Abstract 4142559: The effect of blood pressure monitoring program based on intelligent wearable devices on the compliance of nursing guidelines for intravenous thrombolysis in acute ischemic stroke

Introduction: It is recommended that blood pressure (BP) in patients with acute ischemic stroke should be monitored closely before and until 24 hours after thrombolysis. This study aimed to develop a BP monitoring protocol for acute ischemic stroke patients using smart wearable devices and investigate its feasibility and effectiveness. Methods: 160 stroke patients in the emergency department of a designated advanced stroke center from were recruited from March to September 2023 (Fig.1). The intervention group received the BP monitoring protocol using smart wearable devices, while the control group received traditional bedside BP monitoring using standalone devices. Process evaluation indicators included feasibility, fidelity, and stakeholder acceptability. Outcome evaluation indicators included adherence to BP monitoring guidelines, time from admission to intravenous thrombolysis, National Institutes of Health Stroke Scale scores, modified Rankin Scale scores, and the incidence of symptomatic intracranial hemorrhage. Results: The implementation rate of BP monitoring guidelines from before intravenous thrombolysis to 24 hours after thrombolysis in the experimental group was 90.00 (87.50, 95.00) %, and that in the control group was 87.50 (82.50, 92.50) % (Table 1). The results of the process evaluation showed that the feasibility and intervention fidelity of this study were good. Interviews with stakeholders (11 nurses and 11 patients) revealed that the implementation of the intervention protocol was beneficial in improving nursing efficiency and timely detection of disease changes, but the protocol needed further improvement. Conclusion: The BP monitoring protocol for stroke patients undergoing intravenous thrombolysis based on smart wearable devices is scientifically sound and feasible. It can enhance adherence to BP monitoring guidelines and promote the implementation of evidence-based nursing practices.