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Updated: Jan 10, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Nursing-Led Quality Improvement Project Achieves 30-Minute Door-to-Needle Time
Introduction:
Despite efforts made within the emergency department, delays in intravenous thrombolytic time via telestroke remain.
Methods:
A quality improvement project streamlined stroke care, focusing on workflow optimization, education, improved communication, and real-time feedback, aiming to reduce door-to-needle time.
Results:
A retrospective analysis revealed a reduction in door-to-needle time of 18.05 minutes (95% CI, 7.70-28.41; P = .001) was achieved. Achievement of door-to-needle time goals (30, 45, and 60 minutes) was met after implementation (adjusted P < .005). A higher proportion of intravenous thrombolytic rates occurred after implementation (45 [14.0%] vs 79 [8.1%]; adjusted odds ratio, 1.91; 95% CI, 1.29-2.84; P = .001).
Discussion:
A telestroke-enabled primary stroke center consistently achieved <30-minute door-to-needle time through a nurse-led workflow emphasizing early stroke alert and computed tomography.
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