Date on Paper

7-2020

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Meyer, Kim

Committee Member

Burckardt, Elizabeth

Author's Keywords

Ischemic stroke; tissue plasminogen activator (tPA); patient weight; tPA overdose; hemorrhagic conversion; thrombolytic therapy

Abstract

Purpose: The gold standard of treatment for an ischemic stroke is the administration of weight based tPA within 4.5 hours of patient last neurological known well. The aim of this project was to improve accuracy of tPA dosing and decrease complications, improving outcomes for the stroke patient population. Method: This project implemented a new system, allowing every stroke patient to be accurately weighed when arriving to the hospital. AIS patients from a historical group were compared to patients receiving tPA within the first 3 months following an in-service, evaluating prospectively to determine if estimated or measured weights were used for tPA dosage calculations. Results: There was not a significant difference in mean weights between the historical and post-intervention groups. There was no significant difference in dosages between the historical and post-intervention group. There was no significant decrease in NIHSS scores from admission to discharge for the historical group. There was a significant decrease in NIHSS scores for the post-intervention group from admission to discharge. Conclusion: Although there was not a significant difference in the mean weights between the two groups, there was a clinical difference for patients included in the post-intervention. It is recommended that a larger study, among several hospital systems and over a longer time period be conducted to make a more robust conclusion.

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