamless transition between a retiring stroke Coordinator and her replacement while maintaining quality and adding neurovascular intervention to the Program. Methods: Our facility provides a phased-retirement Program that allows gradual transition between full time employment and retirement. In July 2009, a eighty percent stroke Coordinator position was split between a Coordinator mentee and the experienced Coordinator mentor. Over an eighteen-month period, responsibilities were gradually shifted to the replacement with ongoing education, guidance and support from the previous Coordinator. For the first six months, orientation and coaching took place on an almost daily basis. Over the following year, progressive periods were planned for independent Program management with available backup and support Results: A cerebrovascular intervention Program was successfully implemented during the period. Primary Stroke Center Certification was maintained. Compliance with stroke performance measures did not decrease. The Get with the Guidelines Gold Plus Award was received for 2009, 2010 and 2011. Acute stroke treatment rates increased due to Program enhancements and improvements during the period. Conclusions: This planned, progressive approach to Program leadership transition allowed sufficient training for the replacement Coordinator. At the conclusion of the process, the mentee stepped into the full-time position. This seamless transition provided for successful Program operations and development.