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ENCSN Stroke Champion Highlight: The NC Stroke Association and Its Partners

4/17/10 Read the NC Stroke Association article.



ENCSN Stroke Champion Highlight: Onslow Memorial Hospital

3/23/10 and 3/8/10. The following Stroke Champion Highlight articles were written by Norman Taylor, Stroke Nurse Coordinator at Onslow Memorial Hospital in Jacksonville, NC. Read below to learn about the accomplishments Onslow Memorial has made in becoming a "Stroke Capable" Hospital, and how its work in stroke awareness and education has helped save lives.





March 23, 2010

To: Elynor Wilson and India Foy, ENCSN Staff

From: Norman E. Taylor II. Stroke Nurse Coordinator

Dear Elynor and India,

I am moved to share this story with the network and all those who come in contact with the Eastern North Carolina Stroke Network’s website how a small gesture can make a difference in Stroke outcomes. Recently I was stopped in our hospital by one of our dedicated patient transporters, George. He was so excited to let me know how grateful he was that our hospital’s Stroke awareness and education program assisted him to potentially save one of his friend’s lives.

Over the past year, our Stroke Committee has been working on developing a Stroke awareness and education module for our clinical and non-clinical staff. George had just completed this education module when he recently was visiting one of his friends at home and found the friend to be displaying signs and symptoms of a Stroke. George said he knew what he had to do: “Get help fast and call 911”. His friend was transported quickly to our Hospital, was admitted with an Ischemic Stroke, and was discharged to outpatient rehabilitation with much better outcomes than he would have had if George had not been aware of the signs and symptoms of a Stroke and called 911. His friend stated that if it had not been for George, “I would not have called for help because I didn’t know I was having a Stroke.” Not only did George’s friend have improved outcomes, he left Onslow Memorial Hospital with a better understanding about Stroke and is equipped to make better choices about his health for the future. George and I parted knowing we had made a difference in someone’s life.

This case is an example of how one small hospital, one initiative, and one person can make a difference in the outcomes of someone’s life. One dream and many partnerships across North Carolina and beyond contributed to this man’s successful outcomes. On behalf of Onslow Memorial Hospital, I extend my appreciation and thankfulness to each of you!


Norman E. Taylor II. BSN, RN
Stroke Nurse Coordinator
Onslow Memorial Hospital
Jacksonville, North Carolina

March 8th, 2010

To: Elynor Wilson and India Foy, ENCSN Staff

From: Norman E Taylor II, Stroke Nurse Coordinator

Subject: Stroke Accomplishments

March 1st, 2010 was a joyous day for Onslow Memorial Hospital (OMH). After many tireless hours and a strong commitment for a brighter future for Stroke in Onslow County, our hospital became a “Stroke Capable” hospital. We joined forces with the North Carolina Stroke EMS Triage and Destination plan and promised to be a hospital which provides emergency care with a commitment to Stroke and the following capabilities:

  • 1. CT availability with in-house technician availability 24/7/365
  • 2. Ability to rapidly evaluate an acute Stroke patient to identify patients who would benefit from thrombolytic administration
  • 3. Ability and willingness to administer thrombolytic agents to eligible acute Stroke patients
  • 4. Accepts all patients regardless of bed availability
  • 5. Provides outcome and performance measure feedback to EMS including case review
This journey began in 2008 after grant funds were secured by several organizations including our hospital, The North Carolina Stroke Association, The North Carolina Stroke Care Collaborative, and the generosity and vision of the Kate B. Reynolds Charitable Trust. Our hospital and the citizens of Onslow County are blessed and very thankful for their financial support and without them our Stroke program would still be in its infancy. Other organizations and many wonderful people have been pillars of support throughout our journey and deserve no less appreciation for their role.

OMH is a 162 bed hospital and is situated in one of the fastest growing cities and economies in the Nation. We are home to one of the largest Marine Corps Installations in the world, and our coast line is just as special. At the same time, we are considered part of the “Stroke Belt Buckle”. OMH realizes that we have a part to play in promoting Stroke awareness and education and to remain focused on reaching as many individuals as possible to help reduce the devastating emotional, physical and financial stresses associated with Stroke. The core ingredients to our Stroke education program--whether inpatient or community based--align with the evidenced based practice and quality measure outcomes set by CMS and The Joint Commission. Each person reached by our Stroke education program is taught the different types of Stroke and the following information:

  • 1. Signs and symptoms of a Stroke/TIA
  • 2. Risk factors
  • 3. Prescriptions (understanding and timing)
  • 4. The importance of following up with a physician
  • 5. Calling 9.1.1. if you think you’re having a Stroke/TIA
These 5 teaching elements are crucial if we’re going to make an impact on reducing the number of Strokes in North Carolina and abroad.

In the community, we are offering Stroke risk screenings. These Stroke risk screenings provide total cholesterol checks, glucose checks, and Stroke education through counseling and health materials. Additionally, the hospital is providing Stroke presentations to the faith-based communities, work organizations, and anywhere we are invited to share this important information. We know we are an important link in the Stroke care equation and we invite every hospital (no matter how small) to join forces and do their part. Every hospital is unique and has different challenges, but together we can take North Carolina out of the forefront of Stroke occurrences.

In closing, I want to thank Elynor Wilson and India Foy with the Eastern North Carolina Stroke Network for providing this opportunity for Onslow Memorial Hospital to share its story. I also want to thank a few individuals that our hospital owes great gratitude for all their assistance and support over the past two years. Those members are the following: Our Hospital Authority Board; our CEO and President, Dr. Ed Piper; Josephine Malfitano, who wrote the OMH stroke grant; Nancy Pate; Dr. Garrett; our dedicated Emergency Dept.; Onslow County EMS; Carol Murphy and Sylvia Coleman with the N.C. Stroke Care Collaborative (NCSCC); Beth Parks and Margaret Rudisill with the North Carolina Stroke Association; and Ron Cromartie with the American Heart/Stroke Association.

A Stroke supporter and a family member affected by Stroke,

Norman E. Taylor II BSN, RN
Stroke Nurse Coordinator
Onslow Memorial Hospital
317 Western Blvd
Jacksonville, N.C. 28546
Office: 910-577-2838
Email: norman.taylor@onslow.org




ENCSN Stroke Champion Highlight: Pitt County Memorial Hospital

3/1/10. The PCMH Stroke Center and Neuroscience Center has been recognized by the American Heart Association and the American Stroke Association for achieving 85% or higher adherence to the “Get With The Guidelines®” Stroke Performance Achievement indicators for consecutive 12 month intervals and 75% or higher compliance with 6 of 10 “Get With The Guidelines” Stroke Quality Measures to improve quality of patient care and outcomes. For this commitment to excellence and patient care, PCMH has been awarded the 2009 GET WITH THE GUIDELINES® STROKE GOLD PLUS award.

At a ceremony to celebrate this recognition, Marie Welch, Stroke Center Nurse Coordinator, was also honored. Marie is an eastern NC stroke champion for leading the longest running Stroke Survivor group in eastern NC and remaining committed to obtaining Primary Stroke Center Certification for PCMH throughout the years. Marie is also an indispensible and active member of ENCSN, serving as an ad hoc member on the ENCSN steering committee and helping teach many CE activities. Marie Welch is the epitome of an Eastern NC stroke champion, and her hard work and committment has gone a long way toward improving stroke prevention and treatment in the region.



ENCSN at the NC WISEWOMAN/BCCCP Biennial Conference

9/10/09. India Foy and Elynor Wilson displayed information about ENCSN and the Heart Disease & Stroke Prevention Program at the Biennial WISEWOMAN/BCCCP conference in Greensboro. WISEWOMAN stands for "Well-Integrated Screening and Evaluation for Women Across the Nation," and is a cardiovascular disease (CVD) prevention program for underserved and underinsured women ages 40 to 64. BCCCP stands for the NC "Breast and Cervical Cancer Control Program." Over 160 nurses and other health providers from across the state attended this meeting. All those in attendance were interested in the prevention of breast and cervical cancer, and cardiovascular disease. ENCSN was able to recruit 13 new public health nurses to the Network, and distributed information on the NCcareLink Database, high blood pressure/cholesterol brochures, and many of the new ENCSN business cards.



From Regional to National Influence: An Outreach Success Story



8/31/09. Last week, Elynor Wilson, an ENCSN Staff Member, was contacted by a Stroke Outreach Coordinator in Austin, Texas. The Stroke Outreach Coordinator, Ms. Marcie Wilson, had found the ENCSN website through an online search and wanted to learn more about ENCSN, its history, and its purpose. Marcie was then kind enough to send a follow-up email to share with the rest of ENCSN (seen below).


Hi Elynor,

It was such a great honor and pleasure to speak with you on Tuesday. Your enthusiasm and commitment to the ENCSN program and what it is able to provide to your region is what makes it such a success.

My story:

I am always searching the internet to gather information as to what other communities, cities or states maybe doing in the area of Cardiovascular Disease and Stroke Prevention education in their communities. At some point I came across the ENCSN Program and I can't tell you how excited I was to see all that your stroke network has accomplished.

I shared the ENCSN website with my boss, Lauren Brandt, Director of Brain and Spine Neuroscience Center and she suggested I contact you.

We also partner with various hospitals in our region and come together for meetings with groups such as the Capital area Trauma Regional Advisory Council, Texas Department of Health and Human Services- CVD/Stroke and American Heart/ Stroke Association. The Eastern NC Stroke Network is truly an inspiration for us to come together and perhaps be able to do what ENCSN has done in our region, but in a smaller scale. I realize that the website will be perhaps one of our greatest challenges. Elynor Wilson is doing such a superb job on this site.

Elynor, I truly appreciate the time you spend speaking with me and grateful that you are willing to answer our questions and share stories with us. I applaud ENCSN for their handwork and dedication and for the unbelievable services they are providing their communities. I was also extremely very happy to see that your educational downloads are also available in Spanish.

I wish your group continued success,

Maricela Wilson, RN BSN
Stroke Outreach Coordinator
Brain and Spine Center-Neurosciences
University Medical Center at Brackenridge
Austin, TX



So, to all Eastern NC Stroke Champions: your work matters not only to your regional home communities, but could also have a positive influence on stroke care in the rest of the United States! Our success in outreach shows that the vision of ENCSN is being fulfilled: "to be recognized as a leading resource for voluntary collaboration on stroke best practices in Eastern NC communities"--and now beyond! Collaborative action can have a wide-reaching impact on stroke prevention and systems of care.


ENCSN Featured in NC Stroke Association Summer Newsletter

7/15/09. Download 'Update Stroke' Summer 2009 Newsletter, NC Stroke Association.

In a one-page article, Elynor Wilson and India Foy, ENCSN Staff, describe the history, mission, vision, and accomplishments of ENCSN in its first year of operation since Strategic Planning in 2008.


ENCSN at the Emergency Nurses Association Education Meeting, Eastern Tarheel Chapter #266

6/26/09 India Foy and Elynor Wilson, ENCSN Staff, gave a presentation to the Emergency Nurses Association Eastern Tarheel Chapter #266 on June 25, 2009 at the Chelsea Restaurant in New Bern, NC. Over 70 emergency nurses and emergency medical technicians attended this educational meeting. During their 45 minute presentation, India and Elynor shared stroke epidemiology data, introduced ENCSN, and described the benefits of joining the Network--including continuing education opportunities (from ASLS to pre-hospital education modules) and stroke hospitals' plans of care resources.





ENCSN at GWTG-Stroke Conference

5/13/09 ENCSN had a display table at the Get With the Guidelines-Stroke educational meeting at the Durham Sheraton. Over 107 stroke coordinators and stroke physicians from North Carolina attended this one-day conference. At this meeting, the Stroke Network was able to distribute educational materials, as well as recruit over 20 new members to the ENCSN listserv.

GWTG Presentation Downloads Available!

Due to the generosity of AHA/ASA, PDF downloads of the GWTG meeting presentations can be found on the ENCSN QI webpage or the ENCSN Stroke Resources webpage (both under the Get With the Guidelines-Stroke section). GWTG meeting presentations included "A Unit Based Code Stroke Response Team" by Susan Freeman (PCMH), and "Telestroke: a different approach to stroke care" by Dr. Robert Adams (MUSC), among others.



ENCSN Stroke Champion Highlight: Duplin County

Hospital and EMS Collaborate to Improve Stroke in Duplin County

Click on picture below to download article from April 2009, Duplin Times Newspaper.


  • Also featured on the NC Heart Disease and Stroke Prevention Success Stories Webpage In partnership with the NC Stroke Care Collaborative (NCSCC) and the Eastern NC Stroke Network (ENCSN), Duplin county has become a leading example of coordinated stroke care in eastern NC. In 2009, Duplin County was identified by NCSCC as having a higher number of strokes than the state average (87 deaths per 100,000 in Duplin compared to 61.1 deaths in NC per year). Because of the development of fibrinolytic drugs, or clot busters, it is important to have quick, coordinated stroke response from emergency medical service ( EMS ) and hospital health professionals.

    Following a site visit by NCSCC and the Eastern Heart Disease & Stroke Prevention (HDSP) coordinator, Duplin General Hospital 's stroke prevention coordinator, Carolyn Ezzell, began tracking the hospital's stroke quality improvement data to improve stroke response within the hospital. Duplin General Hospital also joined ENCSN and used its resources to produce a guideline-based stroke plan of care.

    Simultaneously, Duplin county's Emergency Medical Services became involved in addressing pre-hospital response to stroke emergencies by improving health training of all the county's emergency medical technicians. In March 2009, Duplin paramedic and EMS training officer, Dave Cuddeback, taught five Advanced Stroke Life Support (ASLS) classes at James Sprunt Community College in Kenansville. These classes were made mandatory for all Duplin EMS and were funded by Eastern HDSP . Over 140 people participated in these stroke trainings, including both pre-hospital and hospital staff.

    Dave Cuddeback from Duplin EMS and Carolyn Ezzell from Duplin General Hospital continue to collaborate to provide stroke prevention education to their community. For example, in May 2009 for Stroke Awareness Month, both Dave Cuddeback and Carolyn Ezzell used HDSP health education media items in community health fair events.

    The work that Duplin General Hospital and Duplin EMS have done to improve the response system for stroke has lead to better health outcomes for stroke patients. For example, one stroke patient received a full evaluation within 40 minutes and was then given fibrinolytic therapy. As a result, this patient had minimal disability due to the stroke.



    ENCSN Stroke Champion Highlight: Martin Community College Emergency Services

    Community College Makes Stroke Training Accessible

  • Also featured on the NC Heart Disease and Stroke Prevention Success Stories Webpage
    After attending an Advanced Stroke Life Support (ASLS) training in April 2008 at Area L- Area Health Education Center, Martin Community College Emergency Services (MCC-ES) Training Program staff realized a training need for stroke education in the northeast region of the state. They also recognized the time constraints experienced by nearly all of the volunteer-based emergency response personnel in the region.

    With oversight from Lee Black, MCC-ES Training Program Director, Lori Hardison, MCC-ES Training Program staff, began developing a stroke continuing education curriculum. By design, the curriculum condenses the lengthy stroke life support curriculum and provides instruction for proper patient assessment in a three-hour continuing education course. As with all continuing education curricula, the stroke continuing education curriculum meets the National Curriculum Standards-Altered Mental State and includes current stroke information.

    The MCC-ES Training Program’s stroke continuing education curriculum will be offered to all levels of emergency management technicians on campus and at individual squads throughout Martin, Bertie and Washington counties thus enhancing the knowledge/skills and capability of pre-hospital personnel to respond to strokes. Given the critical difference time can make in the stroke treatments available to stroke patients, training of pre-hospital staff is necessary for improving stroke care and outcomes.


    ENCSN at the EAHEC Regional Stroke Conference

    4/24/09. As one of the co-sponsors of the event through NC Heart Disease & Stroke Prevention funds, ENCSN had a display table at the EAHEC Regional Stroke Conference on April 24th, 2009 in Greenville, NC. Over 170 people attended the conference on "Outcomes Based Recovery." The keynote speaker was Dr. George Howard, the Principal Investigator of the REGARDS Study which stands for "REasons for Geographic And Racial Disparities in Stroke." ENCSN was able to provide scholarship funds to 15 regional nurses and EMT's who otherwise could not have attended the conference. Many new members joined ENCSN after visiting the table display and picking up education or media items.




    ENCSN is on Google!

    3/1/09. Web surfers can now find the ENCSN website through the mainstream search engine, Google! This development should improve the visability of the Network and increase its internet presence.




    ENCSN at Legislative Heart Health Day (LHHD)

    2/11/09. ENCSN had a display table at the Legislative Heart Health Day on February 11, 2009 at the Legislative Building in Raleigh, NC. ENCSN members from Pitt County Memorial Hospital also had a display at the all-day event, performing stroke screenings on state legislators and their staff. ENCSN staff, Elynor Wilson and India Foy, visited Eastern region legislators throughout the day, educating the policy makers about high cardiovascular mortality, high stroke mortality, the need for Emergency Medical Dispatch/Emergency Medical Staff training, and the goals of ENCSN. Below are a few photos from the event.

    Raleigh skyline the morning of LHHDInside the State Legislative Building
    Opening Ceremony. Speech by Anita Holmes,
    Heart Disease and Stroke Prevention Branch Director    		ENCSN display shown at LHHD