Get them in fast: Benchmark stroke data

Patient and family education gain importance when you consider how time-sensitive stroke is now known to be. Most patients don’t know, for example, that transient ischemic attacks when a hand goes numb and then gets better are often precursors to strokes.

"The trouble is, most stroke patients wait at home thinking it’s going to go away. By the time they come in, there’s not much we can do for them," says Teri McClean, RN, CEN, an emergency nurse at University of California-San Diego Stroke Center.

Identify your stroke time frames and compare them to the national standards. Here is the recommended time frame for treatment of stroke patients in the emergency department (ED) as developed by the National Institute of Neurological Disorders and Stroke in Bethesda, MD:

• Door to physician evaluation. A candidate for acute intervention should have initial physician evaluation within 10 minutes of arrival at the ED.

• Door to stroke team notification. Members of the stroke team should be notified within 15 minutes of arrival.

• Door to CT scan initiation. The CT scan should be initiated within 25 minutes of arrival.

• Door to CT scan interpretation. The CT scan should be interpreted by a capable individual within 45 minutes of arrival.

• Door to drug (needle) time. If indicated, the patient should be receiving thrombolysis within 60 minutes of arrival. A threshold of 80% is indicated for this parameter.

• Door to monitored bed. The patient should be transferred to the appropriate inpatient setting within 3 hours of arrival.