University of Surrey

Test tubes in the lab Research in the ATI Dance Research

Improving door to needle times with nurse initiated thrombolysis

Wilmshurst, P, Purchase, A, Webb, C, Jowett, C and Quinn, T (2000) Improving door to needle times with nurse initiated thrombolysis Heart, 84 (3). pp. 262-266.

Full text not available from this repository.


Objective - To evaluate the effect of nurse initiated thrombolysis on door to needle time (the interval between arriving at the hospital and starting thrombolytic treatment) in patients with acute myocardial infarction. Design - Comparison of door to needle times before and after the employment of nurses trained and approved to initiate thrombolysis without prescription by a doctor but with a protocol for rapid triage of patients with chest pain. Setting - A district general hospital. Subjects - All patients admitted with suspected myocardial infarction between April 1995 and March 1999. Main outcome measures - Speed (door to needle time) and appropriateness of administration of thrombolytic drugs to patients with acute myocardial infarction who gave a characteristic history and had appropriate criteria on the admission ECG. Results - During seven periods (each of four months) before the introduction of nurse initiated thrombolysis and a new chest pain triage protocol, the median door to needle time varied from 50-58 minutes. In four periods (each of 4-6 months) following the introduction of the changes, the median door to needle time was 25-30 minutes. The improvement was significant (p < 0.001). Nurses trained to initiate thrombolysis currently provide cover for 66% of the time. Median door to needle time for nurses was 15 minutes. Median door to needle time for junior doctors improved to 35 minutes. The median door to needle times when nurses initiated thrombolysis was significantly shorter than when doctors did so (p < 0.001). There have been no inappropriate management decisions by nurses approved to initiate thrombolysis. Conclusions - The use of nurse initiated thrombolysis has resulted in a clinically important reduction in the time taken for thrombolysis to be started in patients with acute myocardial infarction.

Item Type: Article
Divisions : Surrey research (other units)
Authors :
Wilmshurst, P
Purchase, A
Webb, C
Jowett, C
Date : 2000
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 09:30
Last Modified : 24 Jan 2020 17:03

Actions (login required)

View Item View Item


Downloads per month over past year

Information about this web site

© The University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.
+44 (0)1483 300800