关键词: 缺血性脑卒中；静脉溶栓；绿色通道手环；流程优化；院内延迟

Abstract: Objective: To optimize the existing emergency green channel rescue process for acute ischemic stroke patients, aiming to shorten the Door-to-Needle Time (DNT). Methods: Causes of in-hospital delay in patients receiving intravenous thrombolysis were analyzed, and the emergency green channel rescue process was optimized through informatization. Using convenience sampling method, 52 patients who received intravenous thrombolysis at a tertiary grade A hospital in Beijing between November 2023 and February 2024 were selected as the control group (receiving the pre-optimization process), while 50 patients who received intravenous thrombolysis between April and June 2024 were selected as the intervention group (receiving the post-optimization process). The time for each key link, and DNT compliance rates were compared between the two groups. Results: Optimization strategies for key aspects of in-hospital emergency care were developed and process optimization was completed. After optimization, the intervention group showed significant reductions in the time from door to completion of CT/MRI, the time from door to signing informed consent, the time from completion of CT/MRI to signing informed consent and DNT compared to the control group (all P<0.05). The compliance rate for DNT 60 minutes improved from 84.62% to 98.00% (P<0.05), and the compliance rate for DNT45 minutes improved from 28.85% to 56.00% (P<0.05). Conclusion: The optimization of the in-hospital emergency care process for acute ischemic stroke patients has yielded evident effects, with a significant reduction in DNT and the time spent on some key links, as well as a notable increase in DNT compliance rate, thereby saving valuable treatment time for patients.

Key words: ischemic stroke; intravenous thrombolysis; green channel bracelet; process optimization; in-hospital delay