Cannula, glucometer, syringes, test tubes, oxygen mask, blood pressure medication, infusion pump, oropharyngeal tube, cardiac monitor, tranquilisers.*
Out of the 10 items listed above, seven belong on every stroke bag inventory. Can you pick out the three that needn’t be there?
A similar challenge faced 65 nurses who attended Poland’s first Nurse Angels Day in Warsaw in September. Their task was to select, from a much more comprehensive list, the equipment and medication necessary to treat acute stroke in the CT imaging room and significantly reduce treatment delays.
The first-ever Stroke Bag Workshop kicked off at 10.30 am on Friday 23 September under the watchful eyes of Head of Nursing Aneta Karpńska and her colleague nurse Barbara Wutkowska from the stroke unit at Wojewódzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika in Łódź. It was one of three masterclass workshops through which the nurses would rotate over the course of four hours, and it was without question one they would remember for a long time.
That was exactly what innovative Angels consultant Agnieszka Tymecka-Woszczerowicz had had in mind.
Stroke training for nurses typically focuses on the post-acute phase and in some respects this Angels Day was no different. The agenda covered important topics such as the FeSS protocol and nursing care after thrombectomy, and masterclasses provided hands-on training in dysphagia screening, and positioning in early stroke rehabilitation.
But the stroke bag workshop broke the mould. It focused squarely on nursing in the hyperacute phase, and leveraged experiential learning to impact practice.
Agnieszka knew that physical contact with the Angels stroke bag would engage the nurses far more than a slide presentation on the same topic. Moreover, the problem-saving nature of the workshop would create links between the learning content and what the participants already knew. Connecting new concepts to prior knowledge is a tried-and-tested strategy for making learning stick. Finally, the workshop would highlight the importance of key priority actions, in particular treating at CT.
The workshop required small groups of nurses to work together to fill their stroke bag with tools and medicines selected from a line-up that included several decoy items. Medicines were represented by brown paper packages labeled with chemical names, and big ticket items such as glucometer and infusion pump by cardboard boxes labeled with photographs of the equipment.
At the end of the workshop a spokesperson for each group presented their list in a feedback session moderated by nurses Aneta Karpińska and Barbara Wutkowska
A great deal of thoughtful planning had gone into the workshop, Agnieszka says. The nurses from Łódź have been using the Angels stroke bag for years and have finetuned their stroke bag inventory to suit their hospital and patient needs. But because no two stroke units are exactly alike, the exercise generated a great deal of debate among seasoned nurses from different hospitals – another way in which learners connect content to their experiences.
Generously supported by Agnieszka’s fellow consultants Katarzyna Putylo and Anna Kielkowska, and Thea-Maria Leinbohm from the Angels core team, Nurse Angels Day Poland was a success from the outset, with places filling up within two weeks of the invitation going out, and participants eager to sign up their colleagues for a future edition.
The Stroke Bag Workshop, like all good ideas, has already spread to countries as far afield as South Africa where an Angels Day takes place in December. And most importantly, several participating teams have already requested their own stroke bag, which means their hospitals will soon have nurses advocating for treating acute stroke at CT.
Something else that has caught the eye of her fellow consultants is the roll-up banner Agnieszka had designed specially for the event.
“Zespoły pielęgniarskie w doskonaleniu opieki udarowej,” it says in Polish, but the meaning is true in every country and in any language: Stroke nurses make the difference.
*The items that should not be on this list are: oxygen mask, oropharyngeal tube, and tranquilisers.