Evidence map›Paper›PMID 31771599›Full record

Trial reportImplementation science : IS2019

Can a multicomponent multidisciplinary implementation package change physicians' and nurses' perceptions and practices regarding thrombolysis for acute ischemic stroke? An exploratory analysis of a cluster-randomized trial.

Md Golam Hasnain, Christopher R Levi, Annika Ryan, Isobel J Hubbard, Alix Hall, Christopher Oldmeadow, Alice Grady, Amanda Jayakody, John R Attia, Christine L Paul

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Implementation science : IS, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Article
  7. 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

10 authors.

Md Golam HasnainSchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.ORCID 0000-0002-6037-9935
Christopher R LeviSchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.
Annika RyanSchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.
Isobel J HubbardSchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.
Alix HallHunter Medical Research Institute (HMRI), New Lambton Heights, NSW, Australia.
Christopher OldmeadowSchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.
Alice GradySchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.
Amanda JayakodySchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.
John R AttiaSchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia.
Christine L PaulSchool of Medicine and Public Health (SMPH), University of Newcastle (UoN), Callaghan, NSW, Australia. chris.paul@newcastle.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Thrombolysis ImPlementation in Stroke (TIPS) trial tested the effect of a multicomponent, multidisciplinary, collaborative intervention designed to increase the rates of intravenous thrombolysis via a cluster randomized controlled trial at 20 Australian hospitals (ten intervention, ten control). This sub-study investigated changes in self-reported perceptions and practices of physicians and nurses working in acute stroke care at the participating hospitals.

methodsA survey with 74 statements was administered during the pre- and post-intervention periods to staff at 19 of the 20 hospitals. An exploratory factor analysis identified the structure of the survey items and linear mixed modeling was applied to the final survey domain scores to explore the differences between groups over time.

resultThe response rate was 45% for both the pre- (503 out of 1127 eligible staff from 19 hospitals) and post-intervention (414 out of 919 eligible staff from 18 hospitals) period. Four survey domains were identified: (1) hospital performance indicators, feedback, and training; (2) personal perceptions about thrombolysis evidence and implementation; (3) personal stroke skills and hospital stroke care policies; and (4) emergency and ambulance procedures. There was a significant pre- to post-intervention mean increase (0.21 95% CI 0.09; 0.34; p < 0.01) in scores relating to hospital performance indicators, feedback, and training; for the intervention hospitals compared to control hospitals. There was a corresponding increase in mean scores regarding perceptions about the thrombolysis evidence and implementation (0.21, 95% CI 0.06; 0.36; p < 0.05). Sub-group analysis indicated that the improvements were restricted to nurses' responses.

conclusionTIPS resulted in changes in some aspects of nurses' perceptions relating to the evidence for intravenous thrombolysis and its implementation and hospital performance indicators, feedback, and training. However, there is a need to explore further strategies for influencing the views of physicians given limited statistical power in the physician sample.

trial registrationACTRN12613000939796, UTN: U1111-1145-6762.

Indexed as

Attitude of Health PersonnelAdultAustraliaBrain IschemiaFemaleGuideline AdherenceHumansInservice TrainingMaleMedical Staff, HospitalMiddle AgedNursing Staff, HospitalPerceptionPractice Guidelines as TopicStrokeThrombolytic Therapy

Identifiers

PMID31771599
PMCPMC6880372

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Registered trials

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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.