Translation of nurse-initiated protocols to manage fever,
hyperglycaemia and swallowing following stroke across Europe
(QASC Europe): A pre-test/post-test implementation study

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.

Basic information

Original name

Translation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing following stroke across Europe (QASC Europe): A pre-test/post-test implementation study

Authors

MIDDLETON, Sandy (guarantor), Simeon DALE, Benjamin MCELDUFF, Kelly COUGHLAN, Elizabeth MCINNES, Robert MIKULÍK (203 Czech Republic, belonging to the institution), 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 and Tereza KOLABIA

Edition

EUROPEAN STROKE JOURNAL, LONDON, SAGE PUBLICATIONS LTD, 2023, 2396-9873

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 6.100 in 2022

RIV identification code

RIV/00216224:14110/23:00130193

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1177/23969873221126027

UT WoS

000871730000001

Keywords in English

Stroke; implementation; nurses; QASC; FeSS; fever; hyperglycaemia; swallow; dysphagia; translation

Abstract

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.

Citovat

MIDDLETON, Sandy, Simeon DALE, Benjamin MCELDUFF, Kelly COUGHLAN, Elizabeth MCINNES, Robert MIKULÍK, 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 and Tereza KOLABIA. Translation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing following stroke across Europe (QASC Europe): A pre-test/post-test implementation study. EUROPEAN STROKE JOURNAL. LONDON: SAGE PUBLICATIONS LTD, 2023, vol. 8, No 1, p. 132-147. ISSN 2396-9873. Available from: https://dx.doi.org/10.1177/23969873221126027.

@article{2247597,
   author = {Middleton, Sandy and Dale, Simeon and McElduff, Benjamin and Coughlan, Kelly and McInnes, Elizabeth and Mikulík, Robert and Fischer, Thomas and Jan, Van der Merwe and Cadilhac, Dominique and Este, Catherine and Levi, Christopher and Grimshaw, Jeremy M and Grecu, Andreea and Quinn, Clare and Cheung, Ngai Wah and Medukhanova, Sabina and Menendez, Estela Sanjuan and Salselas, Susana and Messchendorp, Gert and CassierandWoidasky, AnneandKathrin and SkrzypekandCzerko, Marcelina and SlavatandPlana, Merce and Antonella, Urso and Pfeilschifter, Waltraud and Kolabia, Tereza},
   article_location = {LONDON},
   article_number = {1},
   doi = {http://dx.doi.org/10.1177/23969873221126027},
   keywords = {Stroke; implementation; nurses; QASC; FeSS; fever; hyperglycaemia; swallow; dysphagia; translation},
   language = {eng},
   issn = {2396-9873},
   journal = {EUROPEAN STROKE JOURNAL},
   title = {Translation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing following stroke across Europe (QASC Europe): A pre-test/post-test implementation study},
   url = {https://journals.sagepub.com/doi/10.1177/23969873221126027},
   volume = {8},
   year = {2023}
}

TY  - JOUR
ID  - 2247597
AU  - Middleton, Sandy - Dale, Simeon - McElduff, Benjamin - Coughlan, Kelly - McInnes, Elizabeth - Mikulík, Robert - Fischer, Thomas - Jan, Van der Merwe - Cadilhac, Dominique - Este, Catherine - Levi, Christopher - Grimshaw, Jeremy M - Grecu, Andreea - Quinn, Clare - Cheung, Ngai Wah - Medukhanova, Sabina - Menendez, Estela Sanjuan - Salselas, Susana - Messchendorp, Gert - Cassier-Woidasky, Anne-Kathrin - Skrzypek-Czerko, Marcelina - Slavat-Plana, Merce - Antonella, Urso - Pfeilschifter, Waltraud - Kolabia, Tereza
PY  - 2023
TI  - Translation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing following stroke across Europe (QASC Europe): A pre-test/post-test implementation study
JF  - EUROPEAN STROKE JOURNAL
VL  - 8
IS  - 1
SP  - 132-147
EP  - 132-147
PB  - SAGE PUBLICATIONS LTD
SN  - 23969873
KW  - Stroke
KW  - implementation
KW  - nurses
KW  - QASC
KW  - FeSS
KW  - fever
KW  - hyperglycaemia
KW  - swallow
KW  - dysphagia
KW  - translation
UR  - https://journals.sagepub.com/doi/10.1177/23969873221126027
N2  - 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.
ER  -

MIDDLETON, Sandy, Simeon DALE, Benjamin MCELDUFF, Kelly COUGHLAN, Elizabeth MCINNES, Robert MIKULÍK, 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 and Tereza KOLABIA. Translation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing following stroke across Europe (QASC Europe): A pre-test/post-test implementation study. \textit{EUROPEAN STROKE JOURNAL}. LONDON: SAGE PUBLICATIONS LTD, 2023, vol.~8, No~1, p.~132-147. ISSN~2396-9873. Available from: https://dx.doi.org/10.1177/23969873221126027.

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