To enhance hospital staff members’ confidence recognizing and managing patients with an acute stroke and increase early activation of stroke codes in the inpatient setting.

One in five strokes occur in the hospital and are more likely to have worse clinical outcomes compared to community-onset strokes. All hospital staff members should be able to recognize and initiate management of patients with a suspected acute stroke.

A tailored education program was held on each inpatient unit at a large academic medical center. A survey was created for participants to take before and after the education session, including questions on identifying signs and symptoms of stroke, how to activate a stroke code, and tasks required during a code. Additional questions included self-assessment of the individual’s confidence level in different aspects of stroke care. Survey results and data obtained through electronic medical record (EMR) on inpatient stroke code activations were analyzed pre- and post-intervention.

Before the session, most participants (56.1%) were slightly or moderately confident in identifying stroke signs and symptoms, but after the session, most participants (80.5%) were very or extremely confident. Before the session, 18% of patients felt comfortable managing a patient during a code, but after the session, 95% of participants felt comfortable. Pre-intervention data showed that only 50% of inpatient stroke codes were activated within 10 minutes of symptom recognition. Following intervention, 75% of inpatient stroke codes were activated within 10 minutes of symptom discovery.

A dedicated education session targeting hospital staff can increase knowledge and confidence in recognition and management of patients with a suspected acute stroke. This curriculum has potential to be used nation-wide to reduce delays to diagnosis of in-hospital stroke, increase the use of acute stroke therapies, and ultimately reduce the morbidity and mortality associated with in-hospital stroke.