Acute Stroke Care at Rural Hospitals in Idaho: Challenges in Expediting Stroke Care

Autor/inn/en	Gebhardt, James G.; Norris, Thomas E.
Titel	Acute Stroke Care at Rural Hospitals in Idaho: Challenges in Expediting Stroke Care
Quelle	In: Journal of Rural Health, 22 (2006) 1, S.88-91 (4 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2006.00004.x
Schlagwörter	Hospitals; Rural Areas; Drug Therapy; Medical Services; Health Personnel; Telephone Surveys; Neurological Impairments; Idaho + Suchen Sie Ihr Suchwort? Krankengymnast; Krankenhaus; Rural area; Ländlicher Raum; Arzt; Medizinisches Personal; Telephone interview; Telefoninterview; Neurodegenerative Erkrankung
Abstract	Context: Thrombolytics are currently the most effective treatment for stroke. However, the National Institute for Neurological Disorders and Stroke criteria for initiation of thrombolytic therapy, most notably the 3-hour time limit from symptom onset, have proven challenging for many rural hospitals to achieve. Purpose: To provide a snapshot of stroke care at rural hospitals in Idaho and to investigate the experiences of these hospitals in expediting stroke care. Methods: Using a standard questionnaire, a telephone survey of hospital staff at 21 rural hospitals in Idaho was performed. The survey focused on acute stroke care practices and strategies to expedite stroke care. Findings: The median number of stroke patients treated per year was 23.3. Patient delays were reported by 77.8% of hospitals, transport delays by 66.7%, in-hospital delays by 61.1%, equipment delays by 22.2%, and ancillary services delays by 61.1%. Approximately 67% of hospitals had implemented a clinical pathway for stroke and 80.0% had provided staff with stroke-specific training. No hospitals surveyed had a designated stroke team, and only 33.3% reported engaging in quality improvement efforts to expedite stroke care. Thrombolytics (tPA) were available and indicated for stroke at 55.6% of the hospitals surveyed. Conclusions: Rural hospitals in Idaho face many difficult challenges as they endeavor to meet the 3-hour deadline for thrombolytic therapy, including limited resources and experience in acute stroke care, and many different types of prehospital and in-hospital delays. (Author).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10