Feasibility and Efficacy of Nurse-Driven Acute Stroke Care.
Background: Acute stroke care requires rapid assessment and intervention. Replacing traditional sequential algorithms in stroke care with parallel processing using telestroke consultation could be useful in the management of acute stroke patients. The purpose of this study was to assess the feasibil...
| Published in: | Journal of Stroke & Cerebrovascular Diseases Vol. 26; no. 5; pp. 987 - 992 |
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| Main Authors: | , , , , , , , |
| Format: | research Journal Article |
| Published: |
W B Saunders
May2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122676135&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122676135 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10523057 DOU jtl: Journal of Stroke & Cerebrovascular Diseases issn: 10523057 maglogo: N pubinfo: dt: May2017 vid: 26 iid: 5 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 122676135 122676135 NLM28012837 122676135 10.1016/j.jstrokecerebrovasdis.2016.11.007 NLM28012837 122676135 ppf: 987 ppct: 5 formats: tig: atl: Feasibility and Efficacy of Nurse-Driven Acute Stroke Care. aug: au: Mainali, Shraddha Stutzman, Sonja Sengupta, Samarpita Dirickson, Amanda Riise, Laura Jones, Donald Yang, Julian Olson, DaiWai M. affil: Department of Neurology and Neurotherapeutics, University of Texas Southwestern, Dallas, Texas sug: subj: Stroke Drug Therapy Thrombolytic Therapy Nursing Staff, Hospital Tissue Plasminogen Activator Administration and Dosage Process Assessment (Health Care) Fibrinolytic Agents Administration and Dosage Stroke Nursing Nursing Role Patient Care Infusions, Intravenous Prospective Studies Time Factors Multidisciplinary Care Team Health Care Delivery, Integrated Pilot Studies Teleradiology Critical Path Stroke Treatment Outcomes Tomography, X-Ray Computed Human ab: Background: Acute stroke care requires rapid assessment and intervention. Replacing traditional sequential algorithms in stroke care with parallel processing using telestroke consultation could be useful in the management of acute stroke patients. The purpose of this study was to assess the feasibility of a nurse-driven acute stroke protocol using a parallel processing model.Methods: This is a prospective, nonrandomized, feasibility study of a quality improvement initiative. Stroke team members had a 1-month training phase, and then the protocol was implemented for 6 months and data were collected on a "run-sheet." The primary outcome of this study was to determine if a nurse-driven acute stroke protocol is feasible and assists in decreasing door to needle (intravenous tissue plasminogen activator [IV-tPA]) times.Results: Of the 153 stroke patients seen during the protocol implementation phase, 57 were designated as "level 1" (symptom onset <4.5 hours) strokes requiring acute stroke management. Among these strokes, 78% were nurse-driven, and 75% of the telestroke encounters were also nurse-driven. The average door to computerized tomography time was significantly reduced in nurse-driven codes (38.9 minutes versus 24.4 minutes; P < .04).Conclusions: The use of a nurse-driven protocol is feasible and effective. When used in conjunction with a telestroke specialist, it may be of value in improving patient outcomes by decreasing the time for door to decision for IV-tPA. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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