Post Ischemic Stroke Complication: How Much Nursing Diagnosis are Confirms by Neurologist?

Abstract

Background: Nursing role in post ischemic stroke is vulnerable by correct nursing recognition, due to limited study and evaluation of, this study was conducted. Material and method: It was a retrospective cross-sectional study that all patients admitted with a diagnosis of ischemic stroke in the Ayatollah Rouhani Hospital of Babol from 2015 to 2016. Data was analyzed by chi-square, t-test and coefficient, Kappa tests in spss21. Results: Of 300 ischemic stroke patients were studied, Distribution of sex was 154 (51.2%) female vs. 146 (48.5%) male, age range was 43-90 years with mean age of 65.8 ± 15.7 years. Pain in 107 patients (35.5%), depression in 101 patients (33.6) and fever in 94 patients (31.2) were the most common early complications of ischemic strokes. Coefficient was excellent agreement between the neurologist and nurses (yes 703 (84%), no 136(16%), Kappa=0.76). The highest amount of agreement was in relation to the diagnosis of pressure ulcer (accurate 70 (93%), misdiagnose 5 (7%), Kappa=0.83) and dysphasia (accurate 79 (91%), misdiagnose 8 (9%), Kappa = 0.84). Although the lowest rate of agreement was in relation to the diagnosis of CHF (accurate 4 (17%), misdiagnose 20(83%), Kappa=0.10). Conclusion: most common early complication was pain and the most accurate recognition by nurses was dysphagia and pressure ulcer. The total agreement between nurse and neurologist was favorable that nurses can play an important role to inform neurologist but continuous education to decrease misdiagnosis is recommended. It suggests a suitable feedback from neurologist to nurses. It can help nurses to analyzed how much it recognition was correct or need be more training. In relation to the incidence of stroke in Iran, a report from Babol northern of Iran, the incidence of stroke was 50 per hundred thousand populations [5,6]. In recent years, despite to all prophylactic measures to reduce the incidence of stroke by decreasing pert time, advances in diagnosis, medical care and treatment of patients, but the number of patients has been increased [7]. Post stroke complication include pressure ulcer, dysphasia, pain, respiratory infections, urinary tract infection, fever, depression deep vein thrombosis, pulmonary embolism, myocardial infarction and cardiac arrhythmias, Congestive heart failure, urinary retention and peptic ulcers. These complications have adverse effects on the physical and mental status of these patients and involve their on other hand have an economic burden to society [8]. Complications of stroke in the early days of hospitalized patients significantly increasing mortality rate [9]. Frequent assessment of neurological status, blood pressure, blood sugar and temperature control and identify early stroke complication is the key to success in the care of these patients [10].