Effect of FOCUS-PDCA on improving thrombolytic effect in patients with acute ischemic stroke
FOCUS-PDCA对提高急性缺血性脑卒中患者溶栓效果的影响

摘要

目的 研究FOCUS-PDCA在缩短急性脑卒中患者DNT（door to needle time，DNT）时间中的应用效果。方法 从十堰市某三甲医院病案管理系统选取FOCUS-PDCA 实施前后共235例进入脑卒中绿色通道的溶栓患者，对照组99例患者，观察组136例患者，比较患者溶栓率、DNT时间等指标差异。结果运用FOCUS-PDCA管理后，DNT时间由52min减少至43min，DNT≤47min的比例也由35.35%上升至68.38%，时间窗内到院溶栓率也由54.32%提高到89.75%，患者溶栓后24h、出院前NIHSS评分比较，差异显著（p＜0.05）。结论 FOCUS-PDCA可促进急性缺血性脑卒中静脉溶栓流程优化，缩短DNT，提高患者溶栓率。

Abstract

Objective To study the application effect of FOCUS-PDCA in shortening DNT (door to needle time, DNT) time in patients with acute stroke.
Methods A total of 235 thrombolytic patients who entered the stroke green channel before and after the implementation of FOCUS-PDCA were selected from the medical record mana- gement system of a tertiary hospital in Shiyan City, 99 patients in the control group and 136 patients in the observa- tion group, and the thrombolytic rate and DNT time of the patients were compared. Indicator differences.
Results After FOCUS-PDCA management, the DNT time was reduced from 52 minutes to 43 minutes, the proportion of DNT≤47 minutes also increased from 35.35% to 68.38%, and the thrombolysis rate within the time window also increased from 54.32% to 89.75%. There was a significant difference in the NIHSS scores after 24 hours and before discharge (p<0.05).
Conclusion   FOCUS-PDCA can promote the optimization of intravenous thrombolysis process in acute ischemic stroke, shorten DNT, and improve the thrombolysis rate of patients.