Minnesota Statewide Stroke Conference

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Thursday Conference Schedule

8 - 9 a.m. - Registration and Exhibits Open

Exhibits are open 8 a.m. to 3 p.m.

8:45 - 9:15 a.m. - Opening Remarks

9:15 - 10:30 a.m. - Keynote Address

Challenges of Paradigm Shift for Stroke Systems of Care: Opening the Time Window for Stroke TreatmentJawad Kirmani
Jawad F. Kirmani, MD, Vice Chair: HMH-JFK Neuroscience Institute & HMH-SOM Department of Neurology, Director: HMH-JFK Stroke and Neurovascular Center, Program Director: Neurology Residency; Vascular Neurology, Neurocritical Care & Endovascular Surgical Neuroradiology Fellowships

Evidence-based advances for treatment of acute ischemic stroke remained largely stagnant for the last 20 years. However, recent advances in devices and techniques have culminated in dramatic improvements in the outcomes of stroke patients. Tissue-based decision making through the utilization of advanced imaging to save the brain has become the standard of care. This new standard has 'opened' the traditional concept of time windows and transformed the way we think about treating stroke patients. This poses unique yet exciting future challenges with an enthusiastic urgency to redesign complex stroke systems of care in order to deliver the highest quality and outcomes for our stroke patients. In this keynote, Dr. Jawad F. Kirmani will examine the evidence-based historical build up to where we are today and propose practical stroke systems of care that have worked successfully in this new paradigm.

Jawad F. Kirmani, MD, is the Vice Chair of HMH- SOM DON, HMH-JFK Neuroscience Institute and Director of the Stroke and Neurovascular Center at the Neuroscience Institute at JFK Medical Center. Dr. Kirmani is the Director of the Neurology Residency Program. He is also the Director of Endovascular Surgical Neuroradiology, Vascular Neurology, and Neurocritical Care Fellowship programs. Dr. Kirmani completed his Neurology training at Ohio State University and went on to do a fellowship in Stroke and Neurocritical care at SUNY, Buffalo. He completed his Endovascular Surgical Neuroradiology training at Rutgers New Jersey Medical School. Dr. Kirmani's clinical activities and professional skills include but are not limited to Neurointerventional procedures; treatment of Ischemic and Hemorrhagic Strokes and Subarachnoid Hemorrhage; Neurocritical and Stroke care. Dr. Kirmani has received many national Awards in the area of his expertise, most recently Dr. Kirmani was the recipient of the American Heart Association 2017 Physician of the Year award. He has trained over 100 residents and fellows. Dr. Kirmani has over a hundred peer reviewed research publications. He has been an invited speaker at numerous national and local forums, and is the founding member and current Secretary of the Society of Vascular and Interventional Neurology.

PowerPoint document, 169 mb

10:30 - 11 a.m. - Break and Exhibits Open

11 a.m. - 12 p.m. - Breakout Sessions I

  1. Patient with a Brain Aneurysm. Who to Treat and Why?
    Jawad F. Kirmani, MD
    There are more than 6 million people living in the US with an aneurysm. However, not all aneurysms rupture. In fact a very small percentage of aneurysms rupture. Endovascular coiling or a flow diverter and surgical clipping can be used to seal off an unruptured brain aneurysm and help prevent a future rupture. In some unruptured aneurysms, the known risks of the procedures may outweigh the potential benefit. As health care providers, it is very important for us to know how to proceed with further care of an unruptured, asymptomatic aneurysm. Kirmani builds upon the operative risks, natural history of subarachnoid hemorrhage and available evidence to suggest best future course of action for a patient with unruptured aneurysm.

    PowerPoint document, 14.3 mb

  2. CPR for the Complicated Discharge Plan
    Kathy Reinartz RN, BSN, CCM, Clinical Coordinator in the Case Management Department at Hennepin Healthcare
    Communication, Planning, and Resources (CPR) is a process to assist in a successful complex discharge plan for the patient following a stroke. Through a recent case study of a complex discharge, Kathy Reinartz will demonstrate how to utilize the CPR method and evaluate its effectiveness. She also will explore some community resources to support this process.

    PDF document, 2.1 mb

  3. Transitions of Care in the Rural Setting
    Wendy Borth, RN, BSN, CHPN, Transitional Care Manager; Sara Shultz, RN, Quality Improvement, Patient Safety, and Patient and Family Advisory Council Coordinator, Sleepy Eye Medical Center
    Sleepy Eye Medical Center has had the Transitional Care Management Program in place since mid 2014. They are now including a process to coordinate stroke patients as they transition back to the community. This presentation will cover how this program has led to greater patient satisfaction, decreased readmission rates and decreased costs.

    PowerPoint document, 1.6 mb

  4. Resources and Communicative Strategies for Patients with Aphasia
    H Sheen Chiou, PhD, CCC-SLP, Associate Professor, Minnesota State University Mankato; Julia Halvorson, MA, CCC-SLP, Executive Director, Minnesota Connect Aphasia Now; Rochelle Anderson, Stroke Survivor
    Many health care professionals are unfamiliar with resources and techniques used to facilitate communication for people with aphasia. This presentation will cover basics of communication strategies to increase communication effectiveness; how the life participation approach to aphasia works; and information on aphasia resources available in Minnesota.

    pdf file, 28.9 mb

  5. Stroke and Seizures
    Nikki Baker, MNM, Senior Program Manager, Epilepsy Foundation of Minnesota
    Nearly 10 percent of stroke survivors suffer from post-stroke seizures. Developing your knowledge and awareness about post-stroke seizures will help you better control and manage them.

    PowerPoint document, 2.5 mb

12 - 1 p.m. - Lunch

1 - 2 p.m. - Breakout Session II

  1. So Easy to Miss!
    Joan Somes PhD, RN-BC, CEN, CPEN, FAEN, NRP, Critical Care Educator, Regions Hospital EMS
    Large Vessel Occlusion stroke symptoms are not always obvious and easily recognized. This session will review actual cases where the presenting symptoms were subtle, or had confounding factors, as well as clues that helped the initial assessor call a stroke code.

    PowerPoint document, 21.5 mb

  2. When Risk Becomes Reality: Antithrombotic Reversal in Hemorrhagic Stroke
    Matthew P. Lillyblad, PharmD, BCPS-AQ Cardiology, Clinical Pharmacy Coordinator- Cardiology and Critical Care, Abbott Northwestern Hospital
    Antithrombotic medications are often used to treat or reduce the risk of thrombotic or embolic events in a variety of medical conditions. Antithrombotic use is expected to rise with greater convenience of new generation agents and increasing prevalence of diseases requiring antithrombotic therapy. Hemorrhagic stroke is a known adverse effect of antithrombotic therapy and the most feared complication of these treatments. Prompt reversal of coagulopathy is essential to mitigate risk and improve outcomes. This presentation will summarize the pharmacology of each antithrombotic class, hemorrhagic risks associated with treatment, and the evidence based strategies for reversing their effect in the setting of hemorrhagic stroke.

    PowerPoint document, 2.6 mb

  3. Harnessing the Electronic Medical Record for a Quality and Outcomes Database, as well as a Tool for Better Secondary Stroke Prevention and Education
    Diane Chappuis, MD, Physiatrist, Medical Director of Stroke Rehabilitation, Courage Kenny Rehabilitation Institute, Allina Health, United Neuroscience; Ganesh Asaithambi, MD, Vascular Neurologist, Allina Health, United Neuroscience
    Tracking stroke survivor outcomes and educating on risk factors for recurrent stroke is a challenge. Dr. Chappuis and Dr. Asaithambi have developed a Stroke Navigator tool in Epic which can reduce dependence on external databases and also provide a more user friendly interface for stroke care for the interdisciplinary team both in the inpatient and outpatient settings. Embedded within the Stroke Navigator is a secondary stroke education tool which can be printed and highly personalized to each patient, rather than giving them generic information about stroke prevention. Population health can be analyzed via the tool as well.

    PowerPoint document, 2.9 mb

  4. Non-pharmacological Treatments for Poststroke Depression
    Niloufar Hadidi, PhD, APRN, ACNS-BC, FAHA, Associate Professor (tenured) and Coordinator of the Adult/Gero Clinical Nurse Specialist/Doctor of Nursing Practice (CNS/DNP) Program at the University of Minnesota Medical Center
    This session will cover post-stroke depression pathophysiology as well as signs, symptoms and treatment modalities that have been explored in the literature. Further, problem solving therapy, a form of cognitive behavior therapy, will be described and an example will be reviewed.

    PDF document - 5.7 mb

  5. Keeping Your Relationship Strong
    Chad Martin, Software Engineering Manager, Medtronic
    Nearly six years ago, when their daughter was only three, Chad Martin’s wife suffered a major stroke. Through his experiences, Chad has developed several lessons on maintaining a strong partnership throughout the recovery process. In this presentation he will cover those experiences and give long-term advice to survivors and caregivers.

    PowerPoint document - 10 mb

2 - 2:30 p.m. - Break and Exhibits Open

2:30 - 3:30 p.m. - Breakout Session II

  1. In-House Stroke Code: Is the Hospital the WORST Place to Have a Stroke?
    Carol Droegemueller, APRN, CNS, Stroke Program Coordinator, Regions Hospital; Roberta Wagner, DNP, APRN, CNS, Clinical Nurse Specialist, Abbott Northwestern Hospital
    Recognition and management of stroke in hospitalized patients is difficult, and the morbidity and mortality rates of in-patient strokes exceed those of out of hospital stroke. This session will cover how one hospital adapted processes made a big impact for those whose stroke happens while hospitalized.

    PowerPoint document - 2.9 mb

  2. Patent Foramen Ovale and Cryptogenic Stroke: Do We Finally Have Closure?
    Christopher Streib, MD, MS, Vascular Neurologist, University of Minnesota, University of Minnesota Physicians, Academic Vascular Neurologist, Stroke Fellowship Director UIMMC
    Three major trials, REDUCE, CLOSE, and RESPECT, studying patent foramen ovale (PFO) closure in cryptogenic stroke were published in the New England Journal of Medicine in September 2017. This session will cover these three trials which all showed a reduced risk for recurrent ischemic stroke in patients undergoing PFO closure in comparison to medical management.

    pdf file, 12.8 mb

  3. Managing the TIA Patient: In Patient vs. Out Patient Workup
    Leah Roering, RN, FNP-BC Certified Nurse Practitioner, Stroke Neurology, CentraCare Clinic/Saint Cloud Hospital
    This session will cover stroke vs. TIA; etiology, physiology, diagnosis; patient selection and triage from ETC; how to assess patient risk and need for admission vs discharge from the ETC for TIA follow up; TIA management; and the impact of TIA clinic on the community/reducing cost by avoiding hospital admission.

    PowerPoint file, 6.5 mb

  4. Prioritize- Ensure the Health of your Community
    Nicky Anderson BSN, RN, SCRN, Stroke System Nurse Specialist, Cardiovascular Health Unit, Minnesota Department of Health
    Rural Brainerd Minnesota was identified as an area in the state that underutilized EMS services when it came to calling for stroke. With the support and ideas between MDH and our marketing department we developed ideas for in-person programs, direct mailings, radio PSA's, and other events to spread awareness in our community. This session will share our process and ideas for ensuring the health of your community.

    PowerPoint file, 9.2 mb

  5. TIA Evaluations in Neurologically Underserved Regions
    Ganesh Asaithambi, MD, Vascular Neurologist, Allina Health, United Neuroscience, John Nasseff Neuroscience Specialty Clinic and United Hospital
    It is estimated that 5 million Americans suffer transient ischemic attacks (TIAs) annually. However, the true prevalence is much higher. TIAs can be considered "mini-strokes" or "warning strokes" and should be addressed immediately by healthcare professionals in order to minimize the risk of another TIA or a potentially disabling stroke. The high prevalence of TIAs in the community require primary care providers, especially in neurologically underserved regions, to be aware of diagnostic and preventive strategies.

    PowerPoint file, 3.4 mb


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