{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:55:51Z","timestamp":1788857751520,"version":"build-2803163510"},"reference-count":13,"publisher":"AACN Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cerebrovascular accident, or stroke, is a common cause of death or disability. Timely diagnosis and intervention are critical for improving survival rates and reducing the long-term effects of stroke. For patients with ischemic stroke, thrombolytic drugs and endovascular intervention are time-sensitive treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Local Problem<\/jats:title>\n                    <jats:p>Patients living in rural areas often do not have access to rapid consultation with specialized neurologic teams for diagnosis and treatment of stroke. The use of telemedicine in the form of a telestroke consultation can improve timely diagnosis and treatment for rural patients exhibiting stroke symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A telestroke program was implemented in the upper Midwest. A team of 4 interventional neurologists provided telestroke consultation to a comprehensive stroke center and 5 other acute stroke\u2013ready rural hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A tiered stroke alert algorithm and telestroke workflow chart were developed to help health care professionals at rural sites determine eligibility for telestroke consultation. A teleneurologist connected with the originating site, and the National Institutes of Health Stroke Scale could be completed remotely with assistance from the originating site. Telestroke has increased the percentage of patients receiving thrombolytics in less than 60 minutes, and door-to-needle time has decreased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rural patients with stroke symptoms may experience a delay in care or stroke diagnosis due to distance to specialized neurologic services. Telestroke consultation is a successful method for timely diagnosis of stroke and recommendation for treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ccn2023505","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T20:01:59Z","timestamp":1696104119000},"page":"49-56","source":"Crossref","is-referenced-by-count":10,"title":["Use of Telestroke to Improve Access to Care for Rural Patients With Stroke Symptoms"],"prefix":"10.4037","volume":"43","author":[{"given":"Lori","family":"Hendrickx","sequence":"first","affiliation":[{"name":"Lori Hendrickx is a professor at South Dakota State University College of Nursing, Brookings, South Dakota, and a staff nurse at St. Mary\u2019s Essentia Health, Detroit Lakes, Minnesota."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsey","family":"Kuznia","sequence":"additional","affiliation":[{"name":"Chelsey Kuznia is the stroke program manager for the Comprehensive Stroke Center, Essentia Health, Fargo, North Dakota."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Maneval","sequence":"additional","affiliation":[{"name":"Lindsey Maneval is an emergency department supervisor and stroke coordinator, St. Mary\u2019s Essentia Health, Detroit Lakes."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"8","key":"2023100100015002200_b1-0430049","doi-asserted-by":"publisher","first-page":"e153","DOI":"10.1161\/CIR.0000000000001052","article-title":"Heart disease and stroke statistics-2022 update: a report from the American Heart Association","volume":"145","author":"Tsao","year":"2022","journal-title":"Circulation"},{"issue":"7","key":"2023100100015002200_b2-0430049","doi-asserted-by":"publisher","first-page":"2131","DOI":"10.1161\/STROKEAHA.120.029318","article-title":"Urban-rural inequities in acute stroke care and in-hospital mortality","volume":"51","author":"Hammond","year":"2020","journal-title":"Stroke"},{"issue":"1","key":"2023100100015002200_b3-0430049","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1111\/jrh.12502","article-title":"Rural stroke patients have higher mortality: an improvement opportunity for rural emergency medical services systems","volume":"38","author":"Georgakakos","year":"2022","journal-title":"J Rural Health"},{"issue":"12","key":"2023100100015002200_b4-0430049","doi-asserted-by":"publisher","first-page":"e344","DOI":"10.1161\/STR.0000000000000211","article-title":"Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"50","author":"Powers","year":"2019","journal-title":"Stroke"},{"issue":"7","key":"2023100100015002200_b5-0430049","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1161\/STROKEAHA.117.017089","article-title":"Contributors to the excess stroke mortality in rural areas of the United States","volume":"48","author":"Howard","year":"2017","journal-title":"Stroke"},{"issue":"10","key":"2023100100015002200_b6-0430049","doi-asserted-by":"publisher","first-page":"3019","DOI":"10.1161\/STROKEAHA.114.006293","article-title":"Geographic access to acute stroke care in the United States","volume":"45","author":"Adeoye","year":"2014","journal-title":"Stroke"},{"issue":"5","key":"2023100100015002200_b7-0430049","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1212\/WNL.0000000000003562","article-title":"Progressive rural-urban disparity in acute stroke care","volume":"88","author":"Gonzales","year":"2017","journal-title":"Neurology"},{"issue":"2","key":"2023100100015002200_b8-0430049","doi-asserted-by":"publisher","first-page":"e004973","DOI":"10.1161\/CIRCOUT-COMES.118.004973","article-title":"Rural-urban differences in stroke risk factors, incidence, and mortality in people with and without prior stroke","volume":"12","author":"Kapral","year":"2019","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"5","key":"2023100100015002200_b9-0430049","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1089\/tmj.2017.0006","article-title":"American Telemedicine Association: telestroke guidelines","volume":"23","author":"Demaerschalk","year":"2017","journal-title":"Telemed J E Health"},{"issue":"5","key":"2023100100015002200_b10-0430049","doi-asserted-by":"publisher","first-page":"34","DOI":"10.4037\/ccn2021109","article-title":"Tele-U to tele-ICU: telehealth nursing education","volume":"41","author":"Gibson","year":"2021","journal-title":"Crit Care Nurse"},{"issue":"10","key":"2023100100015002200_b11-0430049","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1007\/s11606-017-4082-2","article-title":"Ethical practice in telehealth and telemedicine","volume":"32","author":"Chaet","year":"2017","journal-title":"J Gen Intern Med"},{"issue":"12","key":"2023100100015002200_b12-0430049","doi-asserted-by":"publisher","first-page":"2005","DOI":"10.1377\/hlthaff.2018.05089","article-title":"Expansion of telestroke services improves quality of care provided in super rural areas","volume":"37","author":"Zhang","year":"2018","journal-title":"Health Aff (Millwood)"},{"issue":"10","key":"2023100100015002200_b13-0430049","doi-asserted-by":"publisher","first-page":"e01787","DOI":"10.1002\/brb3.1787","article-title":"Telestroke strategies to enhance acute stroke management in rural settings: a systematic review and meta-analysis","volume":"10","author":"Lazarus","year":"2020","journal-title":"Brain Behav"}],"container-title":["Critical Care Nurse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/43\/5\/49\/151994\/49.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/43\/5\/49\/151994\/49.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T20:02:02Z","timestamp":1696104122000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article\/43\/5\/49\/32194\/Use-of-Telestroke-to-Improve-Access-to-Care-for"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,1]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ccn2023505","relation":{},"ISSN":["0279-5442","1940-8250"],"issn-type":[{"value":"0279-5442","type":"print"},{"value":"1940-8250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,1]]}}}