The role of a modified emergency nursing pathway based on the shared decision-making model in alteplase thrombolysis for acute ischemic stroke: A study on establishing an emergency department nursing system

This study aimed to analyze the effect of a modified emergency nursing pathway based on the shared decision-making model during alteplase thrombolysis for acute ischemic stroke and provide a reference for establishing a nursing system in the emergency department. Eighty patients with acute ischemic stroke treated with alteplase thrombolysis in our hospital from October 2023 to August 2024 were selected as the study subjects. They were divided into a control group (receiving conventional emergency care) and an observation group (receiving the modified emergency nursing pathway based on the shared decision-making model), with 40 cases in each group. The total effectiveness rate, triage time, thrombolysis waiting time, rescue time, complication rate, National Institutes of Health Stroke Scale scores, and Activities of Daily Living scale scores before and after thrombolysis were compared between the 2 groups. The modified Rankin Scale scores at discharge were obtained through follow-up. Compared with the control group, the observation group had a significantly higher total effectiveness rate and a lower complication rate (both P  < .05). Triage time, thrombolysis waiting time, and rescue time were significantly shorter in the observation group (all P  < .05). After thrombolysis, the observation group showed lower National Institutes of Health Stroke Scale scores, higher Activities of Daily Living scores, and lower modified Rankin Scale scores at discharge (all P  < .05). After adjustment for potential confounders, these associations remained statistically significant, indicating that the modified emergency nursing pathway was independently associated with improved clinical and process outcomes. The application of the modified emergency nursing pathway based on the shared decision-making model during alteplase thrombolysis for acute ischemic stroke can improve treatment efficiency and efficacy, reduce complications, enhance neurological function and prognosis, and increase the ability in daily activities. It is worthy of adoption. However, this study was conducted in a single center with a relatively small sample size, which may limit the generalizability of the findings. Future multicenter studies with larger samples are needed to further validate these results.