Knowledge and Practice of Emergency Nurses Regarding Streptokinase and Alteplase Administration at a Tertiary Care Teaching Hospital in Peshawar, Pakistan: A Cross‐Sectional Study
Abstract
Background: Thrombolytic therapy with streptokinase and alteplase is a cornerstone in the management of acute myocardial infarction (AMI) and acute ischemic stroke (AIS). Emergency nurses play a critical role in the timely and safe administration of these agents. However, limited data exist regarding emergency nurses’ knowledge and practice in this domain within Pakistan. This study aimed to assess the level of knowledge and self‐reported practice patterns of emergency nurses concerning streptokinase and alteplase administration at a tertiary care teaching hospital in Peshawar, Pakistan.
Methods: A descriptive, cross‐sectional survey was conducted from February to April 2025 among 150 emergency nurses working at A Tertiary Care Hospital, Peshawar. A structured, pretested questionnaire comprising 30 knowledge items (scored 0–30) and 15 practice‐related items (Likert scale 1–5) was administered. Demographic data, educational background, and clinical experience were also recorded. Data were analyzed using SPSS v.25.0; knowledge scores were categorized as poor (<50%), moderate (50–74%), or good (≥75%). Practice scores were expressed as mean ± SD. Correlations between knowledge and practice were evaluated using Pearson’s r.
Results: The mean age of participants was 29.4 ± 4.8 years; 68% were female, and 32% male. The mean professional experience was 5.2 ± 3.1 years. Overall, 42% of nurses demonstrated “good” knowledge (mean knowledge score = 24.1 ± 3.5), 38% had “moderate” knowledge (mean = 19.8 ± 2.6), and 20% exhibited “poor” knowledge (mean = 13.4 ± 3.1). Specific gaps were noted in contraindications for streptokinase (correct responses: 54.7%) and alteplase dosing adjustments in renal impairment (correct responses: 48.0%). The mean practice score was 3.8 ± 0.6 (out of 5), indicating generally acceptable self‐reported adherence to protocols. Yet only 56% reported always verifying the appropriate door‐to‐needle time for AMI patients. A moderate positive correlation was observed between knowledge and practice scores (r = 0.46, p < .001).
Conclusion: While a substantial proportion of emergency nurses in Peshawar demonstrate adequate knowledge and acceptable practice behaviors regarding streptokinase and alteplaseadministration, critical deficiencies persist—particularly in recognizing contraindications and dose adjustments. Targeted in‐service training programs and regular competency assessments are recommended to optimize thrombolytic therapy delivery and improve patient outcomes.
