کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3039860 1579687 2015 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Barriers to administering intravenous tissue plasminogen activator (tPA) for acute ischemic stroke in the emergency department: A cross-sectional survey of stroke centers
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
پیش نمایش صفحه اول مقاله
Barriers to administering intravenous tissue plasminogen activator (tPA) for acute ischemic stroke in the emergency department: A cross-sectional survey of stroke centers
چکیده انگلیسی


• We distributed a survey to stroke coordinators from different stroke centers.
• We identified practice patterns in IV tPA administration for acute stroke.
• Special attention was paid to clinical pharmacy and nursing staff.
• Practices and perceived barriers varied widely between different stroke centers.

ObjectiveThe logistics involved in administration of IV tPA for acute ischemic stroke patients are complex, and may contribute to variability in door-to-needle times between different hospitals. We sought to identify practice patterns in stroke centers related to IV tPA use. We hypothesized that there would be significant variability in logistics related to ancillary staff (i.e. nursing, pharmacists) processes in the emergency room setting.MethodsA 21 question survey was distributed to attendees of the AHA/ASA Southwest Affiliate Stroke Coordinators Conference to evaluate potential barriers and delays with regards to thrombolysis for acute strokes patients in the Emergency Department setting. Answers were anonymous and aggregated to examine trends in responses.ResultsResponses were obtained from 37 of 67 (55%) stroke centers, which were located mainly in the Southwest United States. Logistical processes differed between facilities. Nursing and pharmacy carried stroke pagers in only 19% of the centers, and pharmacy responded to stroke alerts only one-third of centers. Insertion of Foley catheters and nasogastric tubes prior to tPA was routine in some of the sites. Other barriers to IV tPA administration included physician reluctance and inadequate communication between health care providers.ConclusionPractices regarding logistics for giving IV tPA may be variable amongst different stroke centers. Given this potential variability, prospective evaluation to confirm these preliminary findings is warranted.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Neurology and Neurosurgery - Volume 135, August 2015, Pages 79–84
نویسندگان
, , , , , ,