Emergency nurses' knowledge about tissue plasminogen activator therapy and their perception about barriers for thrombolysis in acute stroke care

Abstract

Introduction: Thrombolytic therapy using tissue plasminogen activator (t-PA) has been proven to be a cost-effective means of treating acute stroke. However, several factors lead to the underutilization of this treatment. This study was undertaken to assess the knowledge of emergency nurses regarding t-PA therapy and to identify the barriers perceived by them in the utilization of thrombolysis in acute stroke. Materials and Methods: A cross-sectional survey was conducted among 30 nurses working in the emergency department of a tertiary level public hospital in India. A self-administered questionnaire was used to assess their knowledge and perceived barriers. Results: Against a total score of 26, the score of the sample ranged from 13 to 22 with a mean score of 17.9 ± 2.4. The mean accuracy rate of the questions was 68.6 ± 25.3. Three major categories of barriers were identified in the efficient utilization of thrombolytic therapy. These were patient-related barriers, organizational barriers, and behavioral barriers. “Unaffordability of t-PA therapy due to financial constraints” and “patients not reaching the facility in the window period” were the two topmost barriers for thrombolysis identified by the nurses. Conclusion: Ongoing continuing nursing education is essential to fill the knowledge gap of nurses regarding thrombolysis. Sufficient measures need to be taken at prehospital, institutional, and personnel levels to mitigate the barriers for thrombolysis so that no eligible patients are left without the benefits of the treatment.

Keywords

• acute stroke
• barrier
• emergency department
• knowledge
• nurses
• thrombolytic therapy