Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke
Background. Intravenous tissue plasminogen activator, a time dependent therapy, can reduce the morbidity and mortality of acute ischemic stroke. This study was designed to assess the effect of simple in-hospital interventions on reducing door-to-CT (DTC) time and reaching door-to-needle (DTN) time o...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | International Journal of Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/1656212 |
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| author | Elyar Sadeghi-Hokmabadi Aliakbar Taheraghdam Mazyar Hashemilar Reza Rikhtegar Kaveh Mehrvar Mehrdad Mehrara Reshad Mirnour Rogayyeh Hassasi Hannane Aliyar Mohammadamin Farzi Somayyeh Hasaneh Tamar |
| author_facet | Elyar Sadeghi-Hokmabadi Aliakbar Taheraghdam Mazyar Hashemilar Reza Rikhtegar Kaveh Mehrvar Mehrdad Mehrara Reshad Mirnour Rogayyeh Hassasi Hannane Aliyar Mohammadamin Farzi Somayyeh Hasaneh Tamar |
| author_sort | Elyar Sadeghi-Hokmabadi |
| collection | DOAJ |
| description | Background. Intravenous tissue plasminogen activator, a time dependent therapy, can reduce the morbidity and mortality of acute ischemic stroke. This study was designed to assess the effect of simple in-hospital interventions on reducing door-to-CT (DTC) time and reaching door-to-needle (DTN) time of less than 60 minutes. Methods. Before any intervention, DTC time was recorded for 213 patients over a one-year period at our center. Five simple quality-improvement interventions were implemented, namely, call notification, prioritizing patients for CT scan, prioritizing patients for lab analysis, specifying a bed for acute stroke patients, and staff education. After intervention, over a course of 44 months, DTC time was recorded for 276 patients with the stroke code. Furthermore DTN time was recorded for 106 patients who were treated with IV thrombolytic therapy. Results. The median DTC time significantly decreased in the postintervention period comparing to the preintervention period [median (IQR); 20 (12–30) versus 75 (52.5–105), P<0.001]. At the postintervention period, the median (IQR) DTN time was 55 (40–73) minutes and proportion of patients with DTN time less than 60 minutes was 62.4% (P<0.001). Conclusion. Our interventions significantly reduced DTC time and resulted in an acceptable DTN time. These interventions are feasible in most hospitals and should be considered. |
| format | Article |
| id | doaj-art-d05e93c9cd72438b8a2ddcf92edc394e |
| institution | DOAJ |
| issn | 2090-2824 2090-2832 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Vascular Medicine |
| spelling | doaj-art-d05e93c9cd72438b8a2ddcf92edc394e2025-08-20T03:19:43ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322016-01-01201610.1155/2016/16562121656212Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute StrokeElyar Sadeghi-Hokmabadi0Aliakbar Taheraghdam1Mazyar Hashemilar2Reza Rikhtegar3Kaveh Mehrvar4Mehrdad Mehrara5Reshad Mirnour6Rogayyeh Hassasi7Hannane Aliyar8Mohammadamin Farzi9Somayyeh Hasaneh Tamar10Neuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranImam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranNeuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, IranBackground. Intravenous tissue plasminogen activator, a time dependent therapy, can reduce the morbidity and mortality of acute ischemic stroke. This study was designed to assess the effect of simple in-hospital interventions on reducing door-to-CT (DTC) time and reaching door-to-needle (DTN) time of less than 60 minutes. Methods. Before any intervention, DTC time was recorded for 213 patients over a one-year period at our center. Five simple quality-improvement interventions were implemented, namely, call notification, prioritizing patients for CT scan, prioritizing patients for lab analysis, specifying a bed for acute stroke patients, and staff education. After intervention, over a course of 44 months, DTC time was recorded for 276 patients with the stroke code. Furthermore DTN time was recorded for 106 patients who were treated with IV thrombolytic therapy. Results. The median DTC time significantly decreased in the postintervention period comparing to the preintervention period [median (IQR); 20 (12–30) versus 75 (52.5–105), P<0.001]. At the postintervention period, the median (IQR) DTN time was 55 (40–73) minutes and proportion of patients with DTN time less than 60 minutes was 62.4% (P<0.001). Conclusion. Our interventions significantly reduced DTC time and resulted in an acceptable DTN time. These interventions are feasible in most hospitals and should be considered.http://dx.doi.org/10.1155/2016/1656212 |
| spellingShingle | Elyar Sadeghi-Hokmabadi Aliakbar Taheraghdam Mazyar Hashemilar Reza Rikhtegar Kaveh Mehrvar Mehrdad Mehrara Reshad Mirnour Rogayyeh Hassasi Hannane Aliyar Mohammadamin Farzi Somayyeh Hasaneh Tamar Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke International Journal of Vascular Medicine |
| title | Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke |
| title_full | Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke |
| title_fullStr | Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke |
| title_full_unstemmed | Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke |
| title_short | Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke |
| title_sort | simple in hospital interventions to reduce door to ct time in acute stroke |
| url | http://dx.doi.org/10.1155/2016/1656212 |
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