Fant Grace N, Lakomy Janet M
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J Neurosci Nurs. 2019 Feb;51(1):54-59. doi: 10.1097/JNN.0000000000000414.
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.
在这项采用便利抽样的回顾性、非实验性、比较描述性设计中,研究人员在美国西南部一个小型农村三级卒中机构,比较了11名卒中认证注册护士(SCRN)依据“目标:卒中二期运动手册”急性卒中方案,为95名超急性卒中患者(最后知晓健康状态时间为4.5小时或更短)提供护理的及时性,与13名非SCRN的护理及时性。结果显示,SCRN为超急性卒中患者提供护理的总及时性与非SCRN相比具有统计学意义(t = -4.109,P = .001),且在卒中团队激活时间(t = -3.291,P = .001)、到计算机断层扫描时间(t = -4.020,P < .001)、远程神经科启动时间(t = -4.020,P < .001)以及阿替普酶给药时间(t = -3.367,P = .004)等急性卒中方案目标时间方面也有统计学意义。研究局限包括样本量、护理记录以及正在备考SCRN考试的护士。研究得出结论,在该机构,SCRN在为超急性卒中患者提供护理的及时性方面,在达到方案时间目标上存在统计学显著差异。SCRN还达到了所有方案目标,而非SCRN未达到远程神经科启动和阿替普酶给药目标。未来研究应纳入更大样本量以及卒中患者的预后情况。