Identifying Gaps and Missed Opportunities for Intravenous Thrombolytic Treatment of Inpatient Stroke.

Inpatient stroke-codes (ISC) have traditionally seen low treatment rates with IV-thrombolytic (IVT). The purpose of this study was to identify the predictors of true stroke, prevalent IVT-treatment gap and study the factors associated with such missed treatment opportunities (MTO). A retrospective chart review identified ISC from March 2017 to March 2018.

Migraine History: A Predictor of Negative Diffusion-Weighted Imaging in IV-tPA-Treated Stroke Mimics.

Background: Migraine, seizures, and psychiatric disorders are frequently reported as "stroke mimics" in patients with negative diffusion-weighted imaging (DWI) after IV-tPA. We sought to determine predictors of negative DWI in suspected stroke patients treated with IV-tPA.

Method: A retrospective case-control study encompassing all acute stroke patients treated with IV-tPA (at our hospital or "dripped and shipped") from January 2013 to December 2014 was con- ducted.

Stroke Simulation Improves Acute Stroke Management: A Systems-Based Practice Experience.

Background: Literature on the effectiveness of simulation-based medical education programs for caring for acute ischemic stroke (AIS) patients is limited.

Objective: To improve coordination and door-to-needle (DTN) time for AIS care, we implemented a stroke simulation training program for neurology residents and nursing staff in a comprehensive stroke center.

Methods: Acute stroke simulation training was implemented for first-year neurology residents in July 2011.

The "drip-and-ship" approach: starting IV t-PA for acute ischemic stroke at outside hospitals prior to transfer to a regional stroke center.

Purpose: Acute stroke therapy with intravenous (IV) tissue plasminogen activator (t-PA) is vastly underutilized. Increasingly, patients are being started on IV t-PA and being transferred to regional Stroke Center programs, where additional therapies can be offered in a multimodal format. We describe our experience at the Stroke Center at Hartford Hospital with interhospital patient transfers who received IV t-PA prior to transfer to our medical center.

Thrombolytic therapy in stroke-related trauma.

Purpose: Trauma and/or evidence of nonintracranial bleeding is a relative contraindication for thrombolytic therapy in acute stroke. The aim of this study was to determine the incidence and nature of stroke-related trauma and its influence on treatment of patients.

Methods: Patients with stroke-related trauma were identified among all acute-stroke patients protocoled for intravenous/intraarterial thrombolytic therapy during a two-year period (6/01-5/03).

Expanding the range of therapies for acute ischemic stroke: the early experience of the Regional Stroke Center at Hartford Hospital.

Purpose: Three to four percent of all patients with acute ischemic stroke (AIS) receive the only FDA-approved therapy, intravenous tissue plasminogen activator. We sought to assess the impact of a regional stroke program, the Stroke Center at Hartford Hospital, in facilitating various therapies for patients with AIS, and their early outcomes.

Methods: For a 34-month period (May 2001 to February, 2004), 113 patients received either i.

Reducing unnecessary blood work in the neurosurgical ICU.

Unnecessary blood work in critically ill patients can potentially reduce hemoglobin and circulating blood volume, causing blood replacement and increased care costs. The goals of this project were to (a) increase nursing and medical staff awareness of unessential or redundant blood work and (b) decrease the incidence of unnecessary and unordered blood work in the neurosurgical intensive care unit of an urban teaching hospital. Using the IDEA model of quality improvement, patient charts were reviewed and compared to physicians' orders.

Evidence-based nursing practice, Part 2: Building skills through research roundtables.

Numerous articles describe barriers to nurses conducting research and achieving evidence-based practice as well as strategies for overcoming barriers. The Research Roundtable format is one such strategy. It is an interactive means for providing novice nurse researchers and nursing students with the skill sets required to drive application of existing evidence to nursing practice and conduct outcome studies to derive new evidence.

Evidence-based nursing practice, Part 1: A hospital and university collaborative.

This first article in a two-part series describes a collaboration between healthcare and academic organizations that supports evidence-based nursing practice. The multifaceted activities resulting from this collaboration include an annual research and research utilization conference, a series of research roundtables, talks with nurse authors, and a website. Maintaining such a sustained collaboration encourages more rapid dissemination of research findings into practice, enriching nursing practice, and ultimately benefiting patient outcomes.