Abstract
Background and Rationale: This research and development aimed to review, develop, and evaluate the new normal emergency stroke care system in public and private hospitals during the COVID-19 pandemic. Methodology: A research and development methodology was employed using system implementation form and semi-structured interviews for evaluation. Participants included 40 individuals, comprising 10 acute stroke patients exhibiting symptoms outside the hospital, 2 heads of accident and emergency departments, 4 emergency department physicians, 20 emergency department nurses, and 4 emergency medical workers. Results: The developed system unfolded in three phases. (1) Pre-hospital care phase integrated telemedicine for on-scene patient care, addressing the imperative of preventing COVID-19 infection, and transportation to the hospital systems. (2) Care phase in the emergency department with rigorous COVID-19 infection screening protocols and diligent patient care. (3) Patient in-hospital transfer phase needed a heightened focus on infection prevention and patient isolation during the transfer process. The new normal emergency stroke care system diverged significantly, emphasizing patient isolation, mandatory mask-wearing for patients, utilization of personal protective equipment by healthcare teams, a cautious approach to administering the blood thinner rt-PA (recombinant tissue plasminogen activator) to COVID-19 patients displaying severe symptoms, and enhanced monitoring of patients receiving rt-PA, with the potential inclusion of telemedicine to mitigate exposure risks. Summary: Ninety-nine percent of the samples agreed on the suitability and practicality of the new system’s content and procedures. The new normal model would serve as a robust safeguard for patients and healthcare staff alike, but with an increasing time-to-treatment. Suggestions: To maintain the quality of care, all healthcare staff involved in stroke care must receive comprehensive training on the new system.
