{"id":16077,"date":"2024-03-18T17:26:58","date_gmt":"2024-03-18T17:26:58","guid":{"rendered":"https:\/\/www.writemyessays.app\/blog\/questions\/stroke-patients-getting-thrombolytic-therapy-within-30-minutes-of-arrival-to-the-er\/"},"modified":"2024-03-18T17:26:58","modified_gmt":"2024-03-18T17:26:58","slug":"stroke-patients-getting-thrombolytic-therapy-within-30-minutes-of-arrival-to-the-er","status":"publish","type":"questions","link":"https:\/\/www.writemyessays.app\/blog\/questions\/stroke-patients-getting-thrombolytic-therapy-within-30-minutes-of-arrival-to-the-er\/","title":{"rendered":"Stroke patients getting thrombolytic therapy within 30 minutes of arrival to the ER."},"content":{"rendered":"

This is the PICOT for my project: In adult stroke patients arriving at the emergency
\ndepartment, does the administration of thrombolytic therapy within 30
\nminutes of arrival compared to standard care, lead to improved clinical
\noutcomes such as reduced disability and mortality rates within the acute
\nphase of stroke management?<\/span><\/p>\n


<\/span><\/div>\n
<\/p>\n

Using the information already compiled in previous assignments, create a proposal of at least 8 pages (not including the Title page and Reference page) which includes:<\/p>\n

    \n
  • A Title Page including a title for your project<\/li>\n
  • A Literature Review supporting the need for the project<\/li>\n
  • At least 5 or more peer reviewed articles supporting the proposal<\/li>\n
  • Objectives and strategies for achievement of the Capstone project<\/li>\n
  • Background for the proposal including supportive resources indicated throughout the course e.g. budgeting, outcomes, evaluations.<\/li>\n
  • Formatting using APA style.\n
      \n
    • APA 7th edition format of the American Psychological Association (APA) is the official style used by Nightingale College. This style and format used to cite sources can be referenced from http:\/\/www.apastyle.org<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n


      Write the paper using APA style and upload to this drop box by the due date. Please review the rubric used to give feedback for more information.<\/p>\n

      <\/p>\n

      I’ve included my literary review for reference….<\/p>\n

      This was my Literary review:<\/p>\n

      Literature
      \nReview<\/span><\/b><\/p>\n

      While
      \neveryone’s life is different, the story of people who have had a stroke is a
      \npowerful example of resilience, adaptation, and how hard it is to get better.
      \nPatients who are 18 years or older, have experienced an ischemic stroke and are
      \nadmitted to the hospital will receive thrombolytic therapy treatment within 30
      \nminutes of arrival time. The standard of care at the current time is a window
      \nof 3-4 hours from onset of symptoms. The outcome of this project is to have the
      \npatient achieve an increased likelihood of independence in ADLs at time of
      \ndischarge. The purpose of this paper is to educate the population on stroke
      \nsymptoms and acting F.A.S.T in order to get expedited treatment to minimize any
      \ndeficits the stroke may have caused.<\/span><\/p>\n

      Methods
      \nof Searching<\/span><\/b><\/p>\n

                  <\/span>A literature review was conducted using both electronic
      \nand manual resources from the internet using Google search engine and also a
      \nmanual search using policies and procedures from Sutter Health. I used websites
      \nsuch as NIH, AHA and ASA. The manual search was done at Sutter Health with
      \nreading through policies and procedures related to the protocol and how these
      \nduties are carried out. I reviewed the policies specific to the emergency
      \ndepartment. The policies I researched at Sutter Health outline the times
      \nrelated to door to treatment of thrombolytics for ischemic strokes. <\/span><\/p>\n

      Project
      \nProposal Topic<\/span><\/b><\/p>\n

                  <\/span>The proposed
      \nproject is to optimize the door-to-thrombolytic treatment time for patients
      \npresenting with acute ischemic stroke. Time is of the essence in stroke
      \nmanagement, and evidence suggests that early administration of thrombolytic
      \ntherapy significantly improves outcomes. Therefore, this project seeks to
      \nimplement streamlined protocols and workflow strategies aimed at reducing the
      \ntime from a patient’s arrival at the hospital door to the treatment with
      \nthrombolytic therapies. By managing the innerworkings and collaboration,
      \ntechnology integration, and staff education initiatives, we aim to achieve a
      \nsignificant reduction in door-to-treatment times, ultimately improving patient
      \noutcomes and minimizing disability. Through meticulous monitoring and evaluation
      \nof process metrics and patient outcomes, this project will contribute to the
      \nongoing optimization of stroke care delivery, ensuring that patients receive
      \ntimely and effective treatment to maximize their chances of recovery.<\/span><\/span><\/p>\n

      Review
      \nof the Literature<\/span><\/b>Bottom of Form<\/span><\/span><\/b><\/p>\n

      Guidelines for the early management of patients
      \nwith acute ischemic stroke play a crucial  <\/span>role in optimizing patient care and outcomes.
      \nThese guidelines, informed by extensive research and expert unity, provide
      \nevidence-based recommendations for healthcare professionals involved in the
      \nacute management of stroke patients. They encompass a comprehensive approach,
      \naddressing important aspects such as rapid assessment, diagnostic evaluation,
      \ninitiation of thrombolytic therapy when appropriate, and the implementation of
      \nsupportive measures to mitigate secondary complications. By adhering to these
      \nguidelines, healthcare teams can ensure timely and standardized care delivery,
      \nthereby minimizing treatment delays, reducing the extent of neurological
      \ndamage, and enhancing the potential recovery for stroke patients. These
      \nguidelines serve as a base for quality improvement initiatives, promoting
      \ncontinuous advancements in stroke care practices and maintaining a culture of
      \nexcellence in stroke management across healthcare settings.<\/span><\/span><\/p>\n

      In July 2019, the AHA released an article
      \ndetailing the case of a 35-year-old woman who was discovered paralyzed in a
      \nstore bathroom. She had experienced migraine-like headaches for the previous
      \nthree weeks and got medical attention at an external hospital, where she
      \nunderwent evaluation, including a non-contrast CT scan of the head and a lumbar
      \npuncture, both showing normal results. During a shopping trip which marked her
      \nfirst outing following clearance from the emergency room, she suddenly
      \nexperienced a sensation of feeling “weird” and excused herself to the
      \nrestroom, where her mother found her several minutes later with left-sided
      \nparalysis and confusion. Paramedics were called, and they suspected the woman
      \nwas suffering from a stroke. Countless similar stories underscore the
      \nimportance of stroke guidelines, which have since been established and widely
      \nadopted worldwide<\/span>. Recognizing the symptoms of a stroke: F<\/b>ace
      \ndrooping, A<\/b>rm weakness, S<\/b>lurred speech, T<\/b>ime can save a
      \nlife and be the difference between permanent or temporary paralysis\/deficits. (AHAJournals,
      \n2019) <\/span><\/p>\n

      The
      \nNational Library of Medicine has conducted research on emergency department
      \narrival to needle time called \u201cdoor-to-needle\u201d time in patients with acute
      \nstroke. (NCBI, NLM, 2023) The data was extracted and analyzed from the Get With
      \nThe Guidelines Stroke Registry. This stroke registry not only looks at what
      \ntime the patient was brought to the hospital (day and night), the arrival to
      \nmedication time, time to CT and time to lab, but also whether there was a
      \ndedicated \u201cstroke team\u201d to take care of the patient. What they found was very
      \ninteresting. The median DTN (door to needle) time for the day shift was 37
      \nminutes and the DTN for the night shift was 59 minutes. The DTN time was 36
      \nminutes when the stroke team was present compared to 51 minutes when there was
      \nno designated stroke team. (NCBI, 2023)<\/span><\/p>\n

      The Heart.org provides comprehensive coverage
      \non all aspects related to strokes. Within its resources, you’ll find the
      \n“Get With The Guidelines” registry, which offers a wealth of
      \nquantitative data collected from the onset of stroke symptoms to the patient’s
      \ndischarge and return home. Additionally, the website offers guidance on
      \nobtaining stroke certifications for hospitals, detailing the various
      \ncertification levels based on available resources. It also offers valuable
      \ninformation on stroke types, recognizing stroke symptoms, and emphasizes the
      \nimportance of having a well-educated hospital staff equipped with resources for
      \noptimal patient outcomes. Additionally, there’s a dedicated section on stroke
      \nsurvivors, highlighting how sharing their experiences aids in emotional,
      \nmental, and physical recovery. (Stroke.org, 2021)<\/span><\/span><\/p>\n

      Findings<\/span><\/b><\/p>\n

      Research indicates that individuals who
      \npromptly seek medical attention upon experiencing stroke-like symptoms tend to
      \nachieve better outcomes and exhibit fewer deficits. Delaying hospital arrival
      \nsignificantly affects the brain’s condition, potentially leading to permanent
      \ndeficits. Therefore, calling 9-1-1 and receiving prehospital care are crucial
      \nsteps in ensuring a positive outcome for stroke patients. Literature also
      \nsuggests that early administration of thrombolytic medication, aimed at
      \ndissolving clots in ischemic strokes, has a direct correlation with improved
      \noutcomes and reduced deficits. Therefore, swift access to thrombolytic
      \ntreatment is paramount in mitigating the impact of ischemic strokes.<\/span> <\/span><\/p>\n

      Apart from the timely access to medical care,
      \nhospitals certified as stroke centers and equipped with specialized teams, like
      \nstroke teams, have demonstrated a remarkable ability to shorten the
      \ndoor-to-needle time by 15 minutes for patients experiencing ischemic stroke.
      \nEnsuring that staff members are well-trained and competent is equally important
      \nin optimizing stroke care. Regular trainings are required to ensure that
      \nhealthcare professionals remain up to date with the latest research findings
      \nand advancements in stroke management. This commitment to ongoing education and
      \nskill refinement is essential for delivering the highest quality of care and
      \nimproving patient outcomes. <\/span><\/span><\/p>\n

       <\/span><\/b><\/p>\n

      Conclusion<\/span><\/b><\/p>\n

      In conclusion, the management of acute ischemic
      \nstroke demands a multifaceted approach that encompasses timely intervention,
      \nspecialized care, and continuous staff education. The literature outlines the
      \ncritical importance of seeking immediate medical attention upon experiencing
      \nstroke-like symptoms, as prompt treatment significantly improves outcomes and
      \nreduces long-term deficits. The establishment of stroke centers staffed with
      \nspecialized teams has proven crucial in expediting treatment delivery and optimizing
      \npatient care. Additionally, the ongoing training and education of healthcare
      \nprofessionals are paramount in ensuring that stroke management practices remain
      \naligned with the latest research findings and best practices, ultimately
      \ncontributing to enhanced patient outcomes and quality of life. By adhering to
      \nthese principles and continuously striving for excellence, healthcare systems
      \ncan further advance stroke care and support the journey towards improved
      \npatient recovery and well-being.<\/span><\/p>\n

       <\/span><\/b><\/p>\n

       <\/span><\/b><\/p>\n

      References
      \n<\/span><\/b><\/p>\n

       <\/span><\/p>\n

      U.S. National Library of
      \nMedicine. (2023, March 30). Home – PMC – NCBI<\/i>. National Center for
      \nBiotechnology Information.
      \nhttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10098073\/ <\/p>\n

       <\/p>\n

      Thrombolytic therapy for
      \nacute ischemic stroke | stroke. (2019, July 22). https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.119.025699<\/a><\/p>\n

       <\/span><\/p>\n

      Guidelines for the early
      \nmanagement of patients with acute ischemic … (2020).       https:\/\/www.ahajournals.org\/doi\/10.1161\/STR.0000000000000211<\/a>\n<\/p>\n

       <\/p>\n

      The Joint Commission
      \nStandards Interpretation Group. (2021, October 26). Patient management tool-
      \nget with the guidelines (GWTG) compared to Joint Commission: Advanced DSC –
      \nAcute Stroke Ready Hospital: Performance Measurement DSPM<\/i>. The Joint
      \nCommission.
      \nhttps:\/\/www.jointcommission.org\/standards\/standard-faqs\/advanced-dsc—acute-stroke-ready-hospital\/performance-measurement-dspm\/000001607\/\n<\/p>\n

       <\/i><\/p>\n

      Warning signs<\/i>. The Stroke Foundation. (2021, April 21). <\/p>\n

      \n

      \n

      Warning signs<\/a><\/p><\/blockquote>\n