Evidence map›Paper›PMID 27154485›Full record

ArticleBMJ open2016

From QASC to QASCIP: successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pre-test/post-test study design.

Sandy Middleton, Anna Lydtin, Daniel Comerford, Dominique A Cadilhac, Patrick McElduff, Simeon Dale, Kelvin Hill, Mark Longworth, Jeanette Ward, N Wah Cheung and 2 more

2 registry-linked trialsOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04093245 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Supporting the Creation of a LEARNing INteGrated Health System to Mobilize Context-adapted Knowledge With a Wiki Platform to Improve the Transitions of Frail Seniors From From Hospitals and Emergency Departments to the cOMmunity: Phase II

TypeinterventionalSponsorLaval UniversityRan2019 to 2022Enrolled4,000ConditionsTransition, Emergencies, Health Care Utilization, FrailtyArmsGEM nurse, pre- and post-hospitalization medication list reconciliation, systematic discharge summaries, medical follow-up appointment, follow-up phone call
NCT07627399 narecruitingnot on this mapstarted 2026, after this paper: background citation

Effectiveness of Implementing Best Care Practices in the Management of Patients With Acute Stroke in Conventional Hospitalization: A Cluster-Randomized, Open, Stepped-Wedge Controlled Trial.

TypeinterventionalSponsorUniversity of MalagaRan2026 to 2028Enrolled700ConditionsStroke, Acute Stroke, Ischemic Stroke, Hemorrhagic StrokeArmsBEST CARE ICTUS_HC BUNDLE
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Six years of the Angels Initiative: Aims, achievements, and future directions to improve stroke care worldwide.International journal of stroke : official journal of the International Stroke Society · 2023
    Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Observational
  13. Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Sandy MiddletonNursing Research Institute, St Vincent's Health Australia (Sydney) and Australian Catholic University, Sydney, New South Wales, Australia.ORCID 0000-0002-7201-4394
Anna LydtinNursing Research Institute, St Vincent's Health Australia (Sydney) and Australian Catholic University, Sydney, New South Wales, Australia.
Daniel ComerfordNSW Agency for Clinical Innovation, Chatswood, New South Wales, Australia.
Dominique A CadilhacStroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Patrick McElduffSchool of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
Simeon DaleNursing Research Institute, St Vincent's Health Australia (Sydney) and Australian Catholic University, Sydney, New South Wales, Australia.
Kelvin HillNational Stroke Foundation, Melbourne, Victoria, Australia.
Mark LongworthStroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia.
Jeanette WardUniversity of Notre Dame, Broom Campus, Broome, Western Australia, Australia University of Ottawa, Ottawa, Canada.
N Wah CheungDepartment of Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia University of Sydney, Sydney, New South Wales, Australia.
Cate D'EsteNational Centre for Epidemiology and Population Health (NCEPH), Australian National University, Canberra, Australian Capital Territory, Australia.
QASCIP Working Group and Steering Committee
St Vincent's Health · AUThe University of Melbourne · AUAustralian National University · AUNational Stroke Foundation · AUThe University of Sydney · AUUniversity of Newcastle Australia · AUUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo embed an evidence-based intervention to manage FEver, hyperglycaemia (Sugar) and Swallowing (the FeSS protocols) in stroke, previously demonstrated in the Quality in Acute Stroke Care (QASC) trial to decrease 90-day death and dependency, into all stroke services in New South Wales (NSW), Australia's most populous state.

designPre-test/post-test prospective study.

setting36 NSW stroke services.

methodsOur clinical translational initiative, the QASC Implementation Project (QASCIP), targeted stroke services to embed 3 nurse-led clinical protocols (the FeSS protocols) into routine practice. Clinical champions attended a 1-day multidisciplinary training workshop and received standardised educational resources and ongoing support. Using the National Stroke Foundation audit collection tool and processes, patient data from retrospective medical record self-reported audits for 40 consecutive patients with stroke per site pre-QASCIP (1 July 2012 to 31 December 2012) were compared with prospective self-reported data from 40 consecutive patients with stroke per site post-QASCIP (1 November 2013 to 28 February 2014). Inter-rater reliability was substantial for 10 of 12 variables. PRIMARY OUTCOME MEASURES: Proportion of patients receiving care according to the FeSS protocols pre-QASCIP to post-QASCIP.

resultsAll 36 (100%) NSW stroke services participated, nominating 100 site champions who attended our educational workshops. The time from start of intervention to completion of post-QASCIP data collection was 8 months. All (n=36, 100%) sites provided medical record audit data for 2144 patients (n=1062 pre-QASCIP; n=1082 post-QASCIP). Pre-QASCIP to post-QASCIP, proportions of patients receiving the 3 targeted clinical behaviours increased significantly: management of fever (pre: 69%; post: 78%; p=0.003), hyperglycaemia (pre: 23%; post: 34%; p=0.0085) and swallowing (pre: 42%; post: 51%; p=0.033).

conclusionsWe obtained unprecedented statewide scale-up and spread to all NSW stroke services of a nurse-led intervention previously proven to improve long-term patient outcomes. As clinical leaders search for strategies to improve quality of care, our initiative is replicable and feasible in other acute care settings.

Indexed as

Clinical ProtocolsDeglutition DisordersEvidence-Based MedicineHumansHyperglycemiaMedical AuditNew South WalesPractice Guidelines as TopicProspective StudiesQuality of Health CareReproducibility of ResultsStrokebundleimplementationNursing care

Identifiers

PMID27154485
PMCPMC4861111
OpenAlexW2347205729

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.