2023
Translation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing following stroke across Europe (QASC Europe): A pre-test/post-test implementation study
MIDDLETON, Sandy, Simeon DALE, Benjamin MCELDUFF, Kelly COUGHLAN, Elizabeth MCINNES et. al.Základní údaje
Originální název
Translation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing following stroke across Europe (QASC Europe): A pre-test/post-test implementation study
Autoři
MIDDLETON, Sandy (garant), Simeon DALE, Benjamin MCELDUFF, Kelly COUGHLAN, Elizabeth MCINNES, Robert MIKULÍK (203 Česká republika, domácí), Thomas FISCHER, Van der Merwe JAN, Dominique CADILHAC, Catherine ESTE, Christopher LEVI, Jeremy M GRIMSHAW, Andreea GRECU, Clare QUINN, Ngai Wah CHEUNG, Sabina MEDUKHANOVA, Estela Sanjuan MENENDEZ, Susana SALSELAS, Gert MESSCHENDORP, Anne-Kathrin CASSIER-WOIDASKY, Marcelina SKRZYPEK-CZERKO, Merce SLAVAT-PLANA, Urso ANTONELLA, Waltraud PFEILSCHIFTER a Tereza KOLABIA
Vydání
EUROPEAN STROKE JOURNAL, LONDON, SAGE PUBLICATIONS LTD, 2023, 2396-9873
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30210 Clinical neurology
Stát vydavatele
Velká Británie a Severní Irsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 6.100 v roce 2022
Kód RIV
RIV/00216224:14110/23:00130193
Organizační jednotka
Lékařská fakulta
UT WoS
000871730000001
Klíčová slova anglicky
Stroke; implementation; nurses; QASC; FeSS; fever; hyperglycaemia; swallow; dysphagia; translation
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 26. 1. 2024 10:36, Mgr. Tereza Miškechová
Anotace
V originále
Introduction: Poor adoption of stroke guidelines is a problem internationally. The Quality in Acute Stroke Care (QASC) trial demonstrated significant reduction in death and disability with facilitated implementation of nurse-initiated Methods: This was a multi-country, multi-centre, pre-test/post-test study (2017-2021) comparing post implementation data with historically collected pre-implementation data. Hospital clinical champions, supported by the Angels Initiative conducted multidisciplinary workshops discussing pre-implementation medical record audit results, barriers and facilitators to FeSS Protocol implementation, developed action plans and provided education, with ongoing support co-ordinated remotely from Australia. Prospective audits were conducted 3-month after FeSS Protocol introduction. Pre-to-post analysis and country income classification comparisons were adjusted for clustering by hospital and country controlling for age/sex/stroke severity. Results: Data from 64 hospitals in 17 countries (3464 patients pre-implementation and 3257 patients post-implementation) showed improvement pre-to-post implementation in measurement recording of all three FeSS components, all p < 0.0001: fever elements (pre: 17%, post: 51%; absolute difference 33%, 95% CI 30%, 37%); hyperglycaemia elements (pre: 18%, post: 52%; absolute difference 34%; 95% CI 31%, 36%); swallowing elements (pre: 39%, post: 67%; absolute difference 29%, 95% CI 26%, 31%) and thus in overall FeSS Protocol adherence (pre: 3.4%, post: 35%; absolute difference 33%, 95% CI 24%, 42%). In exploratory analysis of FeSS adherence by countries' economic status, high-income versus middle-income countries improved to a comparable extent. Discussion and conclusion: Our collaboration resulted in successful rapid implementation and scale-up of FeSS Protocols into countries with vastly different healthcare systems.