This hospital is a 454-bed acute care hospital located in Jacksonville, Florida. This hospital has been a leader in providing quality healthcare to Northeast Florida and is a Certified Primary Stroke Center through The Joint Commission.
There were inconsistencies and variations in the stroke alert process, leading to alteplase administration delays and Door-to-Needle (DTN) times above the 45-minutes facility goal.
A comprehensive review of the current stroke process was completed, and areas of common delays were streamlined using American Stroke Association best practice recommendations and TeleSpecialists’ guidelines. The changes included:
- Implementation of a Pit Stop to quickly assess and obtain key treatment elements (blood glucose, weight, blood pressure) within a 5-minutes or less goal, then immediately obtain imaging
- A stroke kit containing alteplase and blood pressure medications was relocated to CT to ensure quick access and availability (implemented Q3 2020)
- Consistently taking the TeleStroke cart to CT to ensure the neurologist can quickly assess and make decisions on treatment
- Alteplase administration is consistently completed in Radiology with the neurologist remaining on screen to assist staff with dosing
- A time out procedure is conducted to review patient safety measures prior to administration