CSC Prep ED Staff Interview Tool
Data Definition Tool
This audit is to be completed by the manager or designee on a monthly basis. "CSC Prep ED 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. For any NO response, the staff member will receive additional
education.
Updated: 11-12-14
QUESTION
STANDARD
LOCATION
YES
1 Staff Name
2 Time of Audit
DEMONSTRATE KNOWLEDGE OF EMS TO ED PROTOLS
Practitioner can verbalize/demonstrate knowledge of EMS protocols
3
location.
By the LifeFlight
Practitioner is able to tell/show
phone/radio in the Alocation of protocols.
pod.
LOCATION AND USE OF STROKE PROTOCOLS
4
Practitioner can verbalize/demonstrate the location and use of stroke
protocols for the ED.
* Green Sheet
* Online
Practitioner is able to
verablize/demonstrate the
location of the stroke protocols.
CARE OF THE PATIENT WITH ACUTE STROKE
Practitioner knows when a patient can have something to drink/eat or
5
take medicine by mouth?
DIAGNOSE ACUTE STROKE
Practitioner verablizes that
* Green Sheet
patient can only have something
* ED Online resources to eat/drink after they pass a
swallow screen.
6 Practitioner can verbalize the signs and symptoms of an acute stroke?
Practitioner responds
* Stroke Badge Buddy
"Weakness, numbness, speech
* ED Screens scolling
changes, vision loss (any
message
combination of these)"
UTILIZE PROTOCOLS FOR ACUTE STROKE
7 Practitioner is able to verbalize when to use the Stroke order set.
Stroke Pathway
Practitioner response - Every
time
Green Sheet
* IV tPA
* Intervention/IA/clot
retrieval/mechanical
thrombectomy
* Medical management/monitor
ED Acute Stroke
Order Set online
Every hour unless otherwise
ordered
Green Sheet
Every 15 minutes for 2 hours,
every 30 minutes for 6 hours,
every 1 until 24 hours total has
passed.
* Located on A-Pod
next to patient
medication cabinet
* CPG's are used to develop the
pathways.
UNDERSTANDING TREATMENT OPTIONS FOR ACUTE STROKE
8
Practitioner is able to verbalize the treatment options for an acute
stroke.
MONITOR ACUTE STROKE
9
Practitioner is able to verbalize how often to check vitals on a stroke
patient without tPA.
Practitioner is able to verbalize how often to check vitals on a stroke
10
patient with tPA.
CLINICAL PRACTICE GUIDELINES (CPG)
Practitioner is able to verbalize what Stroke CPGs are and/or where
11
they are located.
QUALITY IMPROVEMENT PROJECTS, RELATED TO STROKE BASED IN
THE ED
12
Practitioner is able to verbalize some Stroke related quality
improvement projects
Kiersten will provide
information after
posting.
* New Green Sheet
* Code TIA alert