| Objective:This study aimed to explore the reasons for the delay about patients with ischemic strok including thrombolysis in the hospital and the visit time.Targeted measures was taken so as to establish standard workflow and improve the management ability of patients with ischemic stroke and the ischemic stroke cognitive level of of the public.The ultimate goal was to make the treatment of patients with ischemic stroke in a timely manner.Method:The first stage was to track the treatmet process of ischemic stroke patients and record each time of the process;to find the nurses’ cognitive level of the knowledge about ischemic stroke by questionnaire;to find patients’ cognitive level of the knowledge about ischemic stroke by questionnaire.From the above aspects,the influence of delayed thrombolysis of ischemic stroke patients can be analyzed.The second stage was to put forward countermeasures for the delay,hospital thrombolysis process was optimized by using process management theory;The concept map was used to train nurses;illustrated manual of health education was formulated,and analyzed the effect of these countermeasures’ application.SPSS17.0 was used for statistical analysis.The normal distribution data used the mean and standard deviation(`X ± S)to describe.The skewed distribution data used median and quartile range P50(P25 ~ P75)to describe.Single factor analysis between the two groups by using t test,multiple sets of comparison by using variance analysis.Qualitative data used constituent ratio to describe and used chi-square to analyze.Skewed distribution data used rank sum test to analyze.P<0.05 for the difference was statistically significant.Result:The first stage of the study showed that thrombolysis delay phenomenon was serious in hospital,each period of time were longer than the recomend time of American Heart Association / Stroke Council(AHA/ASA)guidelines.The specialists’ consulation time was35(22.75,56.25)minutes to visit time,the blood finished was 32(28.75,41.75)minutes to visit time,patients’ transport to the CT/MRI used 16(13.15,26.75)minutes,the CT report was 32(28.75,41.75)minutes to visit time,the laboratory complete was 98(75.00,120.00)minutes to visit time,the use of drug was 120(59.25,159.00)minutes to visit time.The main reason of thrombolytic delayed lied in tedious process,backward information of the hospital,the relevant sections was poor of convergence.The nurses’ cognitive level of ischemic stroke knowledge was low,cognitive score was9.97±3.71 points,single factor analyzed that nurses’ cognitive level was related to education degree(F=2.303,P=0.041),professional title(F=6.935,P=0.001)and the years of work(F=6.604,P=0.002).The rate of patients’ awareness about thrombolytic knowledge was low,in which 68%of the patients were unaware of intravenous thrombolytic therapy,89% patients were unaware of arterial thrombolysis,71% patients were unaware of thrombolysis time window.The influence of the cognition of patients with ischemic stroke was the patients who had previous ischemic stroke,heart disease and TIA attack history;The cognition of different occupation,different modes of transportation,different residence and different clinic time of the patients with significant cognitive score(P<0.05).There was statistical significance that patients who had TIA attacks、 someone around when the disease happened、paid attention to knowledge of the disease and called an ambulance after the onset got earier treatment(P<0.05).The second stage put forward countermeasure according to the reasons,the results showed that after the treatment process’ optimization,there was statistical significance that every step of visit time to thrombolysis was shortened(P<0.05).The specialists’ consulation time was 12.50(9.00,23.00)minutes to visit time,theblood finished was 13.5(10,20)minutes to visit time,patients’ transport to the CT/MRI used 9(5.00,14.25)minutes,the CT report was 26.50(22.75,29)minutes to visit time,the laboratory complete was 21(12.75,30)minutes to visit time,the use of drug was 97(91,111.25)minutes to visit time,Nurses’ knowledge of ischemic stroke was improved,the average score were 15.92±5.16 points.Conclusion:For patients with delayed thrombolysis,through the establishment of the administrative level,nursing,stroke management team,optimize emergency procedures,improve the quality of the medical care process control management system.For the training for nurses on ischemic stroke related knowledge,improve their cognitive level.According to the related diseases in patients with ischemic stroke,the lack of knowledge,strengthen the ischemic stroke health education,improve public awareness of timely treatment,and ultimately shorten the time of patients,improve the thrombolytic rate. |
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