Diagnostic and interventional radiology (IR) nurses are integral members of an acute stroke care team, especially as they manage a patient's needs 24 hours post-stroke, according to a new study published in the Journal of Radiology Nursing.
“Endovascular therapy is now the first-line treatment for acute ischemic stroke secondary to large vessel occlusions,” wrote lead author Mougnyan Cox, MD, of the Hospital of the University of Pennsylvania in Philadelphia, and colleagues. “As an important part of the neurovascular triad (radiology, neurology and neurosurgery), nurses within the specialty of radiology play in important role in emergency revascularization. However, the role of nursing in acute stroke extends beyond timely recanalization, well into the convalescent phase.”
The researchers specifically sought to assess how diagnostic and IR nurses impact the aspects of clinical care in acute stroke patients.
Cox and colleagues conducted a retrospective review of 100 consecutive patients at a tertiary care stroke center where angiographically proved intracranial large vessel occlusion was performed. Researchers obtained Baseline characteristics including the site of vascular occlusion, admission National Institutes of Health Stroke Scale (NIHSS) score and 30-day mortality. Additionally, inpatient records were reviewed to determine the number of patients who required procedures typically performed by interventional radiologists.
The researchers found the median HIHSS score was 15, designated as “moderate stroke.” In all, 89 patients exhibited anterior circulation ischemia from a large vessel occlusion and 11 exhibited posterior circulation occlusions. The 30-day mortality rate was 15 percent.
Cox and colleagues noted 54 procedures were performed in the study population. Most patients had only one IR-related procedure during their stay other than revascularization of their anterior circulation.
The three most common procedures performed by the IR team in the study population during the patient’s hospitalization were gastrostomy tube placement, inferior vena cava filter placement and peripherally inserted central catheter placement. Less commonly performed procedures included percutaneous cholecystostomy tube placement and various fluid aspirations.
“Our study shows that nurses (diagnostic/interventional radiology and bedside) are heavily involved in the care of acute stroke patients, with over 40 percent of the patients in this study having at least one invasive radiologic procedure in addition to thrombectomy,” Cox and colleagues wrote. “Extrapolating to all acute stroke patients in the United States, this represents a substantial number of patients.”
The researchers noted an increasing trend toward the establishment of inpatient stroke units as previous studies pointed to improved survival rates. Additional personnel and funding allocation will be critical, and radiology nurses will continue to be key members in the management of acute stroke care.
"Educating our clinical colleagues and patients about the services we can offer, these patients can only help to advance the field of radiology nursing while substantially improving the care of the large number of patients afflicted by acute stroke," the authors wrote.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.