Development of A Care Model for Acute Stroke Patients with Administration of Intravenous Recombinant Tissue Plasminogen Activator

Abstract

Acute stroke is the important cause of dead in the elderly. This action research was to develop and evaluate a care model for patients with acute ischemic stroke treated with rt-PA in Srisangwornsukhothai Hospital from  January 2015 to July 2017. The research processes composed of four steps including 1) gap analysis 2)  develop care model 3) implementation 4) evaluate development results.The sample were selected by  purposive sampling with 35 persons from multidisciplinary team and 36 ischemic stroke patients treated with  rt-PA.The data were analyzed with comparative statistics paired t test. The results showed that acute  ischemic stroke care treated with rt-PA by multidisciplinary team followed the care guideline 96% in the  performance. The patients treated with rt-PA, onset to needle time mean 2 hrs. 29 mins, National Institute of Health Stroke Scale at discharge reduction by mean 8 scores (p < 0.001), Barthel index at discharge increase  62 scores (p < 0.001), modified Rankin scale (0-1) at discharge was 51.1% and intracranial hemorrhage found  11.1%. In conclusion, the development of a care model for acute ischemic stroke patients treated with rt-PA  by multidisciplinary team, results in better therapeutic outcomes.