CSC Prep 6N & 6T3 Staff Interview Tool
Data Definition Tool
This audit is to be completed by the manager or designee on a monthly basis. "CSC Pred 6N & 6T3 Staff Interview Tool" audits are due by
the last day of the month. Area is to perform a minimum of 5 Staff Interviews per month.
Instructions: Indicate Yes, No, NA (Not Applicable) for each question below.
Updated: 11-12-14
QUESTION
1
2
STANDARD
LOCATION
YES
Staff Name
Time of Audit
6N/6T3PROTOCOLS
3 Nurse can verbalize/demonstrate protocols location.
*6T3 - By the Charge
Nurse Desk.
*6N - By the Pyxis
Nurse correctly provides
location of protocols for 6N
and/or 6T3.
6N/6T3 Protocols
Nurse verablizes that patient
can only have something to
eat/drink or take meds by
mouth after they pass a swallow
screen.
CARE OF THE PATIENT WITH ACUTE STROKE
4
Nurse knows when a patient can have something to drink/eat or take
medicine by mouth.
DIAGNOSE ACUTE STROKE
5 Nurse can verbalize the signs and symptoms of an acute stroke?
*6N/6T3 Protocols
Nurse responds "Weakness,
* Stroke badge buddy numbness, speech changes,
vision loss (any combination of
these)"
UTILIZE PROTOCOLS FOR ACUTE STROKE
Edocs
6 Nurse is able to verbalize when to use the Stroke Pathway.
UNDERSTANDING TREATMENT OPTIONS FOR ACUTE STROKE
Nurse response - Every time
6N/6T3 Protocols
7
Nurse can verbalize what the treatment options are for an acute
stroke?
Correct response:
* IV tPA
*Intervention/IA/clot
retrieval/mechanical
thrombectomy
MONITORING ACUTE STROKE
6N/6T3 Protocols
6T3 - q 15 minutes for the first
hour
6N - q 4 hours
* 6N/6T3 Protocols
* Acute Stroke Work
Sheet
Every 15 minutes for 2 hours,
every 30 minutes for 6 hours,
every 1 until 24 hours total has
passed.
Nurse can verbalize how often to check vitals on a stroke patient
8
without tPA?
Nurse can verbalize how often to check vitals on a stroke patient with
9 tPA
(only on 6T3)
CLINICAL PRACTICE GUIDELINES (CPG)
10
Nurse can verbalize/demonstrate what Stroke CPG's are and where
they are located?
6T3 - Behind the
Charge nurse desk.
6N - Located behind
the MR desk by the
Pyxis
Nurse correctly provides
location of Clinical Practice
Guidelines for 6N and/or 6T3.
6N/6T3 Protocols
*Rounding/Chart audits by
Robin or Kiersten
*Falls prevention
*Project Oscar
*Progressive mobility
*Anticipated Discharge
QUALITY IMPROVEMENT PROJECTS RELATED TO STROKE
11
Nurse can verbalize some of the Quality Improvement projects, related
to Stroke that are based in 6N/6T3?