Dominique A. A. (Australia)

Monash University Stroke and Ageing Research, School of Clinical Sciences at Monash Health
Professor Dominique Cadilhac (PhD, MPH, BN, RN) is a health services researcher and NHMRC Senior Research Fellow with over 240 articles. She heads the Public Health group within the Stroke theme at the Florey and is the Data Custodian for the Australian Stroke Clinical Registry. She is also the Head of the Translational Public Health and Evaluation Research Division, Stroke and Ageing Research at Monash University. Her skillset includes epidemiology, implementation science and economic evaluation.

Author Of 1 Presentation

 Conference Calendar

IMPLEMENTING NURSE-INITIATED PROTOCOLS TO IMPROVE FEVER, HYPERGLYCEMIA AND SWALLOWING MANAGEMENT POST-STROKE: RESULTS FROM THE QUALITY IN ACUTE STROKE CARE (QASC) EUROPE PROJECT

Session Name
Scientific Communication 03 - Rehab and Recovery
Session Type
Scientific Communication
Date
Wed, 01.09.2021
Session Time
08:30 - 10:00
Room
Hall H
Lecture Time
09:23 - 09:31
Presenter

Abstract

Group Name

On behalf of the QASC Europe Steering and Implementation Committees

Background And Aims

Assisted implementation of protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following stroke significantly reduce 90-day death and disability. An international collaboration between the Nursing Research Institute, Australian Catholic University; European Stroke Organisation; Angels Initiative; and Registry of Stroke Care Quality facilitated nurse-initiated FeSS protocols into stroke units in multiple European countries. We present results on FeSS protocol compliance during the four-year QASC Europe Project.

Methods

Our multi-country, multi-centre, pre-test/post-test study was conducted between 2017-2021. Data were provided at baseline and three months after FeSS protocol implementation. Nursing clinical champions, with support from the Project team (European Liaison Officer, Angels Consultants, Country Coordinators and the Nursing Research Institute) conducted multidisciplinary workshops identifying barriers and facilitators to protocol implementation, and held education sessions. Outcomes were adjusted for clustering by country and hospital controlling for age/sex/NIHSS.

Results

Data from 76 hospitals (18 countries) were received for 4196 patients at baseline, and from 64 hospitals (17 countries) for 3348 patients’ post-implementation (Total n=7544). There were improvements in: temperature monitoring on day of admission (Pre:42.7%; Post:78.5%, p<0.00001); treatment of fever >37.5°C with paracetamol within one hour (Pre:56.8%; Post:79.0%, p<0.00001); blood glucose monitoring on day of admission (Pre:37.5%; Post:74.7%, p<0.00001); treatment of hyperglycemia >10mmol/L with insulin within one hour (Pre:59.0%; Post:75.4%, p<0.00001); and swallow screening before food or fluids (Pre:59.1%; Post:82.7%, p<0.00001).

Conclusions

We achieved successful large-scale implementation of the FeSS protocols into countries with different health care systems, many of which have no access to reperfusion therapies. This will reduce death and disability post-stroke.

Trial Registration Number

Not applicable

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