ASC Stroke Data Management & Registry Reporting 2

Question 1

When performing chart abstraction for GWTG-Stroke, which patient population is EXCLUDED from IV alteplase eligibility measures?

Accepted Answer

Patients with NIHSS score of 0 at arrival who had transient symptoms

Answer

Patients who present with a resolved neurological deficit (NIHSS=0 at arrival) are typically excluded from alteplase eligibility measures because the treatment indication may not apply.

Question 2

A stroke coordinator identifies that 12 out of 80 eligible ischemic stroke patients did not receive antithrombotic therapy by the end of hospital day two. What is the compliance rate for this measure?

Accepted Answer

85%

Answer

(80-12)/80 = 68/80 = 85%, which is the percentage of eligible patients who received antithrombotic therapy within two days of admission.

Question 3

Which data element is required in stroke registries to document why an eligible patient did NOT receive IV alteplase?

Accepted Answer

Contraindication or reason for non-treatment

Answer

Documenting a specific contraindication or reason for non-treatment is required to properly exclude patients from the alteplase measure denominator and avoid penalizing centers for appropriate clinical decisions.

Question 4

In stroke data abstraction, 'last known well' (LKW) time is used primarily to determine eligibility for which intervention?

Accepted Answer

IV alteplase and endovascular thrombectomy time windows

Answer

LKW time is the reference point for calculating onset-to-door and onset-to-treatment times, which determine eligibility for IV alteplase (≤4.5 hours) and endovascular thrombectomy (≤24 hours for selected patients).

Question 5

A stroke coordinator is reviewing GWTG-Stroke data and notices the center's DTN median is 68 minutes. What is the recommended target to meet AHA/ASA guidelines?

Accepted Answer

≤60 minutes

Answer

The AHA/ASA guideline target for door-to-needle time is ≤60 minutes for at least 50% of IV alteplase-treated ischemic stroke patients, and high-performing centers aim for ≤45 minutes.

(ASC) Advanced Stroke Coordinator Certification Practice Test

(ASC) Advanced Stroke Coordinator Certification Practice Test

ASC Stroke Data Management & Registry Reporting 2