J Emerg Nurs. 2023 Jul;49(4):546-552. doi: 10.1016/j.jen.2022.12.008. Epub 2023 Jan 27.
An updated stroke process was designed and implemented at an Acute Stroke Ready community hospital that relies on telestroke services. The objectives of the current quality improvement project were to describe the updates to the stroke process and compare pre- and postintervention data on nurse-driven elements of the process, namely telestroke notification and neurologist assessment.
Our multidisciplinary team reviewed quality data over several months to identify areas of improvement in the stroke process. Delays in door to telestroke notification and neurologist assessment were identified. A new process was developed and implemented, including e-alert notification and storing the telestroke cart in the computed tomography suite. The study period was 14 months, with nonrandomized, convenience sample data collected for 7 months before and after intervention.
There was a significant reduction in door to telestroke notification and neurologist assessment after implementing the new process. Door to telestroke notification and neurologist assessment were also strongly correlated.
This project led to significant improvements in nurse-driven elements of the stroke process. It demonstrates effective implementation of e-alert and collaboration with telestroke services at an Acute Stroke Ready Hospital serving rural communities.
一家依赖远程卒中服务的急性卒中预备社区医院设计并实施了更新的卒中流程。本质量改进项目的目的是描述流程的更新，并比较流程中护士驱动元素（即远程卒中通知和神经科医生评估）的干预前后数据。
我们的多学科团队在几个月的时间里审查了质量数据，以确定卒中流程中的改进领域。发现门到远程卒中通知和神经科医生评估的延迟。开发并实施了新的流程，包括电子警报通知和将远程卒中推车储存在计算机断层扫描套件中。研究期间为 14 个月，干预前和干预后分别收集了 7 个月的非随机便利样本数据。
实施新流程后，门到远程卒中通知和神经科医生评估的时间显著缩短。门到远程卒中通知和神经科医生评估也具有很强的相关性。
该项目显著改善了卒中流程中的护士驱动元素。它展示了在为农村社区服务的急性卒中预备医院中，电子警报的有效实施和与远程卒中服务的合作。
