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:

Impact factor

Impact factor: 6.100 in 2022

RIV identification code

RIV/00216224:14110/23:00130193

Organization unit

Faculty of Medicine

UT WoS

000871730000001

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 26/1/2024 10:36, Mgr. Tereza Miškechová

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.