Your manager has asked you to participate in a committee that is looking at the care of stroke (CVA) patients at your facility. The team includes the...

Your manager has asked you to participate in a committee that is looking at the care of stroke (CVA) patients at your facility. The team includes the following: stroke case manager, nurses who provide bedside care for patients with stroke, unit managers, a representative from the quality department, a neurologist, a hospitalist (physician whose practice is solely in the hospital), a speech therapist, and a physical therapist.

The committee's first task involves creating a clinical pathway. The members determine that they should identify patient care guidelines that provide evidence for the various points of care. After reviewing the available literature, they support their clinical pathway proposal with the best available evidence, taking into account the type of patient the hospital serves, the context in which patients would receive care, and a general idea of the patient population's values and preferences.

1. Is this the most appropriate type of group to develop a clinical pathway for stroke patients? Defend your answer? What is the nurse's role in assuring that the measures are met? Do nurses have the authority to meet the stroke measure set?

2. Did the committee use evidence-based practice to support its clinical pathway? What steps are involved in developing an evidence-based practice guideline?

3. The committee decides that the outcomes from the clinical pathway have dramatically improved the care of patients with stroke. The team decides to apply for certification as a primary stroke center from The Joint Commission and review the disease-specific care for strokes. What are the standardized measures (called the "stroke measures set") for a stroke program?

4. What is the nurse's role in ensuring that the measures are met? Do nurses have the authority to meet the stroke measure set?