Specifications Manual for Joint Commission National Quality Measures (v2018B1)

Release Notes:
Data Element
Version 2018B1

Name:IA Route of Alteplase Administration
Collected For: CSTK-05, CSTK-07, CSTK-08, CSTK-09
Definition:The route of alteplase administration was intra-arterial (IA). Alteplase 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 alteplase into the clot.
Question:Is there documentation that the route of alteplase administration was intra-arterial (IA)?
Format:
Length:1
Type:Alphanumeric
Occurs:1
Allowable Values:

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

N (No) The route of alteplase administration was not intra-arterial (IA), OR unable to determine from medical record documentation.
Notes for Abstraction:
  • If the route of alteplase administration is documented as intra-arterial (IA), select “Yes”.
  • If both intravenous (IV) and intra-arterial (IA) alteplase are given either in different procedures or the same procedure, select “Yes”.
    Examples:
    • “IV alteplase given at hospital ‘A’ prior to transfer to hospital ‘B’ (i.e. drip and ship). Mechanical thrombectomy with IA alteplase was performed at hospital ‘B’”.
    • “NIHSS score 3 on arrival to this hospital. IV alteplase 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 alteplase administered.”
  • If the only route of alteplase administration was intra-venous (IV) at this hospital or a transferring hospital, select “No”.
  • If IA alteplase 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)
  • Tissue Plasminogen Activator(t-PA)

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

IA Route of Alteplase Administration
Specifications Manual for Joint Commission National Quality Measures (v2018B1)
Discharges 01-01-19 (1Q19) through 06-30-19 (2Q19)

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