Development of a Nursing Care Model for Patients with Acute Stroke in The Emergency Room

Abstract

Background: Acute stroke is the leading cause of death, and disability worldwide, and the incidence tends to increase every year. Acute stroke is a critical condition in which the brain becomes ischemic, however, the brain tissues are still not permanently damaged.  If blood circulation to the brain is at a sufficient level, the brain tissues will recovery, and the patients will return to normal. Emergency nurses play a key role in caring to the patient with stroke. Providing early and optimal care to the patient based on standard evidence can prevent further complication, and reduce disability and mortality among patients with stroke.  

Objective: The purpose of this study was to develop and evaluate the effectiveness of the development of a nursing care model for patients with acute stroke in the emergency room.

Materials and Methods: This is a research and development design. The samples were 36 emergency nurses and 55 patients with acute stroke admitted in ER. Data were collected using questionnaires, and analyzed by using descriptive statistics and pair t-test.

Results: the nursing care model for patients with acute stroke in the emergency room includes guidelines for screening. Guidelines for nursing patients in the emergency room. Guidelines for transporting patients in emergency situations in hospitals and a set of knowledge in nursing for acute stroke patients showed that, the feasibility (M=4.43, S.D.=0.54), and satisfaction (M=4.44, S.D.=0.58) levels were at very good levels. Nurses' knowledge scores in caring for patients with acute stroke were significantly different before and after implementation of the nursing care model (p= .000). Clinical outcomes, including door to physician time  less than 10 minutes was at 97 %, door to initial time less than 25 minutes was at 84%, door to needle time less than 60 minutes was at 100%, and Door to puncture time  of thrombectomy  time less than 90 minutes was at 100%. There is no evidence of under or over triage, and deterioration during transfer the patients to other departments.

 Conclusions: The nursing care model for patients with acute stroke in emergency room has been developed and implemented effectively, and help to improve optimal outcomes for patients and organization.