Location

Georgia

Start Date

16-5-2017 1:00 PM

Description

Introduction:

Tissue plasminogen activator (tPA) remains the only medication proven to positively affect outcomes in the treatment of acute ischemic stroke. tPA is given intravenously (IV) and dosed based on the patient’s weight. The national goal Door-to-needle (DTN) time is less than 60 minutes. The primary objective of this review is to assess the door-to-needle time in patients receiving tPA for the treatment of acute ischemic stroke when a pharmacist is present to mix tPA versus when a pharmacist is not present.

Methods:

We conducted a retrospective chart review to gather data on the administration of tPA at Gwinnett Medical Center- Lawrenceville from August 2015 through August 2016. We evaluated 25 patients who received tPA with an ED pharmacist present compared to 25 randomly selected patients who received tPA without an ED pharmacist present. Our primary endpoint was percent of patients with a door-to-needle time <60 minutes. Our secondary endpoint was the accuracy of the patient’s weight that is used to calculate the tPA dose.

Results:

44% of patients received tPA within the goal DTN time of <60 minutes with a pharmacist present compared to 52% of patients with a pharmacist absent and the average DTN time was 64 minutes and 73 minutes in the two groups, respectively. tPA was dosed accurately in 76% of the cases when a pharmacist was present and 50% of the cases when a pharmacist was absent.

Conclusions:

This review shows the potential benefits of having a pharmacist as a member of the stroke team. The percent of patients with a DTN <60 minutes was higher with a pharmacist absent and was likely due to confounding variables and a small sample size. Regardless, both groups were above the national average and the DTN time was improved by an average of 9 minutes when a pharmacist was present. tPA was more accurately dosed when the pharmacist was present.

Embargo Period

6-26-2017

COinS
 
May 16th, 1:00 PM

Pharmacist Intervention on the Stroke Team in the Emergency Department

Georgia

Introduction:

Tissue plasminogen activator (tPA) remains the only medication proven to positively affect outcomes in the treatment of acute ischemic stroke. tPA is given intravenously (IV) and dosed based on the patient’s weight. The national goal Door-to-needle (DTN) time is less than 60 minutes. The primary objective of this review is to assess the door-to-needle time in patients receiving tPA for the treatment of acute ischemic stroke when a pharmacist is present to mix tPA versus when a pharmacist is not present.

Methods:

We conducted a retrospective chart review to gather data on the administration of tPA at Gwinnett Medical Center- Lawrenceville from August 2015 through August 2016. We evaluated 25 patients who received tPA with an ED pharmacist present compared to 25 randomly selected patients who received tPA without an ED pharmacist present. Our primary endpoint was percent of patients with a door-to-needle time <60 minutes. Our secondary endpoint was the accuracy of the>patient’s weight that is used to calculate the tPA dose.

Results:

44% of patients received tPA within the goal DTN time of <60 minutes with a pharmacist present compared to>52% of patients with a pharmacist absent and the average DTN time was 64 minutes and 73 minutes in the two groups, respectively. tPA was dosed accurately in 76% of the cases when a pharmacist was present and 50% of the cases when a pharmacist was absent.

Conclusions:

This review shows the potential benefits of having a pharmacist as a member of the stroke team. The percent of patients with a DTN <60 minutes was higher with a pharmacist absent and was likely due to confounding variables and a small sample size.>Regardless, both groups were above the national average and the DTN time was improved by an average of 9 minutes when a pharmacist was present. tPA was more accurately dosed when the pharmacist was present.