Related Experiment Video
Updated: Jun 20, 2026
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Improving stroke care and outcomes through AHA/ASA primary stroke certification: a pre-post study in Jordan
Mohammad R Alosta1, Elham H Othman2, Tareq Afaneh1
1Faculty of Nursing, Zarqa University, Zarqa, 13132, Jordan.
Summary
Implementing American Heart Association/American Stroke Association (AHA/ASA) stroke care standards significantly improved patient outcomes and timeliness of interventions in Jordan. This demonstrates the success of universal stroke protocols in resource-limited settings.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- Stroke is a leading global cause of disability and death, with delays in treatment worsening patient outcomes.
- Evidence-based guidelines, such as those from the American Heart Association/American Stroke Association (AHA/ASA), improve stroke care but are underutilized in middle-income countries like Jordan.
Purpose of the Study:
- To evaluate the impact of implementing AHA/ASA primary stroke certification standards on stroke care delivery and patient outcomes.
- To assess the feasibility of applying universal stroke protocols in a resource-limited hospital setting in Jordan.
Main Methods:
- A quasi-experimental pre-post study design with non-equivalent groups.
- Comparison of key performance indicators (KPIs) for stroke care in 62 patients (31 before and 31 after certification).
- Statistical analysis using independent-samples t-tests and Chi-square tests.
Main Results:
- Significant improvements observed in most care indicators post-certification.
- Reduced time to CT scan (29.5 to 14.1 min) and CT report (by 68.3 min).
- Increased IV tPA administration (54.2% to 81.5%), early rehabilitation (48.4% to 93.5%), and patient education (9.7% to 90.3%).
- Improved 3-month functional outcomes (29% to 71%) and no 30-day readmissions.
Conclusions:
- Implementation of AHA/ASA standards led to enhanced stroke care processes and patient outcomes.
- Demonstrates the success of universal stroke protocols in resource-limited environments.
- Supports scaling up evidence-based stroke care in Jordanian hospitals for better, sustainable outcomes.
Related Concept Videos
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:23Atherosclerosis IV: Nursing Management
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
01:27Regulation of Stroke Volume
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...