J 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

Štítky

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.