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Of the survey responders, 73% reported their organization had no documented protocol for establishing stroke symptom onset times or LKW. The hospitals were well matched by bed size, stroke center designation status, and annual ischemic stroke volume (average number of acute ischemic strokes of 682 for hospitals with protocols vs.
The subset of hospitals without an established protocol for LKW documentation had significantly lower capture rates for this variable than hospitals of equivalent size and volume with an established protocol (48% vs.
Hospitals, both with and without established protocols, reported that information on LKW time was obtained primarily from family members or the patients themselves.
This work shows that a lack of established protocols for documenting LKW time is common.
(2013) maintain that symptom onset/ LKW time is the "single most important piece of historical information" (p.
Nurses are in a unique position to work collaboratively with ED staff and emergency medical responders to develop a protocol that encourages emergency medical services or first responders to obtain witness or bystander contact information for further interviewing by stroke teams, a standardized tool that delineates responsibility for obtaining and documenting LKW time.
Therefore, establishing and documenting LKW time, even a best estimate, serves a second purpose by contributing valuable information about community education efforts.
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