Abstract WP359: Achieving Target: Stroke Honor Roll Status through the Utilization of 9 Best Practice Strategies
Background: Target: Stroke is a national quality initiative of the American Heart Association/American Stroke Association with the goal of improving <60 minute door-to-needle times (DTN) for at least 50% of patients receiving IV rt-PA. (AHA/ASA, 2012)
Purpose: To improve DTN times <60 minutes at an urban Primary Stroke Center in South California through the utilization of the Target: Stroke national quality initiative.
Methods: Retrospective data analysis for 11 IV rt-PA receiving patients in the Get With The Guidelines-Stroke (GWTG-Stroke) database from 11/01/2011 to 01/31/2012. Employment of 9 Target: Stroke Best Practice Strategies: Advance Hospital Notification by EMS (Emergency Medical Services), Rapid Triage Protocol and Stroke Team Notification, Single Call Activation System, Stroke Tools, Rapid Acquisition and Interpretation of Brain Imaging, Rapid Laboratory Testing, Rapid Access to Intravenous IV rt-PA, Team-Based Approach, and Prompt Data Feedback.
Results: The hospital received advanced hospital notification by EMS for 10 out of 11 (90.9%) IV rt-PA receiving patients. 100% of the patients were rapidly triaged, the stroke team was notified via single call activation & overhead page (stroke alert), and the appropriate thrombolytic stroke order sets were implemented (Stroke Tools). Rapid acquisition and interpretation of brain imaging were measured. CT Scan order to CT complete turn-around-time (TAT) averaged 12 minutes. CT Complete to CT Read TAT averaged 11.33 minutes.Average PT/INR and PTT TATs were 26.1 minutes. Rapid access to intravenous IV rt-PA was mixed by the Emergency Department pharmacist at the bedside for 100% of patients. The Team-Based Approach and prompt Data Feedback were practiced by holding monthly Stroke Steering Committee meetings that included interdisciplinary team members and disseminating data. Eight out of eleven (72.7%) acute ischemic stroke patients treated with IV rt-PA received the medication <60 minutes. Median door-to-needle (DTN) time for patients treated with IV rt-PA: 42 minutes.
Conclusion: By employing 9 Target: Stroke Best Practice Strategies at an urban Primary Stroke Center in South California, the hospital was able to achieve Target: Stroke Honor Roll status from 11/01/2011 to 01/31/2012.
- © 2012 by American Heart Association, Inc.