Defense Date
4-16-2024
Graduation Date
Spring 5-11-2024
Submission Type
DNP Manuscript
Degree Name
Doctor of Nursing Practice (DNP)
Department
Doctor of Nursing Practice (DNP) Program
School
School of Nursing
Faculty Mentor
Catherine Johnson
Keywords
acute ischemic stroke, door-to-needle time, emergency nursing, intravenous thrombolysis, program evaluation, stroke system of care
Abstract
Stroke is a significant public health problem in the United States and globally. For patients experiencing an acute ischemic stroke, also known as “infarct” or “brain attack,” the effectiveness of treatment is extremely time dependent. This DNP Project presents a program evaluation of stroke care delivered in five emergency departments (EDs) in community hospitals in a health system newly formed through the merger of two smaller organizations. This evaluation focused on assessing the five programs’ effectiveness in delivering timely and effective care to stroke patients with the standardized performance measure door-to-needle (DTN). The evaluation also included a review of factors influencing timely telestroke utilization, including workflow evaluation of the Stroke Alert process and interviews with interprofessional Stroke Center Team members.
By comparing these elements, the evaluation identified areas for improvement including streamlining “telestroke” activation, expanding interprofessional stroke team members role responsibilities including considering the stroke coordinator role who would support protocol adherence and training of nurses specifically trained and designated to respond in ED stroke alerts.
A significant recommendation of this program evaluation is the adoption of a single Stroke Center certification for all five programs. Standardizing certification processes not only streamlines data collection efforts but also ensures consistency in performance metrics and benchmarks. This, in turn, facilitates meaningful comparisons between campuses, allowing for more accurate assessment of quality improvement initiatives and patient outcomes. Moreover, a unified certification entity would promote alignment with industry best practices and regulatory requirements, fostering a culture of continuous improvement and accountability across the organization.
Language
English
Recommended Citation
Adams, Joshua, "Strokes of Excellence and Opportunity: A Program Evaluation Analyzing Emergency Department Stroke Care in a Newly Formed Five-Hospital Health System" (2024). Doctor of Nursing Practice (DNP) Manuscripts. 49.
https://dsc.duq.edu/dnp/49