Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement Project
Background. There are a large number of stroke patients in China, and there is currently a lack of prehospital acute stroke care training programs. Aim. To develop a prehospital emergency medical service (PEMS) training program to improve the prehospital identification and acute care of acute stroke...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2022/3456144 |
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| author | Huan Bao Sumian Zhang Junjie Hao Lian Zuo Xiahong Xu Yumei Yang Hua Jiang Gang Li |
| author_facet | Huan Bao Sumian Zhang Junjie Hao Lian Zuo Xiahong Xu Yumei Yang Hua Jiang Gang Li |
| author_sort | Huan Bao |
| collection | DOAJ |
| description | Background. There are a large number of stroke patients in China, and there is currently a lack of prehospital acute stroke care training programs. Aim. To develop a prehospital emergency medical service (PEMS) training program to improve the prehospital identification and acute care of acute stroke. Methods. Forty prehospital emergency doctors whose service stations are located within a 10 km radius from Shanghai Pudong New Area Medical Emergency Service Center took this course on November 13, 2014. A questionnaire was designed to evaluate the PEMS personnel’s knowledge in stroke and acute stroke care and was conducted before and after training as an assessment of the effectiveness of training. The patient population in this study included a baseline cohort before training and a prospective cohort after training, each composed of patients who were sent to Shanghai East Hospital South Stoke Center within one year. The transit time, final diagnosis, administration of thrombolysis, and door-to-needle time (DNT) were collected and analyzed. Results. After the training, 100% of the PEMS personnel were competent to identify stroke cases using the Cincinnati prehospital stroke scale (CPSS). All participants realized that intravenous thrombolysis therapy in a time-sensitive manner is the most effective way to treat acute ischemic stroke. Although there was no difference in first-aid transit time before and after training, the stroke diagnosis rate improved by 6.5% after training P=0.03. The thrombolysis rate increased to 29.6% from 24.3% but did not reach statistical significance. Compared to 84.0 minutes (standard deviation: 23.1 minutes) before the training, the average DNT after training was 53 minutes (standard deviation: 15.0 minutes), demonstrating a remarkable reduction P<0.01. Conclusion. The training program effectively improved the PEMS personnel’s knowledge in stroke and stroke acute care. |
| format | Article |
| id | doaj-art-eba6770be12a4729bff2f70fbef1b2bf |
| institution | OA Journals |
| issn | 2090-2859 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-eba6770be12a4729bff2f70fbef1b2bf2025-08-20T02:22:20ZengWileyEmergency Medicine International2090-28592022-01-01202210.1155/2022/3456144Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement ProjectHuan Bao0Sumian Zhang1Junjie Hao2Lian Zuo3Xiahong Xu4Yumei Yang5Hua Jiang6Gang Li7Department of NeurologyDepartment of ICUDepartment of NeurologyDepartment of NeurologyDepartment of NeurologyDepartment of NeurologyDepartment of Medical EducationDepartment of NeurologyBackground. There are a large number of stroke patients in China, and there is currently a lack of prehospital acute stroke care training programs. Aim. To develop a prehospital emergency medical service (PEMS) training program to improve the prehospital identification and acute care of acute stroke. Methods. Forty prehospital emergency doctors whose service stations are located within a 10 km radius from Shanghai Pudong New Area Medical Emergency Service Center took this course on November 13, 2014. A questionnaire was designed to evaluate the PEMS personnel’s knowledge in stroke and acute stroke care and was conducted before and after training as an assessment of the effectiveness of training. The patient population in this study included a baseline cohort before training and a prospective cohort after training, each composed of patients who were sent to Shanghai East Hospital South Stoke Center within one year. The transit time, final diagnosis, administration of thrombolysis, and door-to-needle time (DNT) were collected and analyzed. Results. After the training, 100% of the PEMS personnel were competent to identify stroke cases using the Cincinnati prehospital stroke scale (CPSS). All participants realized that intravenous thrombolysis therapy in a time-sensitive manner is the most effective way to treat acute ischemic stroke. Although there was no difference in first-aid transit time before and after training, the stroke diagnosis rate improved by 6.5% after training P=0.03. The thrombolysis rate increased to 29.6% from 24.3% but did not reach statistical significance. Compared to 84.0 minutes (standard deviation: 23.1 minutes) before the training, the average DNT after training was 53 minutes (standard deviation: 15.0 minutes), demonstrating a remarkable reduction P<0.01. Conclusion. The training program effectively improved the PEMS personnel’s knowledge in stroke and stroke acute care.http://dx.doi.org/10.1155/2022/3456144 |
| spellingShingle | Huan Bao Sumian Zhang Junjie Hao Lian Zuo Xiahong Xu Yumei Yang Hua Jiang Gang Li Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement Project Emergency Medicine International |
| title | Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement Project |
| title_full | Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement Project |
| title_fullStr | Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement Project |
| title_full_unstemmed | Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement Project |
| title_short | Improving the Prehospital Identification and Acute Care of Acute Stroke Patients: A Quality Improvement Project |
| title_sort | improving the prehospital identification and acute care of acute stroke patients a quality improvement project |
| url | http://dx.doi.org/10.1155/2022/3456144 |
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