ArticleHeart (British Cardiac Society)2000
Improving door to needle times with nurse initiated thrombolysis.
Article in Heart (British Cardiac Society), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00993954 (Reduction of Radial Head Subluxation in Children Via a Nurse Initiated Pathway), which is not on this map. Cited by 12 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Reduction of Radial Head Subluxation in Children Via a Nurse Initiated Pathway: A Randomized Control Trial
Who cites it
12 citing papers in PubMed.
- Nurse Practitioner Contribution to Shortening the Time from Angiography Suite Entry to Puncture in Mechanical Thrombectomy for Acute Ischemic Stroke.Journal of neuroendovascular therapy · 2026Article
- Stroke code simulation benefits advanced practice providers similar to neurology residents.Neurology. Clinical practice · 2018Article
- 24/7 Neurocritical Care Nurse Practitioner Coverage Reduced Door-to-Needle Time in Stroke Patients Treated with Tissue Plasminogen Activator.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2016Article
- Failure to improve door-to-needle time by switching to emergency physician-initiated thrombolysis for ST elevation myocardial infarction.Postgraduate medical journal · 2013Article
- Reduction in Door-to-Needle Time after Transfer of Thrombolysis Site from CCU to Emergency Department.Emergency medicine international · 2013Article
- Advanced nursing directives: integrating validated clinical scoring systems into nursing care in the pediatric emergency department.Nursing research and practice · 2012Article
- Nursing role to improve care to infarct patients and patients undergoing heart surgery: 10 years' experience.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2012Article
- A review of interventions and system changes to improve time to reperfusion for ST-segment elevation myocardial infarction.Journal of general internal medicine · 2008Review
- Using simulation to estimate the cost effectiveness of improving ambulance and thrombolysis response times after myocardial infarction.Emergency medicine journal : EMJ · 2006Article
- Emergency department thrombolysis improves door to needle times.Emergency medicine journal : EMJ · 2004Article
- Nurse initiated thrombolysis in the accident and emergency department: safe, accurate, and faster than fast track.Emergency medicine journal : EMJ · 2003Article
- Fifth report on the provision of services for patients with heart disease.Heart (British Cardiac Society) · 2002Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effect of nurse initiated thrombolysis on door to needle time (the interval between arriving at the hospital and starting thrombolytic treatment) in patients with acute myocardial infarction.
designComparison of door to needle times before and after the employment of nurses trained and approved to initiate thrombolysis without prescription by a doctor but with a protocol for rapid triage of patients with chest pain.
settingA district general hospital. SUBJECTS: All patients admitted with suspected myocardial infarction between April 1995 and March 1999.
main outcome measuresSpeed (door to needle time) and appropriateness of administration of thrombolytic drugs to patients with acute myocardial infarction who gave a characteristic history and had appropriate criteria on the admission ECG.
resultsDuring seven periods (each of four months) before the introduction of nurse initiated thrombolysis and a new chest pain triage protocol, the median door to needle time varied from 50-58 minutes. In four periods (each of 4-6 months) following the introduction of the changes, the median door to needle time was 25-30 minutes. The improvement was significant (p < 0.001). Nurses trained to initiate thrombolysis currently provide cover for 66% of the time. Median door to needle time for nurses was 15 minutes. Median door to needle time for junior doctors improved to 35 minutes. The median door to needle times when nurses initiated thrombolysis was significantly shorter than when doctors did so (p < 0.001). There have been no inappropriate management decisions by nurses approved to initiate thrombolysis.
conclusionsThe use of nurse initiated thrombolysis has resulted in a clinically important reduction in the time taken for thrombolysis to be started in patients with acute myocardial infarction.
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