Date of Graduation
Project/Capstone - Global access
Master of Science in Nursing (MSN)
School of Nursing and Health Professions
Mary Lou De Natale
Saving the Brain Matter(s): Improving Stroke Outcomes Utilizing a Direct to CT Workflow was a project implemented to improve outcomes for acute ischemic stroke patients arriving at a rural emergency department. The project focused on a revision of the emergency department workflow for acute ischemic stroke patients with an aim of lowering the door to needle time to under sixty minutes. An interdisciplinary team used lean methodology and the PDCA cycle to examine and revise the workflow. The workflow was revised to eliminate testing no longer required under the national clinical practice guidelines for the treatment of ischemic stroke. Within the new workflow patients arriving via the 911 system were taken directly from the ambulance to the CT scanner. Additionally, nursing care for all ischemic stroke patients eligible for potential alteplase treatment was increase from one nurse to two nurses until the decision to use or not use alteplase was made. After the interdisciplinary team developed the workflow over 140 healthcare professionals from multiple departments were educated on the process change and the workflow was implemented. After implementation the mean door to alteplase time dropped to forty-five minutes and the facility was recognized by the American Heart Association for providing rapid and quality care to acute ischemic stroke patients.
Schambach, Robert, "Saving the Brain Matter(s): Improving Stroke Outcomes Utilizing a Direct to CT Workflow" (2017). Master's Projects and Capstones. 663.