What is the evidence tosupport nurse led thrombolysis?

• Published in: Clinical effectiveness in nursing Vol. 2; no. 2; pp. 69 - 77
• Main Author: Rhodes, M.A.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.06.1998
• ISSN: 1361-9004; 1532-9275
• DOI: 10.1016/S1361-9004(98)80034-4

The benefits of thrombolytic therapy on mortality from acute myocardial infarction (AMI) are time related. Delays which occur as a result of failure to seek medical assistance or lengthy and unnecessary hospital admission procedures have a detrimental effect on patient survival. In response to nationally agreed guidelines for the management of AMI, nursing strategies within the UK have been developed to streamline admission procedures and to improve the identification of patients requiring thrombolytic therapy. A small number of authors have demonstrated that nursing interventions can have a considerable impact on door-to-needle time. In most cases nurses are responsible for determining patient suitability for thrombolytic therapy, and for commencing thrombolysis in Accident and Emergency after medical staff have confirmed the diagnosis. Unfortunately, the full potential of these interventions has not been realized, as they rarely provide a 24 hour service. There is very little research evidence to support the development of nurse led thrombolysis. Research which thoroughly evaluates the accuracy and safety of nurse led interventions is required. It is essential that there is parity in the provision of such interventions, so that patients are not delayed access to a treatment which is proven to be of time related benefit.