Thrombolytic Timing in the Emergency Department

Abstract

Acute ischemic stroke is a leading cause of disability & morbidity in the United States (US). Timely administration of IV thrombolytic therapy improves neurological outcomes and reduces disability. American Heart Association (AHA) & American Stroke Association (ASA) guidelines emphasize rapid treatment, recommending CTN < 25 minutes & DTN < 45 minutes (Powers et al., 2019). Despite these recommendations, delays in stroke evaluations, imaging, decision making and treatment continue to challenge EDs, and have the potential to negatively impact patient outcomes. The purpose of this Doctor of Nursing Practice (DNP) project was to improve (AIS) treatment timeliness in a Level III emergency department (ED) by reducing computed tomography-to-needle (CTN) & door-to-needle (DTN) times among patients receiving intravenous (IV) thrombolytic therapy.