Impact of Emergency Nursing Interventions on Pre-Hospital and In-Hospital Outcomes in Acute Ischemic Stroke

Tingting ZhanChunyan Xu^*

• Wuhan Fourth Hospital, Wuhan, China

Objective: Acute ischemic stroke (AIS) is a leading cause of mortality and long-term disability worldwide, with clinical outcomes highly dependent on the timeliness and coordination of emergency care. Emergency nurses are at the frontline of acute stroke management, contributing significantly to early recognition, rapid triage, thrombolysis preparation, and prevention of in-hospital complications. However, the real-world impact of structured emergency nursing interventions on both pre-hospital and in-hospital stroke outcomes remains underexplored. This study aimed to evaluate the feasibility and clinical effectiveness of emergency nursing interventions in reducing treatment delays and improving short-term neurological recovery in patients with AIS. Methods: A retrospective cohort study was conducted at Wuhan Fourth Hospital, including 217 adult AIS patients admitted between January 2020 and April 2024. Patients were divided into two groups based on the presence or absence of structured emergency nursing protocols, including pre-hospital triage coordination, stroke code activation, focused neurological monitoring, and post-thrombolysis care. Primary endpoints included door-to-needle time (DNT), thrombolysis rate, and early neurological deterioration. Secondary outcomes were NIHSS score changes at 72 hours, hospital length of stay, and 7-day in-hospital mortality. Results: Patients receiving emergency nursing interventions (n = 107) had significantly shorter median DNT (42 vs. 56 minutes, p < 0.001), higher thrombolysis rates (71.0% vs. 51.4%, p = 0.004), and reduced early neurological deterioration (10.3% vs. 21.5%, p = 0.018). NIHSS improvement ≥4 points was more frequent in the intervention group (64.5% vs. 43.1%, p = 0.003). No significant difference in 7-day mortality was observed. Conclusion: The implementation of structured emergency nursing interventions in AIS care significantly improves treatment timeliness and short-term functional outcomes. These findings support the inclusion of specialized nursing protocols in emergency stroke pathways to enhance quality and efficiency of care.