Stroke system of care

Levels of certification

Cost of certification Why certify?

Outcomes

Summary

References

BACKGROUND

An acute stroke is a medical emergency with treatments that are time dependent. Stroke care has undergone tremendous transformation over the past 2 decades. For ischemic strokes, the introduction of intravenous thrombolysis (alteplase) and endovascular therapies such as mechanical thrombectomy have been imperative to reducing disability and death from stroke Recombinant tissue plasminogen activator (alteplase) was approved by the US Food and Drug Administration in 1996 for use within 3 hours of onset of stroke symptoms. In 2008, the time window for intravenous (IV) alteplase was extended to 4.5 hours after symptom onset as a result of the European Cooperative Acute Stroke Study trial that tested the efficacy and safety of alteplase administered between 3.0 and 4.5 hours after the onset of a stroke A recent trial by Ma and colleagues reviewed the possibility of extending the alteplase window even further to 9 hours in select patients.

SUMMARY

Many academic and community hospitals have obtained stroke center certification. Participation in structured quality improvement programs that also incorporate an objective assessment has been shown to improve outcomes and foster team building. What Is Stroke Certification and Does It Matter? 9 Although certification programs are not always perfect, they provide a framework to ensure hospitals provide evidence-based stroke care. For the ICU nurse, awareness and participation in the certification programs process is an important part of professional nursing practice.