A qualitative assessment of practices associated with shorter door-to-needle time for thrombolytic therapy in acute ischemic stroke

DaiWai M. Olson, Mark Constable, Gavin W. Britz, Cheryl B. Lin, Louise O. Zimmer, Lee H. Schwamm, Gregg C. Fonarow, Eric D. Peterson

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Early treatment with intravenous (IV) recombinant tissue plasminogen activator/alteplase (tPA) is associated with improved outcomes for patients with an acute ischemic stroke. Thus, rapid triage and treatment of stroke patients are essential, with a goal of door-to-needle time of no more than 60 minutes. We sought to identify best practices associated with faster treatment among hospitals participating in Get With the GuidelinesVStroke. Qualitative telephone interviews were conducted to elicit strategies being used by these centers to assess, treat, and monitor stroke patients treated with IV tPA. We sequentially carried out these interviews until we no longer identified novel factors. Interviews were conducted with 13 personnel at 7 top-performing U.S. hospitals.With the use of a hermeneuticYphenomenological framework, 5 distinct domains associated with rapid IV tPA delivery were identified. These included (a) communication and teamwork, (b) process, (c) organizational culture, (d) performance monitoring and feedback, and (e) overcoming barriers.

Original languageEnglish (US)
Pages (from-to)329-336
Number of pages8
JournalJournal of Neuroscience Nursing
Volume43
Issue number6
DOIs
StatePublished - Dec 1 2011

ASJC Scopus subject areas

  • Surgery
  • Endocrine and Autonomic Systems
  • Clinical Neurology
  • Medical–Surgical

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