IA Route of Alteplase Administration (v2020A)

Specifications Manual for Joint Commission National Quality Measures (v2020A)

Posted: August 1, 2019

Discharges 01-01-20 (1Q20) through 6-30-20 (2Q20)

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Release Notes:
Data Element
Version 2020A

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

Specifications Manual for Joint Commission National Quality Measures (v2020A)
Discharges 01-01-20 (1Q20) through 6-30-20 (2Q20)

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