Improving Acute In-Hospital Stroke Care by Reorganization of an In-Hospital Stroke Code Protocol.
J Stroke Cerebrovasc Dis
; 30(1): 105433, 2021 Jan.
Article
em En
| MEDLINE
| ID: mdl-33160124
ABSTRACT
BACKGROUND AND PURPOSE:
Delays in recognition and assessment of in-hospital strokes (IHS) can lead to poor outcomes. The aim was to examine whether reorganized IHS code protocol can reduce treatment time.METHODS:
IHS code protocol was developed, educational workshops were held for medical personnel. In the protocol, any medical personnel should directly consult a stroke neurologist before any diagnostic studies. Time intervals were compared between the pre- and post-implementation periods and between direct consultation with a stroke neurologist (DC group) and non-DC group in the post-implementation period.RESULTS:
A total of 145 patients were included (pre, 42; post, 103). Time from recognition to stroke neurologist assessment (91 vs. 35 min, pâ¯=â¯0.002) and time from recognition to neuroimaging (123 vs. 74, pâ¯=â¯0.013) were significantly lower in the post-implementation period. Time from stroke neurologist assessment to groin puncture was significantly lower (135 vs. 81, pâ¯=â¯0.037). In the post-implementation period, DC group showed significant time savings from last known well (LKW) to recognition (93 vs. 260, pâ¯=â¯0.001), LKW to stroke neurologist assessment (145 vs. 378, pâ¯=â¯0.001), and recognition to stroke neurologist assessment (16 vs. 76, p < 0.001) compared with non-DC group.CONCLUSIONS:
Reorganization of IHS code protocol reduced time from stroke recognition to assessment and treatment time. Reorganized IHS code and direct consultation with a stroke neurologist improved the initial response time.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encaminhamento e Consulta
/
Protocolos Clínicos
/
Prestação Integrada de Cuidados de Saúde
/
Acidente Vascular Cerebral
/
Procedimentos Endovasculares
/
Neuroimagem
/
Tempo para o Tratamento
Tipo de estudo:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Assunto da revista:
ANGIOLOGIA
/
CEREBRO
Ano de publicação:
2021
Tipo de documento:
Article