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Keywords

acute stroke patient, certified nurse, door to alteplase administration, nursing, stroke certified registered nurse, stroke nursing care delivery process, Target Stroke goals

 

Authors

  1. Fant, Grace N.
  2. Lakomy, Janet M.

Abstract

ABSTRACT: In this retrospective, nonexperimental, comparative descriptive design using convenience sampling, the timeliness of care delivered by 11 Stroke Certified Registered Nurses (SCRNs) to 95 hyperacute stroke patients (last known well of 4.5 hours or less) on the acute stroke protocol set by Target: Stroke Phase II Campaign Manual was compared with that of 13 non-SCRNs in a small, rural, level III stroke facility in the southwestern region of the United States. There was statistical significance in the total timeliness of care delivered by SCRNs to hyperacute stroke patients as compared with the non-SCRNs (t = -4.109, P = .001) and acute stroke protocol goal times for door to stroke team activation (t = -3.291, P = .001), door to computed tomography (t = -4.020, P < .001), door to teleneurology initiation (t = -4.020, P < .001), and door to alteplase administration (t = -3.367, P = .004). Limitations included sample size, nursing documentation, and nurses studying for the SCRN examination. It was concluded that, at this facility, SCRNs had a statistically significant difference in the timeliness of care delivered to hyperacute stroke patients on meeting protocol time goals. The SCRNs also met all protocol goals, and the non-SCRNs did not meet the door-to-teleneurology initiation and door-to-alteplase administration goals. Future studies should include a larger sample size and stroke patient outcomes.