Brief Educational Intervention Improves Emergency Medical Services Stroke Recognition
Brief Educational Intervention Improves Emergency Medical Services Stroke Recognition
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DOI：
10.1161/strokeaha.118.023885
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发表时间：
2019-05-01
期刊：
影响因子：
8.3
通讯作者：
Reeves, Mathew J.
中科院分区：
文献类型：
--
作者：
Oostema, J. Adam;Chassee, Todd;Reeves, Mathew J.
背景和目的--通过紧急医疗服务(EMS)识别中风症状和医院预先通知有助于快速治疗中风；然而，三分之一的中风患者没有被EMS识别。为了促进卒中识别和符合质量测量标准的院前卒中护理，我们在密歇根州的一个县部署了30分钟的在线EMS教育模块和绩效反馈系统。方法：在24个月的研究期间，利用连续登记的EMS运输的疑似或未识别的中风病例进行中断的时间序列分析，以评估EMS教育和反馈干预的影响。对于每个机构，我们比较了干预前12个月的EMS卒中认知率和质量测量遵从率，以及急诊科表现和住院结果与其余研究月的表现。结果-总共有1805例EMS运输的病例符合纳入标准；其中1235例(68.4%)有缺血性或出血性中风或短暂性脑缺血发作。在干预之前，任何结果都没有改善的趋势。干预后EMS卒中识别率由干预前的63.8%提高到干预后的69.5%(P=0.037)。预告比例从60.9%提高到77.3%(P
Background and Purpose-Recognition of stroke symptoms and hospital prenotification by emergency medical services (EMS) facilitate rapid stroke treatment; however, one-third of patients with stroke are unrecognized by EMS. To promote stroke recognition and quality measure compliant prehospital stroke care, we deployed a 30-minute online EMS educational module coupled with a performance feedback system in a single Michigan county.Methods-During a 24-month study period, a registry of consecutive EMS-transported suspected or unrecognized stroke cases was utilized to perform an interrupted time series analysis of the impact of the EMS education and feedback intervention. For each agency, we compared EMS stroke recognition and quality measure compliance rates, as well as emergency department performance and hospital outcomes during 12 preintervention months with performance in the remaining study months.Results-A total of 1805 EMS-transported cases met inclusion criteria; 1235 (68.4%) of these had ischemic or hemorrhagic strokes or transient ischemic attacks. There were no trends toward improvement in any outcome before the intervention. After the intervention, the EMS stroke recognition rate increased from 63.8% to 69.5% (P=0.037). Prenotification increased from 60.9% to 77.3% (P