A Novel Mobilization Criteria Checklist 12 to 24 Hours After Intravenous Thrombolysis in Acute Ischemic Stroke

Purpose: This study describes the development and utilization of a novel mobilization criteria checklist that can guide clinical decision making to safely initiate very early mobilization for patients with acute ischemic stroke within 12 to 24 hours after intravenous (IV) thrombolysis. Methods: The evidence was examined, and risk factors for hemorrhagic transformation and considerations for initiating or terminating mobility within the first 12 to 24 hours were identified. The information was formatted into a mobilization criteria checklist for use in a case study 12 to 24 hours after tissue plasminogen activator (tPA), an IV thrombolytic, was given for acute ischemic stroke at a certified comprehensive stroke center. Outcomes: The tool was an additive to clinical practice and provided a clinical guide to optimize patient safety for an established institutional practice. Discussion: A mobilization criteria checklist is a helpful tool to screen for serious risk factors of hemorrhagic transformation in the first 24 hours after IV thrombolysis for acute ischemic stroke. With further development, the foundational concepts may guide future research to establish clinical practice guidelines and a standard of care to optimize the selection of patients most appropriate for mobility within 12 to 24 hours.