Stroke Nurses Research Articles

Stroke self-management: what does good nursing support look like?

Nurses play a pivotal role in stroke self-management, yet there is a gap in our understanding of the perspectives of, and challenges faced, by stroke nurses in relation to the development, implementation and effect of stroke self-management support services. This article describes the qualitative findings from a recent study that aimed to develop, pilot and evaluate a nurse-led, person-centred stroke self-management support intervention. The findings may help inform the future design and delivery of such support, and will increase understanding of the issues and challenges that nurses face in delivering it in clinical practice.

Nasogastric feeding for stroke patients: practice and education.

Dysphagia is common after stroke, so feeding through a nasogastric (NG) tube may be necessary. These tubes are frequently dislodged, causing interruption to feeding and hydration, and potential aspiration of feed or fluids into the lungs. Interventions to prevent this may include taping tubes to the face; the application of hand mittens or bandaging patients' hands; inserting the NG tube into the nostril on the stroke-affected side; and nasal bridles. The aims of this survey were to investigate the management of NG feeding for stroke patients, including current tube confirmation and securing techniques, and associated nurse education. This was part of a three-phased sequential mixed-methods study. This paper reports on the second quantitative phase. A quantitative postal survey, based on initial qualitative findings, was sent to registered nurses (n=528) from the National Stroke Nurses Forum and Scottish Stroke Nurses Forum, in addition to registered nurses working on stroke units within the local health board. The overall response rate was 59% (n=314/528). Tape was the most commonly used method for securing tube position, followed by inserting the tube on the stroke-affected side. Hand mittens were used more frequently than the nasal bridle; bandaging hands was reported once. Taping was considered to be more acceptable and safer than hand mittens or the nasal bridle, but less effective. Training in inserting NG feeding tubes was received by 56% (n=176/314). Methods used for confirming tube position included aspiration and X-ray. Provision of training in confirmation techniques varied. This study shows that the management of NG feeding for dysphagic stroke patients requires standardisation, as does the education for nurses to ensure that this intervention is carried out safely, effectively and acceptably.

Report from the Council on Cardiovascular and Stroke Nursing.

Report from the Council on Cardiovascular and Stroke Nursing.

Comprehensive Review for Stroke Nursing

Journal of Neuroscience Nursing: December 2014 - Volume 46 - Issue 6 - p 371 doi: 10.1097/JNN.0000000000000102

ACP Journal Club: ambulatory ECG monitoring for 30 d increased AF detection more than 24 h of ECG monitoring after cryptogenic stroke.

ACP Journal Club18 November 2014Ambulatory ECG monitoring for 30 d increased AF detection more than 24 h of ECG monitoring after cryptogenic strokeLucas McCarthy, MD, MSLucas McCarthy, MD, MSUniversity of Washington, Seattle, Washington, USA (L.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-161-10-201411180-02002 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationGladstone DJ, Spring M, Dorian P, et al; EMBRACE Investigators and Coordinators. Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med. 2014;370:2467-77. https://pubmed.ncbi.nlm.nih.gov/24963566Clinical Impact RatingsGIM/FP/GP: Cardiology: Neurology: References1 Kishore A, Vail A, Majid A, et al. Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis. Stroke. 2014;45:520-6. [PMID: 24385275] Google Scholar2 Kernan WN, Ovbiagele B, Black HR, et al; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2160-236. [PMID: 24788967] Google Scholar3 Kamel H. Heart-rhythm monitoring for evaluation of cryptogenic stroke. N Engl J Med. 2014;370;26:2531-3. [PMID: 24963573] Google Scholar Author, Article, and Disclosure InformationAuthors: Lucas McCarthy, MD, MSAffiliations: University of Washington, Seattle, Washington, USA (L.M.)This article was published at Annals.org on 4 November 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoECG monitoring with implanted monitors increased AF detection more than usual follow-up after cryptogenic stroke Lucas McCarthy Metrics Cited byScreening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysisAtrial Fibrillation Monitoring in Cryptogenic Stroke: the Gaps Between Evidence and Practice 18 November 2014Volume 161, Issue 10Page: JC2KeywordsAnticoagulantsAtrial fibrillationElectrocardiographyIntent to treat analysisIschemic strokeNeurologyStrokeSystematic reviewsTransient ischemic attacks ePublished: 18 November 2014 Issue Published: 18 November 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

ACP Journal Club: ECG monitoring with implanted monitors increased AF detection more than usual follow-up after cryptogenic stroke.

ACP Journal Club18 November 2014ECG monitoring with implanted monitors increased AF detection more than usual follow-up after cryptogenic strokeLucas McCarthy, MD, MSLucas McCarthy, MD, MSUniversity of Washington, Seattle, Washington, USA (L.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-161-10-201411180-02003 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationSanna T, Diener HC, Passman RS, et al; CRYSTAL AF Investigators. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014;370:2478-86. https://pubmed.ncbi.nlm.nih.gov/24963567Clinical Impact RatingsGIM/FP/GP: Cardiology: Neurology: References1 Kishore A, Vail A, Majid A, et al. Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis. Stroke. 2014;45:520-6. [PMID: 24385275] Google Scholar2 Kernan WN, Ovbiagele B, Black HR, et al; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2160-236. [PMID: 24788967] Google Scholar3 Kamel H. Heart-rhythm monitoring for evaluation of cryptogenic stroke. N Engl J Med. 2014;370;26:2531-3. [PMID: 24963573] Google Scholar Author, Article, and Disclosure InformationAuthors: Lucas McCarthy, MD, MSAffiliations: University of Washington, Seattle, Washington, USA (L.M.)This article was published at Annals.org on 4 November 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAmbulatory ECG monitoring for 30 d increased AF detection more than 24 h of ECG monitoring after cryptogenic stroke Lucas McCarthy Metrics 18 November 2014Volume 161, Issue 10Page: JC3KeywordsAnticoagulantsAtrial fibrillationElectrocardiographyNeurologyNumber needed to treatPacemakersPatientsStrokeSystematic reviewsTransient ischemic attacks ePublished: 18 November 2014 Issue Published: 18 November 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

A framework of counseling for patients with stroke in nursing: a narrative literature review.

Stroke is a major cause of death in developed countries. Its prevalence and disability burden are expected to increase in the future because of an aging population. The consequences of stroke are specific to the individual. Whereas some patients experience long-term functional and cognitive deficits, others may recover completely and be discharged quickly. Counseling is needed to help patients and their families cope with the effects of stroke after discharge. This is a systematic literature review with a narrative analysis. The purpose was to describe the content and characteristics of stroke patients' counseling. A review of studies published between January 2000 and February 2013 describing stroke patients' counseling was conducted by CINAHL and Medline databases. Studies were selected based on inclusion criteria, and the quality of the included studies was assessed. The final data (n = 33) were extracted and synthesized. Seven prominent themes were identified in the literature relating to (a) information about the disease and concerns regarding stroke, (b) the aims of counseling, (c) counseling methods, (d) interaction as a method for counseling, (e) the stroke nurse as a counselor, (f) emotional support, and (g) decision making in patients' care. The results of the review show that stroke patients' counseling is a multifaceted phenomenon with distinctive characteristics. The findings of the review can be used to develop counseling for patients with stroke and their families. In addition, the review can be used when educating stroke nurses for stroke units.

Council on Cardiovascular and Stroke Nursing

Council on Cardiovascular and Stroke Nursing

Abstract W P281: Inter-Rater Reliability of Clinical Decision Making Based on Recorded Telemedicine Assessments and Case Histories

Background: Patient outcomes are improved by reducing time, and increasing access, to stroke-specialist consultation and treatment. Telemedicine may ensure earlier and wider access to stroke-specialist consultation. However, reliable and accurate decision making is necessary by various professional groups in the emergency department in order for the telemedicine assessment to be initiated. Aim: To explore the inter-rater reliability of clinical decision making by various health professionals, when using telemedicine assessments in acute stroke. Method: Twenty-six telemedicine assessments in patients with suspected stroke (final/gold standard diagnosis: 16 strokes and 10 non-strokes) were recorded, edited and then presented with case histories. Health professionals viewed 6, randomly selected assessments and rated: whether ‘stroke or not’; level of confidence with their diagnosis. Data were analysed using Cohen’s kappa (K) with 95% confidence interval (CI) calculated using bias-corrected bootstrapping in STATA with 10000 replicates. Sensitivity and specificity were estimated. Results: Forty raters: 13 stroke physicians, 15 stroke nurses, 12 non-stroke specific staff (NSS) (including 3 ED consultants, 8 registrars and 1 neurologist). Median of 8 raters per assessment. For ‘stroke or not’, agreement between all health professions was fair (K=0.36, CI 0.22-0.54); correctly diagnosing whether the patient was ‘stroke or not’ on 8 occasions, Sensitivity 77% (98/128), Specificity 67% (45/67). Agreement within each health professional group ranged from K=0.37 (stroke physicians and nurses) to K=0.43 (NSS group), although CIs were wide. Sensitivity ranged from 74% (stroke physicians) to 81% (NSS group); specificity from 58% (stroke physicians) to 74% (NSS group). Median confidence was highest in 4 of the 8 on which all raters agreed the ‘stroke or not’ diagnosis. Conclusion: Agreement was ‘fair’ overall and was similar for all groups, although CIs were wide. Nurses’ agreement or diagnostic accuracy were similar to stroke physicians and NSS doctors when rating telemedicine consultations.

Abstract NS7: Measurement of Acute Stroke Nursing Knowledge: Opportunities for Improvement in Stroke Nursing Education

Background: Nurses caring for acute stroke patients require significant knowledge and skills to deliver expert evidence-based care. However, stroke nurse knowledge has not been captured with standardized methods until recently. We sought to measure knowledge in nurses participating in the NET SMART Junior program. Methods: NET SMART Junior is a novel on-line acute stroke learning system with more than 2500 users worldwide. The program provides both didactic and optional clinical skills exercises, with topics covering all aspects of prehospital and acute hospital management. We analyzed an international sample of test scores from NET SMART Junior, among users that completed the clinical competency portion of the program. Data were auto-assembled in Moodle and analyzed in SPSS. Results: 216 scores were analyzed; the sample consisted of 8 MSN nurses and 208 (96%) basic nurses. Overall program entry knowledge scores were 37%+/-14%, median 39% correct; significantly lower scores of 36%+/-14%, median 38% correct were found among staff nurses, as compared to 50%+/-15%, median 49% correct (mean diff 13.8; 95% CI 3.8-23.8; p=0.007) among MSN nurses. The lowest knowledge scores were found for reperfusion therapy, neurocritical care and complication avoidance (Table). No differences were found in users indicating completion of unit-based stroke educational programs or other for-profit on-line educational programs. Post-test scores were similar between groups with MSN nurses scoring 94%+/-5% (median 90%) and staff nurses scoring 95%+/-5% (median 100%; p=ns) on completed modules. Among 29 (13%) users indicating completion of a stroke certification examination (SCRN or NVRN), 100% pass rates were reported. Conclusions: Staff nurses have a variety of learning needs tied to acute stroke management. Comprehensive acute stroke education programs should include more expert level content and be supported by clinical application methods to ensure content mastery.

Abstract T P275: Hospital’S Role In Community Stroke Risk Screening

Background: Hospitals can contribute to the success of the American Heart Association’s 2020 Impact Goals through community stroke risk screenings and educational awareness events. Purpose: The purpose of this quality project was to evaluate the effectiveness of strategies used to conduct community stroke risk and education events. Method: Marketing strategies were utilized to promote free community stroke risk screenings and awareness events at nine sites. Stroke nurses used standardized risk screening and FAST teaching tools. Participant data was aggregated into a dashboard and analyzed. A survey was developed and distributed to participants in order to evaluate satisfaction and responses to recommendations from the screening events. Results: 423 participants attended the stroke events. The average age of participants was 51 years and the majority of participants were Caucasian (82%) and female (73%). Two or more risk factors were identified in 67% of participants. Nearly half (48%) of participants were classified as pre-hypertensive, with 12% of participants presenting with stage I hypertension, and 3% with stage II hypertension. Over half (53%) of participants made appointments with a PCP after the screening, and 5% of participants without a PCP at the time of the event found a provider. After the stroke events, 47% of participants began an exercise program, 47% implemented a change in diet, and 23% implemented strategies to decrease stress. Overall, 75% of participants agreed that their stroke risk factors were fully explained, 75% agreed recommendations were informative, and 80% would recommend the screening events to family and friends. Conclusions: Hospital-based stroke programs with a commitment to the communities they serve should provide free risk screening and educational stroke awareness events. Events should be evaluated for effectiveness. Goals should focus on the quality of the screenings rather than quantity of participants. Effective strategies for community outreach include the utilization of marketing departments, offering year round events, and engaging with local employers to expand screening locations.

Abstract W MP12: Changing Policies for Blood Pressure Management in Spontaneous Intracerebral Hemorrhage

Background: Current American Heart Association guidelines for targeted blood pressure management in spontaneous intracerebral hemorrhage (ICH), published in 2010, suggest a target mean arterial pressure of less than 110 or a blood pressure of less than 160/90 in patients without elevated intracranial pressure. These guidelines acknowledge that these recommendations have been based on incomplete efficacy evidence. A lower level recommendation was given for reducing target blood pressure to a systolic of 140, based on the INTERACT trial published in 2008. The INTERACT2 trial, published in May 2013, has been interpreted to establish the safety of rapid blood pressure lowering to 140 systolic. Purpose: To determine the current level of adoption by stroke centers of lower targets for blood pressure in patients with spontaneous intracerebral hemorrhage, and whether these targets have changed in 2013. Methods: We developed a web-based survey that was distributed via email and professional groups to stroke advanced practice nurses and stroke program coordinators. The survey asked specific questions regarding changes in clinical practice and stroke center policies on blood pressure management in spontaneous ICH. The survey was anonymous, and the survey software was able to exclude multiple entries from the same computer. Results: Responses were obtained from academic medical centers, community teaching hospitals, and community non-teaching hospitals. Awareness of the results of INTERACT2 was known by 65%, 50%, and 31% of stroke nurses at these hospitals, respectively. Targets for systolic blood pressure were changed in 2013 at 46%, 44%, and 11% of hospitals by group. A time target to lower blood pressure of less than one hour was adopted by 57%, 46%, and 28% respectively. Conclusion: Stroke centers have rapidly adopted changes in blood pressure management in intracerebral hemorrhage in advance of guideline revisions. Non-teaching hospitals were less likely to adopt these changes.

State-of-the-Science Stroke Nursing Symposium 2014 Abstract Reviewers

Christie Artuso, EdD, RN, CCRN, PCCN, CNRN Dawn Aycock, RN MSN JJ Baumann, RN, MS, CNS Cynthia Bautista, PhD, RN, CNRN, CCNS, ACNS-BC Terrie Black, MBA, BSN, RN, BC, CRRN Patricia Blissitt, RN, PhD, CCRN, CNRN, CCNS, CCM, ACNS-BC Mary Brethour, CRNP Deborah Camp, RN, MHA Smi Choi-Kwon, PhD Pei-Ying Chuang, RN, PhD Patricia Clark, PhD RN FAHA Jennifer Cohn, MSN, CNRN Kerrin Connelly, RN, MSN, MPH Michele Cournan, DNP, RN, CRRN, FNP, ANP-BC Lesley Cranick, RN, BSN, MBA Anne Deutsch, PhD, CRRN, RN Holli DeVon, PhD, RN, FAHA Shirley Duane, MSN Debbie Ferguson, MSN, RN, CCRN, CNRN Erica Frangione, DNP, RN-BC Teri Green, RN, PhD Liliana Hanrahan, RN, MSEd, CCRN Kathleen Henderson, RN, MN, ACNS-BC, LNC Millie Hepburn, PhD (c), RN, ACNS-BC Janice Hinkle, RN. PhD, CNRN Kathleen Hubner, MSN, RN, ACNS-BC, ANVP, CNRN Jill Hulbert, NP-C, MSN Jennifer Humbert, MSN, RN J. Lynn Hundley, RN, MSN, APRN, CCRN, CNRN, CCNS Elizabeth Hundt, ACNS-BC, NP-C, CCRN-CSC Mary Kelly, RN, MBA Elizabeth Kim, MSN, APN, CNS Rosemarie King, RN, PhD, FAHA Andrea Korsnack, RN, CNRN, CCRC Angela Larkins, RN, BSN, CCPC Ann Leonhardt, MS ANP Sarah Livesay, DNP, RN, ACNP, CNS-A Mary Lough, PhD, RN, CNS, CCRN, CNRN, CCNS James Lugtu, RN Barbara Lutz, PhD, RN, CRRN, FAHA Barbara Mancini, BSN, MBA, CNRN, FAHA Janet Martin, RN, MS Minna Masor, MSN, ED, RN, CCRN Lori Massaro, MSN, CRNP Kristen Mauk, PhD, DNP, RN, CRRN, GCNS-BC, GNP-BC, FAAN Debra McCann, RN, MSN/MBA/HC, CCRN, NE-BC Desiree Metzger, MSN, ARNP-C Elaine Miller, DNS, RN, CRRN, FAHA, FAAN Kari Moore, RN, BSN Kathy Morrison, MSN, RN, CNRN Ann Mroz, RN, BSN Nancy Newcommon DaiWai Olson, PhD, RN Audrey Paulson, RN, MSN, FNP-BC, CCRN, CNRN Amy Perez, RN, MSN, CNRN Linda Pierce, PhD, RN, CNS, CRRN, FAHA Theresa Price, MSN Sue Pugh, MSN Ginger Reilly, APN, CNP Karen Saban, PhD, APRN, CNRN Karen Seagraves, MS, MPH Naomi Seef, MSN, CRRN Cydnee Seneveratne, RN, PhDF Gail Sims, RN, MSN, CRRN Carla Staruk, RN, CCRC Mary Straw, DHA, MS, RN Kim Suda, BS, RN, CNRN, EMT Laurie Theeke, RN, MSN, PhD, FNP-BC, GCNS-BC Michelle Vandemark, RN, MSN Stephanie Vaughn, PhD, RN, CRRN Eileen Walsh, PhD, APRN, CVN Christine Whelley, MSN, CNRN Susan Zimmermann, RN, BSN, CNRN

State-of-the-Science Stroke Nursing Symposium 2014 Program Committee

The American Heart Association/American Stroke Association is grateful to the members of the State-of-the-Science Stroke Nursing Symposium 2014 Program Committee for their dedication and leadership provided throughout the year in planning the program. Jennifer Cohn, MSN, CNRN, Chair Karen Saban, PhD, APRN, RN, CNRN, Vice Chair Tamilyn Bakas, PhD, RN, FAHA, FAAN, (ISC Program Committee Liaison) Terrie Black, MBA, BSN, RN, BC, CRRN Theresa Green, RN, PhD Millie Hepburn-Smith, MSN, ACNS-BC Sarah Livesay, DNP, RN, ACNP, CNS-A (AANN Liaison) Linda Pierce, PhD, RN, CNS, CRRN, FAHA, FAAN Sue Pugh, RN, MSN, CRRN, CNRN, FAHA Karen Seagraves, MS, MPH, ACNS-BC, ANP-BC

Analysis of Related Factor in Professional Autonomy Among Stroke Nurses

Analysis of Related Factor in Professional Autonomy Among Stroke Nurses

Continuous learning with a quiz for stroke nurses

A continuous learning solution was sought which allows stroke nurses to keep the vast body of theoretical knowledge fresh, stay up-to-date with new knowledge, and relate theoretical knowledge to practical experience. Based on the theoretical background of learning in the medical domain, reflective and game-based learning, we carried out a user-oriented design process that involved a focus group and a design workshop. In this process, a quiz that includes both content-based and reflection questions was identified as a viable means of transportation for theoretical knowledge. In this paper we present the result of trialling a quiz with both content-based and metacognitive reflective questions in two settings: In one trial the quiz was used by nurses as part of a qualification programme for stroke nurses, in the second trial by nurses outside such a formal continuous learning setting. Both trials were successful in terms of user acceptance, user satisfaction and learning. Beyond this success report, we discuss barriers to integrating a quiz into work processes within an emergency ward such as a stroke unit.

Keys to Early Career Success

Nurse scientists often travel diverse and challenging trajectories during their preparation for a productive career in cardiovascular and stroke nursing. Building on that diversity and using the resources available from the American Heart Association, National Institutes of Health, and other organizations to support an early career is a key component of success. In this lecture, we will consider the importance of good mentorship, the qualities to be looked for in mentors, the elements of a successful productive career, and the lessons to be learned and decisions to be made on the way to achieving work-life balance.

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

Aim: To develop a practical system to enable nurses to screen for psychological distress following stroke. Background: Mood disorders and psychological distress are prevalent following stroke, but often go undetected and therefore untreated. National guidelines recommend screening for distress, but the evidence suggests that there are significant barriers to the implementation of post-stroke mood and psychological distress screening programmes. One barrier relates to limitations of questionnaire methods for identifying distress. Specifically, existing mood questionnaires are often too lengthy; miss important emotional changes that result from stroke; and do not necessarily point nurses towards the most helpful intervention approaches. Methods: We sought to develop a brief, clinically valid screening system that could be used by nurses to identify the levels of psychological distress experienced by stroke survivors. As well as determining levels of distress, the system was intended to aid the identification of first-line interventions that nurses could offer to alleviate distress. Results: A screening system was identified from the oncology literature (the Distress Management System [DMS]) that appeared to meet the broad requirements for screening for stroke-related distress. To tailor the DMS for stroke settings, we obtained feedback on the components of the DMS from stroke survivors and stroke nurses, and also consulted the research literature. This led us to: (1) retain the distress screening component of the DMS, the ‘Distress Thermometer’; (2) modify the DMS’s ‘Concerns Checklist’ to reflect the main problems encountered after stroke; and (3) add a ‘Resource Pack’ to the screening system to enable nurses to offer first-line interventions targeted at individuals’ distress. The result, the Distress Management System for Stroke (DMSS), is presented in full in this paper. Conclusion: The DMSS is a potentially useful tool for nurses working in stroke settings. It is brief, straightforward to administer, captures the main emotional concerns of stroke survivors, and the findings from the DMSS can be used to structure interventions for psychological distress. Future work is required, however, to establish the DMSS’s reliability, validity and clinical effectiveness.

American Heart Association Council on Cardiovascular and Stroke Nursing

American Heart Association Council on Cardiovascular and Stroke Nursing

The nursing role in thrombolysis treatment for acute ischaemic stroke: an overview

Clot-busting thrombolysis treatment is recommended for some patients with stroke if it can be administered within 4.5 hours of stroke onset. Over the past few years, initiatives across the UK stemming from the Department of Health's (2007) National Stroke Strategy have attempted to improve various aspects of stroke treatment, including rates and speed of administration of thrombolysis ( NHS Improvement, 2010a ; 2010b ). Specialist stroke nurses have played an important part in these efforts, but there is a limited amount of literature defining the nursing role in thrombolysis treatment. This article provides an overview of the nursing role in delivering thrombolysis treatment in acute ischaemic stroke and the factors that affect it.