TY - JOUR
T1 - Achieving a door-to-needle time of 25 minutes in thrombolysis for acute ischemic stroke
T2 - A quality improvement project
AU - van Schaik, Sander M.
AU - van der Veen, Bas
AU - van den Berg-Vos, Renske M.
AU - Weinstein, Henry C.
AU - Bosboom, Wendy M. J.
PY - 2014
Y1 - 2014
N2 - Background: Providing intravenous thrombolysis with shortdoor-to-needle time is the result of a complex process that requires specific work standards. To expedite care for acute ischemic stroke patients, close collaboration between all participating health care professionals is required. The aim of this project was to reduce in-hospital treatment delay for acute ischemic stroke patients through the introduction of a standard operating procedure and by creating higher and sustained awareness of the importance of intravenous thrombolysis. Methods: This study was set up as a before-versus-after study, divided into a preintervention period, an immediate postintervention period, and a late postintervention period. During the study, a standard operating procedure was implemented that defined the targeted standard of care to be provided to all acute stroke patients. Involved health care professionals received regular feedback to create greater awareness of the importance of this time-driven protocol. Results: Themedian door-to-needle time decreased significantly, from 60 minutes in the preintervention period to 30 minutes in the immediate postintervention period (P < .001), and compared with the immediate postintervention period it decreased significantly further, to 25 minutes, in the late postintervention period (P <.001). The proportion of patients with a door-to-needle time <30minutes and <20 minutes increased significantly across the 3 study periods (P <.001). Conclusions: The door-to-needle time for acute ischemic stroke patients can be reduced through the introduction of a standard operating procedure and by creating higher and sustained awareness of the importance of intravenous thrombolysis among health care professionals involved.
AB - Background: Providing intravenous thrombolysis with shortdoor-to-needle time is the result of a complex process that requires specific work standards. To expedite care for acute ischemic stroke patients, close collaboration between all participating health care professionals is required. The aim of this project was to reduce in-hospital treatment delay for acute ischemic stroke patients through the introduction of a standard operating procedure and by creating higher and sustained awareness of the importance of intravenous thrombolysis. Methods: This study was set up as a before-versus-after study, divided into a preintervention period, an immediate postintervention period, and a late postintervention period. During the study, a standard operating procedure was implemented that defined the targeted standard of care to be provided to all acute stroke patients. Involved health care professionals received regular feedback to create greater awareness of the importance of this time-driven protocol. Results: Themedian door-to-needle time decreased significantly, from 60 minutes in the preintervention period to 30 minutes in the immediate postintervention period (P < .001), and compared with the immediate postintervention period it decreased significantly further, to 25 minutes, in the late postintervention period (P <.001). The proportion of patients with a door-to-needle time <30minutes and <20 minutes increased significantly across the 3 study periods (P <.001). Conclusions: The door-to-needle time for acute ischemic stroke patients can be reduced through the introduction of a standard operating procedure and by creating higher and sustained awareness of the importance of intravenous thrombolysis among health care professionals involved.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84923225904&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/25263647
U2 - https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.07.025
DO - https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.07.025
M3 - Article
C2 - 25263647
SN - 1052-3057
VL - 23
SP - 2900
EP - 2906
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 10
ER -