TY  - JOUR
A1  - Tahtali, Damla
A1  - Bohmann, Ferdinand
A1  - Kurka, Natalia
A1  - Rostek, Peter
A1  - Todorova-Rudolph, Anelia
A1  - Buchkremer, Martin
A1  - Abruscato, Mario
A1  - Hartmetz, Ann-Kathrin
A1  - Kuhlmann, Andrea
A1  - Henke, Christian
A1  - Stegemann, André
A1  - Menon, Sanjay
A1  - Misselwitz, Björn
A1  - Reihs, Anke
A1  - Weidauer, Stefan
A1  - Thonke, Sven
A1  - Meyding-Lamadé, Uta
A1  - Singer, Oliver Caspar
A1  - Steinmetz, Helmuth
A1  - Pfeilschifter, Waltraud
T1  - Implementation of stroke teams and simulation training shortened process times in a regional stroke network—a network-wide prospective trial
T2  - PLoS one
N2  - Background: To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units.
Methods: We recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings.
Results: The intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8–60,0, n = 122) to 31,0 (IQR 24,0–42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds.
Conclusions: The composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks.
KW  - Stroke
KW  - Nurses
KW  - Radiology and imaging
KW  - Technicians
KW  - Physicians
KW  - Simulation and modeling
KW  - Critical care and emergency medicine
KW  - Neural networks
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/34408
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-344087
SN  - 1932-6203
N1  - opyright: © 2017 Tahtali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 12
IS  - (12): e0188231
SP  - 1
EP  - 13
PB  - PLoS
CY  - Lawrence, Kan.
ER  -