Abstract Number: Esoc2026a12 Implementation of Intravenous Thrombolysis for Acute Ischemic Stroke at Alejandro Posadas National Hospital: Impact of Continuous Training and Service Expansion

Abstract Background and aims Until 2017, Alejandro Posadas National Hospital in Buenos Aires did not perform intravenous thrombolysis for acute ischemic stroke (AIS) due to lack of protocols, training, and resources. We aimed to implement a structured stroke program, optimize workflows, and evaluate its impact on thrombolysis rates and treatment times. Methods A descriptive retrospective study was conducted including AIS patients from 2017 onward. The intervention comprised continuous education (theoretical workshops, high-fidelity simulation, Body Interact® modules), protocol standardization, participation in the Angels initiative, and monthly audits. Nursing staff were trained to recognize stroke symptoms and activate the stroke code. The protocol established immediate Cincinnati Stroke Scale on arrival, CT activation with priority, senior staff notification, and NIHSS assessment during transport to CT. If no hemorrhage or contraindications, alteplase bolus was initiated followed by continuous infusion in the shock room. Outcomes included thrombolysis rate, door-to-imaging, and door-to-needle times. Results Thrombolysis was achieved in ~12% of all AIS patients and in 78% of those arriving within the therapeutic window. Average door-to-CT time was 23.3 minutes and door-to-needle time 38.7 minutes. Monthly audits showed progressive protocol optimization. Simulation-based training and nursing empowerment were key for rapid activation and decision-making. Conclusions Continuous education, standardized protocols, and service expansion enabled a resource-limited hospital to reach thrombolysis performance comparable to high-income settings. Structured teamwork and nursing involvement were crucial. Further efforts should focus on public awareness and prehospital coordination to reduce delays. Conflict of interest Leandro Aguilar. Nothing to disclose