Evidence map›Paper›PMID 39420409›Full record

ArticleNeurological research and practice2024

Quality in Acute Stroke Care (QASC) Germany: improving efficiency in stroke care with nurse-initiated FeSS-protocols.

Anne-Kathrin Cassier-Woidasky, Sandy Middleton, Simeon Dale, Kelly Coughlan, Catherine D'Este, Elizabeth McInnes, Dominique A Cadilhac, Waltraud Pfeilschifter

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Article in Neurological research and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
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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

8 authors.

Anne-Kathrin Cassier-WoidaskySaarland University of Applied Sciences, htw saar, Goebenstraße 40, Saarbrücken, D-66117, Germany. a.cassier-woidasky@htwsaar.de.ORCID http://orcid.org/0000-0002-0282-2185
Sandy MiddletonNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Sydney, Australia.
Simeon DaleNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Sydney, Australia.
Kelly CoughlanNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Sydney, Australia.
Catherine D'EsteThe Sax Institute, Sydney, Australia.
Elizabeth McInnesNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Sydney, Australia.
Dominique A CadilhacTranslational Public Health Division, Stroke and Ageing Research, School of Clinical Sciences, Monash University, Melbourne, Australia.
Waltraud PfeilschifterDepartment of Neurology and Clinical Neurophysiology, Klinikum Lueneburg, Lueneburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNurse-initiated supported implementation of protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following acute stroke reduced 90-day death and disability in the landmark Australian Quality in Acute Stroke Care (QASC)-Trial. An international interprofessional collaboration sought to evaluate the effects of nurse-led FeSS implementation on FeSS Protocol adherence in German stroke units.

methodsThis pre-test/post-test study was conducted in eight German stroke units between 2020 and 2022. Stroke nurses as clinical champions, supported by the project team, 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 from Australia. Medical record audit data were collected by nurses, pre-implementation and three months post-implementation.

resultsIn 771 (pre-implementation) and 679 (post-implementation) patients there were improvements in overall FeSS adherence (pre 20%, post 28%; adjusted difference in proportions (95% CI) 11%, (5.1%, 16%); p < 0.001), adherence to hyperglycaemia (pre 43%, post 55%; adjusted difference 23%, (17%, 29%); p < 0.001) and swallowing (pre 52%, post 61%; adjusted difference 11%, (5.2%, 17%); p < 0.001) but not fever protocol (pre 76%, post 78%; adjusted difference 1.5%, (-2.6%, 5.7%); p = 0.474). Improvements also were noted in administration of anti-pyretics (pre 29%, post 59%; adjusted difference 32%, (20%, 44%); p < 0.001); and insulin (pre 41%, post 60%; adjusted difference 14%, (1.1%, 28%); p < 0.034) both within one hour, as well as in performing a swallow screen within 24 h of admission (pre 65%, post 74%; adjusted difference 18% (8.8%, 26%); p < 0.001).

conclusionsSupported implementation of the FeSS Protocols significantly improved acute care for post stroke complications of fever, hyperglycaemia and dysphagia in terms of higher adherence and shorter time to treatment.

trial registrationAs this is a pre-test/post-test study and does not meet the WHO/ICMJE definition of a clinical trial, registration was not required.

Indexed as

DysphagiaFeSS protocolFeverHypergycaemiaNurse-led interventionNursesStroke unit

Identifiers

PMID39420409
PMCPMC11484436

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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.