Evaluation of Patients’ Nursing Care Outcomes Following Thrombolytic Therapy – a Retrospective Study

Abstract

Introduction. Nursing documentation is an indicator of healthcare quality. After extensive data analysis, it has been shown that nursing documentation has become an assessment tool and a tool to change clinical practice. Stroke is the most significant individual cause of disability in the adult population. In instances of ischemic stroke, brain circulation is abruptly disconnected. Causes of this break in blood flow may be blockage or compression of blood vessels due to thrombosis, embolism or systemic hypoperfusion. Therapy administered in cases of acute ischemic stroke includes intravenous thrombolytic therapy-recombined tissue activator of plasminogen within 180, i.e. 270 minutes of the stroke. Aim. To determine the quality of outcomes as regards patient care after administering thrombolytic therapy in a display of progress notes of patients' condition during their stay in the hospital, both before and after administering thrombolytic therapy. Methods. A retrospective study was carried out at the neurology department of "Dr. Ivo Pedišić" General Hospital in Sisak during 43 months from January 1, 2013 to May 31, 2017. 85 patients participated in the study. Data were obtained from one component of nursing documentation in electronic form, namely progress notes on the patients' conditions. Results. With a 95% confidence level, a statistically significant difference (p<0.05) was found for parameters of hygiene, feeding, elimination, dressing, walking, moving, sitting, standing, turning, nutrition-diet, strain tolerance, Braden scale and categorization, before and after thrombolytic therapy. Statistical significance was not found in the parameters of pain (p=0.067), GCS/ Trauma score scale (p=0.339), risk of fall (p=0.072). Conclusion. The implementation of the healthcare process, continued monitoring of the patient's condition and progress, as well as validation of nursing activities provide an imperative for the application of nursing documentation as an essential tool in describing regular nursing activities. Application of documentation enables a more permanent insight into a patient's general state, data availability, care continuity, progress chronology and result evaluation, as well as a material background for professional, expert and scientific development of nurses through studies in the field of nursing.