Welcome to the WSC 2022 Interactive Program

Background and Aims

The hospital-to-home transition for stroke survivors often involves fragmented care, leading to many adverse health and service-related impacts. Technology, such as websites, may improve transitional care and related outcomes. This study explored patients’, caregivers’, and healthcare providers' perceptions of the feasibility, usability, and benefits of the “My Stroke Recovery Journey” (MSRJ) website, which was co-designed by patients, providers, and researchers. The website supports system navigation for older adult (≥ 55 years) stroke survivors with multimorbidity (≥ 2 chronic conditions) and their caregivers using outpatient stroke rehabilitation services. An interprofessional team delivered a 6-month Transitional Care Stroke Intervention (TCSI), which included phone/video visits and a website orientation.

Methods

Data were obtained from outreach meetings and focus groups with providers, interviews with patients, and website usability metrics. A qualitative descriptive approach explored website feasibility and benefits, and descriptive statistics summarized usability.

Results

Providers, patients, and caregivers reported positive overall perceptions of the website, yet some patients did not understand how to use the website; provider support was critical to patient’s website use; providers often had insufficient time for website orientation since the TCSI was multifaceted; and orientations were challenging for providers in phone visits. Despite these challenges, the website was consistently used.

Conclusions

This study demonstrated the potential of a patient-centered website, when supported by providers, to enhance patients’ knowledge of stroke recovery and community supports. Optimal website use requires provider and patient training and support. Further research is warranted to evaluate the website on its own.

Background and Aims

Commonly, urgency of stroke care always focuses on out-of-hospital onset strokes. However, in-patient strokes are relatively common. Despite of staff education and well-developed code stroke algorithm, in-patient strokes are still under-recognized with result in patients missing out possible interventional therapies and lead to poor outcomes.

Raising awareness of in-patient stroke for earlier activation of assessment and possible intervention is crucial.

Methods

Since 2019, we had developed an in-patient code stroke algorithm which was coordinated by Stroke Nurse. A series of “In-patient Stroke Awareness Promotion Strategies” (IPSPS) were also implemented, including: i) In-patient stroke workflow poster design; ii) Roadshow promotion to all Medical wards and other departments; iii) Yearly cluster World Stroke Day promotion activities; and, iv) Simulation Training on emergency in-patient stroke management to Medical ward nurses. A retrospective review was conducted to compare the response between 2018 and 2021.

Results

Between 2018 and 2021, the annual number of acute strokes was around 1000. 6% were in-patient strokes, with 70% to 83% occurring in Medical wards and >93% of ischaemic cause. After implementation of IPSAPS, in-patient Code Stroke activation rate increased from 35.4% to 74.2% and successfully received hyperacute stroke intervention rate from 4.6% to 14.3% of all in-patient ischaemic strokes in 3 years. Consistent reduction in mean time to computed tomographic scan from 84.9 (10-379) to 64.8 (18-152) minutes was observed.

Conclusions

The positive figures reinforced the important role of Stroke Nurse as a coordinator in in-patient stroke management. A series of sustained IPSPS can enhance ward nurse awareness to in-patient strokes.

Background and Aims

Online learning tools are widely used in various sectors including education and medicine (Woods, & Rosenberg, 2016). Stroke Support Organisation Faculty Tool (SSOFT) is a free online source (Stroke Alliance for Europe, 2018). Its purpose is to educate experts about stroke support organizations (SSO), networking, and advocacy. This is a first attempt to present an infographic to graduate students about the six interactive modules and explore its effectiveness for stroke education.

Methods

We created an infographic for SSOFT in the Greek language and a short questionnaire aimed to assess beliefs and knowledge about SSOFT. Of the 52 participants 51 were females and 1 male (26–60 years old, mean age: 27,56).

Results

The infographic summarizes SSOFT learning tool and it was presented along with the tool. 34 out of 52 participants (65,3%) and 39 out of 52 participants (75%) said it is important to get familiarized with SSOFT but also to gain knowledge on how to build a support group, respectively.

Conclusions

SSOFT modules provide a firm foundation for a topic not included in university curricula. More research evidence is needed to explore its potential use in academic coursework. A long-term goal is that SSOFT digital education should be included in curricula for stroke. Transition discharge planning should be prioritized and using SSOFT can help provide stroke support.

Background and Aims

Intensive care unit (ICU) must be managed optimally by the intensivist, use of the FASTHUG (Feeding,Analgesia,Sedation,Thromboembolic prophylaxis,Head-of-bed elevation,stress Ulcer prophylaxis,Glucose control) mnemonic especially in the neurologic cases can help to decrease mortality and ICU-related morbidity and complications. The aim of this study is to analyze the implementation of FASTHUG mnemonic in stroke patients at ICU Dr. Kariadi Hospital Semarang.

Methods

This is a descriptive-analytical study with a retrospective approach conducted among twenty four ishemic or hemorrhage stroke patients at ICU Dr. Kariadi Hospital Semarang from January to March 2022. The secondary data were obtained from the medical records including gender, age, history of hypertension, history of stroke, history of diabetes, duration of surgery, duration of anesthesia, duration of CPB, amount of bleeding, and the ventilator use as well the kind of element of FASTHUG mnemonic. The data were presented in the percentage.

Results

The are 17 patients with ischemic stroke and 6 patients with hemorrhage stroke. The implementation of FASTHUG among that patients are feeding using a nasogastric tube was performed on all patients (100%). Only 2 patients (8.7%) were given analgesia and 4 patients (17.4%) were given sedation. 13 patients (46.2%) were given anticoagulants for thromboembolic prophylaxis. 17 patients (73.9%) underwent head-of-bed elevation. 20 patients (87%) were given stress ulcer prophylaxis intravenously, and 3 patients (13%) were given intravenously and orally. 14 patients (60.9%) had diabetes mellitus and were given insulin therapy.

Conclusions

Not all elements in FASTHUG can be performed in the ICU of Kariadi Hospital Semarang.