Abstract TP251: The Direct and Indirect Impact of the Acute Stroke Nurse Role on Thrombolysis Treatment Times and Rates
Background: The Acute Stroke Nurse (ASN) role at Box Hill Hospital is a business hours (weekday 8am - 4.30pm) first responder role designed to fast track acute stroke patients through thrombolysis screening in the Emergency Department. Since 2004, this role has been filled in either a full-time (FT) or part-time (PT) capacity, except for a 5-month period in 2010 where the role was vacant. We sought to explore the influence of having a full-time ASN, compared to part-time or no ASN, on thrombolysis rates and times.
Methods: Data was extracted from the hospital’s stroke thrombolysis database for the period 2004 to 2012. Comparisons were made for those patients seen by the ASN, when FT and PT and those who saw medical staff only. Statistical comparisons were made using Mann-Whitney Rank Sum test.
Results: Almost half (43% n=182) of the 428 thrombolysis cases occurred during business hours, the ASN attended 84% of cases when the role was filled FT and 15% when PT. No difference was seen in median door-to-CT times (25 minutes.) Faster median door-to-needle times were achieved during business hours when the patient was seen by the ASN compared to those who were not (66 mins vs. 83 mins, p=<0.001.) Faster times were seen when the ASN role was FT (68 min) or PT (79 min) compared to vacant (89 mins, p=0.006,) with more patients treated within 60 minutes of arrival (35% FT, 27% PT and 8% vacant, NS). While the ASN only works within business hours, faster door-to-needle times were seen after hours when the ASN role was filled FT and PT compared to vacant (87mins and 100 mins vs. 103 mins, p=0.013;) and treatment was only commenced under 60 minutes when the ASN was employed FT.
Conclusion: The Acute Stroke Nurse role seems to have a positive impact on thrombolysis treatment times and rates, with the best results being achieved during and outside business hours when the ASN is employed FT.
- © 2012 by American Heart Association, Inc.