Missed Opportunities Related to Misdiagnosed of Acute Ischemic Stroke in the Emergency

Department

Problem of statement:
There are lack of current quantitative research related to missed ischemic stroke diagnosis in the
emergency department in Palestine. The failure in early diagnosis of acute ischemic stroke in
emergency department is a missed opportunity for early intervention for appropriate treatment.
Therefore, there is a need to understand the factors associated with misdiagnosis of acute stroke
in emergency department, in order to increase the quality of care, improve pts outcome and
reduce mortality rate.
Research question

Dependent variables:
Ischemic stroke:
Conceptual definition: “Brain attack” it occurs when blood flow to an area of brain is cut off.
And the brain cells deprived of o2 and begin to die.
Operational definition: An episode of neurological dysfunction caused by focal cerebral, spinal
or retinal infarction.

Missed diagnosis
Conceptual definition: it is failure to diagnose or delayed diagnosis, occurs when failed to
identify a medical condition at the time they’re presented with it.
Operational definition: failure to recognize the clinical characteristic of AIS, or to do regular
exams and screening tests.

Independent variables: //// factors////

Secondary prevention therapy
Conceptual definition: is early detection and diagnosis that improves the chances for positive
health outcomes and to prevent complications.
Operational: reduce the impact of a disease or injury that has already occurred by regular exams
and screening tests to detect disease in its earliest stages.
e.g CT, MRI to detect ischemic stroke.

Quality of care

Conceptual: degree to which health services for individuals and populations increase the
likelihood of desired health outcomes and are consistent with current professional knowledge

Operational: reflect the characteristics of health services, and actions that is consistent with
current clinical guidelines for a specific disease or condition.

Health outcome
Conceptual definition:
Operational definition:

Mortality rate
Conceptual definition: is the number of people who die in a given year and area, divided by the
population of that area.
Operational definition: is a measure of the number of deaths in a population, scaled to the size
of that population, per unit of time.

Emergency department
Conceptual:
Department in hospital responsible for providing primary care, emergency medicine and first
intervention for patients.
Operational: Unit in hospital to provide care for hazard cases.