Effect Of Education To Hospital Staff On Efficiency Of Acute Stroke Thrombolysis (P3.105)

OBJECTIVE:To study effect of stroke related education to the emergency department(ED) physicians , residents and nurses on various stroke treatment metrics /quality measures. BACKGROUND:Given the narrow therapeutic windows for acute stroke treatment, in hospital delays need to be avoided.In resource limited settings where pre-hospital notification is unavailable, internal systems need to be improved. DESIGN/METHODS:Evaluation of thrombolysis related measures was done before and after an intervention in form of educational program targeting ED staff in an audio-visual lecture based format.Data was collected from the Pre-intervention phase (November 2011-August 2012) and compared to data after intervention (September’12 - June ‘13).Inclusion criteria were clinical diagnosis of Ischemic stroke and patients arriving within 8 hours of symptom onset, patients undergoing IV thrombolysis and or bridging therapy (IV+IA) with IV thrombolysis initiated within 4.5 hours. RESULTS:93 patients were enrolled in pre-intervention(PI)period vs 118 in post-intervention(PoI).The age and gender distribution were similar.Two (2.2%) patients were detected with in hospital stroke in PI vs 15 (12.7%) in PoI. In PI,15(16.1%) patients underwent thrombolysis, with median door to CT (DCT)and door to needle times(DTN) of 30 min (IQR 15-60) and 84.5 min(IQR 58.75-116) while in PoI,45 (38.1%) (p=.001) patients underwent thrombolysis with DCT and DTN of 30 and 60 min.In PI,23.2% of eligible patients while in PoI 43.3% got thrombolysed.Patients with DNT<60 min increased from 35.7% to 58.5% .CONCLUSIONS:Education of ED staff leads to higher rates of IV thrombolysis as well as significant reduction in door to needle times. Study Supported by: Disclosure: Dr. Khurana has nothing to disclose. Dr. Hirachan has nothing to disclose. Dr. Bhalla has nothing to disclose. Dr. Prabhakaran has nothing to disclose.