2.50
Hdl Handle:
http://hdl.handle.net/10755/324159
Category:
Abstract
Type:
Presentation
Title:
Time is Brain, Team is Key
Author(s):
Howard, Chantal; Flanagan, Leighann
Author Details:
Chantal Howard, MSN, RN, CEN, email: chhoward@wakemed.org; Leighann Flanagan, RN, CEN
Abstract:
Evidence-based Practice Abstract Purpose: The American Heart Association has set 60 minutes as the goal for “door to needle” time for the treatment of Acute Ischemic Stroke. The objective of this quality assurance project was to significantly reduce the 120 minute ‘processing’ time for stroke patients from time of arrival in a Level I Trauma Center to the administration of t-PA. Design: Quality assurance project using a multidisciplinary team approach. Setting: 870-bed urban healthcare system and Level One Trauma Center; Primary Stroke Center. Participants: In order to identify and problem-solve delays in care, we enlisted the participation of every internal AND external entity that impacted the care of our stroke patients. These included the local area Emergency Medical Systems, Laboratory, Radiology, Clinical Administrator (House Supervisor), Rapid Response Team, Pharmacy and, of course, all staff in the Adult Emergency Department (N=~250). Methods: Once it was determined that a change needed to occur, our ED Leadership team scrutinized each step in the process-- from initiation of the 911 call in the community to the administration of t-PA. With the assistance of ED staff, time guzzlers were identified and strategies proposed to reduce them. Internal and external partners were identified; champions included the EMS Medical Director and the Director of Pathology. Inter-departmental barriers were discussed and reduced through collaborative problem-solving; policies and procedures were written, education was created and disseminated and supplies were standardized. Results/Outcomes: Results have been remarkable primarily because of the multidisciplinary team buy-in to the new process. For example, the pre-hospital (EMS) lab draw has helped reduced our lab turnaround time from 43 minutes to 31. Keeping the patient on the EMS stretcher from arrival in the ED to CT has reduced door to CT time from 19 to 11 minutes. Before the initiation of the project, the door to treatment with t-PA was 120 minutes. This was reduced to 40 minutes within the first month and sustained at less than 60 minutes for six months after its commencement. (Additional results will be available on the poster at the conference.) Implications: Key to our success was creating a coordinated, choreographed process that actively sought the assistance of any discipline or department that impacted the care of our Acute Ischemic Stroke patient. The outcomes speak for themselves; as does our subsequent recognition on the American Heart Association’s Target Stroke Honor Roll.
Keywords:
Reduce time to administration of t-PA; Stroke
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleTime is Brain, Team is Keyen_GB
dc.contributor.authorHoward, Chantalen_GB
dc.contributor.authorFlanagan, Leighannen_GB
dc.author.detailsChantal Howard, MSN, RN, CEN, email: chhoward@wakemed.org; Leighann Flanagan, RN, CENen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324159-
dc.description.abstractEvidence-based Practice Abstract Purpose: The American Heart Association has set 60 minutes as the goal for “door to needle” time for the treatment of Acute Ischemic Stroke. The objective of this quality assurance project was to significantly reduce the 120 minute ‘processing’ time for stroke patients from time of arrival in a Level I Trauma Center to the administration of t-PA. Design: Quality assurance project using a multidisciplinary team approach. Setting: 870-bed urban healthcare system and Level One Trauma Center; Primary Stroke Center. Participants: In order to identify and problem-solve delays in care, we enlisted the participation of every internal AND external entity that impacted the care of our stroke patients. These included the local area Emergency Medical Systems, Laboratory, Radiology, Clinical Administrator (House Supervisor), Rapid Response Team, Pharmacy and, of course, all staff in the Adult Emergency Department (N=~250). Methods: Once it was determined that a change needed to occur, our ED Leadership team scrutinized each step in the process-- from initiation of the 911 call in the community to the administration of t-PA. With the assistance of ED staff, time guzzlers were identified and strategies proposed to reduce them. Internal and external partners were identified; champions included the EMS Medical Director and the Director of Pathology. Inter-departmental barriers were discussed and reduced through collaborative problem-solving; policies and procedures were written, education was created and disseminated and supplies were standardized. Results/Outcomes: Results have been remarkable primarily because of the multidisciplinary team buy-in to the new process. For example, the pre-hospital (EMS) lab draw has helped reduced our lab turnaround time from 43 minutes to 31. Keeping the patient on the EMS stretcher from arrival in the ED to CT has reduced door to CT time from 19 to 11 minutes. Before the initiation of the project, the door to treatment with t-PA was 120 minutes. This was reduced to 40 minutes within the first month and sustained at less than 60 minutes for six months after its commencement. (Additional results will be available on the poster at the conference.) Implications: Key to our success was creating a coordinated, choreographed process that actively sought the assistance of any discipline or department that impacted the care of our Acute Ischemic Stroke patient. The outcomes speak for themselves; as does our subsequent recognition on the American Heart Association’s Target Stroke Honor Roll.en_GB
dc.subjectReduce time to administration of t-PAen_GB
dc.subjectStrokeen_GB
dc.date.available2014-08-04T13:28:34Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:34Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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