Background and Purpose: Acute ischemic strokes remain one of the main causes of morbidity and mortality in the United States (US). With a stroke occurring every 40 seconds, the interest in advancing stroke care is critical to improving survival and reduces the loss of function (Taylor, Uchino, Hussain, & Carlson, 2014). Presently, 12% of acute ischemic strokes evaluated in US Emergency Departments (ED) receive stroke intervention (Lin et al., 2015). The purpose of the extended window protocol for acute stroke treatment (EPAST) study was to evaluate it’s impact on stroke patients’ treatment rates and quality indicators (door to the needle (DTN) and door to groin (DTG) times). Patient outcome was measured by the change in the modified Rankin Score (mRS). The investigation also assessed a new nursing process, which extended the assessment and screening window for acute stroke patients presenting within the emergency department (Omelchenko & Cerone, 2017). Methods: A chi-square test of independence, an Independent t-test and Mann-Whitney U test were used for data analysis (Sheskin, 2011). Results: The study examined the stroke alerts during January-February 2017 to establish a baseline (n=8) vs. total stroke alerts during January-February 2018 identified as the sample (n=9). Study showed number of alerts at X 2 (1) = .118, p = 0.732. The DTN baseline was 72.50 minutes vs. sample time of 64.75 minutes. t (7.031) = .374, p = 0.720. DTG baseline was 90.50 minutes vs. sample time of 70.00 minutes, t (2) = .179, p = 0.874. The mRS baseline median was 4.50 vs. sample median of 2.67 ( p< 0.05). Conclusion: EPAST project showed overall improvements in the stroke process quality indicators such as DTN and DTG with the average improvement of 11% and 22% respectively. Study also showed positive trends in overall stroke treatment rates, as it included additional patients who would be excluded in the past. Study was limited by small sample size. Additional studies are recommended in the future.