24/7 Neurocritical Care Nurse Practitioner Coverage Reduced Door-to-Needle Time in Stroke Patients Treated with Tissue Plasminogen Activator

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Jennifer L MoranMatthew A Koenig

Abstract

Stroke centers with limited on-site neurovascular physician coverage may experience delays in acute stroke treatment. We sought to assess the impact of providing 24/7 neurocritical care acute care nurse practitioner (ACNP) "stroke code" first responder coverage on treatment delays in acute stroke patients who received tissue plasminogen activator (tPA). Consecutive acute ischemic stroke patients treated with intravenous tPA at a primary stroke center on Oahu between 2009 and 2014were retrospectively studied. 24/7 ACNP stroke code coverage (intervention) was introduced on July 1, 2011. The tPA utilization, door-to-needle (DTN) time, imaging-to-needle (ITN) time, and independent ambulation at hospital discharge were compared between the preintervention period (24 months) and the postintervention period (33 months). We studied 166 stroke code patients who were treated with intravenous tPA, 44 of whom were treated during the preintervention period and 122 of whom were treated during the postintervention period. After the intervention, the median DTN time was reduced from 53 minutes (interquartile range [IQR] 45-73) to 45 minutes (IQR 35-58) (P = .001), and the median ITN time was reduced from 36 minutes (IQR 28-64) to 21 minutes (I...Continue Reading

References

Jun 1, 2002·BMJ : British Medical Journal·Asif QasimMary E Heber
Dec 13, 2005·Stroke; a Journal of Cerebral Circulation·Jeffrey L Saver
Nov 18, 2011·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·DaiWai M OlsonEric D Peterson
Jan 9, 2014·Stroke; a Journal of Cerebral Circulation·Ilana M RuffLee H Schwamm

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Citations

Aug 12, 2018·Practical Neurology·Laurent M WillemsWaltraud Pfeilschifter
Jan 6, 2018·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Erin LawrenceElisabeth B Marsh
Mar 23, 2021·Soins; la revue de référence infirmière·Perrine BoursinBenjamin Maïer

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