Stroke care system through collaboration with multiple departments and nurse practitioners

Abstract

  With the increase in the number of cases of acute cerebral infarction requiring mechanical thrombectomy (MT), overwork and “burn‒out syndrome” of neurointerventionalists (NIs) have become major concerns. We herein report a new stroke care system that takes the work‒life balance of a single NI into consideration. In 2014, the Nagasaki Medical Center launched its stroke hotline (N‒SHOT), through which the emergency department receives the first call and manages initial care. The Departments of Neurosurgery and Neurology work together to treat stroke patients. MT is managed by a single NI and is performed in collaboration with the Departments of Neurology and Radiology. The NI receives MT calls when patients with acute ischemic stroke are found to have large vessel occlusion. Because the number of inpatients under the NI’s charge and the number of MT cases increased, support from nurse practitioners (NPs) was started in 2016. Even in a hospital with only one NI, it is possible to deal with MT cases while maintaining a certain level of clinical outcome by taking advantage of N‒SHOT, collaborating with multiple other departments, and receiving medical support from NPs.