| A computerized in-hospital alert system for thrombolysis in acute stroke. | |
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MedLine Citation:
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PMID: 20651269 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: An effective stroke code system that can expedite rapid thrombolytic treatment requires effective notification/communication and an organized team approach. We developed a stroke code program based on the computerized physician order entry (CPOE) system and investigated whether implementation of this CPOE-based program is useful for reducing the time from arrival at emergency departments (ED) to evaluation steps and the initiation of thrombolytic treatment in various hospital settings. METHODS: The CPOE-based program was implemented by 10 hospitals. Time intervals from arrival at the ED to blood tests, computed tomography scanning, and thrombolytic treatment during the 1-year period before and the 1-year period after the program implementation were compared. RESULTS: Time intervals from ED arrival to evaluation steps were significantly reduced after implementation of the CPOE-based program. Times from ED arrival to CT scan, complete blood counts, and prothrombin time testing were reduced by 7.7 minutes, 5.6 minutes, and 26.8 minutes, respectively (P<0.001). The time from ED arrival to intravenous thrombolysis was reduced from 71.7+/-33.6 minutes to 56.6+/-26.9 minutes (P<0.001). The number of patients who were treated with thrombolysis increased from 3.4% (199/5798 patients) before the CPOE-based program to 5.8% (312/5405 patients) afterward (P<0.001). The CPOE implementation also improved the inverse relationship between onset-to-door time and door-to-needle time. CONCLUSIONS: The CPOE-based stroke code could be successfully implemented to reduce in-hospital time delay in thrombolytic therapy in various hospital settings. CPOE may be used as an efficient tool to facilitate in-hospital notification/communication and an organized team approach. |
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Authors:
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Ji Hoe Heo; Young Dae Kim; Hyo Suk Nam; Keun-Sik Hong; Seong Hwan Ahn; Hyun Ji Cho; Hye-Yeon Choi; Sang Won Han; Myoung-Jin Cha; Ji Man Hong; Gyeong-Moon Kim; Gyu Sik Kim; Hye Jin Kim; Seo Hyun Kim; Yong-Jae Kim; Sun Uck Kwon; Byung-Chul Lee; Jun Hong Lee; Kwang Ho Lee; Mi Sun Oh |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-07-22 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 41 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-31 Completed Date: 2010-09-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 1978-83 Citation Subset: IM |
Affiliation:
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Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. jhheo@yuhs.ac |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Cell Count Emergency Service, Hospital Female Fibrinolytic Agents / therapeutic use Humans Male Medical Order Entry Systems* Outcome Assessment (Health Care) Prospective Studies Prothrombin Time Regression Analysis Stroke / drug therapy* Thrombolytic Therapy / methods* Time Factors Triage |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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