Application of an Integrated Emergency Protocol Based on HFMEA in Intravenous Thrombolysis for Acute Ischemic Stroke:A Clinical Effectiveness Study

ZHANG Gaolan

doi:10.13919/j.issn.2095-6274.ZHJY202410047

Abstract：Objective To analyze the clinical value of implementing a comprehensive emergency plan based on Healthcare Failure Mode and Effect Analysis (HFMEA) during the intravenous thrombolysis process in patients with acute ischemic stroke. Methods A total of 120 patients with acute ischemic stroke,who received intrave-nous thrombolysis at the Department of Neurology,Taian Traditional Chinese Medicine Hospital between Novem-ber 2021 and October 2023,were included in this study. Of these,60 patients treated between November 2021 and October 2022,prior to the implementation of the HFMEA-based emergency plan,were assigned to the conventional management group,while the remaining 60 patients treated between November 2022 and October 2023,after the implementation of the HFMEA-based emergency plan,were assigned to the HFMEA management group. The two groups were compared based on emergency response times,time-to-thrombolysis compliance rate,degree of neu-rological damage,patient satisfaction,and occurrence of adverse events. Results Compared with the conven-tional management group,the HFMEA management group showed significantly shorter times for patient admission,time to first contact with emergency physicians,time to obtain test reports,time to complete CT scans,and time from admission to thrombolysis (P<0.001). Addition-ally,the HFMEA management group demonstrated a higher rate of compliance with the time-to-thrombol-ysis standard (P<0.05). After the intervention,both groups showed significant reductions in NIHSS scores and levels of neuron-specific enolase (NSE),a neurological biomarker,compared to pre-intervention values (P<0.001). Moreover,the HFMEA management group had signifi-cantly lower NIHSS scores and NSE levels compared to the conventional management group after the intervention (P<0.001). Conclusion The implementation of an HFMEA-based comprehensive emergency plan during the in-travenous thrombolysis process for acute ischemic stroke patients can significantly improve the timeliness of throm-bolysis,enhance neurological recovery,and reduce adverse events. This approach demonstrates higher clinical safety,effectiveness,and patient satisfaction,making it a valuable clinical strategy for improving outcomes in acute ischemic stroke management.