Development of a Nursing Care Protocol for Patients with Stroke in the First 24 Hours of Thrombolysis

Libang Ugu, Kaur Sukhpal, Khurana Dheeraj, Bhalla Ashish


Even though thrombolysis in acute stroke predicts good outcome, these patients are at risk for developing complications of thrombolysis as well as the disease itself. Strict monitoring and effective interventions initiated early in the first 24 h can enhance the recovery process and minimize functional disability. This methodological study was undertaken to study the current practices of nursing care and to develop a nursing care protocol for the care of thrombolysed patients suffering with stroke in the first 24 h. The current practices of nursing care assessed through focus group discussion with nurses revealed the absence of protocol in the wards. A preliminary draft of protocol was developed based on review of literature. Four Delphi rounds were conducted to validate the protocol. Modifications were made as per the suggestions of the ten Delphi members. Feasibility of the protocol was checked on three patients. Training on care of thrombolysed patients according to the developed protocol was given to thirty nurses meeting the inclusion criteria. They were observed for implementation of the protocol on twenty patients by using an observation checklist based on the protocol. The internal consistency reliability of the checklist was calculated using Cronbach’s alpha coefficient. The Cronbach's alpha coefficient for the protocol was 0.83, whereas for each item the alpha coefficients ranged between 0.81 and 0.84. The developed protocol demonstrated high validity and reliability in providing care to thrombolysed stroke patients through best practices.


Keywords: Nursing care protocol, thrombolysis, Delphi, internal consistency reliability

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Libang Ugu, Kaur Sukhpal, Khurana Dheeraj et al. Development of a nursing care protocol for patients with stroke in the first 24 hours of thrombolysis. Research and Reviews: Journal of Neuroscience. 2015; 5(3): 27–39p.


Nursing care protocol, Thrombolysis, Delphi, Internal consistency reliability

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