Development and Evaluation of the Stroke Fast Track Care System for Acute Ischemic Stroke Patients at Hatyai Hospital and Songkhla Provincial Hospital Network

Abstract

Objective. The purpose of study was to develop and evaluate the stroke fast track care for patients with acute ischemic stroke who were admitted at Hatyai Hospital and Songkhla Provincial Hospital network. Methods. This research and development (R&D) included three groups of participants. There were patients with acute ischemic stroke, registered nurses at Hatyai Hospitals, and Songkhla Provincial Hospital network. This R&D project was launched during October 2015 to September 2016. Outcomes were evaluated after implementation of Stroke Fast Track care system compared to the priori. There were three outcome domains as following; (1) patient’s outcomes, which focused on patient’s knowledge, self-care, and satisfaction on nursing and multidisciplinary care; (2) nurse’s outcome, focused on stroke care competency; and (3) care system, focused on stroke fast track development. Outcomes were analyzed by using descriptive statistics and paired t-test. Results. Post-test outcomes revealed that stroke patients had improved at good or very good levels on knowledge, self-care, and satisfaction (all p<0.001), compared to prior. Nurses had improved stroke care competency (p<0.001). For care system, the entire referral hospital network of Hat Yai Hospital in Songkhla Province improved their stroke fast tract care systems. For patients who received intravenous thrombolytic treatment, door- to- needle time decreased from 89.40 minutes to 53.45 minutes. Transferring time to the referral hospitals decreased from 64.29 minutes to 36.55 minutes. Additionally, all stroke patients had received standard care protocols. Conclusion. The stroke fast track care system development had impact on the outcomes of patients, and the process of care. These research and development project had demonstrated that the commitment and cooperation of stroke care team tremendously improved the stroke care.