Acute Ischemic Stroke Vein Based On Delphi Method Thrombolytic Optimization Nursing Model And Application Research

ObjectiveThe Delphi method was used to construct an optimized intravenous thrombolytic care model for acute ischemic stroke to ensure its scientific and practicality,and the optimized intravenous thrombolytic care model for acute ischemic stroke was clinically applied to provide a scientific basis for the prevention and treatment strategy of intravenous thrombolysis in acute ischemic stroke.MethodThe Delphi method was used to conduct three rounds of expert correspondence on the first draft of the constructed intravenous thrombolytic care model for acute ischemic stroke,and the data were collected and statistically analyzed using Excel 2010 and SPSS25.0 software to describe the basic situation of experts,their motivation,degree of authority,degree of opinion concentration,and degree of expert coordination.The optimized intravenous thrombolytic care model for acute ischemic stroke was implemented,and the application time(July 2021)was used as the cut-off point before and after the experiment,and the time points of the control and experimental groups were selected with sufficient sample size,and patients with intravenous thrombolysis of AIS from January 2021 to June 2022 were selected as the control group,and patients with intravenous thrombolysis of AIS from July 2022 to March 2023 were selected as the experimental group.Data were collected and statistically analyzed using Epidata 3.1software and SPSS 25.0 software,and the primary and secondary outcome indicators were statistically described with α=0.05 as the test level and P <0.05 as a statistically significant difference.ResultsAfter three rounds of expert correspondence,a model of intravenous thrombolytic care for acute ischemic stroke covering 3 primary entries,10 secondary entries,and 47 tertiary entries was finally determined.The effective recall rate of the included 15 experts was 88.24% in 7 tertiary hospitals and 3 medical schools in 7 provinces and cities nationwide,and 100% in the second and third rounds,with expert authority coefficients Cr of 0.935,0.957,and 0.957,and Kendall coordination coefficients of 0.206,0.33,and 0.447,respectively(P < 0.001)The differences were statistically significant.There were 172 cases in this study,and 86 cases in both the control and experimental groups.After implementing the optimized intravenous thrombolytic care model for acute ischemic stroke,the median DNT was reduced from 41 minutes to 27 minutes(P < 0.001);the proportion of patients who underwent thrombolysis within 60,45,and 30 minutes increased from 84.88% to 96.51%(P= 0.016),from 61.63% to 86.05%(P < 0.001),respectively,from 25.58% to 60.47%(P < 0.001);patient admission-to-CT time(DIT)was shorter than when the model was not implemented.ConclusionThe Delphi method was used to construct an optimal intravenous thrombolytic care model for acute ischemic stroke.The model is scientific and practical;it can shorten the time of intravenous thrombolytic treatment and improve the achievement rate of DNT,which can provide a novel and effective model for the prevention and treatment strategy of intravenous thrombolysis in acute ischemic stroke.