Teri Curington, MSN, RN at the East Texas Medical Center Gilmer Emergency Room, told the Gilmer Rotary Club Tuesday about ETMC Gilmer’s goals, achievements and objectives.
She told them that the facility is one of only five in Texas to have a Level III Stroke Designation. It received this designation March 1.
“Our Mission Statement is ‘Decrease the occurrence of strokes in our community and aid in the efforts to trend and monitor to improve patient outcomes,’” she said.
Goals she listed include:
• Commitment to Excellence
• 100 percent Chart Audits
• Performance Improvement process
• Monthly Staff Education
In the are of stroke prevention, their efforts include:
• Education—Health Risks Specific to Upshur County
Stroke affects approximately one person every 45 seconds.
Someone in the U.S. dies every 3.3 minutes from stroke.
Stroke is the leading cause of disability among adults in the U.S.
Four out of five families will be somehow affected by stroke over the course of a lifetime.
Obesity, diabetes and heart disease are precursor’s which can increase one’s risk to having a stroke.
Upshur County’s numbers about percentages of the population affected by various condition, compared to the State of Texas, are revealing:
• Diabetes—Upshur, 9.8%; Texas, 8.9%.
• Obesity—Upshur, 28.3%; Texas, 26.6%.
• Heart Disease—Upshur, 12.9%; Texas, 6.7%.
• Hypertension—Upshur, 33.2%; Texas, 27.8%.
• Cardiovascular Disease—Upshur, 18.9%; Texas, 8.3%.
•High Cholesterol—pshur, 42.7%; Texas, 38.5%.
Intervention In The ER
“When a patient presents with STROKE-like symptoms, CODE STROKE is immediately paged overhead,” Nurse Curington said. “Since time is of the essence when brain tissue is at risk, all necessary personnel report to the stroke patient’s bedside immediately.”
She presented the following Code Stroke Timeline, with the goal first and ETMC Gilmer’s actual performance second:
• Doctor at bedside, <10 min.; 9 min.
• Patient to CT, < 25 min.; 23 min.
• CT brain read by Radiologist, < 45 min.; 44 min.
“The diagnosis will determine if the patient can be admitted, or if they need to be transferred to a level of higher care where in-house neurologists are present,” Mrs. Curington said.
Vertical Beds —On May 6, the ER transformed Room 3 in the ER to accommodate 10 “vertical beds,” which are actually chairs (VBRs).
“By creating 10 more spaces in the ER to treat those patients who do not require being in a reclining position, we are able to decrease the time it takes to initiate treatment, thus providing faster service to the patients,” Mrs. Curington said.
The first week of utilizing this new form of service yielded the following results:
• Total of 197 patients seen in the ER.
• 25 of patients utilized the VBR (50 patients).
• Average Length of Stay (LOS) for ER patients was 2 hrs. 27 min.
• Average LOS for VBR patients was 1 hr. 24 min.
“Since implementing vertical beds, our customer satisfaction has increased and those patients who would usually leave without being seen by a physician are less than one-half of one percent of our ER patient population,” she said.
A new service soon to become available at ETMC Gilmer is the Sexual Assault Nurse Examiner (SANE) Program.
“Upshur County has one of the highest sexual assault occurrence rates among counties in the East Texas region,” Mrs. Curington said.
“Beginning in the fall of 2013, we will be offering SANE at ETMC Gilmer ER,” she said. “Four of our dedicated RNs have been receiving specialized training for pediatric, adolescent and adult sexual assault examination techniques, evidence collection, and documentation that will stand up in court.”
She said the Texas Attorney General’s office credentials SANE RNs. To become credentialed, an RN must attend 80 hours of didactic training for pediatric, adolescent and adult sexual assault examinations at state-sponsored educational events, as well as complete 78 hours of practicum experience.
“We endeavor to provide this valuable service to victims within our community and surrounding area to decrease the distance victims and their families currently have to travel in order to obtain SANE exams,” Mrs. Curington said.
“By decreasing the amount of time from the actual assault to when the SANE exam is performed, we are also able to preserve more evidence so that the perpetrator can be prosecuted to the fullest extent in which the law provides.”
“ETMC Gilmer is here to serve the healthcare needs of Gilmer and Upshur County citizens,” said ET Gilmer Administrator Gorge Leal, who introduced Mrs. Curington.