Journal Article10.1016/J.JSTROKECEREBROVASDIS.2009.09.007
Stroke Alert Program Improves Recognition and Evaluation Time of In-Hospital Ischemic Stroke
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TL;DR: An inpatient stroke alert program is effective in decreasing evaluation time for in-hospital strokes, although response times remain significantly longer than those in the emergency department.
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Abstract: An inpatient stroke alert program is effective in decreasing evaluation time for in-hospital strokes, although response times remain significantly longer than those in the emergency department. It is capable of increasing the percentage of ischemic strokes identified by the hospital's stroke team, at the cost of an increased percentage of false alarms.
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Citations
Quality of Care and Outcomes for In-Hospital Ischemic Stroke Findings From the National Get With The Guidelines-Stroke
Ethan Cumbler,Heidi L. Wald,Deepak L. Bhatt,Margueritte Cox,Ying Xian,Mathew J. Reeves,Eric E. Smith,Lee H. Schwamm,Gregg C. Fonarow +8 more
TL;DR: There is an important opportunity for targeted quality improvement efforts for patients with in-hospital stroke, as compared with community-onset ischemic stroke, which experienced more severe strokes, received lower adherence to process-based quality measures, and had worse outcomes.
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In-Hospital Ischemic Stroke
TL;DR: Evidence points toward a “quality gap” for in-hospital stroke with longer in- hospital delays to evaluation and treatment, lower rates of evaluation for etiology, and decreased adherence to consensus quality process measures of care.
Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era.
Feras Akbik,Haolin Xu,Ying Xian,Shreyansh Shah,Eric E. Smith,Deepak L. Bhatt,Deepak L. Bhatt,Roland A. Matsouaka,Roland A. Matsouaka,Gregg C. Fonarow,Lee H. Schwamm +10 more
TL;DR: In-hospital onset was associated with longer delays to reperfusion and worse functional outcomes, highlighting opportunities to further care for patients with in-hospital stroke onset.
Quality of care for in-hospital stroke: analysis of a statewide registry.
TL;DR: Quality of care for in-hospital ischemic strokes compared to stroke with out-of-hospital onset was examined using cohort analysis of a statewide stroke database maintained by the Colorado Stroke Alliance and adherence to GWTG-Stroke performance measures was better.
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Identifying Best Practices to Improve Evaluation and Management of In-Hospital Stroke: A Scientific Statement From the American Heart Association
TL;DR: In this paper , the authors describe a path to optimizing care for patients who experience an in-hospital stroke, and propose five core elements to optimize in hospital stroke care: 1. Deliver stroke training to all hospital staff. 2. Create rapid response teams with dedicated stroke training and immediate access to neurological expertise.
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References
Early stroke treatment associated with better outcome The NINDS rt-PA Stroke Study
John R. Marler,B. C. Tilley,M. Lu,T. G. Brott,P. C. Lyden,J. C. Grotta,Joseph P. Broderick,Steven R. Levine,M. P. Frankel,S. H. Horowitz,E. C. Haley,C. A. Lewandowski,T. P. Kwiatkowski +12 more
TL;DR: If the NINDS rt-PA Stroke Trial treatment protocol is followed, this analysis suggests that patients treated 0 to 90 minutes from stroke onset with rt -PA have an increased odds of improvement at 24 hours and favorable 3-month outcome compared to patients treated later than 90 minutes.
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In-hospital stroke.
TL;DR: Increasing the awareness by hospital physicians of such interventions may be an important factor that reduces delays in assessment of patients who have stokes while in hospital.
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Evaluation times for patients with in-hospital strokes.
TL;DR: A substantial number of in-hospital stroke patients experience a long delay between symptom recognition and a neurological evaluation, and additional education of hospital staff may reduce these time delays.
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In-Hospital Stroke Treated With Intravenous Tissue Plasminogen Activator
Jaime Masjuan,P. Simal,Blanca Fuentes,Jose Antonio Egido,Fernando Díaz-Otero,Antonio Gil-Núñez,Maria Elena Novillo-López,Exuperio Díez-Tejedor,María Alonso de Leciñana +8 more
TL;DR: In-hospital procedures for thrombolysis proceed more slowly in IHSs than in OHSs, and the treatment procedures, safety, and efficacy of intravenous tissue plasminogen activator (IV-tPA) in I HSs compared with out-of-hospital strokes are safe and efficient.
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Introduction of an acute stroke team: an effective approach to hasten assessment and management of stroke in the emergency department.
F S Nazir,I Petre,Helen M Dewey +2 more
TL;DR: It is concluded that the introduction of the AST emergency call system has increased the number of eligible patients receiving rtPA and set-needle time and door-needling times significantly improved following introduction of this team approach.
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