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Improving treatment times for patients with in-hospital stroke using a standardized protocol.
- Source :
-
Journal of the neurological sciences [J Neurol Sci] 2017 Oct 15; Vol. 381, pp. 68-73. Date of Electronic Publication: 2017 Aug 18. - Publication Year :
- 2017
-
Abstract
- Background: Previous reports have shown significant delays in treatment of in-hospital stroke (IHS). We developed and implemented our IHS alert protocol in April 2014. We aimed to determine the influence of implementation of our IHS alert protocol.<br />Methods: Our implementation processes comprise the following four main steps: IHS protocol development, workshops for hospital staff to learn about the protocol, preparation of standardized IHS treatment kits, and obtaining feedback in a monthly hospital staff conference. We retrospectively compared protocol metrics and clinical outcomes of patients with IHS treated with intravenous thrombolysis and/or endovascular therapy between before (January 2008-March 2014) and after implementation (April 2014-December 2016).<br />Results: Fifty-five patients were included (pre, 25; post, 30). After the implementation, significant reductions occurred in the median time from stroke recognition to evaluation by a neurologist (30 vs. 13.5min, p<0.01) and to first neuroimaging (50 vs. 26.5min, p<0.01) and in the median time from first neuroimaging to intravenous thrombolysis (45 vs. 16min, p=0.02). The median time from first neuroimaging to endovascular therapy had a tendency to decrease (75 vs. 53min, p=0.08). There were no differences in the favorable outcomes (modified Rankin scale score of 0-2) at discharge or the incidence of symptomatic intracranial hemorrhage between the two periods.<br />Conclusion: Our IHS alert protocol implementation saved time in treating patients with IHS without compromising safety.<br /> (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Subjects :
- Administration, Intravenous
Aged
Endovascular Procedures
Female
Health Personnel education
Humans
Male
Neuroimaging
Retrospective Studies
Stroke diagnostic imaging
Thrombolytic Therapy
Treatment Outcome
Clinical Protocols standards
Hospitalization
Quality Improvement
Stroke therapy
Time-to-Treatment
Subjects
Details
- Language :
- English
- ISSN :
- 1878-5883
- Volume :
- 381
- Database :
- MEDLINE
- Journal :
- Journal of the neurological sciences
- Publication Type :
- Academic Journal
- Accession number :
- 28991718
- Full Text :
- https://doi.org/10.1016/j.jns.2017.08.023