J Emerg Nurs. 2025 Nov 21:S0099-1767(25)00428-3. Revista: 10.1016/j.jen.2025.10.013. Online ahead of print.

INTRODUCTION: Despite efforts made within the emergency department, delays in intravenous thrombolytic time via telestroke remain.

METHODS: A quality improvement project streamlined stroke care, focusing on workflow optimization, education, improved communication, and real-time feedback, aiming to reduce door-to-needle time.

RESULTS: A retrospective analysis revealed a reduction in door-to-needle time of 18.05 minutes (95% CI, 7.70-28.41; P = .001) was achieved. Achievement of door-to-needle time goals (30, 45, and 60 minutes) was met after implementation (adjusted P < .005). A higher proportion of intravenous thrombolytic rates occurred after implementation (45 [14.0%] vs 79 [8.1%]; adjusted odds ratio, 1.91; 95% CI, 1.29-2.84; P = .001).

DISCUSSION: A telestroke-enabled primary stroke center consistently achieved <30-minute door-to-needle time through a nurse-led workflow emphasizing early stroke alert and computed tomography.

PubMed:41269200 | Revista:10.1016/j.jen.2025.10.013