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2011
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Document type:
Journal Article; Article
Author(s):
Etgen, T; Freudenberger, T; Schwahn, M; Rieder, G; Sander, D
Title:
Multimodal strategy in the successful implementation of a stroke unit in a community hospital.
Abstract:
Etgen T, Freudenberger T, Schwahn M, Rieder G, Sander D. Multimodal strategy in the successful implementation of a stroke unit in a community hospital. Acta Neurol Scand: 2011: 123: 390-395. © 2010 John Wiley & Sons A/S. Objectives - Thrombolysis in stroke remains underutilized in daily practice. We analyzed the impact of a multimodal strategy on the rate of thrombolysis and specific procedure times during the implementation of a community hospital stroke unit. Material and methods - During a period of 2 years before and after implementation of a stroke unit, we prospectively recorded all patients with thrombolysis and specific procedure times. Calculated door-to-needle time (DNT), door-to-CT time (DCT) and CT-to-needle time (CNT) were analyzed. All structural changes before and after the implementation were analyzed. Results - The number of patients with thrombolysis increased from 24 in 2005-2006 (4.8% of all admitted patients with ischemic stroke) to 95 in 2007-2008 (12.8%). DNT was significantly reduced from 62.2 ± 36.1 to 38.5 ± 22.2 min (P < 0.001). DCT remained unchanged at 10.3 ± 9.5 to 10.4 ± 13.9 min (P = 0.974), whereas CNT improved from 45.7 ± 23.1 to 28.3 ± 20.3 min (P = 0.001). Several structural changes concerning staff, logistics, procedures and laboratory were identified which contributed to decreasing DNT. Conclusions - A multimodal strategy including several structural changes enables the successful implementation of a community hospital stroke unit offering rapid access to thrombolysis with a very short DNT.
Journal title abbreviation:
Acta Neurol Scand
Year:
2011
Journal volume:
123
Journal issue:
6
Pages contribution:
390-5
Language:
eng
Fulltext / DOI:
doi:10.1111/j.1600-0404.2010.01413.x
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/20704572
Print-ISSN:
0001-6314
TUM Institution:
Klinik und Poliklinik für Psychiatrie und Psychotherapie; Neurologische Klinik und Poliklinik
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mediaTUM Gesamtbestand
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TUM School of Medicine and Health
Departments
Clinical Medicine
Klinik und Poliklinik für Neurologie (Prof. Hemmer)
2011
mediaTUM Gesamtbestand
Einrichtungen
Schools
TUM School of Medicine and Health
Departments
Clinical Medicine
Klinik und Poliklinik für Psychiatrie und Psychotherapie (Prof. Priller)
2011