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Stroke, patient navigation, discharge planning



  1. Deen, Tonya MSN, RN
  2. Terna, Theresa MSN, RN
  3. Kim, Elizabeth MSN, APN, ACNS-BC, FAHA
  4. Leahy, Brian PhD, ABPP
  5. Fedder, Wende DNP, MBA, FAHA


Purpose: The purpose of this study was to describe the impact a stroke nurse navigation program has on concurrent chart reviews and patient compliance postdischarge.


Design: Phase I: Concurrent chart review of The Joint Commission Primary Stroke Center core measures for ischemic stroke patients. Phase II: Longitudinal study of 100 ischemic stroke patients discharged to home.


Methods: Telephone surveys were conducted at prescribed intervals posthospital discharge (Phase II). Surveys focused on medication compliance, follow-up medical appointment compliance, and neurovascular emergency department (ED) visits/readmissions.


Findings: Phase I trends included increased stroke performance measures compliance. Phase II favorable trends included increased medication compliance (>98%), increased follow-up appointments (100%), decreased rate of neurovascular ED visits/rehospitalizations (3%), and improvement in activities of daily living and quality of life measures through 12 months postdischarge.


Conclusions: Stroke nurse navigation increased conformity of stroke performance measures and stroke patient discharge compliance through 12 months postdischarge.