ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2016
24/7 Neurocritical Care Nurse Practitioner Coverage Reduced Door-to-Needle Time in Stroke Patients Treated with Tissue Plasminogen Activator.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Effect of implementing care protocols on acute ischemic stroke outcomes: a systematic review.Arquivos de neuro-psiquiatria · 2023Pooled it
- Reducing care time after implementing protocols for acute ischemic stroke: a systematic review.Arquivos de neuro-psiquiatria · 2022Pooled it
- Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis.Implementation science : IS · 2020Pooled it
- Pooled it
- The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review.Human resources for health · 2017Pooled it
- 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
- Teleneurocritical Care for Patients with Large Vessel Occlusive Ischemic Stroke Treated by Thrombectomy.Neurocritical care · 2023Article
- Clinical significance of stroke nurse in patients with acute ischemic stroke receiving intravenous thrombolysis.BMC neurology · 2021Article
- Nurse Practitioners and Physician Assistants in Acute and Critical Care: A Concise Review of the Literature and Data 2008-2018.Critical care medicine · 2019Review
- How a CT-Direct Protocol at an American Comprehensive Stroke Center Led to Door-to-Needle Times Less Than 30 Minutes.The Neurohospitalist · 2017Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundStroke centers with limited on-site neurovascular physician coverage may experience delays in acute stroke treatment. We sought to assess the impact of providing 24/7 neurocritical care acute care nurse practitioner (ACNP) "stroke code" first responder coverage on treatment delays in acute stroke patients who received tissue plasminogen activator (tPA).
methodsConsecutive acute ischemic stroke patients treated with intravenous tPA at a primary stroke center on Oahu between 2009 and 2014were retrospectively studied. 24/7 ACNP stroke code coverage (intervention) was introduced on July 1, 2011. The tPA utilization, door-to-needle (DTN) time, imaging-to-needle (ITN) time, and independent ambulation at hospital discharge were compared between the preintervention period (24 months) and the postintervention period (33 months).
resultsWe studied 166 stroke code patients who were treated with intravenous tPA, 44 of whom were treated during the preintervention period and 122 of whom were treated during the postintervention period. After the intervention, the median DTN time was reduced from 53 minutes (interquartile range [IQR] 45-73) to 45 minutes (IQR 35-58) (P = .001), and the median ITN time was reduced from 36 minutes (IQR 28-64) to 21 minutes (IQR 16-31) (P < .0001). Compliance with the 60-minute target DTN improved from 61.4% (27 of 44 patients) in the preintervention period to 81.2% (99 of 122 patients) in the postintervention period (P = .004). The tPA treatment rates were similar between the preintervention and postintervention periods (P = .60).
conclusionsAddition of 24/7 on-site neurocritical care ACNP first responder coverage for acute stroke code significantly reduced the DTN time among acute stroke patients treated with tPA.
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