Authors (including presenting author) :
Yip KY(1), Mok YNM(1), Lee TY(1), Chan YS(1), Wong TWD(1), Cheung CM(1)
Affiliation :
(1) Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Pamela Youde Nethersole Eastern Hospital Neurology Nurse Clinic (Stroke) was developed since 2011. This Clinic mainly provided service to 3 types of patients: Transient Ischaemic Stroke, Recent Minor Stroke and Recurrent Stroke after medical consultation. Stroke specialty nurses collaborated with patients to support risk factor reduction to prevent recurrent stroke events. We aimed to provide a holistic approach and continuity of care to discharged stroke patients, to improve access for stroke patient care through health assessment and service triage, to improve the quality of care and clinical outcomes (such as patient satisfaction, function performance, stroke-related risk factors control and stroke recurrence) of stroke patients through modified and preventive strategies, health education, counseling and compliance monitoring.
Objectives :
To evaluate the efficacy of Neurology Nurse Clinic (Stroke) on risk factors reduction and recurrent stroke prevention.
Methodology :
A retrospective study was conducted to review the clinical outcomes items for Neurology Nurse Clinic (Stroke) in PYNEH from 2011 to 2019, we based on evaluation of the following practice outcomes: Clients/ Families’ satisfaction survey, post 6-month optimal Blood Pressure and Low-density Lipoprotein (LDL) level (for ischaemic stroke with hyperlipidemia) control, ideal improvement percentage in stroke risk factor control, summary of drug treatment for ischaemic stroke with Atrial Fibrillation (AF) and periodic review of readmission related to recurrent stroke within 28 days & post 6-month recurrent stroke.
Result & Outcome :
There were total of 2960 attendances from 2011 to 2019 (around 348 to 428 attendances every year). The mean patients’ satisfaction score remained at 9.5 out of 10. The percentage improvement of post-stroke patients with optimal blood pressure and LDL level were from 44.8% to 84.56% and 61.68% to 81.69% respectively. More than 63% post-stroke patients could reach at least 25% ideal improvement of their stroke risk factors control. The compliance of drug treatment for post 6-month ischaemic stroke patients with AF kept almost 100%. The percentage of readmission within 28 days and post 6-month recurrent stroke were below 2.72% and 5.2% respectively. In 2019, the Clinic successfully passed periodic Nurse Clinic Assessment by Hospital Authority. In conclusion, the results indicated that Stroke nurse-led clinic could enhance patient empowerment in both stroke risk factor management and recurrent stroke prevention.
