Background/Aims
Stroke thrombolysis requires precise time-critical administration to be safe and effective. Safety time-outs in stroke thrombolysis are underutilised. A multidisciplinary stroke thrombolysis ‘time-out’ was implemented at NSW Telestroke referral sites. This research evaluated the efficacy and safety of the Stroke Thrombolysis Time-Out Procedure (StToP) utilised by code stroke teams.
Methods
We conducted a comparative pre and post-implementation evaluation, using cross-sectional surveys to measure nursing perceptions of safety, communication and efficacy (7-point Likert scale) during thrombolysis in acute ischaemic stroke. Retrospective and prospective ‘door-to-needle’ time data are collected to ensure efficiency of process without delay. The StTop education, including professional video, and protocol were developed and implemented in 2025. Five regional NSW Telestroke referral sites were recruited with 40 participants pre-intervention and 12 post-intervention, survey collection ongoing.
Results
The StToP initiative was performed in 34/36 (94%) of acute stroke thrombolysis cases. The median door-to-needle time in the pre-intervention group (n=45) was 48 minutes (IQR 38–65) and 46 minutes (IQR 38–66) in the post-intervention group (n=39) exceeding national targets (<60 minutes). Pre-to-post improvement in team communication was identified, specifically the ability to ask questions within the team according to current data (pre: 51%, post: 91%), and input acknowledgment (pre: 45%, post: 83%). 12/12 (100%) of respondents agreed the StTop improved patient safety, supported a culture of safety, whilst allowing for timely thrombolysis.