Efforts to reduce the door-to-needle time of thrombolysis in acute ischemic stroke: Video-assisted therapeutic risk communication

Background/Purpose Explaining the risks and benefits of recombinant tissue-plasminogen activator (rtPA) to eligible patients with acute ischemic stroke (AIS) within a few minutes is important but difficult. We examined whether a new thrombolysis program can decrease the door-to-needle (DTN) time whe...

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Bibliographic Details
Published in:Journal of the Formosan Medical Association 2014-12, Vol.113 (12), p.929-933
Main Authors: Hsieh, Cheng-Yang, Chen, Wei-Fen, Chen, Chih-Hung, Wang, Chih-Yuan, Chen, Chien-Jung, Lai, Edward Chia-Cheng, Chen, Tsang-Shan
Format: Article
Language:English
Subjects:
Aged
Brain Ischemia - drug therapy
cerebral infarction
emergency medicine
Female
Fibrinolytic Agents - therapeutic use
Humans
Informed Consent
Internal Medicine
Male
Middle Aged
Patient Education as Topic - methods
plasminogen activators
Quality Improvement
Retrospective Studies
Risk Factors
Stroke - drug therapy
Taiwan
thrombolytic therapy
Time-to-Treatment - standards
Tissue Plasminogen Activator - therapeutic use
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Summary:Background/Purpose Explaining the risks and benefits of recombinant tissue-plasminogen activator (rtPA) to eligible patients with acute ischemic stroke (AIS) within a few minutes is important but difficult. We examined whether a new thrombolysis program can decrease the door-to-needle (DTN) time when treating patients with AIS. Methods A new rtPA thrombolysis program with video assistance was adapted for patients with AIS and their families. We retrospectively compared outcome quality before (2009–2011) and after (2012) the program began. Outcomes included DTN time, the percentage of rtPA thrombolysis within 3 hours of onset in all hospitalized patients with AIS who presented within 2 hours of onset (2hr%) and the percentage of rtPA thrombolysis in all hospitalized patients with AIS (AIS%). Results We recruited patients with AIS who had undergone thrombolytic therapy before ( n  = 18) and after ( n  = 14) the initiation of the new program. DTN time decreased (93 ± 24 minutes to 57 ± 14 minutes, p  
ISSN:0929-6646
DOI:10.1016/j.jfma.2013.11.012