Abstract T P348: The Presence of an Advanced Practice Nurse Stroke Program Coordinator Decreases Door-to-Needle Times
Background: Benefits of intravenous tissue plasminogen activator (IV-tPA) are greatest when patients are treated immediately. Our Comprehensive Stroke Center hires Advanced Practice Nurse stroke program coordinators (APN SPC) to respond to the bedside of all acute stroke alert calls. Between 08:00-17:00, an APN SPC works with dedicated on-duty neurologists to rapidly treat acute stroke patients with IV-tPA.
Purpose: The purpose of this study was to determine if the presence of an APN SPC decreases door-to-needle (DTN) times in acute stroke patients.
Methods: Data were collected by stroke coordinator abstractors from January 1, 2010 to June 14, 2014. DTN times were compared using a Student’s t-test between times when an APN SPC was on duty with times the APN SPC was not present. Patient age, time between symptom onset to hospital arrival, and NIH Stroke Scale (NIHSS) categories were compared between groups using Student’s t-test and chi-squared test.
Results: There were 245 patients who received IV-tPA over the study period. Over half (52%, n=127) of patients were treated in the presence of an APN SPC; 48% of patients (n=118) were not treated in the presence of an APN SPC. There were no significant differences in age, time between symptom onset to hospital arrival, or NIHSS values between groups. Median DTN time for patients treated with an APN SPC present was 36 minutes versus 45 minutes for patients treated without an APN SPC present; this 9-minute difference in median DTN time was borderline statistically significant (p=.051).
Conclusion: The presence of an APN SPC was associated with reduced median DTN times. The presence of an APN SPC, in addition to an on duty neurologist, may reduce time between door and needle, engendering improvements in patient outcomes.
Author Disclosures: M. Whaley: None. L.M. Caputo: None. J.C. Wagner: None.
- © 2015 by American Heart Association, Inc.