Abstract W P346: Sustainable Reduction in IV TPA Door to Needle Time Using Key Elements from Target Stroke Tool Kit
Current literature clearly demonstrates decreased in-hospital mortality and increased functional outcomes with every 15 minute reduction in door-to-needle (DTN) time for IV-TPA treatment. At VCU Health System, 70% of eligible acute ischemic stroke (AIS) patients received IV-TPA treatment within 60 minutes of hospital arrival, with a median DTN time of 56 minutes for the time period between May 2012 to April 2013. The goal was to further increase percentage of eligible AIS patients receiving IV-TPA within 60 minutes of hospital arrival and decrease DTN time for IV-TPA treatment. A systematic approach was used to retrospectively analyze IV-TPA charts, identify rate limiting factors in administration of IV-TPA and implement clinical process changes. As a result of implementing an organized team approach, pre-hospital stroke alerts, immediate aggressive BP management, pre-mixing IV-TPA and prompt feedback, the number of eligible AIS patients that received IV-TPA within 60 minutes increased 43% from 70% to 100%. The median DTN time decreased 36% from 56 minutes to 36 minutes for the time period between May 2013 to May 2014.
Author Disclosures: L.F. Selleck: None. V.R. Feeser: None. G.R. Stalnaker: None. S. Stevens: None. L. Wacksman: None. W.L. Felton: None.
- © 2015 by American Heart Association, Inc.