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Latin American Stroke Centers Certification
To verify the classification of your center fill this form - TEST
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* Indicates required question
Email
*
Your email
I. Identification
Name of Hospital
*
Your answer
Address of Hospital
*
Your answer
Country
*
Choose
Argentina
Bolivia
Brazil
Chile
Colombia
Costa Rica
Cuba
El Salvador
Ecuador
Guatemala
Honduras
Mexico
Nicaragua
Panama
Paraguay
Peru
Dominican Republic
Uruguay
Venezuela
City
*
Your answer
State
*
Your answer
Person responsible
*
Person responsible for answering the questionnaire (Name and position in the hospital)
Your answer
Coordinator stroke program
*
Name of coordinator of stroke program
Your answer
Eletronic Records
*
Does your hospital use electronic records?
No
Yes
SITS-QR/RES-Q
*
Is your hospital using SITS-QR or RES-Q registries?
No
Yes, RES-Q
Yes, SITS-QR
Other registry?
*
Is your hospital using other quality indicators registry for stroke? (no SITS-QR or RES-Q)
No
Yes, a hospital registry
Yes, a national registry
Other:
II. Characteristics of hospital
Your hospital is:
*
Public
Private
Public and Private
Other:
Number of beds in the hospital
*
Your answer
Number of strokes in 1 year
*
Your answer
Number of IV thrombolysis in 1 year
*
Your answer
Number of thrombectomies in 1 year - if not available, please answer 0 (zero)
*
Your answer
Type of stroke center:
*
Are you applying for certification of your stroke center as?
Essential Stroke Center (Primary)
Advanced Stroke Center (Comprehensive)
ACCESS TO HYPERACUTE STROKE CARE
*
Are there protocols for rapid evaluation and diagnosis of stroke patients in Hospital/Emergency department 24hours/day, 7days/week, with time metrics assessment?
No
Yes
ACCESS TO BASIC DIAGNOSIS SERVICES
Which one(s) of the following are available in your hospital?
Laboratory blood test 24/7
*
Complete blood count, electrolytes, urea, glucose, INR, PT available 24 hours a day, 7 days a week
No
Yes
Electrocardiogram 24/7
*
Electrocardiogram (12 lead) available 24 hours a day, 7 days a week
No
Yes
Computed Tomography (CT) brain scan available 24/7
*
Computed Tomography (CT) brain scan in the hospital (on site) available 24 hours/day, 7 days/week
No
Yes
CTA capability 24/7
*
capability to do Computed Tomography Angiography (CTA) in the hospital (on site) 24h/7 days
No
Yes
Transthoracic Echocardiogram
*
Echocardiography is available in your hospital?
No
Yes
Vascular Doppler ultrasound
*
Extracranial Doppler ultrasound is available in your hospital?
No
Yes
Holter monitors
*
Prolonged ECG monitoring devices (Holter monitors) are available in your hospital?
No
Yes
ADVANCED DIAGNOSTIC SERVICES
Which one(s) of the following are available in your hospital?
Magnetic Resonance Imaging (MRI)
*
MRI is available in your hospital (on site)?
No
Yes
MR Angiography
*
MRA is available in your hospital (on site)?
No
Yes
CT or MR Perfusion scans
*
CT or MR perfusion are available in your hospital (on site)?
No
Yes
Prolonged ECG monitoring
*
Prolonged ECG monitoring devices is available in your hospital (on site)?
No
Yes
Transcranial Doppler
*
Transcranial Doppler is available in your hospital?
No
Yes
Transesophageal Echocardiogram
*
Transesophageal Echocardiogram is available in your hospital?
No
Yes
ACCESS TO AMBULANCE
*
Is there access to emergency medical services (EMS - ambulance)?
No
Yes
Ambulance - training
*
Training of ambulance crews to identify stroke signs using FAST mnemonic or similar?
No
Yes
Ambulance - priority
*
Work with ambulance systems to have stroke identified as a high priority transport emergency
No
Yes
NURSING AVAILABILITY
Access to nurses and nursing assessment with stroke training (tick all that apply):
Nurse for acute care
*
Access to nurses and nursing assessment with stroke training in acute care (the training should be documented, at least 4 hours/year - the documentation can be uploaded in the platform or should be presented during the onsite visit)
No
Yes
Nurse for stroke unit
*
Access to nurses and nursing assessment with stroke training in stroke unit settings (the training should be documented, at least 4 hours/year - the documentation can be uploaded in the platform or should be presented during the onsite visit, including stroke unit protocols, neurological assessment and swallow screen)
No
Yes
STROKE SPECIALISTS 24/7 FOR THROMBOLYSIS
*
Access to neurologist with expertise in stroke 24/7 or other doctors with expertise in stroke (should include expertise TO TREAT ACUTE STROKE). Check below the specialist responsible for THROMBOLYSIS treatment in your hospital (check all available):
Neurologist
Neurosurgeon
Emergency physician
Intensivists
Other speciality
Access to stroke specialists through telestroke modalities, and teleradiology
Required
STROKE SPECIALISTS FOR PREVENTION AND REHABILITATION
*
Access to physicians with stroke expertise in stroke prevention and stroke rehabilitation
No
Yes
PROGRAM TO DEVELOP COMPETENCIES
*
Is there a program to develop and maintain core competencies in stroke care?
No
Yes
STROKE UNIT INPATIENT STROKE CARE
*
Access to acute inpatient stroke care in a stroke unit (exclusive or clustered)
No
Yes
Stroke Unit (Exclusive)
*
Access to a Stroke Unit (a defined group of beds, staff, and protocols that are used for the acute care of patients with a stroke)
No
Yes
Clustered stroke unit
*
Access to a clustered model of stroke unit on same ward
No
Yes
THROMBOLYSIS
*
Access to IV thrombolysis 24h/day, 7days/week:
No
Yes
INTERDISCIPLINARY STROKE TEAM
Are there members of an interdisciplinary stroke team?
Neurologist with stroke expertise (or Stroke physician)
*
No
Yes
Stroke Nurses
*
Nurses with training in stroke
No
Yes
Nursing assistants
*
No
Yes
Pharmacist
*
No
Yes
Social worker/case manager
*
No
Yes
Palliative Care team
*
No
Yes
Physiotherapist
*
No
Yes
Occupational Therapist
*
No
Yes
Speech Therapist
*
No
Yes
Neurosurgeon
*
No
Yes
Neurointerventionalist 24/7
*
Access to Neurointerventionalist available 24/7 ((Interventional Neurologist OR Endovascular Neurosurgeon OR Interventional Neuroradiologist)
No
Yes
STROKE UNIT PROTOCOLS
Is there access to stroke unit protocols to guide acute stroke care based on best practice guidelines?
Swallowing assessment
*
You can check "yes" If is described that swallowing has not been evaluated because the patient is intubated or in coma,
No
Yes
Nutrition, hydration
*
No
Yes
Mobility and prophylaxis
*
Functional status, mobility, DVT risk and prophylaxis protocols
No
Yes
Level of dependency
*
Evaluation of level of dependency
No
Yes
Skin Integrity
*
Evaluation of skin Integrity
No
Yes
Continence
*
Evaluation of bladder and bowel continence
No
Yes
Temperature
*
Temperature management
No
Yes
Positioning, mobilization
*
No
Yes
Prevention therapies
*
Access to stroke prevention therapies such as antiplatelet therapy, anticoagulants, statins, lifestyle change recommendations, blood pressure management
No
Yes
ADVANCED INTERVENTIONS
Which of the following advanced interventions are available?
Endovascular thrombectomy 24/7
*
Is endovascular thrombectomy available 24/7?
No
Yes
Neurosurgery for hemorrhagic stroke
*
No
Yes
Hemicraniectomy for ischemic stroke
*
No
Yes
Acute inpatient stroke units
*
No
Yes
Intensive care unit on site
*
No
Yes
Products to reverse coagulopathy
*
No
Yes
REHABILITATION
Access to stroke rehabilitation services (tick all that are available):
Early Rehabilitation
*
Early access to rehabilitation therapies – including cross training of skills to nurses, nursing assistants and family members
No
Yes
Early Functional Assessment
*
Early functional assessments, goal setting and individualized rehab plans developed
No
Yes
STROKE CARE ORGANIZATION
Stroke Care Organization (with or without stroke unit)
Weekly meetings
*
Interdisciplinary meetings weekly to discuss patient progress against treatment goals; update management plans
No
Yes
Patient and family education
*
Are patient and family education, skills training, and involvement in care planning being applied?
No
Yes
Discharge
*
Is a discharge planning always available?
No
Yes
Stroke training
*
Stroke training programs for all levels of healthcare providers:
No
Yes
Quality assessment
*
Participation in quality assessment of services (registry):
No
Yes
Material for patients
*
Printed stroke patient educational materials:
No
Yes
GEOGRAPHICALLY DISCRETE REGIONS
Fully coordinated stroke care provided across geographically discrete regions
Stroke pathways in the region
*
Stroke pathways that define movement of stroke patients across region to higher and lower levels of services as required
No
Yes
Coordinated referral system
*
No
Yes
Telestroke
*
Provide telestroke consultations to smaller and more rural centres
No
Yes
Ambulance agreement
*
Ambulance bypass agreements in place in the region
No
Yes
Research in stroke
*
Research in stroke implemented
No
Yes
PASSWORD REQUEST FOR APPLICATION
To officially apply for certification, include here the name, email and phone number of the person responsible for application. We will send a password for application. It can be the director of hospital (or the representative of the director) or the coordinator of stroke center/stroke unit
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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