Date of Graduation

Fall 12-18-2015

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Elena Capella, EdD MSN/MPA RN CNL CPHQ LNCC

Abstract

Abstract Final

The specific goal of the project is to decrease the arrival to t-PA treatment times to <45 minutes in > 50% of the cases. The decreased treatment time will prove to shorten the average length of stay on average by two days (Audebert & Sobesky, 2014). The goal will be accomplished by decreasing the arrival to computerized tomography (CT) scan completion time by at least 20%. The specific population of patients will be all stroke alert arrivals to the process’s microsystem via EMS, an Advanced Primary Stroke Center in Sacramento California. Root Cause Analysis, Strength, Weakness, Opportunity, Threat (SWOT), and Plan, Do, Study, Act (PDSA) are several of the tools used to identify and implement the project. The data six months after process implementation showed a decrease in arrival to CT completion time of 42.9%, well below the target decrease of 20%. The door to needle (DTN) times experienced an overall average decrease of 32.1 % and met the AHA/ASA Target Stroke Phase II goal of 50% of t-PA cases treated < 45 minutes. Finally, patients who received t-PA after process initiation experienced a 2.5 decrease in length of stay when compared to the previous year. This represents a 58.3% decrease in LOS compared to the goal of 50%. These results are very encouraging that the process is having a positive effect on the target patient population.

References

Audebert, H. J., & Sobesky, J. (2014, October 21st). . ’Time is brain’ after stroke, regardless of age and severity, 10, 675-676. http://dx.doi.org/10.1038.nrnerol.2014.194

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