Analogous Measures Endorsed by Other Organizations Identical measures endorsed or used by NQF (Nos. 0244 and 0441), TJC (STK-10), AHA Ischemic Stroke Performance Measure 9, AHA GWTG-Stroke, and CDC PCNASP AHA indicates American Heart Association; ASA, American Stroke Association; CDC, Centers for Disease Control and Prevention; CSTK, Comprehensive Stroke; DNR, do not resuscitate; GWTG Stroke, Get With The Guidelines Stroke; ICH, intracerebral hemorrhage; NQF, National Quality Forum; PCNASP, Paul Coverdell National Acute Stroke program; and TJC, The Joint Commission. *The assessment should be documented in the medical record by a physician, a physical therapist, an occupational therapist, or a speech-language pathologist, as appropriate. If rehabilitation is not needed, then that should be documented explicitly in the record. Appendix. Continued 9. Avoidance of Corticosteroid Use for Elevated Intracranial Pressure: Percentage of patients with ICH who do not receive corticosteroids during acute hospitalization Numerator Patients who do not receive intravenous or oral corticosteroids Denominator Included patients: All patients with ICH Excluded patients: <18 y of age Length of stay >120 d Received corticosteroids before arrival at hospital and being assessed Participation in a clinical trial in which corticosteroids are part of the investigational regimen Documentation of a neurological or other medical condition for which corticosteroids may be indicated, including brain tumor, cerebral venous sinus thrombosis, vasculitis, asthma, COPD, cortisol deficiency, postcraniotomy Period of Assessment From ED arrival until acute care hospital discharge Sources of Data Prospective flowsheet, retrospective medical record review, electronic medical record, pharmacy records Rationale Corticosteroids may be used for the treatment of cerebral mass effect and elevated intracranial pressure if vasogenic edema is present from brain tumors or cerebral abscess. A prior randomized clinical trial in ICH found increased complications and no outcome benefit. 