Effectiveness of Nurse-Led atrial Fibrillation Detection for Patients With Embolic Stroke of Unknown Source in Stroke Units: A Retrospective Study.
Junghee Han, Hyunjin Oh, Sunja Park and 1 others
PMID 42444390WHAT IT FOUND
Nurses suspected atrial fibrillation in 24 of 235 cryptogenic stroke patients; 23 were confirmed.
These notified patients started anticoagulation earlier, stayed in hospital shorter, and had lower reimbursed costs. Association, not proof nurses caused these outcomes.
Key findings
01In 235 cryptogenic stroke patients, nurses suspected atrial fibrillation in 24; 23 of those 24 were confirmed, and 72 patients had newly confirmed atrial fibrillation overall.
02Compared with un-notified patients, nurse-notified patients had more confirmed atrial fibrillation (95.8% vs 23.2%), more oral anticoagulant initiation (91.7% vs 35.1%), earlier anticoagulation (3.7 vs 5.6 days), and shorter stays (7.4 vs 9.9 days).
03Atrial fibrillation detection rates increased with nurses' neurology experience: 2.6 per 1000 person-days for 1 to 3 years, 12.78 for 4 to 9 years, and 45.11 for over 10 years.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Retrospective record review at one centre, so nurse notification was not assigned. Only 24 patients were nurse-notified, a small group for comparisons. Notified patients had more ECG follow-up (70.8% vs 46.0%), so the effect of nurse notification cannot be separated from additional confirmatory testing. Long-term outcomes such as recurrent stroke, disability, or safety were not measured. The unit had structured nurse training and experience, which may not transfer to other settings.
Declared interests
Asan Medical Center Research Fund supported the work; authors declared no conflicts of interest. Gemini 3.0 was used for grammar and sentence structure.
The easy way to misread this
Do not conclude that nurse-led atrial fibrillation detection caused shorter stays or earlier anticoagulation. This was a retrospective record review, so nurse notification was not assigned; nurse notification was associated with more ECG follow-up (70.8% vs 46.0%), and adjusted analysis did not show a significant association with anticoagulation timing (p=0.052).