Specifications Manual for Joint Commission National Quality Measures (v2018A)
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Release Notes:
Data Element
Version 2018A

Data Element Name: IA Route of t-PA Administration
Collected For: CSTK-05, CSTK-07, CSTK-08, CSTK-09
Definition:The route of thrombolytic (t-PA) administration was intra-arterial (IA). Thrombolytic therapy may be administered intra-venously (IV) by infusion directly into a vein through a peripheral or central venous catheter, or it may be given through an endovascular mircrocatheter delivery system positioned in an artery to directly infuse t-PA into the clot.
Suggested Data Collection Question:Is there documentation that the route of thrombolytic (t-PA) administration was intra-arterial (IA)?
Format:
Length:1
Type:Alphanumeric
Occurs:1
Allowable Values:

Y (Yes) The route of t-PA administration was intra-arterial (IA).

N (No) The route of t-PA administration was not intra-arterial (IA), OR unable to determine from medical record documentation.
Notes for Abstraction:
  • If the route of thrombolytic administration is documented as intra-arterial (IA), select “Yes”.
  • If both intravenous (IV) and intra-arterial (IA) thrombolysis are given either in different procedures or the same procedure, select “Yes”.
    Examples:
    • “IV t-PA given at hospital ‘A’ prior to transfer to hospital ‘B’ (i.e. drip and ship). Mechanical thrombectomy with IA thrombolysis was performed at hospital ‘B’”.
    • “NIHSS score 3 on arrival to this hospital. IV t-PA initiated in ED with initial improvement noted and NIHSS score zero post-infusion. NIHSS score 5 one hour later. Patient taken to interventional suite and IA t-PA administered.”
  • If the only route of thrombolytic administration was intra-venous (IV) at this hospital or a transferring hospital, select “No”.
  • If IA thrombolytic was administered at another hospital and the patient subsequently transferred to this hospital, select “No”.
Suggested Data Sources:

  • Consultation notes
  • Diagnostic test reports
  • Operative notes
  • Procedure notes

Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion

Only Acceptable Thrombolytic Therapy for Stroke:
  • Activase
  • Alteplase
  • IA t-PA
  • Recombinant Tissue Plasminogen Activator (rt-PA)

  • Intravenous (IV) t-PA
  • IA administration of thrombolytic agents not listed as inclusions

IA Route of t-PA Administration
Specifications Manual for Joint Commission National Quality Measures (v2018A)
Discharges 07-01-18 (3Q18) through 12-31-18 (4Q18)
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