Annabelle Braun, DNP, NE-BC

Abstract:

Background: Every forty seconds a stroke occurs and every four minutes someone in the United States dies from a stroke. Strokes are responsible for taking 140,000 lives every year, which is one out of every twenty deaths in the United States (U.S.) (American Heart Association [AHA], 2019; Centers for Disease Control and Prevention [CDC], 2019). The CDC identified “stroke” as the 5th leading cause of death and one of the leading causes of long-term disability in the U.S. The physical and social complications of stroke can be translated into healthcare dollars. The cost of stroke in the U.S. is estimated at $34 billion annually and the cost is expected to triple to $184.1 billion annually by 2030. Objective: This evidence-based quality improvement (QI) project was to determine if education and application of the Target: Stroke Best Practices can influence direct transport to computed tomography (CT) scan transport, as compared to current practice and improve door-to-needle (DTN) times within 30 minutes in at least 50% of patients within a three-month period. Setting and Sample was a 552-bed community hospital located in Southern California. This project was a single site, retrospective, chart review comparing two sample groups, pre and post an educational intervention (Group 1, 2019), Group 2 (2020). Analysis: A paired t-test was performed to compare Group 1’s mean door-to-CT scan times and DTN times with Group 2’s mean door-to-CT scan and DTN times. Results: Group 2’s mean door-to-CT time significantly decreased by 18 minutes (P < .001). Group 2’s mean DTN time also decreased significantly by 21 minutes (P < .001) when compared to Group 1. Conclusions: The implementation of stroke education sessions and Target: Stroke Best Practices of direct to CT scan were associated with improved door-to-CT times and DTN times. Future research is needed to explore the functional outcomes at 30- and 90-days post discharge. Keywords: acute ischemic stroke, DTN time, door-to-CT time, patient outcomes. 

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