Delayed Diagnosis of Stroke: Case Review for Advanced Practice Clinicians - Activity ID 3279

In reviewing closed malpractice claims, The Doctors Company identified diagnostic failure as a reoccurring problem and one of the top three leading allegations that result in malpractice claims. This failure often leads to a delay in treatment and causes significant harm to patients. The following highlights the importance of recognizing the signs and symptoms of a stroke. Factors contributing to delayed diagnosis and treatment included failure to recognize the window (“last known well time”) for tissue plasminogen activator (tPA) clot buster administration, failure to order a stat MRI and neurology consult, failed communication among providers regarding changes of recurring in symptoms of ischemic stroke, failure to appreciate new signs and symptoms of a stroke, and poor or inconsistent documentation. The National Academy of Medicine (NAM) has identified the top three causes of serious harm from diagnostic failure. Number one is ischemic stroke.

To obtain credit and a certificate of completion, learners must score 80% or higher on the post-test and complete a program evaluation.

Learning Objectives/Outcomes apply to all professions. 

Learning Outcome Statement: 80% of learners will demonstrate an increase in knowledge related to best practices for diagnosis of stroke by scoring 80% or higher on the post-test.

1. Calculate the last known well time and identify the window for administration of tPA (3-4.5 hours of stroke onset).
2. Conduct an accurate and thorough review of chief complaints and a neurological examination, and thoroughly document findings.
3. Evaluate when an urgent/emergent action is required such as a neurology consultation, stroke code or order for an MRI.
4. Identify at least two strategies that can reduce the risk for a malpractice claim involving the failure to timely diagnosis and treat a stroke.

The Doctors Company is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. The Doctors Company designates this activity for a maximum of 0.5 nursing contact hours. Learners should claim only the credit commensurate with the extent of their participation in the activity.

The Doctors Company is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical educational activities for physicians. The Doctors Company designates this activity for a maximum of 0.5 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclaimer
The information and guidelines contained in this activity are generalized and may not apply to all practice situations. We recommend that legal advice be obtained from a qualified attorney for specific application to your practice. The information is intended for educational purposes and should be used as a reference guide only.

State Requirements for Continuing Education
Please see your state licensing organization for continuing education requirements for your profession and specialty.

Accessibility
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