Hospitals across the U.S. often overestimate how quickly they administer clot-busting drugs to stroke patients, according to new research.
Stroke is the fourth-leading cause of death in the U.S.
For the study, researchers surveyed data on more than 48,000 stroke patients treated at 141 hospitals in 2009 and 2010. They found that hospital staff members’ perceptions of how quickly they administered the IV drug tissue plasminogen activator (tPA) did not match up with actual stroke care performance.
The study appears in the July 22 issue of the Journal of the American Heart Association.
Researchers compared patient data, including onset of stroke symptoms, the time patients arrived at the hospital, treatments and administration of tPA with survey responses from hospital staff members.
When should the drug be administered?
Guidelines call for tPA to be administered within 60 minutes of a stroke patient’s arrival at the hospital. The drug, which breaks up clots that block blood flow to and in the brain, needs to be administered quickly to prevent both immediate and long-term stroke damage. Hospitals were categorized as high-, middle- or low-performing based on how often they appropriately administered the drug.
Among the findings on hospitals’ “door-to-needle” time:
- Only 29 percent of hospitals accurately identified their performance in administering the drug within the recommended time.
- Forty-two percent of middle-performing hospitals and 85 percent of low-performing hospitals overestimated their ability to quickly administer tPA.
- Hospitals that overestimated performance had lower volumes of tPA administration
The hospitals surveyed were all participants in the American Heart Association’s “Get with the Guidelines-Stroke” quality improvement initiative designed to improve outcomes in stroke treatment.
Factors affecting staff perceptions included the volume of stroke patients treated. Neither hospital size nor region were major factors.
To learn more about strokes, awareness and prevention, consider attending the Stroke Prevention and Awareness session on Thursday, October 29 at 11:30 a.m. at the Highland Country Club in Fort Thomas. It is free, but reservations are required. Call (859) 301-WELL (9355) to reserve your seat.
