The development of care model for Stroke Fast Track in community hospital Raman district yala province

Abstract

Background: Acute ischemic stroke management in community hospitals often faces delays in diagnosis and administration of thrombolytic therapy (rt-PA) due to a lack of specialists and modern medical equipment.

Objective: This study aimed to: 1) investigate the current situation and challenges in caring for acute ischemic stroke patients in the emergency department of Raman Hospital, 2) develop a care model for acute stroke patients, and 3) evaluate the effectiveness of the developed care model in reducing the time to receive thrombolytic therapy and improving patient care.

Material and methods: This research is a research and development (R&D) study involving 17 professional nurses in the emergency department and acute ischemic stroke (Stroke Fast Track) patients meeting the inclusion criteria. Data were collected using a Stroke Fast Track patient care tracer and a knowledge assessment tool for nurses. Data analysis included frequency, percentage, mean, one-sample t-test, and Wilcoxon signed-ranks test.

Result: The study found that Stroke Fast Track patients at Raman Hospital experienced delays in receiving thrombolytic therapy due to limitations in diagnosis and treatment. The development of the Stroke Fast Track care model resulted in the RAMAN Model. The implementation of the RAMAN Model led to a significant reduction in time for CT scan and rt-PA administration (p<0.001). Additionally, nurses demonstrated a statistically significant increase in knowledge regarding Stroke Fast Track care (p<0.001). The developed care model is suitable for improving stroke care services in community hospitals.

Conclusion: The development of a care model for stroke patients at Raman Hospital has proven to be appropriate and can be applied to other community hospitals. This model enhances the timely administration of thrombolytic therapy and improves overall patient care.