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Jan. 13, 2026 — A streamlined, nurse-led response for hospitalized patients experiencing an acute stroke at a Texas academic medical center improved time from symptom discovery to imaging and treatment, which is associated with better outcomes.
“Use of Rapid Response Teams to Expedite Imaging and Treatment for Inpatients With Acute Stroke” examines more than six years of data from Code Stroke activations at University of Texas (UT) Southwestern Medical Center, Dallas.
The analysis revealed that a high percentage of Code Stroke activations was initiated by the rapid response team (RRT), and those patients underwent critical imaging studies and received confirmed results from the radiologist faster than those without RRT nurses in the lead. 
The article is published in AACN Advanced Critical Care. The research team presented the study at the American Association of Critical-Care Nurses’ 2024 National Teaching Institute & Critical Care Exposition, where it was recognized as an Outstanding Research Abstract.
Co-author Kathrina Siaron, BSN, CCRN, SCRN, is assistant unit manager, Rapid Assessment Team, Parkland Hospital, UT Southwestern Neuroscience Nursing Research Center.
“The Code Stroke process is driven by the rapid response team from activation to intervention, leading to a significant decrease overall in inpatient stroke treatment times within our institution,” she said. “Our findings highlight the domino effect of reducing the time from initial symptom recognition to calling the RRT, thereby also shortening the time to Code Stroke activation, imaging and treatment.”
Based on best-practice recommendations from the American Stroke Association, the hospital’s stroke coordinators worked with the RRT to streamline the in-hospital Code Stroke activation protocol in late 2016. The study examines data from January 2017 through March 2023 in an in-house database maintained by the hospital’s stroke coordinators.
The patient’s primary nurse is responsible for activating the RRT when noting a significant change in a patient’s neurological status. The responding RRT nurse performs an initial assessment and judges whether to activate an in-hospital Code Stroke. Once a Code Stroke is activated, key stakeholders are notified via the paging system, and the RRT nurse can use an order set to authorize relevant diagnostic examinations and imaging.
The updated workflow minimizes the time to initial diagnostic imaging and expedites results that factor heavily into the neurologist’s decision-making process for potential interventions.
Of 900 patients who met the inclusion criteria, 836 Code Stroke activations were driven by the RRT and 64 were not. Institutional compliance with the new workflow improved over time, possibly reducing the number of patients in the non-RRT-driven cohort over the six-year study period.
Patients with RRT-initiated codes received imaging faster, with a mean time from code to imaging of 15.7 minutes compared with 23.2 minutes for patients whose Code Stroke was not driven by RRT. Imaging results from the radiologist were also received eight minutes faster (16.7 minutes vs. 24.5 minutes).
More Code Strokes were activated in the intensive care units and cardiovascular units than in other areas, reinforcing the need for staff nurses in critical care and cardiac progressive care units to have strong stroke assessment skills.
Since the institution is a comprehensive stroke center, the on-call neurologist, on-call interventional neuroradiologist and procedural nurse are available at all operating hours. The study team noted that the mean time for the in-house neurologist to respond to code activations was longer for RRT-driven activations (5.2 minutes) than for those that are not RRT-driven activations (3.5 minutes). According to the initial report of the patient’s condition, the neurologist might have ordered bedside staff to activate the Code Stroke while en route or, for a few patients, the neurologist activated the Code Stroke at the bedside, resulting in quicker neurologist response times being recorded.
Access the issue by visiting the AACN Advanced Critical Care website at https://acc.aacnjournals.org/.
December 23, 2025 
