What is the community standard on frequency of vital signs and neuro
checks on you stroke order sets !NSWE"S: #ost t#! Q$% &ith modified NI%SS ' ()h* then Q( in I+U, Q)h on the floor for any stroke -atient. We have ada-ted our orders from the !lte-lase insert and inlcuded /S monitoring as -art of our order set 0I have attached a co-y that you may share1. /S 2 Neuro +hecks are done q ) hours for the first )3 hr or 4ased on &hat the -hysician orders. +ritical +are555every one hour Neuro ste- do&n every ( hours 6eneral Neuro floor55every ) hours 7or all t#! -atients* &e follo& the recommended !%!8!S! guidelines. 7or telemetry -atients* it9s q ) hrs* for all others* it9s q shift and &ith any change in neurological condition unless other&ise s-ecified 4y :;. 7or -ost alte-lase -atients 5 q$<mins')* then q=>mins'(* then q$hr ' () hrs 5 o4viously done in the +ritical +are. 7or all stroke admitted -atients to the acute floors it is q$hr ' ()hrs and then q)hrs. /ital signs are every hour in the I+U and every ) hours on the neuro unit. We -erform neuro e'ams on admission* then every ( hours for () hours and then every ) hours5no matter &hich unit they are on. The NI%SS is -erformed also on admission and then the modified NI% cale is used &ith the same frequency as the neuro e'ams5q( ' () hours* then q) hours. standard -ost t#!* ++U Q (* stroke unit Q) We use the following during t-PA administration and immediately following- B/P,HR AND NER! "HE"#$ E%ER& '( )*N$ DR*N+ ,REA,)EN, AND ,HEN -!R AN!,HER . H!R$, ,HEN E%ER& /0 )*N$1-!R 2 H!R$ AND ,HEN E%ER& H!R -!R '2 H!R$1 -!R N!N ,-PA *$"HE)*" $,R!#E PA,*EN,$, E%ER& 3 H!R$ -!R .3 H!R$ AND ,HEN E%ER& 4 H!R$1 -!R HE)!RRHA+*" $,R!#E ,NER! "HE"#$ E*,HER E%ER& H!R -!R .3 H!R$ AND ,HEN "HE"# W*,H NER!$R+E!N !R NER!5!+*$, -!R -R,HER !RDER$, !R E%ER& 3 H!R$ ,HEN "HE"#1 %*,A5 $*+N$ ARE E%ER& H!R -!R .3 H!R$ ,HEN "HE"# W*,H NER!5!+*$, !R NER! $R+EA!N -!R -R,HER !RDER$1 Perform neurologi6al assessments and 7ital signs e7ery '( minutes during the infusion of rtPA, and for . hours following 6om8letion of treatment, and then, e7ery /0 minutes, thereafter, for the ne9t 2 hours and, then, e7ery hour until .3 hours after treatment1 -or non rtPA stro:e 8atients; Patient in *" - neuro assessment and 7ital signs e7ery hour Patient on med-surg unit - neuro assessment and 7ital signs e7ery 3 hour -re<uen6y 6an always =e in6reased =ased on 8atient 6ondition and 6hanges1 Neuro assessment entails the 6om8lete E)R neuro assessment in the ongoing or admission forms1